Vaccines have contributed to a significant reduction in many childhood infectious diseases, such as diphtheria, measles, and Haemophilus influenzae type b (Hib). Some infectious diseases, such as polio have been eliminated in the United States due to effective vaccines. With high vaccination rates, it is now rare for children in the United States to experience the devastating and often deadly effects of some infectious diseases that were once common in the United States and other countries.

Vaccines to prevent infectious diseases are given to millions of babies, children, adolescents and adults and it is critical that they are demonstrated to be safe and effective. Ensuring the safety and effectiveness of vaccines is one of the Food and Drug Administration's (FDA) top priorities. The Center for Biologics Evaluation and Research (CBER) is the center within FDA that has regulatory oversight of vaccines in the United States assuring the availability of safe and effective vaccines.

Because immunization programs of the 20th and 21st century have been so successful, many of today’s parents have never seen many vaccine-preventable diseases and do not understand the potential for them to re-emerge. If too many individuals choose not to vaccinate themselves or their children, some diseases that are now rare or non-existent in this country may resurface.

The viruses and bacteria that cause vaccine-preventable diseases and death still exist and can cause disease in people who are not protected by vaccines. For example, although measles has not been constantly present in the United States since 2000 and was declared eliminated in the U.S. that year, cases and outbreaks continue to occur. This is attributed to various factors, including the common occurrence of measles in many parts of the world, unvaccinated travelers with measles who are bringing the disease into the United States from other countries, and the spread of measles in communities in the U.S. where groups of people are unvaccinated. The U.S. closed out 2018 with a total of 17 outbreaks of measles and cases have continued to occur in 2019. 2019 marks greatest number of reported measles cases in the U.S. since 1992 and since measles was declared eliminated in 2000. Of those diagnosed with measles, approximately 10% required hospitalization. The majority of the cases are among people who were not vaccinated against measles.

Measles is one of the most contagious diseases and can cause severe complications, including pneumonia, swelling of the brain, and death. Outbreaks of infectious diseases, such as measles, serve as a reminder that they are only a plane-ride away and the best way not to get sick is to get vaccinated.

Benefits and Risks

A vaccine is a medication. Like any medicine, vaccines have benefits and risks, and although highly effective, no vaccine is 100 percent effective in preventing disease or 100 percent safe in all individuals. Most side effects of vaccines are usually minor and short-lived. For example, a person may feel soreness at the injection site or experience a mild fever. Serious vaccine reactions are extremely rare, but they can happen.

"Parents should know that the risk of being harmed by a vaccine is significantly smaller than the risk of serious illness from infectious diseases," says Marion Gruber, Ph.D., director of the Office of Vaccines Research and Review in CBER. "Vaccination is a very important step to get children off to a healthy start."

For more information on potential adverse reactions, talk with your healthcare provider, and some vaccines also have FDA-approved labeling for the patient that can be a resource of information. It is important to discuss with your healthcare provider any prior reactions to vaccines and any adverse reactions following vaccination.

Types of Routinely Administered Vaccines for Children

How vaccines work

Vaccines work by preparing the body’s immune system for future exposure to disease-causing viruses or bacteria. Vaccines contain antigens, which are weakened bacteria or viruses, or parts of bacteria or viruses, which mimic the disease-causing agents. As a result of vaccination, the body’s immune system thinks the antigens from the vaccine are foreign and shouldn’t be in the body, but the antigens don’t cause disease in the person receiving the vaccine. After receiving the vaccine, if the virus or bacteria that cause the real disease then enters the body in the future, the immune system is prepared and responds quickly and forcefully to attack the disease-causing agent to prevent the person from getting sick with the disease. Vaccines are frequently given by injection (a shot), but some are given by mouth and one is sprayed into the nose.

There are various types of vaccines that are routinely given to children

Attenuated (weakened) live viruses- These vaccines contain a live virus that has been weakened during the manufacturing process so that they do not cause the actual disease in the person being vaccinated. However, because they contain a small amount of the weakened live virus, people with weakened immune systems should talk to their healthcare provider before receiving them. Examples include vaccines that prevent chickenpox and rotavirus and measles, mumps and rubella.

Inactivated (killed) viruses- These vaccines contain a virus that has been killed so as not to cause disease, but the body still recognizes it and stimulates production of antibodies against the virus. They can be given to individuals with weakened immune systems. Examples include vaccines to prevent polio and hepatitis A.

Subunits- In some cases, the entire virus or bacteria is not required for an immune response to prevent disease; just the important parts, a portion or a "subunit" of the disease-causing bacteria or virus is needed to provide protection. The vaccine to prevent influenza (the flu) that is given as a shot is an example of a subunit vaccine, because it is made with parts of the influenza virus.

Toxoids- Some bacteria cause illness in people by secreting a poison (a toxin). Scientists discovered that weakening the toxins, so that they are “detoxified” does not cause illness. Examples of vaccines that contain toxoids include those to prevent tetanus and diphtheria disease.

Recombinant- These vaccines are made by genetic engineering, the process and method of manipulating the genetic material of an organism. An example of this type of vaccine is those that prevent certain diseases caused by the human papillomavirus (HPV), such as cervical cancer. In this case, the genes that code for a specific protein from each of the virus types of HPV included in the vaccine are expressed in yeast to create large quantities of the protein. The protein that is produced is purified and then used to make the vaccine. Because the vaccine only contains a protein, and not the entire virus, the vaccine cannot cause the HPV infection. It is the body's immune response to the recombinant protein(s) that then protects against diseases caused by the naturally occurring virus.

Polysaccharides- To protect against certain disease-causing bacteria, the main antigens in vaccine are sugar-like substances called polysaccharides; these are purified from the bacteria to make polysaccharide vaccines. However, vaccines composed solely of purified polysaccharides are only effective in older children and adults. Pneumovax 23, a vaccine for the prevention of pneumococcal disease caused by 23 different strains, is an example of a polysaccharide vaccine.

Conjugates- Vaccines made only with polysaccharides do not work very well in young children because their immune system has not fully developed. To make vaccines that protect young children against diseases caused by certain bacteria, the polysaccharides are connected to a protein so that the immune system can recognize and respond to the polysaccharide. The protein acts as a “carrier” for the part of the vaccine that will make protective antibodies in the body. Examples of conjugate vaccines include those to prevent invasive disease caused by Haemophilus influenzae type b (Hib).

