Routine Well-Child Visits and Child Immunization Schedule by Age: What Parents Need to Know
A pediatrician shares an easy guide to the annual checkups, screenings, and vaccines children need at every stage.
From newborns to teenagers, regular doctor visits are part of growing up. But it’s difficult to keep track of which checkups are needed and when.
So, to better understand the doctor visits, screenings, and vaccines children and adolescents need to stay healthy, Health Matters spoke with Dr. Melissa Stockwell, Chief of the Division of Child and Adolescent Health at NewYork-Presbyterian Morgan Stanley Children’s Hospital of Children’s Hospital of New York and medical director of the NewYork-Presbyterian Immunization Registry (EzVac).
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Health Checklist for Toddlers (1 - 3 Years Old)
Well checkups: The frequency of pediatrician visits varies with age. Between the ages of 12 and 18 months, children should have a well visit with their pediatrician every 3 months. For ages 18 months to 3 years, it’s every 6 months.
Vaccinations: Every child should receive routine vaccinations throughout childhood. Dr. Stockwell recommends following the American Academy of Pediatrics (AAP) vaccine schedule as closely as possible to prevent children and adolescents against diseases. If you have questions about your child’s immunization schedule, consult with their doctor and use them as your trusted source.
- Measles, mumps, rubella (MMR) and varicella: To safeguard against measles, mumps, and rubella, the AAP recommends a dose of MMR vaccine between the ages of 12 to 15 months, and another dose between 4 and 6 years of age. The same timeline applies for vaccinating children against varicella (chickenpox).
- Hepatitis A: To protect against hepatitis A (a series virus that can damage the liver), it’s recommended that children receive two doses of the hepatitis A vaccine between the ages of 12 and 23 months, separated by 6 months.
- Sequential doses: Remember that in this age range, kids will also be receiving booster doses of vaccines that were administered before the age of 1. For example, subsequent doses of vaccines for DTaP (diphtheria, tetanus, and pertussis, otherwise known as whooping cough); HiB (haemophilus influenzae type b, a bacteria that can cause pneumonia, blood infections, and meningitis); and pneumococcal (a bacteria that can cause ear infections, pneumonia, blood infections and meningitis) would be administered during this time.
“It’s important kids are up-to-date not only on their routine vaccinations, but also their flu and COVID vaccines,” says Dr. Stockwell, who is also a professor of pediatrics at Columbia University Vagelos College of Physicians and Surgeons. “Every child should have their annual flu shot, especially during back-to-school season, and remain up to date on the COVID vaccine, which is now available for children 6 months and older.”
Dental checkups: For young children, their first visit to the dentist usually occurs when they turn 1 year old. “After that first visit, the cadence of checkups can be determined by your dentist,” says Dr. Stockwell.
Vision and hearing screening: Beginning at age 3, annual vision and hearing screenings can help keep eyes healthy and identify vision and hearing problems early. These may be done at a child’s pediatrician visits. Many school health clinics also offer these screenings.
Health Checklist for Preschool and Elementary School Children (4 - 10 Years Old)
Well checkups: Visit the pediatrician once a year. The checkups are also an opportunity to talk about bedtime routines, nutrition and exercise, and screen time.
Vaccinations:
- HPV vaccine: As per the AAP, it is recommended children start the human papillomavirus (HPV) vaccine series between ages 9 and 12, before they are ever exposed to HPV. The HPV vaccine protects against certain cancers later in life, such as cervical cancer. “Younger kids have a more robust immune response and generate higher levels of antibodies to protect them from the virus,” says Dr. Stockwell.
The AAP also recommends that children receive a booster shot of these vaccines between the ages of 4 to 6.
- DTaP: Protects against diphtheria, tetanus, and pertussis (whooping cough)
- Polio: Protects against polio
- MMR: Protects against measles, mumps, and rubella
- Varicella: Protects against chickenpox
- Annual flu vaccine
- COVID: Complete the primary series and stay up to date on booster doses, as applicable for your child’s age.
Keep in mind, kids with chronic health conditions may need more or fewer vaccines. “Parents should talk with their pediatrician about which vaccines they need to stay protected,” shares Dr. Stockwell.
Dental checkups: Visit the dentist once a year.
Anxiety screening: Due to an uptick in anxiety in children in the United States, the recommendation is for children to be screened for anxiety beginning at age 8. This screening can take place during pediatrician visits.
“Anxiety is very most common in kids,” says Dr. Stockwell. “While back-to-school jitters are completely normal, if there is something more serious going on that is interfering with your child’s daily activities, it’s helpful to pick it up early including through screening so that it can be supported and treated early if needed.”
Health Checklist for Middle School and High School Adolescents (11 – 18 Years Old)
Well checkups: Visit your child’s primary care physician once a year. For adolescents ages 12 and above, the AAP recommends a screening for depression and substance use. “The teenage [years are] a crucial time in brain development, and substance abuse can really impair that process,” says Dr. Stockwell. “Having open, honest communication can help kids stay not only healthy but safe.”
Sexual health screening: If a young person is sexually active, they should use contraception and get regular sexual health screenings when they can get tested for sexually transmitted infections.
Vaccinations: In this age range, you can expect to introduce new protections, as well as boosters to uphold protections from previously received vaccinations.
- HPV: If your child hasn’t already been vaccinated for human papillomavirus (HPV) vaccine, now is the time. “If a child starts the HPV series before age 15, they only need two doses,” says Dr. Stockwell. “If you start after 15, they need three. Starting them according to the vaccine schedule saves them a vaccine dose."
- Meningococcal: This vaccine, which protects against meningitis, is recommended for when your child is 11. A booster is recommended at age 16.
Routine boosters: Adolescents still need vaccine boosters every few years. These will be given at their doctor visits, or sometimes at school. These vaccinations can include:
- DTaP (every 10 years)
- Annual flu vaccine
- COVID: Consult with your pediatrician as to if and when boosters may be needed.
OB-GYN visits: A visit to the obstetrician-gynecologist is optional. According to Dr. Stockwell, Pap smears and pelvic exams for girls are not routinely needed until age 21. However, some teens might want to establish a routine gynecologist visit starting around ages 13 to 17. During these visits, families and patients can receive general information on how to stay healthy, along with contraceptive counseling.
Children’s Hospital of New York at NewYork-Presbyterian
The Children’s Hospital of New York at NewYork-Presbyterian provides pediatric care in every area of medicine at two major sites: NewYork-Presbyterian Morgan Stanley Children’s Hospital and NewYork-Presbyterian Komansky Children’s Hospital. The team of pediatricians and pediatric specialists covers all major pediatric subspecialties, including pediatric cardiology, pediatric neurology, and pediatric oncology. Using the latest innovations in medicine and surgery to diagnose even the rarest and most complex disorders, the physicians at the Children’s Hospital of New York at NewYork-Presbyterian treat the whole child — mind and body — with a focus on overall health and wellness.
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