AAP Guidelines: Routine Immunizations

From the very first day your baby is born, and often even during pregnancy, new parents are bombarded with vaccine information and baby immunization recommendations. Some parents may be hesitant or even against vaccinating their children altogether, while others are strong advocates for infant vaccines. Whatever your stance on early childhood vaccinations, it's important to have a comprehensive understanding of the benefits of infant vaccines. Read on to see what the AAP says about routine immunizations and when to expect your baby’s first shots. 

What are the AAP recommendations on immunization?

The AAP recommends on-time routine vaccinations for babies and children. According to the AAP, immunizations are the “safest and most cost-effective way of preventing disease, disability, and death.” All laws and regulations regarding mandatory vaccinations are adamantly supported by the AAP, with the exception of individually based medically necessary exemptions for some vaccines. Medical exemptions can be granted for various reasons, including allergies to a vaccine ingredient, extreme immune system issues, chemotherapy, or prior adverse reactions to a vaccine. Exemptions can be temporary or permanent, depending on the child’s condition. 

How are immunizations determined for infants?

Watching your baby get their first shot is heartbreaking. Their tiny cry, but only for a second. Why do they need them so young, and who sets these standards anyways?

Immunization recommendations are set by The Centers for Disease Control and Prevention (CDC). The CDC comes to all conclusions about each vaccine with the guidance and opinions of a group of doctors, scientists, public health professionals, vaccine experts, and scientists that form The Advisory Committee on Immunization Practices (ACIP). The ACIP gets together three times every year to go over all of the criteria that they use to make decisions regarding vaccine schedules. This includes current vaccine recommendations, vaccine safety, the effectiveness of vaccines, and the seriousness of the diseases they are preventing. This group of experts and professionals carefully weigh the pros and cons of every vaccine before submitting recommendations. 

Infants' age at the time of vaccination, medical contradictions, and the time between doses are all considered before a final recommendation is set. 

Once these recommendations are submitted by the ACIP, they are reviewed and approved by multiple entities, including The American Academy of Pediatrics, The American College of Obstetricians and Gynecologists, and The American Academy of Family Physicians. 

So although those tiny cries are gut-wrenching, rest assured that much thought and professional collaboration is put into deciding what vaccinations are necessary and when. 

What is the first vaccine given to a newborn baby?

Your baby’s first vaccine will likely be given while you are still in the hospital, as the first dose of the Hepatitis B Vaccine is recommended within 24 hours of birth. It may be difficult to think about your brand-new newborn going through birth, then heel pricks, a vitamin K shot, eye drops, screening tests, and an immunization all before you even get to go home, but these are all very regular and common precautions to make sure your baby is, and stays, as healthy as can be. A dose of the Hepatitis B (HepB) Vaccine is important so early on because HepB is often a silent disease, which means your loved ones may not even know they have it. Passing HepB to an infant could result in extreme jaundice, failure to thrive, and spleen and liver enlargement. This can lead to a life-long infection impairing liver function, causing liver cirrhosis or even liver cancer. Side effects from the HepB Vaccine in newborns are minimal, and complications are rare. 

According to the AAP, the vaccine is 75-95% effective in preventing HepB infection transmission from mom to baby if given within 24 hours of birth - making it extremely effective. There is an additional medication (HBIG) that can be given to babies of infected parents to further decrease the chances of contracting the disease to just .7-1.1%. 

What is considered a routine vaccine?

A routine vaccine is an immunization that is recommended on a standard schedule. These schedules may be adjusted, or delayed, based on your comfort level or the recommendation of your child’s pediatrician. 

While there are routine vaccines for infants and children, there are also routine vaccinations for throughout adulthood. 

Before age six, your child may receive up to 9 routine vaccinations, including; 

• HepB (Hepatitis B)
• RV (Rotavirus)
• DTAP (includes Diphtheria, Pertussis, & Tetanus)
• HIB (Haemophilus influenzae type b)
• PCV (Pneumococcal disease)
• IPV (polio)
• MMR (Measles, Mumps, & Rubella)
• Varicella (Chickenpox)
• HepA (Hepatitis A)

Around age eleven, your child may receive the following:

• TDAP booster
• HPV (Human papillomavirus)
• MENACWY (Meningococcal disease)
• MENB (Meningococcal disease) 

…as well as Covid and Flu vaccines if you opt for your child to receive those.

That may sound like a lot, but these are typically spaced out between appointments months or years apart and only administered together when it is safe to do so. 

Routine vaccine recommendations through adulthood can differ based on your travel habits, age, general health, and lifestyle. 

Conclusion

As parents, we all want our babies to be safe, happy, and comfortable. Luckily, sometimes that is within our control. 

All vaccines are subjected to safety monitoring from the production phase all the way to administration. All adverse reactions are recorded, and any signs of a dangerous response would lead to a recall of that vaccine. So rest easy, mama; the recommended vaccinations for your precious little one are all generally considered very safe.