Vaccination schedule
Encyclopedia
A vaccination schedule is a series of vaccination
Vaccination
Vaccination is the administration of antigenic material to stimulate the immune system of an individual to develop adaptive immunity to a disease. Vaccines can prevent or ameliorate the effects of infection by many pathogens...

s, including the timing of all doses, which may be either recommended or compulsory, depending on the country of residence.

A vaccine
Vaccine
A vaccine is a biological preparation that improves immunity to a particular disease. A vaccine typically contains an agent that resembles a disease-causing microorganism, and is often made from weakened or killed forms of the microbe or its toxins...

 is an antigen
Antigen
An antigen is a foreign molecule that, when introduced into the body, triggers the production of an antibody by the immune system. The immune system will then kill or neutralize the antigen that is recognized as a foreign and potentially harmful invader. These invaders can be molecules such as...

ic preparation used to produce active immunity to a disease
Disease
A disease is an abnormal condition affecting the body of an organism. It is often construed to be a medical condition associated with specific symptoms and signs. It may be caused by external factors, such as infectious disease, or it may be caused by internal dysfunctions, such as autoimmune...

, in order to prevent or reduce the effects of infection
Infection
An infection is the colonization of a host organism by parasite species. Infecting parasites seek to use the host's resources to reproduce, often resulting in disease...

 by any natural or "wild" pathogen
Pathogen
A pathogen gignomai "I give birth to") or infectious agent — colloquially, a germ — is a microbe or microorganism such as a virus, bacterium, prion, or fungus that causes disease in its animal or plant host...

. Many vaccines require multiple doses for maximum effectiveness, either to produce sufficient initial immune response or to boost response that fades over time. For example, tetanus vaccine boosters are often recommended every 10 years. Vaccine schedules are developed by governmental agencies or physicians groups to achieve maximum effectiveness using required and recommended vaccines for a locality while minimizing the number of health care system interactions. Over the past two decades, the recommended vaccination schedule has grown rapidly and become more complicated as many new vaccines have been developed.

Some vaccines are recommended only in certain areas (countries, subnational areas, or at-risk populations) where a disease is common. For instance, yellow fever
Yellow fever
Yellow fever is an acute viral hemorrhagic disease. The virus is a 40 to 50 nm enveloped RNA virus with positive sense of the Flaviviridae family....

 vaccination is on the routine vaccine schedule of French Guiana, is recommended in certain regions of Brazil but in the United States is only given to travelers heading to countries with a history of the disease. In developing countries, vaccine recommendations also take into account the level of health care access, the cost of vaccines and issues with vaccine availability and storage. Sample vaccinations schedules discussed by the World Health Organization
World Health Organization
The World Health Organization is a specialized agency of the United Nations that acts as a coordinating authority on international public health. Established on 7 April 1948, with headquarters in Geneva, Switzerland, the agency inherited the mandate and resources of its predecessor, the Health...

 show a developed country using a schedule which extends over the first five years of a child's life and uses vaccines which cost over $700 including administration costs while a developing country uses a schedule providing vaccines in the first 9 months of life and costing only $25. This difference is due to the lower cost of health care, the lower cost of many vaccines provided to developing nations, and that more expensive vaccines, often for less common diseases, are not utilized.

In 1900, the smallpox vaccine
Smallpox vaccine
The smallpox vaccine was the first successful vaccine to be developed. The process of vaccination was discovered by Edward Jenner in 1796, who acted upon his observation that milkmaids who caught the cowpox virus did not catch smallpox...

 was the only one administered to children. By the early 1950s, children routinely received four vaccines, for protection against (diphtheria
Diphtheria
Diphtheria is an upper respiratory tract illness caused by Corynebacterium diphtheriae, a facultative anaerobic, Gram-positive bacterium. It is characterized by sore throat, low fever, and an adherent membrane on the tonsils, pharynx, and/or nasal cavity...

, pertussis
Pertussis
Pertussis, also known as whooping cough , is a highly contagious bacterial disease caused by Bordetella pertussis. Symptoms are initially mild, and then develop into severe coughing fits, which produce the namesake high-pitched "whoop" sound in infected babies and children when they inhale air...