Steps to Take When Your Child is Vaccinated

Review the vaccine information sheets

These sheets explain both the benefits and risks of a vaccine. Healthcare providers are required by law to provide them.

Talk to your healthcare provider about the benefits and risks of vaccines

Learn the facts about the benefits and risks of vaccines, along with the potential consequences of not vaccinating against diseases. Some parents and caregivers are surprised to learn that children can be harmed or die of measles, diphtheria, pertussis, and other vaccine-preventable diseases.

Conditions to make your healthcare provider aware of before vaccination

This might include being sick or having a history of certain allergic or other adverse reactions to previous vaccinations or their components. For example, eggs are used to grow many influenza (flu) vaccines; therefore, it is important to inform the healthcare provider if a child is severely allergic to eggs.

The packaging of some vaccines that are supplied in vials or prefilled syringes may contain natural rubber latex, which may cause allergic reactions in latex-sensitive individuals; therefore, an allergy to latex is helpful to inform healthcare providers of beforehand.

It is also particularly important to discuss with your healthcare provider which vaccines should or should not be given to children who have weakened immune systems.

Report adverse reactions

Adverse reactions and other problems related to vaccines should be reported to the Vaccine Adverse Event Reporting System, which is maintained by FDA and the Centers for Disease Control and Prevention (CDC). For a copy of the vaccine reporting form, call 1-800-822-7967, or report online to www.vaers.hhs.gov

Routinely Administered Vaccines for Children

Some of the most commonly administered vaccines are briefly discussed below. A complete list of licensed vaccines in the United States and additional information, such as prescribing information and patient labeling are available at: https://www.fda.gov/vaccines-blood-biologics/vaccines/vaccines-licensed-use-united-states.

Diphtheria and Tetanus Toxoids and Acellular Pertussis Adsorbed (DTaP)

• Brand Names:  Daptacel and Infanrix
• What it's for: Prevents the bacterial diseases diphtheria, tetanus (lockjaw), and pertussis (whooping cough). This combination vaccine is given as a series in infants and children 6 weeks through 6 years of age, prior to their 7th birthday. The bacteria that cause diphtheria can infect the throat, causing a thick covering that can lead to problems with breathing, paralysis, or heart failure. Tetanus can cause painful tightening (spasms) of the muscles, seizures, paralysis, and death. Pertussis, also known as whooping cough, has the initial symptoms of runny nose, sneezing, and a mild cough, which may seem like a typical cold.  Usually, the cough slowly becomes more severe.  Eventually the patient may experience bouts of rapid coughing followed by the “whooping” sound that gives the disease its common name as they try to inhale. While the coughing fit is occurring, the patient may vomit or turn blue from lack of air.  Patients gradually recover over weeks to months.
• Common side effects may include: Fever, drowsiness, fussiness/irritability, and redness, soreness, or swelling at the injection site.
• Tell your healthcare provider beforehand if: The child is moderately or severely ill, has had swelling of the brain within 7 days after a previous dose of vaccine, has a neurologic disorder such as epilepsy, or has had a severe allergic reaction to a previous shot.

Tetanus Toxoid, Reduced Diphtheria Toxoid and Acellular Pertussis Vaccine Adsorbed (Tdap)

• Brand Names: Adacel and Boostrix
• What it's for: Booster shot for kids at 10 or 11 years of age to prevent the bacterial infections diphtheria, tetanus (lockjaw), and pertussis (whooping cough).  In addition, Boostrix is approved for all individuals 10 years of age and older, (including the elderly).  Adacel is approved for use in people ages 10 through 64 years.   
• Common side effects may include: Pain, redness and swelling at the injection site, headache, and tiredness.
• Tell your healthcare provider beforehand if: The child is moderately or severely ill, has had swelling of the brain within 7 days after a previous dose of pertussis vaccine, or any allergic reaction to any vaccine that protects against diphtheria, tetanus or pertussis diseases.

Haemophilus b Conjugate Vaccine (Hib)

• Brand Names:  ActHIB, Hiberix, PedvaxHIB
• What it's for:  Prevents Haemophilus influenzae type b (Hib) invasive disease.  Before the availability of Hib vaccines, Hib disease was the leading cause of bacterial meningitis among children under 5 years of age in the United States. Meningitis is an infection of the tissue covering the brain and spinal cord, which can lead to lasting brain damage and deafness. Hib disease can also cause pneumonia, severe swelling in the throat, infections of the blood, joints, bones, and tissue covering of the heart, as well as death.  Both ActHIB and PedvaxHIB are approved for infants and children beginning at 2 months.  ActHIB can be given through 5 years of age and PedvaxHIB can be given through 71 months of age; Hiberix is approved for children 6 weeks through the age of 4 (prior to their 5th birthday).
• Common side effects may include: Fussiness, sleepiness, and soreness, swelling and redness at the injection site.
• Tell your healthcare provider beforehand if: The child is moderately or severely ill, or has ever had an allergic reaction to a previous dose of Hib vaccine.

Hepatitis A Vaccine

• Brand Names: Havrix and Vaqta
• What it's for: Prevents disease caused by hepatitis A virus. People infected with hepatitis A may not have any symptoms; and if they do have symptoms, they may feel like that they have a mild "flu-like" illness; or they may have jaundice (yellow skin or eyes), tiredness, stomachache, nausea and diarrhea.  Young children may not have any symptoms, so when a child’s caregiver becomes sick, that is when it is recognized that the child is infected.  Hepatitis A is most often spread by an object contaminated with the feces of a person with hepatitis A, such as when a parent or caregiver does not properly wash his or her hands after changing diapers or cleaning up the stool of an infected person.  Both vaccines are approved for use in people 12 months of age and older. 
• Common side effects may include: Soreness and redness at the injection site, and loss of appetite.
• Tell your healthcare provider beforehand if: The child is moderately to severely ill, or has ever had an allergic reaction to a previous dose of the vaccine.

