all information and pictures on this web page are from the Immunization Action Coalition,
Hepatitis B (HepB)
0–2 months, 1st dose; 1 – 4 months, 2nd dose, 6 – 18 months, 3rd dose.
Hepatitis B is an disease of the liver, causing it to swell and stop working effectively. It is caused by a virus which is passed through contact with an
infected person’s blood, semen, or other bodily fluid.
Symptoms of Hepatitis B are lethargy, nausea, fever, loss of appetite, diarrhea, dark yellow urine,  stomach pain, light-colored stools, yellowish skin
and eyes. Hepatitis B can be treated with drugs (Interferon, Lamivudine, and Adefovir Dipivoxil) or surgery.

Hepatitis A
2 doses, 12 – 23 months for first, and no sooner than 6 months later for second
Hepatitis A is caused by a virus, causing the liver to swell and stop working effectively.
Symptoms of Hepatitis A are lethargy, nausea, fever, loss of appetite, diarrhea, dark yellow urine, stomach
pain, light-colored stools, yellowish skin and eyes.   

Diphtheria, Tetanus, Pertussis (DtaP)
2 months, 4 months, 6 months, 15 – 18 months, 4–6 years
Diphtheria is a bacterial disease that is spread through respiratory droplets (coughing, sneezing).
Symptoms are fever, sore throat, and a thick coating on the back of the tongue which may make it hard
to breathe or swallow. Sometimes it can also affect the larynx, eyes, vagina, skin, and nose. Untreated diphtheria
can cause heart problems, paralysis, and even death.
Tetanus is a bacterial disease that is spread through punctures and contamination with the bacteria. It is
not spread from person to person.
Symptoms include tightness of the jaw muscle, painful neck, difficulty swallowing, painful abdomen, fever,
sweat, and elevated blood pressure. Tetanus can lead to seizures and death.
Pertussis is a bacterial disease that is spread through infectious droplets and it is highly contagious. The
three stages: 1) runny nose, sneezing, mild cough, low grade fever; 2) characterized by a burst or paroxysm
of numerous rapid coughs. It is followed by a long inhaling effort characterized by a high-pitched whoop
(whooping cough); 3) convalescing which may last for months.

Haemophilus influenzae type b (Hib)
2 months, 4 months, 6 months, 12 – 15 months
Haemophilus influenzae type b is a bacterial disease spread by respiratory droplets, but it is not highly contagious. The most common type of Hib is
meningitis, an inflammation of the meninges (covering of the brain).
Symptoms are fever, stiff neck, and decreased mental status. The disease can lead to death or permanent neurological damage such as deafness,
blindness, or intellectual disability.

Rotavirus vaccine (Rota)
2 months, 4 months, 6 months
Rotavirus is a virus that causes severe diarrhea, mostly in babies and young children. It is often accompanied by vomiting and fever.
Rotavirus is not the only cause of severe diarrhea, but it is one of the most serious. Each year in the United States rotavirus is responsible for:
~more than 400,000 doctor visits;
~more than 200,000 emergency room visits;
~55,000 to 70,000 hospitalizations;
~20 to 60 deaths
Rotavirus vaccine is an oral vaccine. It will not prevent diarrhea or vomiting caused by other illnesses.
About 98% of children who get the vaccine are protected from severe rotavirus diarrhea, and about 74%
do not get rotavirus diarrhea at all.

Inactivated Poliovirus (IPV)
2 months, 4 months, 16 – 18 months, 4 – 6 years
Polio is usually spread via the fecal-oral route, but may be spread through the oral-oral route. It is
caused by a virus. Surprisingly, 95% of people who are infected with polio never show any symptoms.
Another 4% to 8% have regular symptoms of a viral infection – fever, sore throat, nausea, vomiting. Another
1% to 2% develop nonparalytic aseptic meningitis with temporary stiffness of the neck, legs, and/or back.
Less than 2% show the classic “flaccid paralysis”, which leaves the patient with permanent weakness, or paralysis of the legs, arms, or both. Severe
polio can be fatal.