, tetanus
Tetanus
Tetanus is a medical condition characterized by a prolonged contraction of skeletal muscle fibers. The primary symptoms are caused by tetanospasmin, a neurotoxin produced by the Gram-positive, rod-shaped, obligate anaerobic bacterium Clostridium tetani...

, polio, and smallpox
Smallpox
Smallpox was an infectious disease unique to humans, caused by either of two virus variants, Variola major and Variola minor. The disease is also known by the Latin names Variola or Variola vera, which is a derivative of the Latin varius, meaning "spotted", or varus, meaning "pimple"...

), and as many as five shots by two years of age. Since the mid-1980s, many vaccines have been added to the schedule. , the US Centers for Disease Control and Prevention
Centers for Disease Control and Prevention
The Centers for Disease Control and Prevention are a United States federal agency under the Department of Health and Human Services headquartered in Druid Hills, unincorporated DeKalb County, Georgia, in Greater Atlanta...

 (CDC) now recommends vaccination
Vaccination
Vaccination is the administration of antigenic material to stimulate the immune system of an individual to develop adaptive immunity to a disease. Vaccines can prevent or ameliorate the effects of infection by many pathogens...

 against at least fourteen diseases. By two years of age, U.S. children receive as many as 24 vaccine injections, and might receive up to five shots during one visit to the doctor. The use of combination vaccine products means that, , the United Kingdom
United Kingdom
The United Kingdom of Great Britain and Northern IrelandIn the United Kingdom and Dependencies, other languages have been officially recognised as legitimate autochthonous languages under the European Charter for Regional or Minority Languages...

's immunization program consists of 10 injections by the age of two, and a further three injections (or four, including the human papillomavirus vaccine) by the time of leaving school.

Worldwide

The World Health Organization
World Health Organization
The World Health Organization is a specialized agency of the United Nations that acts as a coordinating authority on international public health. Established on 7 April 1948, with headquarters in Geneva, Switzerland, the agency inherited the mandate and resources of its predecessor, the Health...

 monitors vaccination schedules across the world, noting what vaccines are included in each country's program, the coverage rates achieved and various auditing measures. The table below shows the types of vaccines given in example countries. Current vaccination schedules for all WHO member states can be accessed here. Additional vaccines are given to individuals that are much more likely to come into contact with certain diseases due to their occupation or travel to regions where the disease is present (including members of the Military), or only after potentially infectious exposure. Examples include Rabies vaccine
Rabies vaccine
Rabies vaccine is a vaccine used to control rabies. Rabies can be prevented by vaccination, both in humans and other animals.-In animals:Currently, pre-exposure immunization has been used on domesticated and normal non-human populations...

, Anthrax vaccine
Anthrax vaccine
Anthrax vaccines are vaccines against the infectious disease anthrax. Anthrax is caused by the spore-forming bacterium Bacillus anthracis, that most commonly occurs in wild and domestic mammals. Anthrax also occurs in humans when they are exposed to infected animals, hides, or tissue from infected...

, Cholera vaccine
Cholera vaccine
Cholera vaccine is a vaccine used against cholera.The first vaccines against cholera were developed in the late nineteenth century. These injected whole cell vaccine became increasingly popular until they were replaced by oral vaccines starting in the 1980s. Although no longer in use, the injected...

 and Smallpox vaccine
Smallpox vaccine
The smallpox vaccine was the first successful vaccine to be developed. The process of vaccination was discovered by Edward Jenner in 1796, who acted upon his observation that milkmaids who caught the cowpox virus did not catch smallpox...

.
Characteristics of Vaccine Preventable Disease and Schedules for Example Countries
Vaccine Target Transmission Worldwide
incidence
(2004)
Worldwide
deaths
(2004)
Chile Cuba USA UK Finland Germany Saudi
Arabia
Ethiopia Botswana India Australia China Japan
Diphtheria  Saliva 34,000 5,000
Pertussis  Airborne droplet 18,387,000 254,000
Tetanus  Penetrating injury 251,000 163,000
Hepatitis B
Hepatitis B vaccine
Hepatitis B vaccine is a vaccine developed for the prevention of hepatitis B virus infection. The vaccine contains one of the viral envelope proteins, hepatitis B surface antigen . It is produced by yeast cells, into which the genetic code for HBsAg has been inserted...