Hepatitis B Vaccine

• Brand Names: Engerix-B and Recombivax HB
• What it's for: Prevents infection caused by hepatitis B virus. Hepatitis B is spread when body fluid infected with hepatitis B enters the body of a person who is not infected.  Hepatitis B can lead to chronic hepatitis (liver inflammation), liver cancer, and death. The vaccines are approved for individuals of all ages, including newborns. It is particularly important for those at increased risk of exposure to hepatitis B virus such as a baby born to mom who is infected with the virus.
• Common side effects may include: Soreness, redness, swelling at injection site, irritability, fever, diarrhea, fatigue/weakness, loss of appetite and headache.
• Tell your healthcare provider beforehand if: The child is moderately or severely ill, or has ever had a life-threatening allergic reaction to yeast or to a previous dose of the vaccine.

Human Papillomavirus Vaccine

• Brand Names: Gardasil 9
• What it's for: Gardasil 9 is for use in females and males ages 9 through 45 years. It prevents cervical, vulvar, vaginal and anal cancers caused by any of the following human papillomavirus (HPV) Types 16, 18, 31, 33, 45, 52 and 58. Overall, Gardasil 9 has the potential to prevent approximately 90% of cervical, vulvar, vaginal and anal cancers. Gardasil 9 is also approved for the prevention of genital warts caused by types 6 and 11 in both males and females.
• Common side effects may include: Headache, fever, nausea, dizziness, fainting, and pain, swelling, redness, itchiness or bruising at the injection site.
• Tell your healthcare provider beforehand if: The individual has had an allergic reaction to yeast or to a previous dose of the vaccine.  

Influenza Vaccine (administered with a needle)

• Brand Names (for children): Afluria Quadrivalent, Fluarix Quadrivalent, Flucelvax Quadrivalent, FluLaval Quadrivalent, and Fluzone Quadrivalent
• What it's for:  Different vaccines are approved for different age groups to prevent influenza disease, caused by the strains of influenza virus that are included in the vaccine.  
  Influenza, commonly called “flu,” is a contagious respiratory virus that can cause mild to severe illness.  The elderly, young children and people with certain health conditions (such as asthma, diabetes, or heart disease) are at high risk for serious influenza-related complications. Complications may include pneumonia, ear infections, sinus infections, dehydration, and worsening of certain medical conditions such as congestive heart failure, asthma or diabetes.
  The strains of influenza virus that cause disease in people frequently change, so yearly vaccination is needed to provide protection against the influenza viruses likely to cause illness each winter.
• Common side effects may include: Pain, redness and swelling at the injection site, low grade fever, and muscle aches, headache, fatigue and general feeling of being unwell.
• Tell your healthcare provider beforehand if: The child is moderately or severely ill, has immune system problems, or has had Guillain-Barre Syndrome (GBS), a neurological disorder that causes severe muscle weakness.  Also, tell your healthcare provider about any allergies, including severe allergies to eggs and any allergic reaction to a previous dose of any influenza vaccine.

Influenza Vaccine, Intranasal (nasal spray)

• Brand Names (for children): FluMist Quadrivalent
• What it's for: Protects against four different strains of influenza virus included in the vaccine; for children and adults ages 2 through 49 years of age.  
• Common side effects may include: Runny or stuffy nose and cough.
• Tell your healthcare provider beforehand if: The child is moderately or severely ill, has a weakened immune system, has asthma or recurrent wheezing, or has a history of Guillain-Barre Syndrome (GBS), a neurological disorder that causes severe muscle weakness.  Also, tell your healthcare provider about any allergies, including severe allergies to eggs and any allergic reaction to a previous dose of any influenza vaccine. In addition, because of the association of Reye's syndrome with aspirin and wild-type influenza infection, the healthcare provider should be made aware if the child is currently receiving aspirin or aspirin-containing therapy.

Measles, Mumps and Rubella Vaccine

• Brand Name: M-M-R II
• What it's for: Prevents measles, mumps, and rubella in those 12 months of age and older. Measles is a respiratory disease that causes a skin rash all over the body, and fever, cough and runny nose.  Measles can be severe, causing ear infections, pneumonia, seizures, and swelling of the brain. Mumps causes fever, headache, loss of appetite and the well-known sign of swollen cheeks and jaw which is from the swelling of the salivary glands. Rare complications include deafness, meningitis (infection of the lining that surrounds the brain and spinal cord), and painful swelling of the testicles or ovaries. Rubella, also called German Measles, causes fever, a rash, and--mainly in women--can also cause arthritis.  Rubella infection during pregnancy can lead to birth defects.
• Common side effects may include: Fever, mild rash, fainting, headache, dizziness, irritability and burning/stinging, redness, swelling, and tenderness at the injection site.
• Tell your healthcare provider beforehand if: The child is ill and has a fever or has ever had an allergic reaction to gelatin, the antibiotic neomycin, or a previous dose of the vaccine, has immune system problems, or cancer, or problems with the blood or lymph system.

Meningococcal Vaccine

There are two different types of meningococcal vaccines. One type protects against four groups of meningococcal bacteria called groups A, C, W-135, and Y. FDA has approved two vaccines of this type. The other type protects against a meningococcal bacterium called group B.  FDA has also approved two meningococcal group B vaccines, but they are only recommended for routine use in certain high-risk groups.

• Brand Names: Bexsero, Menactra, Menveo, and Trumenba
• What it's for: Prevents certain types of meningococcal disease, a life-threatening illness caused by the bacteria Neisseria meningitidis (N. meningitidis) that infects the bloodstream and the lining that surrounds the brain and spinal cord (meningitis). Neisseria meningitidis is a leading cause of meningitis in young children.  Even with appropriate antibiotics and intensive care, between 10 and 15 percent of people who develop meningococcal disease die from the infection.  Another 10 to 20 percent suffer complications such as brain damage or loss of limb or hearing.  Bexsero and Trumenba are approved for use in those 10 through 25 years of age to prevent invasive meningococcal disease caused by N. meningitidis serogroup B. Menactra and Menveo prevent meningococcal disease caused by N. meningitidis serogroups A, C, Y and W-135.  Menactra is approved for use in those 9 months through 55 years of age.  Menveo is approved for use in those 2 months through 55 years of age. 
• Common side effects may include: Tenderness, pain, redness and swelling at the injection site, irritability, headache, fever, tiredness, chills, diarrhea and loss of appetite for a short while.
• Tell your healthcare provider beforehand if: The child is moderately or severely ill, has had a severe allergic reaction to a previous dose of meningococcal vaccine, or has a known sensitivity to vaccine components.

