Make Sure Your Children are Properly Immunized

Vaccines are necessary from infancy through college years

A friendly Scripps Health doctor engages with a small child and her mother in a clinical setting.

by Siva Ganesh, Board-Certified Pediatrician

With the new school year upon us, now is the time for parents to make sure their children are fully immunized. While many of these immunizations are required by the state and school, some are not.

However, all parents are strongly encouraged to protect their children, from infancy to college age, from preventable illnesses.

California vaccination requirements

In California, children are required to be immunized against the following infectious diseases: polio vaccine, measles, mumps, rubella, diphtheria, tetanus, pertussis (whooping cough), chickenpox vaccine, hepatitis B, and H. influenza Type B.

Complications from these diseases can be devastating to both children and their families. Most schools require immunizations before the child can enter the classroom. Kindergartners are required to have a total of five DTaP (diphtheria, tetanus, pertussis), four polio shots, three hepatitis B, two MMR (measles, mumps, rubella) and one varicella (chickenpox) immunization.

Children entering seventh grade must have the hepatitis B series completed and MMR and tetanus booster along with their primary immunizations (in the event they didn’t get it.)

However, immunizations should start long before kindergarten. Children in childcare must receive their immunizations at 2, 4, 6, 12 and 15 months.


  • DTaP (formerly DTP) immunizes against tetanus, diphtheria and whooping cough and should be given at ages 2 months, 4 months, 6 months and 12 to 15 months. Kindergartners are expected to have a minimum of four shots. A booster is then needed between ages 4 and 7; however, most California schools recommend the fifth shot is given before entering school. A booster is given every 7 to 10 years until adulthood.
  • Polio, the IPV vaccine, follows the same primary schedule as DTaP, with a booster at 4 to 7 years old.
  • H. influenza Type B is similarly recommended at 2, 4, 6 and 15 months.
  • Prevnar, which prevents pneumonia and other illnesses caused by the pneumococcal bacteria, should be given at 2, 4 and 6 months and again at 12 to 15 months.


  • MMR immunizes against measles, mumps, and rubella. The first dose should be given after the first birthday, with a second shot at school entry (age 4 or 5).
  • Varicella vaccinates against chickenpox. Like MMR, this is a live virus and must be given after the child’s first birthday. This vaccine is relatively new and there may be children at the middle school level who have not had it. A child age 12 or older who has not had the vaccine or chickenpox, will need two doses to be fully immunized.
  • Hepatitis A vaccine is recommended for toddlers age 2 and older. This is an especially important vaccine for San Diegans because of our proximity to the U.S. – Mexico border. Hepatitis A is transmitted through contaminated water and is often recommended for international travelers. This vaccine requires two doses. The second dose is given six months after the first.
  • Hepatitis B requires three shots; the second shot is given 1-2 months after the first, and the final shot is given 4 to 5 months later. Once all three boosters are given, it has a strong immunity. Because this is another relatively new vaccine, anyone born before 1990 may not have had it and should ask their doctor.

Middle school

  • This is the time for the TD (tetanus and diphtheria) and MMR booster (age 11 to 12).
  • If your child has not had the chickenpox vaccine or contracted chickenpox, this is the time to have the vaccine. Children over age 12 need two doses to be fully immunized.
  • Hepatitis B, if not already received, should be given now.

College entry

  • Many colleges and universities are requiring incoming freshman to have the meningococcal vaccine in order to prevent the spread of an aggressive bacterium that can lead to limb loss and even death. College students, especially those planning to live in dorms, are at an increased risk and should be vaccinated. Some schools offer the vaccine through the college health service.

Immunizations for healthy children, healthy communities

It’s very important that we immunize our children to maintain a healthy community for everyone. We are all living longer, healthier lives because of these very important shots. However, all live vaccines such as MMR and chickenpox must be used with caution if the child or someone in the child’s home has a compromised immune system. Please consult with your doctor if this is the case.

There is no reason not to make sure your children are immunized — all vaccines are safe. Most health plans cover immunizations and if cost is a concern there are federal programs to assist you. Ask your physician’s office about payment options.

Parents should also keep their children’s yellow immunization folders recording all of their vaccination records in a safe place. This record should be brought to the physician’s office each time the child is receiving an immunization.

For more information on school immunization laws and vaccine-preventable diseases, contact your physician, school nurse or the County of San Diego’s Immunization Program.

This Scripps Health and Wellness tip was provided by Siva Ganesh, MD, a board-certified pediatrician with Scripps Mercy Medical Group, which was rated the top medical group in San Diego County in 2002 by the California Cooperative Healthcare Reporting Initiative.