 
Bodily fluids 5,700,000 (acute) 105,000
Haemophilus influenzae
type b
Airborne droplet 2,000,000–3,000,000 386,000
Measles
Measles vaccine
Measles vaccine is a highly effective vaccine used against measles. The measles-mumps-rubella-varicella combo vaccine has been available since 2005...

 
Airborne 27,000,000 424,000
Tuberculosis
Bacillus Calmette-Guérin
Bacillus Calmette-Guérin is a vaccine against tuberculosis that is prepared from a strain of the attenuated live bovine tuberculosis bacillus, Mycobacterium bovis, that has lost its virulence in humans by being specially subcultured in an artificial medium for 13 years, and also prepared from...

 
Airborne 7,782,000 1,464,000
Polio
Polio vaccine
Two polio vaccines are used throughout the world to combat poliomyelitis . The first was developed by Jonas Salk and first tested in 1952. Announced to the world by Salk on April 12, 1955, it consists of an injected dose of inactivated poliovirus. An oral vaccine was developed by Albert Sabin...

Fecal-oral 1,606
Hepatitis A
Hepatitis A vaccine
Hepatitis A vaccine is a vaccine against the hepatitis A virus. The first successful vaccine against it was invented by Maurice Hilleman at Merck. The vaccine protects against the virus in more than 95% of cases and provides protection from the virus for at least ten years...

 
Fecal-oral 1,400,000
Human papillomavirus
HPV vaccine
The human papilloma virus vaccine prevents infection with certain species of human papillomavirus associated with the development of cervical cancer, genital warts, and some less common cancers...

 
Sexual contact 493,000 247,000
Influenza (seasonal)  Airborne droplet 3,000,000–5,000,000 250,000–500,000
Meningococcus
Meningococcal vaccine
Meningococcal vaccine is a vaccine used against Meningococcus, a bacterium that causes meningitis, meningococcemia, septicemia, and rarely carditis, septic arthritis, or pneumonia.-Types:...

 
Airborne droplet 340,000
Mumps
Mumps vaccine
Several varieties of mumps vaccine have been used since 1949, and at least 10 strains were in use in 2006:The first vaccine was a killed mumps virus vaccine developed in 1948 and used in the United States from 1950-1978. This vaccine produced little immune memory, thus had a short duration of...

 
Airborne droplet 544,000
Pneumococcus
Pneumococcal vaccine
A pneumococcal vaccine is a vaccine against Streptococcus pneumoniae.Types include:* Pneumococcal polysaccharide vaccine* Pneumococcal conjugate vaccine-Vaccination in the USA:...

 
Airborne droplet 14,500,000 826,000
Rotavirus  Fecal-oral 527,000
Rubella
Rubella vaccine
Rubella vaccine is a vaccine used against rubella.One form is called "Meruvax"....

 
Airborne droplet 196,000
Typhoid fever
Typhoid vaccine
Typhoid vaccine is a vaccine used against typhoid fever.There are two effective types:* Ty21a, which is a live vaccine* Vi capsular polysaccharide vaccine, which is a subunit vaccine...

 
Fecal-oral 22,000,000 216,000
Varicella
Varicella vaccine
The varicella vaccine is a live virus that protects against the viral disease commonly known as chickenpox caused by Varicella Zoster Virus . Varicella vaccine is marketed as Varivax in the U.S. by Merck...

 
Airborne
Yellow fever
Yellow fever vaccine
Yellow fever vaccine is a vaccine used against yellow fever.The vaccine consists of a live, but attenuated, strain of the yellow fever virus called 17D. The 17D vaccine has been used commercially since the 1950s. The mechanisms of attenuation and immunogenicity for the 17D strain are not known...

 
Mosquito 200,000 30,000
Tick-borne encephalitis  Tick 5,000–7,000
Japanese encephalitis
Japanese Encephalitis
Japanese encephalitis —previously known as Japanese B encephalitis to distinguish it from von Economo's A encephalitis—is a disease caused by the mosquito-borne Japanese encephalitis virus. The Japanese encephalitis virus is a virus from the family Flaviviridae. Domestic pigs and wild birds are...