Pneumococcal 13-valent Conjugate Vaccine

• Brand Name: Prevnar 13
• What it's for: Prevents invasive disease caused by 13 different types of the bacterium Streptococcus pneumoniae in infants, children and adolescents ages 6 weeks through 17 years.  In infants and children 6 weeks through 5 years of age, it is also approved for the prevention of otitis media (ear infection) caused by 7 different types of the bacterium.  Streptococcus pneumonie can cause infections of the blood, middle ear, and the covering of the brain and spinal cord, as well as pneumonia.  Prevnar 13 is also approved for adults 18 years of age and older.
• Common side effects may include: Pain, redness and swelling at the injection site, irritability, decreased appetite and fever.
• Tell your healthcare provider beforehand if: The child is moderately or severely ill, has ever had an allergic reaction to a previous dose or component of the vaccine, including diphtheria toxoid (for example, DTaP vaccine).

Poliovirus Vaccine

• Brand Name: Ipol
• What it's for: Prevents polio in infants as young as 6 weeks of age.  Polio is a disease that can cause paralysis or death. 
• Common side effects may include: Redness, hardening and pain at the injection site, fever, irritability, sleepiness, fussiness, and crying.
• Tell your healthcare provider beforehand if: The child is moderately or severely ill, including illness with a fever, has ever had a severe allergic reaction to a previous dose of polio vaccine, any component of the vaccine, or an allergic reaction to the antibiotics neomycin, streptomycin, or polymyxin B.

Rotavirus Vaccine

• Brand Names: Rotarix and RotaTeq
• What it's for: Prevents gastroenteritis caused by rotavirus infection in infants as young as 6 weeks of age.  Rotavirus disease is the leading cause of severe diarrhea and dehydration in infants worldwide.  In the United States, the disease occurs more often during the winter.  Before rotavirus vaccines were available, most children in the United States were infected with rotavirus before the age of two.  In addition, rotavirus resulted in about 55,000-70,000 hospitalizations and 20-60 infant deaths in the United States each year.
• Common side effects may include: Fussiness/irritability, cough/runny nose, fever, and loss of appetite.
• Tell your healthcare provider beforehand if: The child has illness with a fever, a weakened immune system because of a disease, has a blood disorder, any type of cancer, has gastrointestinal problems, has had stomach surgery or ever had intussusception, which is a form of blockage of the intestines, is allergic to any of the ingredients of the vaccine, or has ever had an allergic reaction to a previous dose of the vaccine, or has regular close contact with a member of a family or household who has a weak immune system.

Varicella Virus Vaccine

• Brand Name: Varivax
• What it's for: Prevents varicella (chickenpox) in children 12 months of age and older. Chickenpox usually causes a blister-like itchy rash, tiredness, headache and fever. It can be serious, particularly in babies, adolescents, adults and people with weak immune systems, causing less common, but more serious complications such as skin infection, scarring, pneumonia, brain swelling, Reye's syndrome, (which affects the liver and brain), and death.
• Common side effects may include: Soreness, pain, redness or swelling at the injection site, fever, irritability, and chicken-pox like rash on the body or at the site of the shot.
• Tell your healthcare provider beforehand if: The child is moderately or severely ill, including a fever, has a weak immune system, has received a blood or plasma transfusion or immune globulin within the last 5 months, takes any medicines, has allergies including any life-threatening allergic reaction to gelatin, the antibiotic neomycin, or a previous dose of chickenpox or any other vaccine.

Your healthcare provider may decide to use the following vaccines to prevent the diseases described previously.  These are also approved by FDA and could reduce the total number of shots a child receives.

• Brand Name: Kinrix
• What it’s for: Preventsdiphtheria, tetanus, pertussis, and polio in children 4 through 6 years of age (prior to 7th birthday).
• Common side effects: Similar to those vaccines described previously for the prevention of diphtheria, tetanus, pertussis, and polio.
• Tell your healthcare provider beforehand: See information included in the sections for those vaccines that prevent diphtheria, tetanus, pertussis, and polio.


• Brand Name: Pediarix
• What it’s for: Preventsdiphtheria, tetanus, pertussis, hepatitis B and polio in children 6 weeks of age through 6 years of age (prior to the 7th birthday).
• Common side effects: Similar to those vaccines described previously for the prevention of diphtheria, tetanus, pertussis, hepatitis B and polio.
• Tell your healthcare provider beforehand: See information included in the sections for those vaccines that prevent diphtheria, tetanus, pertussis, hepatitis B and polio.


• Brand Name: Pentacel
• What it’s for: Preventsdiphtheria, tetanus, pertussis, polio and invasive Hib disease in children 6 weeks through 4 years of age (prior to 5th birthday).
• Common Side Effects: Similar to those vaccines described previously for the prevention of diphtheria, tetanus, pertussis, polio and Hib.
• Tell your healthcare provider beforehand: See information included in the sections for those vaccines that prevent diphtheria, tetanus, pertussis, polio and Hib.


• Brand Name: ProQuad
• What it’s for: Preventsmeasles, mumps, rubella (German measles), and varicella (chicken pox) in children 12 months through 12 years of age.
• Common side effects: Fever, measles-like rash and injection site reactions such as pain, tenderness, soreness, redness and swelling.
• Tell your healthcare provider beforehand:   See information included in the sections for those vaccines that prevent measles, mumps, rubella and chicken pox.


• Brand Name: Quadracel
• What it’s for: Prevents diphtheria, tetanus, pertussis and polio in children 4 through 6 years of age.
• Common side effects: muscle aches, fever andinjection site reactions such as pain, swelling and redness
• Tell your healthcare provider beforehand: See information included in the sections for those vaccines that prevent diphtheria, tetanus, pertussis and polio.


