What is the CDC childhood vaccination schedule?

The CDC publishes an annual recommended immunization schedule for ages birth through 18. The first dose of Hep B is given at birth. The 2-, 4-, and 6-month visits each include 4-5 shots (DTaP, Hib, IPV polio, PCV13, rotavirus). The 12-15 month visit adds MMR, varicella, and Hep A. School-age boosters happen at 4-6 years. The adolescent series at 11-12 adds Tdap, HPV, and meningococcal. In total, a child following the standard schedule receives about 30 vaccine doses by age 18.

Are vaccines covered by insurance?

Yes, fully. ACA law mandates that all ACA-compliant plans cover CDC-recommended vaccines at 100% with no copay, no deductible, no coinsurance — when administered at an in-network provider. This includes employer plans, marketplace plans, Medicaid, and CHIP. The Vaccines for Children (VFC) federal program also provides free vaccines to uninsured and underinsured children through federally-qualified health centers and participating pediatricians.

Can I space out vaccines or use an alternative schedule?

Medically, you can delay any non-mandatory vaccine. The concern is that delayed schedules leave children unprotected during the age window when each disease is most dangerous — pertussis for infants under 6 months, for example, has very high mortality. Most major pediatric organizations (AAP, AAFP, CDC) strongly recommend the standard schedule. If you want an alternative schedule, discuss with your pediatrician; some accommodate requests to split shots across extra visits, but extra visits mean extra cost, stress, and co-pays for non-preventive visits.

What vaccines are required for school and daycare?

Requirements vary by state, but most states require DTaP, Hib, polio, MMR, varicella, and Hep B for daycare entry; plus boosters for kindergarten. All 50 states allow medical exemptions; states differ on religious and philosophical exemptions. By 2026, California, Maine, Mississippi, New York, West Virginia, and Connecticut have eliminated non-medical exemptions for school entry. Check your state's requirements before enrollment.

What happens if I miss a scheduled vaccine?

The CDC publishes a detailed catch-up schedule that specifies the minimum intervals between doses for children who fall behind. Most vaccines can be caught up without starting the series over. Your pediatrician's electronic health record will flag catch-up needs at each visit. Don't panic about a missed 2-month or 4-month appointment — most families can be fully caught up within 2-3 visits. The longer you wait, the more the protection gap matters, though, so catch up promptly rather than skipping.

Childhood Vaccination Schedule | CDC Immunization Calendar

The CDC schedule in plain English

The US childhood vaccination schedule protects against 15 preventable infectious diseases. It's published annually by the CDC in consultation with AAP, AAFP, and ACIP. The 2026 schedule is substantively the same as 2025 with minor updates to COVID-19 guidance and the Meningococcal B recommendations.

Most vaccines are multi-dose series — you need 2-5 doses spaced across months or years to build and maintain immunity. The calendar below shows when each series happens and what each visit covers. A child on the standard schedule receives about 30 total doses by age 18, delivered across roughly 12 vaccine-bearing visits.

The 15 preventable diseases

Hepatitis B (at birth, 1 month, 6 months) — protects against liver disease and liver cancer
Rotavirus (2, 4, sometimes 6 months) — the #1 cause of severe diarrhea in infants worldwide
DTaP — diphtheria, tetanus, pertussis (whooping cough) — critical for infants since pertussis is deadly in them
Hib — haemophilus influenzae type B — once a major cause of childhood meningitis
IPV — inactivated polio vaccine — polio is eradicated in the US thanks to this
PCV13 — pneumococcal, protects against pneumonia, meningitis, ear infections
Influenza (flu) — annual, starting at 6 months
MMR — measles, mumps, rubella
Varicella (chickenpox)
Hepatitis A
Tdap — adolescent booster for tetanus, diphtheria, pertussis
HPV — human papillomavirus, prevents cervical and other cancers
Meningococcal ACWY — meningococcal disease
Meningococcal B — separate strain, college entry age
COVID-19 — current ACIP recommendations (evolving)