 
Mosquito 50,000 15,000


  1. At risk groups or certain populations only. See reference for more details.
  2. Incidence and deaths noted are for cervical cancer
    Cervical cancer
    Cervical cancer is malignant neoplasm of the cervix uteri or cervical area. One of the most common symptoms is abnormal vaginal bleeding, but in some cases there may be no obvious symptoms until the cancer is in its advanced stages...

    . Nearly 100% of cervical cancer is caused by HPV.

Australia

The Immunise Australia Program implements the National Immunisation Program (NIP) Schedule. All vaccines available under the Australian immunisation schedule are free of charge under the Pharmaceutical Benefits Scheme
Pharmaceutical Benefits Scheme
The Pharmaceutical Benefits Scheme or PBS is a program of the Australian Government that provides subsidised prescription drugs to residents of Australia. The PBS ensures that all Australians have affordable and reliable access to a wide range of necessary medicines.-History:The PBS was established...

.
Australia Vaccine Schedule: 2010
Vaccine Birth 2 mo. 4 mo. 6 mo. 12 mo. 18 mo. 4 yrs 10–13 yrs 15–17 yrs ≥65 yrs
Hepatitis B
Hepatitis B vaccine
Hepatitis B vaccine is a vaccine developed for the prevention of hepatitis B virus infection. The vaccine contains one of the viral envelope proteins, hepatitis B surface antigen . It is produced by yeast cells, into which the genetic code for HBsAg has been inserted...

HepB HepB HepB HepB
Rotavirus RV RV RV
Diphtheria, pertussis, and tetanus
DPT vaccine
DPT refers to a class of combination vaccines against three infectious diseases in humans: diphtheria, pertussis and tetanus...

DTPa DTPa DTPa DTPa dTpa
Haemophilus influenzae type b
Hib vaccine
Haemophilus influenzae type B vaccine is a conjugate vaccine developed for the prevention of invasive disease caused by Haemophilus influenzae type b bacteria. The Centers for Disease Control and Prevention has recommended the use of the Hib vaccine. Due to routine use of the Hib vaccine in...

Hib Hib Hib Hib
Pneumococcal
Pneumococcal vaccine
A pneumococcal vaccine is a vaccine against Streptococcus pneumoniae.Types include:* Pneumococcal polysaccharide vaccine* Pneumococcal conjugate vaccine-Vaccination in the USA:...

7vPCV 7vPCV 7vPCV 23vPPV
Polio vaccine
Polio vaccine
Two polio vaccines are used throughout the world to combat poliomyelitis . The first was developed by Jonas Salk and first tested in 1952. Announced to the world by Salk on April 12, 1955, it consists of an injected dose of inactivated poliovirus. An oral vaccine was developed by Albert Sabin...

 (inactivated)
IPV IPV IPV IPV
Measles, mumps, and rubella
MMR vaccine
The MMR vaccine is an immunization shot against measles, mumps, and rubella . It was first developed by Maurice Hilleman while at Merck in the late 1960s....

MMR MMR
Varicella Varicella
Meningococcus MenCCV
Human papillomavirus vaccine
HPV vaccine
The human papilloma virus vaccine prevents infection with certain species of human papillomavirus associated with the development of cervical cancer, genital warts, and some less common cancers...

HPV
Influenza Yearly



  1. 12-13 years, females only


United Kingdom

The United Kingdom childhood vaccination schedule is recommended by the Department of Health and National Health Service
National Health Service
The National Health Service is the shared name of three of the four publicly funded healthcare systems in the United Kingdom. They provide a comprehensive range of health services, the vast majority of which are free at the point of use to residents of the United Kingdom...

, and uses combination immunisations where available (NB recent change as of December 2010: 13 month vaccination now at 12 months):
United Kingdom Vaccine Schedule: 2010
Vaccine 2 mo. 3 mo. 4 mo. 12 mo. 3–4 yrs 12–13 yrs 13–18 yrs
Diphtheria, pertussis, and tetanus
DPT vaccine
DPT refers to a class of combination vaccines against three infectious diseases in humans: diphtheria, pertussis and tetanus...

DTaP DTaP DTaP DTaP Td
Haemophilus influenzae type b
Hib vaccine
Haemophilus influenzae type B vaccine is a conjugate vaccine developed for the prevention of invasive disease caused by Haemophilus influenzae type b bacteria. The Centers for Disease Control and Prevention has recommended the use of the Hib vaccine. Due to routine use of the Hib vaccine in...

