Tag: minimum

How Long Is a Vaccine Month?

Are you ever concerned that your kids will get their vaccines too early or too late?

Vaccine intervals are typically based on weeks and "months."
Vaccine intervals are typically based on weeks and “months.” But how long is a month?

For example, if your child needs a booster dose of a vaccine in a month, just how long is that?

Does it depend on which month you are in?

For intervals of 3 months or less, you should use 28 days (4 weeks) as a “month.”

Ask the Experts on Scheduling Vaccines

In general, while we often use calendar months, because it is more convenient, you can use a minimum interval of 28 days or 4 weeks as a full month, as long as we are only counting up to three months.

So a second flu shot after a dose on January 1st could be done as early as January 29th. That’s technically one month (28 days, 4 weeks) later. And no, you wouldn’t have to repeat the second dose if you got it on February 1st, as we are typically worried about the minimum intervals or spacing and not about getting the dose a little late.

For intervals of 4 months or longer, you should consider a month a “calendar month”: the interval from one calendar date to the next a month later.

Ask the Experts on Scheduling Vaccines

And just count calendar months if you are counting more than 3 months. So if you got a vaccine on January 1 and needed another 4 months later, you would return on May 1.

Why switch to using “calendar months” for longer intervals? With longer 28 day intervals, scheduling mistakes will likely be made.

More on Spacing and Scheduling Vaccine Doses

What Are the Recommended and Minimum Ages and Intervals Between Doses of Vaccines?

Most parents likely don’t think about the minimum age or minimum intervals between vaccines, as they just get their kids vaccinated according to the routine immunization schedule.

Things don’t always go according to schedule though…

Recommended and Minimum Ages for Vaccines

After their birth dose of the hepatitis B vaccine, your baby’s next vaccines are usually at two months.

Can you get them earlier?

When necessary, many vaccines can be given earlier and faster than the standard schedule.
When necessary, many vaccines can be given earlier and faster than the standard schedule.

Yes. The minimum age for the first dose of rotavirus, DTaP, IPV, Hib, Prevnar, is 6 weeks.

Some other vaccines can be given earlier than their recommended age too, including:

  • the first MMR vaccine, which can be given as early as age 6 months in certain high risk situations, like traveling out of the country or in an outbreak situation, although this dose will have to be repeated once the child is 12 months old
  • the 4th dose of DTaP, which can be given as early as age 12 to 15 months, as long as at least 4 to 6 months have passed since the third dose
  • the 2nd dose of Varivax, which may be given as early as 1 to 3 months after the first dose
  • the Tdap vaccine, which can be given as early as age 7 years, instead of the more typical 11 to 12 years
  • the HPV vaccine, which can be given as early as age 9 years, instead of the more typical 11 to 12 years

Why would you get a vaccine early?

What if you are going to be traveling just before you infant is going to be 2 months old? Or your 9 year old stepped on a rusty nail, and it had been just over 5 years since his last tetanus (DTaP) shot?

Recommended and Minimum Intervals for Vaccines

In addition to earlier ages, you can sometimes get vaccines more quickly, on an accelerated schedule.

For example:

  • the minimum interval between the 1st and 2nd dose of rotavirus, DTaP, IPV, Hib, Prevnar is 4 weeks, instead of the standard 2 months
  • the minimum interval between the 2nd and 3rd dose of rotavirus, DTaP, IPV, Hib, Prevnar is 4 weeks, instead of the standard 2 months
  • the minimum interval between the 1st and 2nd dose of HPV is either 4 weeks (3 dose schedule) or 5 months (2 dose schedule)
  • the minimum interval between the 2nd and 3rd dose of HPV is 12 weeks
  • the minimum interval between the 1st and 3rd dose of HPV is 5 months, instead of the standard 6 months

Why give these vaccines more quickly than usual?

The usual reason is that a child is a little behind and is working to get caught up.

Absolute Minimum Ages for Vaccines

It is important to remember that in some cases, there are some hard and fast rules about minimum ages. That means that if you get these vaccines any earlier, they won’t count and you will likely have to repeat them, including getting :

  • the 3rd dose of hepatitis B before 6 months (24 weeks) or sooner than 8 weeks after 2nd dose and  16 weeks after 1st dose
  • the first dose of MMR, Varivax or hepatitis A before 12 months
  • the 4th dose of Hib before 12 months
  • the 4th dose of Prevnar before 12 months
  • the 4th dose of DTaP before 12 months
  • the 5th dose of DTaP before 4 years
  • the 4th dose of IPV before 4 years

Sticking to the routine schedule helps to avoid vaccine errors, like giving a vaccine too early. In some situations, the 4 day grace period helps if a vaccine is given a little early.

More on Recommended and Minimum Ages and Intervals Between Doses of Vaccines

One-Size-Fits-All Immunization Schedule

Some people say that they are not anti-vaccine. Instead they oppose our so-called one-size-fits-all vaccine policy and immunization schedule.

Looking at the latest CDC schedule, it should be clear that it is not a one-size fits all immunization schedule.
Looking at the latest CDC schedule, it should be clear that it is not a one-size fits all immunization schedule.

With so much flexibility and exemptions built into the immunization schedule though, it is wrong to call it one-size-fits-all.

One-Size-Fits-All Immunization Schedule?

For example, infants and toddlers can get their:

  • third dose of IPV and hepatitis B vaccines any time between 6 and 18 months
  • first dose of MMR and the chicken pox vaccines any time between 12 and 15 months
  • fourth dose of DTaP any time between 15 and 18 months
  • first dose of the hepatitis A vaccine any time between 12 and 23 months, getting the second dose six months after the first
  • get their “four year boosters” any time between four and six years of age
  • an early MMR, once they are six months old, if they will be traveling out of the United States

Jenny McCarthy who was one of the first to champion the one-size-fits-all argument against vaccines once said that:

“Should a child with the flu receive six vaccines in one doctor visit? Should a child with a compromised immune system be treated the same way as a robust, healthy child?”

It is easy to see that they don’t have to with our current immunization schedule. Your child’s pediatrician has the flexibility to temporarily delay one or more vaccines if your child has any precautions at the time of the visit, such as  a “moderate or severe acute illness with or without fever.”

There are also medical contraindications that keep some children from getting one or more vaccines on the immunization schedule. For example, children with severe combined immunodeficiency (SCID) should not get live vaccines. They are not treated the same way as children who do not have immune system problems.

This is reaffirmed by the American Academy of Pediatrics:

“The schedule is not “one size fits all.”

It is considered the ideal schedule for healthy children, but it has flexibility built in. There are established medical reasons why some children should not receive certain vaccines; for example, allergies to one or more ingredients in the vaccine, or a weakened immune system due to illness, a chronic condition, or another medical treatment. Sometimes a shot needs to be delayed for a short time, and sometimes it may need to be skipped altogether .

Your pediatrician is educated and updated about such exceptions to the immunization schedule. This is one reason your child’s complete medical history is taken at the pediatrician’s office, and why it is important for your child’s health care providers to be familiar with your child’s medical history.”

Delaying or skipping one or more vaccines to create a customized alternative vaccine schedule for your child, a non-standard, parent-selected, delayed protection vaccine schedule, isn’t safer than the CDC immunization schedule.

It simply puts your child at greater risk for vaccine-preventable diseases.

More on the One-Size-Fits-All Immunization Schedule