• Brand Name: Vaxelis
• What it’s for: Prevents diphtheria, tetanus, pertussis, (whooping cough), hepatitis B, polio and invasive disease caused by Haemophilus influenzae type b (Hib) in children 6 weeks through 4 years of age.
• Common side effects: irritability, injection site reactions such as pain, swelling and redness, drowsiness, decreased appetite and fever.
• Tell your healthcare provider beforehand: See information included in the sections for those vaccines that prevent diphtheria, tetanus, pertussis, hepatitis B, polio and Hib.

Parents and Caregivers are Asking

Should I be worried about the increasing number of vaccines recommended for children?

No. Because of advances in science and manufacturing, it is easier than in the past to be sure that vaccines are highly pure. Vaccines represent only a minor stimulation of the infant immune system compared to the large number of potentially dangerous bacteria and viruses babies routinely encounter: starting immediately after a baby is born; thousands of different bacteria begin to live on the skin and the lining of the nose, throat, and intestines. The baby’s immune system rapidly launches immune responses to these bacteria that prevent them from invading the blood stream.

Are the ingredients that are used to make vaccines safe?

Yes. Each ingredient in a vaccine is included for a reason. Before FDA determines that a vaccine is safe and effective and licenses it for use by the public in the United States, the vaccine is carefully evaluated by FDA scientists and doctors, taking into account the ingredients that make up the entire vaccine.

Are vaccines linked to autism?

No, the scientific evidence does not support a link between vaccination and autism or other developmental disorders.

Although children continue to get several vaccines up to their second birthday and sometimes, several in one office visit, these vaccines do not overload the immune system.

Thirty years ago, vaccines used 3,000 antigens to protect against 8 diseases by age two. Today, vaccines use 305 antigens to protect against 14 diseases by age two.

Thanks to scientific advances, today’s vaccines can protect children from more diseases using fewer antigens. Vaccines contain only a tiny fraction of the antigens that babies encounter in their environment every day.

You want to do what is best for your children. You know about the importance of car seats, baby gates, and other ways to keep them safe. But did you know that one of the best ways to protect your children is to make sure they have all of their vaccinations?

Immunizations can save your child's life. Because of advances in medical science, your child can be protected against more diseases than ever before. Some diseases that once injured or killed thousands of children have been eliminated completely, and others are close to extinction – primarily due to safe and effective vaccines. Polio is one example of the great impact that vaccines have had in the United States. Polio was once America's most-feared disease, causing death and paralysis across the country, but today, thanks to vaccination, there are no reports of polio in the United States.

Vaccination is very safe and effective. Vaccines are only given to children after a long and careful review by scientists, doctors, and healthcare professionals. Vaccines will involve some discomfort and may cause pain, redness, or tenderness at the site of injection, but this is minimal compared to the pain, discomfort, and trauma of the diseases these vaccines prevent. Serious side effects following vaccination, such as severe allergic reaction, are very rare. The disease-prevention benefits of getting vaccines are much greater than the possible side effects for almost all children.

Immunization protects others you care about. Children in the U.S. still get vaccine-preventable diseases. In fact, we have seen resurgences of measles and whooping cough (pertussis) over the past few years. Since 2010, there have been between 10,000 and 50,000 cases of whooping cough each year in the United States. About 10 to 20 babies, many of whom were too young to be fully vaccinated, died each year. While some babies are too young to be protected by vaccination, others may not be able to receive certain vaccinations due to severe allergies, weakened immune systems from conditions like leukemia, or other reasons. To help keep them safe, it is important that you and your children who can get vaccinated are fully immunized. This not only protects your family, but also helps prevent the spread of these diseases to your friends and loved ones.

Immunizations can save your family time and money. A child with a vaccine-preventable disease can be denied attendance at schools or childcare facilities. Some vaccine-preventable diseases can result in prolonged disabilities and can take a financial toll because of lost time at work, medical bills or long-term disability care. In contrast, getting vaccinated against these diseases is a good investment and usually covered by insurance. The Vaccines for Children program is a federally funded program that provides vaccines at no cost to children from low-income families.

Immunization protects future generations. Vaccines have reduced and, in some cases, eliminated many diseases that killed or severely disabled people just a few generations ago. For example, smallpox vaccination eradicated that disease worldwide. Your children don't have to get smallpox shots anymore because the disease no longer exists. By vaccinating children against rubella (German measles), the risk that pregnant women will pass this virus on to their fetus or newborn has been dramatically decreased, and birth defects associated with that virus no longer are seen in the United States. If we continue vaccinating now, and vaccinating completely, parents in the future may be able to trust that some diseases of today will no longer be around to harm their children in the future.

Vaccines protect against diseases

Different vaccines work in different ways, but every vaccine helps the body’s immune system learn how to fight germs. It typically takes a few weeks for protection to develop after vaccination, but that protection can last a lifetime. A few vaccines, such as those for tetanus or seasonal flu, require occasional booster doses to maintain the body’s defenses.

Strengthening your baby’s immune system

Immunity is the body’s way of preventing disease. Because a baby’s immune system is not fully developed at birth, babies face a greater risk of becoming infected and getting seriously ill. Vaccines help teach the immune system learn how to defend against germs. Vaccination protects your baby by helping build up their natural defenses.

Children are exposed to thousands of germs every day. This happens through the food they eat, the air they breathe, and the things they put in their mouth.

Babies are born with immune systems that can fight most germs, but some germs cause serious or even deadly diseases a baby can’t handle. For those, babies need the help of vaccines.

Vaccines use very small amounts of antigens to help your child’s immune system recognize and learn to fight serious diseases. Antigens are the parts of a germ that cause the body’s immune system to go to work.

Learn more about how vaccines work with the body’s immune system and different types of immunity.

Vaccine ingredients

Today’s vaccines use only the ingredients they need to be as safe and effective as possible. A vaccine could include any of these kinds of ingredients:

• Adjuvants such as aluminum salts help boost the body’s response to a vaccination. (Also found in antacids, antiperspirants, etc.)
• Stabilizers such as sugars or gelatin help keep a vaccine effective after it is manufactured. (Naturally present in the body and found in foods such as Jell-O®.)
• Formaldehyde helps prevent bacterial contamination during manufacturing. Formaldehyde is naturally present in the body  at levels higher than vaccines. (Also found in the environment, preservatives, and household products.)
• Thimerosal is a preservative used in the vaccine manufacturing process. It is no longer used to make any vaccine except multi-dose vials of the flu vaccine. Single dose vials of the flu vaccine are available as an alternative.