Hib Hib Hib Hib
Pneumococcal
Pneumococcal vaccine
A pneumococcal vaccine is a vaccine against Streptococcus pneumoniae.Types include:* Pneumococcal polysaccharide vaccine* Pneumococcal conjugate vaccine-Vaccination in the USA:...

PCV PCV PCV
Polio vaccine
Polio vaccine
Two polio vaccines are used throughout the world to combat poliomyelitis . The first was developed by Jonas Salk and first tested in 1952. Announced to the world by Salk on April 12, 1955, it consists of an injected dose of inactivated poliovirus. An oral vaccine was developed by Albert Sabin...

 (inactivated)
IPV IPV IPV IPV IPV
Measles, mumps, and rubella
MMR vaccine
The MMR vaccine is an immunization shot against measles, mumps, and rubella . It was first developed by Maurice Hilleman while at Merck in the late 1960s....

MMR MMR
Meningococcus MenC MenC MenC
Human papillomavirus vaccine
HPV vaccine
The human papilloma virus vaccine prevents infection with certain species of human papillomavirus associated with the development of cervical cancer, genital warts, and some less common cancers...

HPV

  1. Females only


Non-routine vaccinations

Some children may receive vaccines in addition to those listed in the table:
  • BCG
    Bacillus Calmette-Guérin
    Bacillus Calmette-Guérin is a vaccine against tuberculosis that is prepared from a strain of the attenuated live bovine tuberculosis bacillus, Mycobacterium bovis, that has lost its virulence in humans by being specially subcultured in an artificial medium for 13 years, and also prepared from...

     vaccine is given at birth "to babies who are more likely to come into contact with Tuberculosis
    Tuberculosis
    Tuberculosis, MTB, or TB is a common, and in many cases lethal, infectious disease caused by various strains of mycobacteria, usually Mycobacterium tuberculosis. Tuberculosis usually attacks the lungs but can also affect other parts of the body...

     than the general population."
  • Hepatitis B vaccine
    Hepatitis B vaccine
    Hepatitis B vaccine is a vaccine developed for the prevention of hepatitis B virus infection. The vaccine contains one of the viral envelope proteins, hepatitis B surface antigen . It is produced by yeast cells, into which the genetic code for HBsAg has been inserted...

     is given at birth "to babies whose mothers are hepatitis B positive."

Adult vaccinations

The five scheduled childhood tetanus vaccinations are thought to generally confer lifelong immunity; thus, no routine booster dose
Booster dose
In medicine, a booster dose is an extra administration of a vaccine after an earlier dose. After initial immunization, a booster injection or booster dose is a re-exposure to the immunizing antigen. It is intended to increase immunity against that antigen back to protective levels after it has been...

s are given in adulthood. Those adults at risk of contaminated cuts (e.g., gardeners) may have booster tetanus vaccination every ten years.

Pneumococcal vaccinations (pneumococcal polysaccharide vaccine/PPV) are recommended for those over 65 and for people without a functional spleen (asplenia
Asplenia
Asplenia refers to the absence of normal spleen function and is associated with some serious infection risks. Hyposplenism is used to describe reduced splenic functioning, but not as severely affected as with asplenism.-Congenital:...

), either because the spleen has been removed or does not work properly.

Flu vaccine
Flu vaccine
The influenza vaccine, also known as flu shot, is an annual vaccine to protect against the highly variable influenza virus. Each injected seasonal influenza vaccine contains three influenza viruses: one influenza type A subtype H3N2 virus strain, one influenza type A subtype H1N1 virus strain, and...

 is recommended for anyone who is aged 65 years and over, people with certain long-term medical conditions, health and social care professionals and poultry
Poultry
Poultry are domesticated birds kept by humans for the purpose of producing eggs, meat, and/or feathers. These most typically are members of the superorder Galloanserae , especially the order Galliformes and the family Anatidae , commonly known as "waterfowl"...

 workers.

