At the 15-month wellness visit, your toddler may receive up to five vaccines: DTaP (diphtheria, tetanus, and whooping cough), Hib (a type of bacterial meningitis), a pneumococcal vaccine, MMR (measles, mumps, and rubella), and varicella (chickenpox). Some of these are booster doses your child has had before, while others are brand new. The exact number of shots depends on which vaccines were already given at earlier visits and whether your provider uses combination vaccines.
The Five Vaccines on the Schedule
The CDC’s current immunization schedule lists these vaccines for the 15-month visit:
- DTaP, 4th dose: This protects against diphtheria, tetanus, and whooping cough. Your child likely received the first three doses at 2, 4, and 6 months. The fourth dose must be given at least six months after the third and is typically scheduled at 15 months or later.
- Hib, 3rd or 4th dose: This protects against a bacteria that can cause meningitis and pneumonia in young children. Whether your child needs a third or fourth dose depends on the brand used earlier. Some brands require three primary doses (at 2, 4, and 6 months) plus a booster, while others need only two primary doses (at 2 and 4 months) plus a booster.
- Pneumococcal conjugate, 4th dose: This vaccine (PCV15 or PCV20) guards against bacteria that cause ear infections, pneumonia, and meningitis. The booster is recommended between 12 and 15 months.
- MMR, 1st dose: This is the first time your child receives protection against measles, mumps, and rubella. The recommended window is 12 through 15 months.
- Varicella, 1st dose: The chickenpox vaccine is also new at this age, with the same 12-to-15-month window as MMR.
If your child already received MMR and varicella at 12 months, they won’t need those again at 15 months. In that case, the visit may involve only two or three shots instead of four or five.
Hepatitis A May Also Be Due
The hepatitis A vaccine is a two-dose series, and the first dose is typically given at 12 months. If your child got it then, the second dose won’t be due until at least six months later, so it usually falls closer to 18 months. But if the first dose was delayed, your provider might add it to the 15-month visit. That’s one more potential shot to be aware of.
Catching Up on Missed Doses
If your toddler missed earlier doses of hepatitis B or polio (IPV), the 15-month visit is a good time to catch up. A vaccine series never needs to be restarted no matter how much time has passed between doses, so your provider will simply pick up where you left off. Polio doses need at least four weeks between them, and the final hepatitis B dose can’t be given before 24 weeks of age. Your pediatrician’s office will review your child’s records and let you know if any catch-up shots are needed.
The MMRV Combination Option
Some providers offer MMRV, a single shot that combines measles, mumps, rubella, and chickenpox into one injection instead of two. The obvious advantage is one fewer needle stick. However, the combination vaccine carries a slightly higher risk of febrile seizures (seizures triggered by fever) after the first dose: roughly 1 in every 1,500 to 2,000 children, compared to a lower rate when MMR and varicella are given as separate shots at the same visit. About 85% of U.S. parents already opt for the separate shots for the first dose. The seizure risk after the second dose, given between ages 4 and 6, is almost nonexistent.
If you have a preference, let your pediatrician know before the visit. Either approach provides the same protection.
Common Side Effects to Expect
With multiple vaccines given at once, it’s normal for your toddler to be fussy for a day or two. The most common reactions across all the 15-month shots are soreness, redness, or swelling at the injection site, along with a mild fever, irritability, tiredness, and reduced appetite. These typically resolve on their own within 48 hours.
The MMR and varicella vaccines can cause a mild rash one to two weeks after the shot. This is a sign the immune system is responding and isn’t cause for concern in most cases. However, if your child develops a rash after the varicella vaccine, keep them away from newborns and anyone with a weakened immune system until it clears, since the vaccine virus can occasionally spread through the rash.
Temporary swelling of the glands in the cheeks or neck and brief joint stiffness are less common but possible after MMR.
How to Comfort Your Toddler
A few simple strategies make the visit easier for both of you. Dress your child in loose clothing with easy access to the thighs and upper arms, since that’s where the shots go. Bring a favorite toy, book, or blanket, something familiar that smells like home can be genuinely soothing.
During the shots, hold your toddler on your lap rather than laying them on the exam table. The American Academy of Pediatrics recommends a few positions that keep your child secure while you provide comfort:
- Back to chest: Your child sits on your lap facing outward while you wrap your arms over theirs in a hug-like hold. Tuck their feet between your thighs to keep their legs still.
- Chest to chest: Your child faces you on your lap with their legs wrapped around your waist. Their arms go under or over yours.
- Sideways lap sit: Your child sits sideways on your lap while you secure one arm and anchor their legs with your own.
Distraction works surprisingly well at this age. Reading a story, playing a short video on your phone, or handing over a new small toy right as the needle goes in can redirect their attention. After the visit, a clean, cool, wet washcloth on any red or swollen injection sites provides relief. If your child seems to be in pain or develops a fever, you can give the recommended dose of acetaminophen or ibuprofen. Avoid aspirin.
How Many Shots Total
The maximum number of injections at a single 15-month visit is typically four or five, depending on whether MMR and varicella are given separately or combined as MMRV, and whether hepatitis A is also due. If your child already received MMR, varicella, and the Hib booster at 12 months, the 15-month visit could be as few as two shots (DTaP and pneumococcal). Your pediatrician’s office can tell you exactly what’s needed when you schedule the appointment, so you know what to expect walking in.