Healthy living means playing an active role in managing your own health and taking advantage of the preventive care available through your health insurance plan and primary care physicians.

The information provided here is intended as a guideline for basic preventive health screenings, check-ups, and immunizations. These guidelines are based on recommendations published by the US Preventive Services Task Force, American Academy of Pediatrics, and government statutes.

The single most important step you can take to protect your child from serious childhood illnesses is timely immunization. It’s a process that involves several steps. The chart below outlines standard preventive screenings, immunizations, and parent education tips.

You can use this guide to plan your child’s immunizations. If your child has missed any of the recommended vaccinations, consult your pediatrian for advice. It is also important to remember that the following chart is a recommended plan only. Each child is unique and may require a different immunization schedule or more frequent primary care visits. If you have any questions or concerns, please consult your physician.

Birth to age 2
Ages 2 to 6
Ages 7  to 12
Ages 13 to 18 

Children birth to age two

Regular visits — at birth, two weeks, and two, four, six, nine, 12, 15, and 18 months

Screenings

• Erythrocyte protoporphyrin (lead poisoning) at nine to 12 months
• Head circumference
• Height and weight
• Hematocrit and hemoglobin once during infancy, one to nine months, and usually at nine months
• Infant metabolic screening (T4, TSH, phenylalanine blood tests), phenylketonuria (PKU) at three to six days old
• Visual and hearing evaluation at six months (subjective)

Immunizations

• DTP (diphtheria, tetanus [lockjaw], pertussis [whooping cough]) at two, four, and six months, and 15 to 18 months
• HBV (Hepatitis B vaccine) at birth, one to two months, and six to 18 months
• Hib (Haemophilus influenza type B) at two, four, and six months, and 12 to 18 months
• MMR (measles, mumps, rubella) at 12 to 15 months
• OPV (oral polio vaccine) at two, four, and 12 to 18 months
• Varicella zoster vaccine at 12 to 18 months

Parent education/responsibility

• Development
• Nutrition — breastfeeding, iron-rich foods
• Injury prevention — child safety seats, smoke detectors, poison control telephone number
• Discipline, behavior
• Sleep habits
• Effects of passive smoke
• Dental health — baby bottle tooth decay
• Safe sun exposure

Children ages two to six

Annual physicals

• Additional visits at your physician’s discretion

Screenings

• Eye examination for amblyopia strabismus from three to five years of age
• Visual and hearing evaluation from four to six years of age (objective)
• Height, weight, and blood pressure
• Urinalysis from five years of age

Immunizations

• DTaP or DTP (diphtheria, tetanus [lockjaw], pertussis [whooping cough]) once from four to six years of age
• MMR (measles, mumps, rubella) from four to six years of age
• OPV (oral polio vaccine) once from four to six years of age

Parent education/responsibility

• Dental health
• Diet and exercise
• Injury prevention — seat belts, bicycle safety helmets, storage of toxic chemicals and matches, poison control phone numbers, smoke detectors
• Development, discipline, behavior
• Safe sun exposure

Children ages seven to 12

Annual physicals

• Additional visits at your physician’s discretion

Screenings

• Height, weight, and blood pressure
• Urinalysis from 11 to 21 years of age

Immunizations (make-up)

• Hepatitis B vaccine from 11 to 12 years of age
• Second MMR (measles, mumps, rubella) from 11 to 12 years of age
(acceptable alternative for second dose if not given at age four to six)
• TD (tetanus-diphtheria booster) from 11 to 16 years of age and once every 10 years thereafter

Parent/patient education/responsibility

• Bicycle safety helmets, seat belts, and smoke detectors
• Dental health, good health habits
• Diet and exercise
• Injury prevention — storage of firearms
• Prevention of tobacco, alcohol, and drug use
• Discipline, behavior
• Safe sun exposure

Children ages 13 to 18

Annual physicals

• Or at your physician’s discretion

Screenings

• Medical history
• Sexual practices
• Physical activity
• Tobacco, alcohol, and drug use

Physical examination

• Height, weight, and blood pressure
• Urinalysis once every year from 11 to 21 years of age

Parent/patient education/responsibility

• Dental health
• Injury prevention
• Diet and exercise
• Social history
• Seat belts
• Sexual practices
• Prevention and cessation of tobacco, alcohol, and drug use
• Safe sun exposure

Laboratory/diagnostic procedures

• Pap smear for sexually active females (or for females on oral contraceptives for non-contraceptive indications)

Immunizations

• TD (tetanus-diphtheria booster) from 11 to 16 years of age and once every 10 years thereafter