Measles, Mumps, Rubella (MMR)
12 – 18 months, 4 – 6 years
Measles is caused by a virus, and are spread by infectious droplets and is very contagious. Symptoms are fever, runny nose, cough, lack of appetite,
“pink eye” and a rash. Complications from measles can be diarrhea, ear infections, pneumonia, and encephalitis, which can be fatal or cause
permanent brain damage.
Mumps is a viral infection, spread through the air. It is less infectious than measles or chicken pox. Symptoms include fever, headache, loss of
appetite, and a swelling of the salivary glands, or “parotitis.” Mumps is a generally mild illness for small children, but adults have more serious
complications. Complications from mumps include meningitis, testicular inflammation, sterility, and deafness.
Rubella is a viral infection, spread through the air. It is less infectious than measles or chicken pox. The first symptom is a rash, and it is a mild illness
in children, but adults may have more serious complications, particularly pregnant women. If a pregnant woman is infected with rubella in the first
trimester, her baby may experience fetal death, premature delivery, or serious birth defects. Congenital Rubella Syndrome can cause deafness, eye
defects, heart defects, intellectual disability, etc. for a developing fetus.

~ one year (between 12 and 18 months), 4 - 6 years
Chicken pox (varicella) is a viral infection, caused by the varicella zoster virus. It is spread through direct contact or through airborne droplets
(coughing, sneezing). It is highly contagious. Symptoms are rash, coughing, fever, fussiness, headache, and loss of appetite. Complications are
pneumonia, infection of the brain, bacterial infection of the skin or other parts of the body, and has been known to be fatal.

Meningococcal (MPSV4)
11 – 12 years, booster 16 -- 18 tears
Meningococcal disease is caused by a bacterium. There are 5 subtypes, A, B, C, Y, and W135. It is spread person to person through exchange of
respiratory and throat secretions through kissing, coughing, or sharing eating utensils. It can cause extreme illness with septicemia (blood infection) or
meningitis (infection of the meninges). This disease progresses very quickly, and symptoms include high fever, chills, lethargy, rash, headache, neck
stiffness, seizures. Shock, coma, and even death can occur in extreme cases. 10% to 15% of people who recover from bacterial meningitis suffer
permanent hearing loss, limb loss, brain damage, or other serious after-effects.

Pneumococcal (PCV)
2 months, 4 months, 6 months, 12 – 15 months
Pneumococcal disease is caused by the streptococcus pneumoniae, a bacterium. It is spread by droplets in the air. It can cause pneumonia,
meningitis, and bacteremia.
Pneumonia (lungs) is presented with fever, shaking chills or rigors, chest pain, cough, shortness of breath, rapid
breathing, rapid heart rate, and weakness. Fatality rate is 5% to 7%.
Bacteremia is infection of the blood. The symptoms of meningitis (bacterial) are headache, tiredness, vomiting, irritability, fever, seizures, and
coma. Fatality rate is high (30% in children). Pneumococci are a common cause of otitis media.

yearly after age 1
Influenza is characterized by the abrupt onset of fever, aching muscles, sore throat, non-productive cough, runny nose, headache, burning sensation
in the chest, eye pain, and sensitivity to light.

Genital HPV infection
11 -- 12 years, 3 dose series
Genital HPV is a sexually transmitted disease (STD) that is caused by human papillomavirus (HPV). Human papillomavirus is the name of a group
of viruses that includes more than 100 different strains or types. More than 30 of these viruses are sexually transmitted, and they can infect the genital
area of men and women including the skin of the penis, vulva (area outside the vagina), or anus, and the linings of the vagina, cervix, or rectum. Most
people who become infected with HPV will not have any symptoms and will clear the infection on their own. Some of these viruses are called "high-
risk" types, and may cause abnormal Pap tests. They may also lead to cancer of the cervix, vulva, vagina, anus, or penis. Others are called "low-risk"
types, and they may cause mild Pap test abnormalities or genital warts. Genital warts are single or multiple growths or bumps that appear in the genital
area, and sometimes are cauliflower shaped. Approximately 20 million people are currently infected with HPV. At least 50 percent of sexually active
men and women acquire genital HPV infection at some point in their lives. By age 50, at least 80 percent of women will have acquired genital HPV
infection. About 6.2 million Americans get a new genital HPV infection each year.
Hospital respiratory  ward in Los Angeles, 1952.
Polio patients were placed in "iron lungs" to help
them to breathe.
The American Academy of
Pediatrics has a great
website with a ton of
information about
A normal liver, above.
liver damaged by Hepatitis B. below.