Vaccines are safe

Before a new vaccine is ever given to people, extensive lab testing is done. Once testing in people begins, it can still take years before clinical studies are complete and the vaccine is licensed.

After a vaccine is licensed, the Food and Drug Administration (FDA), CDC, National Institutes of Health (NIH), and other federal agencies continue routine monitoring and investigate any potential safety concerns.

Mild side effects are expected

Vaccines, like medicine, can have some side effects. But most people who get vaccinated have only mild side effects or none at all. The most common side effects include fever, tiredness, body aches, and redness, swelling, and tenderness where the shot was given. Mild reactions usually go away on their own within a few days. Serious, long-lasting side effects are extremely rare. We know they are rare because CDC tracks and investigates reports of serious side effects.

If you have questions or concerns about a vaccine, talk with your child’s doctor.

Why your child should get vaccinated

Vaccines can prevent common diseases that used to seriously harm or even kill infants, children, and adults. Without vaccines, your child is at risk of becoming seriously ill or even dying from childhood diseases such as measles and whooping cough.

It is always better to prevent a disease than to treat one after it occurs.

• Vaccination is a safe, highly effective, and easy way to help keep your family healthy.
• The recommended vaccination schedule balances when a child is likely to be exposed to a disease and when a vaccine will be most effective.
• Vaccines are tested to ensure they can be given safely and effectively at the recommended ages.

Combination vaccines reduce the number of shots your child needs while protecting against the same number of serious diseases.

Fewer shots, but same protection

Combination vaccines take two or more vaccines that could be given individually and put them into one shot.

So, at a doctor’s visit, your child may only get two or three shots to protect him from five diseases, instead of five individual shots.

Several vaccines are so common that they are generally known by their initials: MMR (measles, mumps, and rubella) and DTaP (diphtheria, tetanus, and pertussis). Each protect your child against three diseases. However, today these two particular vaccines are not considered true combination vaccines because in the United States, you cannot get separate vaccines for all of the diseases that MMR and DTaP protect against.

Common combination vaccines for children

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All vaccines, including combination vaccines, can help protect your child from various diseases.

Benefits of combination vaccines

Combining vaccines into fewer shots may mean that more children will get recommended vaccinations on time. And that means fewer delays in disease protection.

Benefits for children

• Fewer shots
• Less pain and discomfort
• On-time protection

Benefits for parents

• Fewer visits to doctor
• Less hassle and cost with fewer visits
• Less time off from work or family activity

Safety and effectiveness

Before a combination vaccine is approved for use, it goes through careful testing to make sure the combination vaccine is as safe and effective as each of the individual vaccines given separately. And, just as with individual vaccines, there are systems in place to watch for any rare reactions to combination vaccines that can be detected only after the vaccine is used widely.

Combination vaccines have been in use in the United States since the mid-1940s.

Side effects

Side effects from combination vaccines are usually mild. They are similar to those of the individual vaccines given separately.

Sometimes combination vaccines cause slightly more pain or swelling where the shot was given. But if your child got the shots individually, he or she might have pain or swelling in two or three spots, instead of just one.

If your child has moderate or serious side effects from a combination vaccine, tell your child’s doctor. If the separate vaccines are available, the doctor may be able to give additional doses of certain vaccines separately.

Growing future for combination vaccines

As scientists develop and test new vaccines to protect children against more diseases, more combination vaccines may become available. This will allow children to get additional protection with fewer shots.

Recommendations for the MMRV vaccine

The MMRV vaccine combines the MMR (for measles, mumps, and rubella) vaccine with the chickenpox vaccine.

Some children who get the first MMRV shot at 12 through 23 months of age may have a higher chance of a seizure caused by fever after the shot. But, this is not common. These “febrile” seizures are scary for parents, but they are not harmful to children.

Because of this slightly higher risk of seizures, the Centers for Disease Control and Prevention recommend that children under 4 years old get the first dose of MMR and chickenpox vaccines separately.

If you choose to delay, skip, or reject all or some vaccines entirely, there can be risks. With this decision comes an important responsibility to protect your child’s life, or the life others in your family, community, or other countries you visit.

When your child is being evaluated, the doctor will need to consider the possibility that your child has a vaccine-preventable disease (VPD); while uncommon, VPDs still occur. Keep a vaccination record easily accessible and share it with the doctor.

It is your responsibility to notify the doctor’s office, urgent care facility, ambulance personnel, or emergency room staff that your child has not been fully vaccinated.

Others who help your child can take precautions, such as isolating your child, so that the disease does not spread to others especially

• Infants, who are too young to be fully vaccinated.
• People are those with weaker immune systems, such as some people with cancer, who are not vaccinated due to certain medical conditions.

During an outbreak in your community:

Inform your child’s school or childcare facility about your child’s vaccination status.

Sometimes vaccine-preventable diseases cause outbreaks (clusters of cases in a given area).

For some diseases, one case is enough to cause concern in a community. Such as measles one of the most contagious diseases. This disease and others spread quickly among people who are not immune.

• Get protection by getting vaccinated immediately.
• Take your child out of school, daycare, or organized activities such as playgroups or sports, if you are asked.
• Be prepared to keep your child home for several days up to several weeks.
• Learn about the disease and how it is spread.
• Contact your child’s doctor or your local or state’s health department to get their guidelines for determining when your child is no longer at risk.
• Respond to your state or local health department who track infectious disease outbreaks in your community.

In most cases, there is no way to know beforehand if a child will get a mild or serious (life-threating) case.

If you suspect your child is exposed to a vaccine-preventable disease:

• Be aware that your child can catch diseases from people who don’t have any symptoms.
• Learn the early signs and symptoms of the disease.
• Seek immediate medical help if your child or any family members develop early signs or symptoms of the disease.
• Follow recommendations to isolate your child from others, including family members, and especially infants and people with weakened immune systems.
• Be aware that for some vaccine-preventable diseases, there are medicines to treat infected people and medicines to keep people they come in contact with from getting the disease.
• Ask your child’s doctor about other ways to protect your family members and anyone else who may come into contact with your child.

