12-Month Vaccines: What You Should Know

Up to nine different vaccines may be given at the 12-month wellness checkup. Some pediatricians and parents opt to space out the vaccines and give some shots at the 6-, 9-, or 15-month visits instead.

The Centers for Disease Control and Prevention (CDC) recommended immunization schedule splits vaccines into a series of doses spread out during early childhood.

The 12-month shots include the first doses of the measles, mumps, and rubella (MMR) and chicken pox vaccines. One-year-olds may also receive additional doses of hepatitis B (HepB), Haemophilus influenza type b (Hib), pneumonia (PCV), and polio (IBV) vaccines.

This article discusses the 12-month vaccine schedule. It explains the different childhood immunizations that may be given during the 1-year well-child visit and the age range for different shots in the series.

12-Month Vaccination Schedule

The CDC recommends a schedule for vaccine-preventable diseases. Most vaccines are split into two or more doses. Your 1-year-old has likely already received the first dose of some of the immunizations scheduled for the 12-month wellness check-up.

The CDC and the American Academy of Pediatrics (AAP) recommend the following vaccinations to be given to children around 12 months old:

• COVID-19: Doses can be started at the age of 6 months and repeated.
• Haemophilus influenza type b (Hib): The fourth dose should be given between 12 and 15 months old.
• Hepatitis A (HepA): The first of two doses is given at 1 year old. 
• Hepatitis B (HepB): The third dose should be given between 6 and 18 months old.
• Influenza (flu): Doses can be started at 6 months of age and may be needed once or twice a year
• Measles, mumps, and rubella (MMR): The first of two doses is given between 12 and 15 months old.
• Pneumococcal disease (PCV13, PCV15): The fourth dose should be given between 12 and 15 months old.
• Polio (IPV): The third dose should be given between 6 and 18 months old.
  
• Varicella (chicken pox): The first of two doses is given between 12 and 15 months old.
  

Haemophilus Influenzae Type B (Hib)

Haemophilus influenzae type B (Hib) is a bacterial infection that is rare in the United States due to routine vaccination. However, it can be severe and can cause:

• Pneumonia (lung infection)
• Meningitis (infection of the spinal cord and brain)
• Sepsis (an infection that enters the bloodstream)
• Epiglottitis (swelling in the upper airway or windpipe)

The fourth and final dose of the Hib vaccine is usually given between 12 and 15 months old. 

Pneumococcal Conjugate Vaccine (PCV)

Pneumococcal disease is a bacterial infection that causes:

• Ear infections
• Sinus infections
• Meningitis (infection of the brain and spinal cord)
• Pneumonia (lung infection)

The PCV is part of a four-dose series. The last is given around 12 to 15 months old.

Hepatitis A (HepA)

The hepatitis A virus is a highly contagious disease that causes liver inflammation (swelling) and infection. Humans who are not vaccinated get it through close contact with an infected person or by eating contaminated food and drinks.

While hepatitis A is highly contagious, it is preventable through the hepatitis A vaccination (HAV) for children 1 year and older. 

There are two different hepatitis A vaccines approved by the Food and Drug Administration (FDA) for children:

• Havrix, which was approved in 1995
• Vaqta, which was approved in 1996

HepA vaccine is given as a two-shot series. The first is given at 12 to 23 months, and the second is given at least 6 months later (often at age 2).

Hepatitis B (HepB)

Like HepA, hepatitis B is a viral infection that causes liver damage. Babies are vaccinated against hepatitis B in three doses. 

The first HBV dose is usually given within 12 hours of an infant’s life. This is done in case their mother unknowingly passed Hepatitis B to them at birth. The final dose of HBV is given between 6 and 18 months.

If your child is up-to-date on shots, the third HepB vaccination may have been administered at an earlier visit.

Measles, Mumps, and Rubella (MMR)

The first dose of the MMR vaccine is given to children between 12 and 15 months old. It protects against the following diseases:

• Measles: This is a very contagious virus that spreads through coughing and sneezing. Those with measles get a cough, red eyes, fever, and runny nose. A rash with tiny red spots develops starting around the head and spreads to the rest of the body. Before the measles vaccine was introduced in 1963, 3 to 4 million Americans were diagnosed with measles each year.
• Mumps: This is a virus that causes fever, headache and muscle aches, decreased appetite, swollen glands under the ears, soreness in the jaw, and puffy cheeks. Most people recover from mumps in a couple of weeks. However, it can cause serious complications, including encephalitis (brain swelling) and deafness. Vaccines helped decrease mumps cases in the United States by more than 99%.
• Rubella: This is a virus that is sometimes called "German measles." Rubella can cause fevers, swollen glands, respiratory infections, and rashes.

