APPENDIX X
IMMUNIZATION AND
ROUTINE EXAMINATION SCHEDULES
Preventive health examinations and immuniza-
tions are crucial for optimal health and disease
resistance across the spectrum of life. Recom-
mended schedules, examination procedures, and
immunizations change as knowledge grows and
new developments become available. The infor-
mation in this appendix represents a composite of
common recommendations current at the time of
publication. Recommendations may differ accord-
ing to age and between men and women.
Preventive Health Care for Infants and ChildrenMost health experts recommend well child exami-
nations for basic preventive health care on a
schedule frequent enough for early detection of
physical or mental developmental delays and
concerns. Well child exams should include age-
appropriate general health measures such as
- length/height
- weight
- head circumference (infants)
- reflexes
- vital signs (heart rate, breathing rate, blood
pressure, body temperature) - basic vision and hearing screening
- scoliosis detection
- coordination, balance, and gait
- nutritional status
- appropriate immunizations
WELL CHILD EXAMINATION
SCHEDULE RECOMMENDATIONS BY AGE
Infancy
2 to 4 days after birth 10 days after birthEarly Childhood
2 months 4 months
6 months 9 months
12 months 15 months
18 months 24 monthsMiddle Childhood
3 years 4 years
5 years 6 years
8 years 10 yearsAdolescence
12 years 14 years
16 years 18 yearsImmunizations and immunization schedules
change as new vaccines become available. The
American Academy of Pediatrics (AAP) establishes
and updates recommendations. The most current
immunizations and their schedules are available
on the AAP’s Web site (www.aap.org) as well as
through public health departments and public and
private health organizations.
Immunization schedules for children vary
according to the age at which the child receives
the first dose of a multidose vaccination series. For
some immunizations there is a window of oppor-
tune timing. The pediatrician adjusts each child’s
schedule for appropriate timing of doses, includ-
ing “catch-up” scheduling for children who begin422