Children do not receive any known benefits from delaying vaccines or skipping vaccines.

If you travel:

Before traveling, learn about possible disease risks and vaccines that will protect your family.

Travelers are exposed to diseases during travel or by others that traveled and returned to the U.S.

• Any vaccine preventable disease can strike at any time in the U.S.; all of these diseases still circulate in the U.S. or elsewhere in the world.
• Vaccine-preventable diseases that still circulate in the U.S. include:
  • Whooping cough
  • Chickenpox
  • Hib (a cause of meningitis)
  • Flu (Influenza)
• Vaccine-preventable diseases can range from mild to severe and life-threatening.

Are vaccines safe?

Yes. Vaccines are very safe. The United States’ long-standing vaccine safety system ensures that vaccines are as safe as possible. Currently, the United States has the safest vaccine supply in its history. Millions of children safely receive vaccines each year. The most common side effects are very mild, such as pain or swelling at the injection site.

What are the risks and benefits of vaccines?

Vaccines can prevent infectious diseases that once killed or harmed many infants, children, and adults. Without vaccines, your child is at risk for getting seriously ill and suffering pain, disability, and even death from diseases like measles and whooping cough. The main risks associated with getting vaccines are side effects, which are almost always mild (redness and swelling at the injection site) and go away within a few days. Serious side effects after vaccination, such as a severe allergic reaction, are very rare and doctors and clinic staff are trained to deal with them. The disease-prevention benefits of getting vaccines are much greater than the possible side effects for almost all children. The only exceptions to this are cases in which a child has a serious chronic medical condition like cancer or a disease that weakens the immune system, or has had a severe allergic reaction to a previous vaccine dose.

Is there a link between vaccines and autism?

No. Scientific studies and reviews continue to show no relationship between vaccines and autism.

What are common side effects of vaccines?

Vaccines, like any medication, may cause some side effects. Most of these side effects are very minor, like soreness where the shot was given, fussiness, or a low-grade fever. These side effects typically only last a couple of days and are treatable. For example, you can apply a cool, wet washcloth on the sore area to ease discomfort.

Can vaccines overload my baby’s immune system?

Vaccines do not overload the immune system. Every day, a healthy baby’s immune system successfully fights off thousands of germs. Antigens are parts of germs that cause the body’s immune system to go to work to build antibodies, which fight off diseases.

The antigens in vaccines come from the germs themselves, but the germs are weakened or killed so they cannot cause serious illness. Even if babies receive several vaccinations in one day, vaccines contain only a tiny fraction of the antigens they encounter every day in their environment. Vaccines give your child the antibodies they need to fight off serious vaccine-preventable diseases.

Why do vaccines start so early?

The recommended schedule protects infants and children by providing protection early in life, before they come into contact with life-threatening diseases. Children receive vaccinations early because they are susceptible to diseases at a young age.

Should my child get shots if she is sick?

Talk with your child’s doctor, but children can usually get vaccinated even if they have a mild illness like a cold, earache, mild fever, or diarrhea. If the doctor says it is okay, your child can still get vaccinated.

Should I delay some vaccines or follow a non-standard schedule?

Children do not receive any known benefits from following schedules that delay vaccines. Infants and young children who follow immunization schedules that spread out or leave out shots are at risk of developing diseases during the time you delay their shots.

Why can’t I delay some vaccines if I’m planning for my baby to get them all eventually?

Young children have the highest risk of having a serious case of disease that could cause hospitalization or death. Delaying or spreading out vaccine doses leaves your child unprotected during the time when they need vaccine protection the most. For example, diseases such as Hib or pneumococcus almost always occur in the first 2 years of a baby’s life. And some diseases, like hepatitis B and whooping cough (pertussis), are more serious when babies get them.

If I’m breastfeeding, do I vaccinate my baby on schedule?

Yes, even breastfed babies need to be protected with vaccines at the recommended ages. The immune system is not fully developed at birth, which puts newborns at greater risk for infections.

Breast milk provides important protection from some infections as your baby’s immune system is developing. For example, babies who are breastfed have a lower risk of ear infections, respiratory tract infections, and diarrhea. However, breast milk does not protect children against all diseases. Even in breastfed infants, vaccines are the most effective way to prevent many diseases. Your baby needs the long-term protection that can only come from following CDC’s recommended schedule.

Can I wait to vaccinate my baby since he isn’t in child care?

No, even young children who are cared for at home can be exposed to vaccine preventable diseases, so it’s important for them to get all their vaccines at the recommended ages. Children can catch these illnesses from any number of people or places, including from parents, brothers or sisters, visitors to their home, on playgrounds or even at the grocery store. Regardless of whether your baby is cared for outside the home, your baby comes in contact with people throughout the day, some of whom may have a vaccine-preventable disease.

Many of these diseases can be especially dangerous to young children, so it is safest to vaccinate your child at the recommended ages.

Can I wait until my child goes to school to catch up on immunizations?

No. Before entering school, young children can be exposed to vaccine-preventable diseases. Children under age 5 are especially susceptible to diseases because their immune systems have not built up the necessary defenses to fight infection.

Why do adolescents need vaccines?

Vaccines are recommended throughout our lives to protect against serious diseases. As protection from childhood vaccines wears off, adolescents need vaccines that will extend protection. Adolescents need protection from additional infections as well, before the risk of exposure increases.

Why are multiple doses needed for each vaccine?

Getting every recommended dose of each vaccine provides your child with the best protection possible. Depending on the vaccine, your child will need more than one dose to build high enough immunity to help prevent disease or to boost immunity that fades over time. Your child may also receive more than one dose to make sure they are protected if they did not get immunity from a first dose, or to protect them against germs that change over time, like flu. Every dose is important because each protects against an infectious disease that can be especially serious for infants and very young children.

Do infants have natural immunity?

Babies may get some temporary protection from mom during the last few weeks of pregnancy, but only for diseases to which mom is immune. Breastfeeding may also protect your baby temporarily from minor infections, like colds. These antibodies do not last long, leaving your baby vulnerable to disease.

Haven’t we gotten rid of most of these diseases in this country?