Polio (IPV)

Polio is a disabling and potentially fatal viral infection that has been largely eradicated due to global vaccination programs. During the late 1940s—before the vaccination program began—an average of more than 35,000 people were paralyzed each year due to polio.

In the United States, children are given four doses of a shot called an inactivated polio vaccine (IPV). IPV doses are commonly administered at 2 months, 4 months, between 6 and 18 months, and between 4 and 6 years old.

If your child is up-to-date on immunizations, they may have already received their third dose of IPV.

Varicella

Varicella is a virus that is more commonly called chickenpox. It is a member of the herpes virus group. The first time a person is infected with varicella, it causes chickenpox. Once it’s in the body, it can reactivate later in life. This causes a painful rash called herpes zoster or shingles.

The first varicella vaccination is given at 12 to 15 months old, and the booster is due around 4-6 years old. Healthcare providers can give it at a younger age as long as it has been three months since the last dose.

Influenza (Flu)

Influenza is a respiratory infection that most call the flu or seasonal flu. The first vaccination can begin after an infant is 6 months old. Children younger than 9 years old who are getting their flu shot for the first time usually receive two doses at least four weeks apart.

After the initial vaccination, the flu shot is due yearly during flu season, usually from October through May. It’s best to get vaccinated early in the season. The vaccine takes about two weeks to build immunity against the flu.

COVID-19

In 2023, the CDC added COVID-19 vaccination to the immunization schedules for children and adults. Children are eligible to receive an mRNA vaccine from Moderna or Pfizer starting at 6 months old. Updated, or bivalent, boosters that provide protection against the original virus and the Omicron variant are also available.

The Moderna vaccine primary series is two doses, and an updated booster is recommended at least two months after the second dose. The Pfizer primary series is three doses, and the third shot is a bivalent dose given 8 weeks after the second dose.

Vaccine Side Effects

The most common side effect of vaccinations is a local reaction such as swelling, redness, or soreness at the shot site. Your child may also run a low-grade fever (100 to 102 degrees F or lower).

Less common vaccination side effects are generally mild and include:

• Chills
• Irritability
• Loss of appetite
• Muscle aches
• Headache
• Nausea, vomiting, or diarrhea

Most side effects begin within 24 hours and last one or two days. Delayed reactions such as fever and a rash can occur one to four weeks after the MMR and chickenpox shots. 

What to Do if Your Baby Has Side Effects

Your 1-year-old may need a little extra love and care after their shots. It may be helpful to keep them busy with play or distraction. To help decrease mild reactions or side effects, you can try the following techniques: 

• Use a cool cloth for local reactions (redness and swelling)
• Give a cool sponge bath for low-grade fevers
• Offer more to drink to keep them hydrated
• Give Tylenol (acetaminophen) or Motrin/Advil (ibuprofen)

Motrin, Advil, and Tylenol are safe for a 12-month-old and can help reduce fever and discomfort. Children should not receive aspirin unless directed by their healthcare provider.

When to Contact the Pediatrician

If your 12-month-old has any of the following symptoms, contact their pediatrician or healthcare provider:

• Temperature (fever) greater than 104 degrees
• Redness larger than 1 inch or lasting longer than three days
• Extreme fussiness for more than 24 hours
• Severe vomiting or diarrhea

When to call 9-1-1

If you think your child is having a life-threatening emergency or any of the following rare reactions, call 9-1-1 immediately:

• Trouble breathing
• Trouble swallowing
• Lethargy (not moving or very weak)
• Not waking up
• Seizures

Summary 

The CDC and AAP recommend a vaccination schedule for disease prevention. Between six and nine shots are usually given at the 12-month-old wellness check, including the Haemophilus influenzae type B (Hib), pneumococcal conjugate (PCV), hepatitis A (HAV), influenza, MMR, and varicella vaccines.

Vaccination side effects are generally mild, and parents can usually treat them at home. If your child is experiencing more severe side effects, call their pediatrician or seek emergency care.

A Word From Verywell

While it can be stressful for your child to experience the discomfort of shots, vaccinations are essential to help keep them healthy. You can help reassure them with a calm, soothing voice and a smile. It may also be helpful to bring their favorite toy or blanket to distract and comfort them during or after their appointment.