Vaccination Schedule at Four Months of Age

Core Vaccine Series at 4 Months

The American Academy of Pediatrics recommends that infants receive the second doses of DTaP, IPV, Hib, pneumococcal conjugate vaccine (PCV), rotavirus vaccine, and potentially the second dose of hepatitis B vaccine at four months of age, with a minimum interval of 4 weeks after the first dose given at 2 months 1, 2
The Centers for Disease Control and Prevention recommends a 3-dose primary series of DTaP given at 2, 4, and 6 months 1, 2
The Advisory Committee on Immunization Practices recommends that all children receive IPV at 2, 4, 6-18 months, and 4-6 years as part of the all-IPV schedule 3, 1
The second dose of Hib conjugate vaccine should be given at 4 months, with a caveat that if PRP-OMP is used at 2 and 4 months, a dose at 6 months is not required 2, 1, 3
If other Hib conjugate types are used, three primary doses at 2, 4, and 6 months are needed, although this fact is from a less preferred source 4

The Centers for Disease Control and Prevention states that DTaP-IPV-Hib-HepB (hexavalent vaccine) is licensed for use at 2, 4, and 6 months and can simplify the immunization schedule by reducing the number of injections 1

The American Academy of Pediatrics advises against delaying vaccination if the original vaccine brand is unavailable, as different brands are interchangeable 4
The Centers for Disease Control and Prevention recommends ensuring proper minimum intervals, with the second dose given at least 4 weeks after the first dose 1, 4
The Centers for Disease Control and Prevention notes that higher rates of fever have been observed with hexavalent vaccines compared to pentavalent vaccines 1