Infancy: the heavy-lift years

The first 18 months have the highest vaccine density for biological reasons: many of these diseases are most dangerous in very young children, and building protection before the risk window is essential. Parents find these visits emotionally tough — 2-5 shots at a single visit is normal. A few things help:

Hold your baby during shots. Skin-to-skin or breastfeeding during/immediately after significantly reduces crying time (multiple RCTs).
Give acetaminophen (Tylenol) 30 minutes before if your pediatrician approves. Reduces fever and fussiness. Never give ibuprofen to infants under 6 months.
Schedule for morning. Gives the full day to monitor any side effects during waking hours.
Plan a quiet day after. No big outings, no vaccines- and-then-grandparents. Rest helps.
Expected side effects: low-grade fever (under 102°F), injection site redness/soreness, fussiness for 24-48 hours. Call your pediatrician for fever over 102.5°F, seizures, persistent crying beyond 3 hours, or severe swelling.

The 12-15 month "MMR appointment"

This visit often looks different than the 2/4/6 month visits. MMR and varicella are live-attenuated vaccines — side effects (fever, rash) can appear 7-14 days after the shot rather than the next day. Parents should plan for:

A mild fever 1-2 weeks after (normal)
A brief rash (normal, not measles)
Soreness at the injection site same day
Possible fussiness 5-12 days later (immune response peak)

The adolescent series (11-12 and 16 years)

The 11-12 year visit includes three vaccines that do a lot of long-term work:

Tdap: booster for tetanus, diphtheria, pertussis. Needed every 10 years after this.
HPV: 2-dose series if started before 15 (if started 15+, 3 doses). Prevents cervical, throat, anal, and penile cancers. Research shows strongest immune response before age 15 — which is why the schedule puts it here.
Meningococcal ACWY: protects against meningitis strains that peak in adolescence and college.

The 16-year visit adds a Meningococcal ACWY booster (important before college dorms) and a discussion of Meningococcal B, which is a separate vaccine not universally recommended but available and sometimes required by colleges.

What to do if you fall behind

The CDC publishes a "catch-up schedule" for every vaccine. Your pediatrician's office will automatically flag what's needed at each visit based on your child's history. Key principles:

Don't restart the series.Missed doses just get caught up — you don't lose prior doses.
Minimum intervals apply. Each vaccine has a minimum gap between doses — 4 weeks for most infant vaccines.
Catch-up visits are well-child visits. Fully covered by insurance.
School and daycare compliance: requirements have deadlines. Most states allow a brief grace period but require catch-up within 30-60 days of enrollment.

Travel and added vaccines

Some destinations require vaccines not on the standard US schedule: yellow fever (many African and South American countries), typhoid (South Asia, some Africa), Japanese encephalitis (rural Asia), rabies (certain itineraries), cholera. Travel vaccines generally require:

A visit to a travel medicine clinic 6-8 weeks before departure
Payment out of pocket (not ACA-covered for non-standard vaccines)
Documentation (yellow fever certificate) for border entry

The CDC maintains a travel vaccine recommendations site by country. Check 2-3 months before any international trip with children.

Records and documentation

Every state maintains an immunization registry (most are called IIS — Immunization Information System). Your pediatrician's office submits every vaccine to the registry. This means:

Moving pediatricians: the new office can pull records automatically
School enrollment: schools can verify directly from the registry
College and camp: you can print records through the registry's online portal

Keep a personal vaccine record card too — CDC provides a template called the Childhood Immunization Schedule for Parents. Useful when you need to reference history without calling the pediatrician's office.

Vaccines not on the standard schedule to know about

COVID-19— ACIP recommendations have evolved. Discuss with your pediatrician based on child's age and risk factors.
RSV (respiratory syncytial virus) — monoclonal antibody (nirsevimab) recommended for infants entering first RSV season (Oct-March). Not technically a vaccine but schedule-adjacent.
Meningococcal B — discussed at 16+ but not universally recommended. Some colleges require it.

Related tools

Well-child visit schedule — when each vaccine visit happens.
Child growth tracker — growth milestones at vaccine visits.
Feeding schedule — nursing/feeding considerations around shots.
Daycare cost — where vaccination requirements kick in.

Childhood vaccination schedule

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