Some vaccine-preventable diseases, like pertussis (whooping cough) and chickenpox, remain common in the United States. On the other hand, other diseases vaccines prevent are no longer common in this country because of vaccines. If we stopped vaccinating, the few cases we have in the United States could very quickly become tens or hundreds of thousands of cases. Even though many serious vaccine-preventable diseases are uncommon in the United States, some are common in other parts of the world. Even if your family does not travel internationally, you could come into contact with international travelers anywhere in your community. Children who don’t receive all vaccinations and are exposed to a disease can become seriously sick and spread it through a community.

It’s normal to have questions when it’s time for your child to get vaccinated. The good news is that being prepared can make getting vaccinated less stressful — for both you and your child.

Below you’ll find information to help you learn what to expect before, during, and after your child’s appointment.

Before the appointment

There are steps you can take before your child’s appointment to help things go more smoothly at the doctor’s office.

Find your child’s vaccination records

It can be helpful to bring your child’s vaccination records to the appointment so the doctor knows which vaccines they’ve already had. If you can’t find your child’s vaccination records, you can:

• Ask your child’s doctor — or doctors they’ve seen in the past.
• Call your state health department to see if they have a copy of your child’s vaccination records.
• Check to see if your child’s school or daycare has vaccination records on file.

Talk to your child

If your child is old enough, try talking with them about what to expect at the appointment. This can help them feel more comfortable. Use these tips to talk with your child:

• Explain that vaccines help keep us healthy.
• Tell your child that shots can hurt a little — but not for long.

Tip: If your child has a favorite blanket or toy, consider bringing it to the appointment to help comfort your child.

During the appointment

It’s important to know what to discuss with the doctor during your child’s appointment. You can also learn strategies for comforting your child while they get vaccinated.

Get the facts about vaccines

During your vaccination appointment, the doctor is required to give you a Vaccine Information Statement (VIS) that explains the benefits and risks of a vaccine. If your child’s doctor doesn’t give you one, you can ask for it.

Tell the doctor if your child is sick

Be sure to let the doctor know if your child isn’t feeling well on the day they’re supposed to get vaccinated. Children who have a mild illness — like a low fever or a cold — may still be able to get vaccines. If your child has a more serious illness, you may need to come back when they’re feeling better.

Some children may not be able to get certain vaccines — or may need to wait to get them. Tell the doctor if your child:

• Has a long-term health condition, like cancer
• Is taking medicine that can weaken their immune system
• Has had a severe allergic reaction to a vaccine in the past

Comfort your child

You may be able to hold your child during the vaccination. Holding your child can comfort them while they get the shot. Additionally:

• Activities that bring you close to your baby — like swaddling or breastfeeding — can help soothe them after the shot.
• You can help your older child feel calm by reminding them to breathe deeply — or distracting them by telling stories or pointing out things in the room.

Teens and preteens can sometimes faint after a shot, so it’s important to have them sit down during their vaccination and for 15 minutes after they get vaccinated.

Before you leave the appointment, ask the doctor if there are any steps you can take to help your child feel more comfortable. For example, having your child move their arm around after vaccination may help with pain and swelling.

After the appointment

Most people don’t have any serious side effects after getting vaccinated. The most common side effects are usually mild. They include:

• Pain, swelling, or redness where the shot was given
• Mild fever
• Chills
• Feeling tired
• Headache
• Muscle and joint aches

If your child has mild side effects, you can take steps to help them feel better. For example:

• Make sure your child drinks plenty of fluids.
• Put a cool, wet washcloth on places where they’re sore.
• If the doctor approves, you can give your child a non-aspirin pain reliever.

It’s very unlikely that your child will have serious side effects from a vaccine. If you see anything that concerns you, call your child’s doctor.

Why you need your child’s vaccine records

It is important to keep your child’s vaccination records (the history of which vaccines they received) up to date and in a safe place. Without documentation, your child might not be allowed to attend school, play sports, or travel abroad. Your child may need their vaccination records later as adults for certain occupations.

Keeping track of records

Keep your child’s vaccination records in a safe place beginning with their first vaccine. Your child’s doctor will keep a record of vaccines given in their clinic. Ask your child’s doctor or nurse how they keep vaccination records and how you can get an official copy. You can also ask your child’s doctor to enter vaccination information in your state’s immunization information system (IIS), a statewide registry for records.

Finding official vaccination records

If you can’t find a copy or do not have your child’s vaccination records, you can try to get an official copy from a few different places.

Your child’s doctor or clinic

Doctors and health clinics keep records of the vaccines they give to your child. Keep in mind that they may save records for only a few years. If your child has gotten vaccines at different locations, you may have to contact each of them to get your child’s records.

Your state’s immunization registry

States and some large cities have secure immunization information systems (IIS) that keep vaccination records for the people in the state or city. However, some people’s records may not be complete. Contact the IIS in your state or the state where your child received their last vaccine to see if they have your child’s records and learn how to request an official copy. Your doctor may also be able to help you get vaccination records from your state’s IIS for vaccines that were given at other locations by other providers.

Your child’s school

Most schools keep vaccination records on file. Schools may keep records for a year or two after a student leaves or graduates. Contact your child’s school for more information.

If you can’t find your child’s vaccine records

If you can’t find the vaccination records, it’s important to stay on the safe side and vaccinate (or revaccinate) your child. It is safe for your child to repeat a vaccine that they received earlier. Sometimes repeat vaccinations may be required for proof of immunizations. Talk to your child’s doctor about how to protect your child.

Alternatively, you can also have your child’s blood tested for antibodies to check immunity for some vaccine preventable diseases. However, these tests aren’t always completely accurate.

Saving your child’s vaccination records

It’s important to keep your child’s vaccination records safe and updated. Schools, summer camps, athletic teams, college, international travel, and more may require vaccination records.

Storing your child’s records

Keep your child’s vaccination records in a safe place where you can easily find them. Some people keep their child’s records with other important documents, such as birth certificates and passports.

Updating your child’s records

Bring your child’s vaccine record to each doctor visit and ask the doctor or nurse to write down the vaccine, date, and dosage. It’s also helpful to write down the name of the doctor’s office or clinic where your child got the shot, so you know where to get the official records from if you misplace the record.