United States

The Recommended Childhood and Adolescent Immunization Schedule and the Recommended Adult Immunization Schedule are revised annually. The most up-to-date schedules are available from CDC's National Center for Immunization and Respiratory Diseases. In the US, the National Childhood Vaccine Injury Act
National Childhood Vaccine Injury Act
The National Childhood Vaccine Injury Act of 1986 was enacted in the United States to reduce the potential financial liability of vaccine makers due to vaccine injury claims. The legislation was aimed at ensuring a stable market supply, and to provide cost-effective arbitration for vaccine...

 requires all health-care providers to provide parents or patients with copies of Vaccine Information Statements before administering vaccines.
United States Vaccine Schedule: 2010
Vaccine Birth 1 month 2 mo. 4 mo. 6 mo. 12 mo. 15 mo. 18 mo. 19-23 mo 4–6 yrs 11–12 yrs 19–26 yrs ≥27 years
Hepatitis B
Hepatitis B vaccine
Hepatitis B vaccine is a vaccine developed for the prevention of hepatitis B virus infection. The vaccine contains one of the viral envelope proteins, hepatitis B surface antigen . It is produced by yeast cells, into which the genetic code for HBsAg has been inserted...

HepB HepB HepB
Rotavirus RV RV RV
Diphtheria, pertussis, and tetanus
DPT vaccine
DPT refers to a class of combination vaccines against three infectious diseases in humans: diphtheria, pertussis and tetanus...

DTaP DTaP DTaP DTaP DTaP DTaP Td (every 10 years)
Haemophilus influenzae type b
Hib vaccine
Haemophilus influenzae type B vaccine is a conjugate vaccine developed for the prevention of invasive disease caused by Haemophilus influenzae type b bacteria. The Centers for Disease Control and Prevention has recommended the use of the Hib vaccine. Due to routine use of the Hib vaccine in...

Hib Hib Hib Hib
Pneumococcal
Pneumococcal vaccine
A pneumococcal vaccine is a vaccine against Streptococcus pneumoniae.Types include:* Pneumococcal polysaccharide vaccine* Pneumococcal conjugate vaccine-Vaccination in the USA:...

PCV PCV PCV PCV PPSV
Polio vaccine
Polio vaccine
Two polio vaccines are used throughout the world to combat poliomyelitis . The first was developed by Jonas Salk and first tested in 1952. Announced to the world by Salk on April 12, 1955, it consists of an injected dose of inactivated poliovirus. An oral vaccine was developed by Albert Sabin...

 (inactivated)
IPV IPV IPV IPV
Measles, mumps, and rubella
MMR vaccine
The MMR vaccine is an immunization shot against measles, mumps, and rubella . It was first developed by Maurice Hilleman while at Merck in the late 1960s....

MMR MMR 1 or 2 doses
Varicella
Varicella vaccine
The varicella vaccine is a live virus that protects against the viral disease commonly known as chickenpox caused by Varicella Zoster Virus . Varicella vaccine is marketed as Varivax in the U.S. by Merck...

 (chickenpox
Chickenpox
Chickenpox or chicken pox is a highly contagious illness caused by primary infection with varicella zoster virus . It usually starts with vesicular skin rash mainly on the body and head rather than at the periphery and becomes itchy, raw pockmarks, which mostly heal without scarring...

)
Varicella Varicella 2 doses
Hepatitis A
Hepatitis A vaccine
Hepatitis A vaccine is a vaccine against the hepatitis A virus. The first successful vaccine against it was invented by Maurice Hilleman at Merck. The vaccine protects against the virus in more than 95% of cases and provides protection from the virus for at least ten years...

HepA (2 doses)
Meningococcus MCV
Human papillomavirus vaccine
HPV vaccine
The human papilloma virus vaccine prevents infection with certain species of human papillomavirus associated with the development of cervical cancer, genital warts, and some less common cancers...

3 doses 3 doses,
Influenza Influenza (yearly) Yearly ≥50



  1. ≥65 years; Pneumococcal polysaccharide vaccine
    Pneumococcal polysaccharide vaccine
    Pneumococcal polysaccharide vaccine — the latest version is known as Pneumovax 23 — is the first pneumococcal vaccine, the first vaccine derived from a capsular polysaccharide, and an important landmark in medical history...


  2. For all persons in this category who meet the age requirements and who lack evidence of immunity (e.g., lack documentation of vaccination or have no evidence of prior infection).

  3. Females

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