Houston Cardiovascular Associates Houston Cardiovascular Associates

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Childhood Immunization Record

Overview

My child's name is __________________________. My child's birthday is _________________.

My child's doctor is __________________________. The doctor's phone number is _____________________.

Age

Immunization

Dose

Notes

Date given

Birth

Hepatitis B (HepB)

1 of 3


2 months

Diphtheria, tetanus, and pertussis (DTaP)

1 of 5

 

Haemophilus influenzae type b (Hib)

1 of 4

 

Hepatitis B (HepB)

2 of 3

Can be given from 1 to 2 months of age
 

Pneumococcal (PCV)

1 of 4

 

Polio (IPV)

1 of 4

 

Rotavirus

1 of 2 or 3


4 months

DTaP

2 of 5

 

Haemophilus influenzae type b (Hib)

2 of 4

 

Pneumococcal (PCV)

2 of 4

 

Polio (IPV)

2 of 4

 

Rotavirus

2 of 2 or 3


6 months

DTaP

3 of 5

 

Haemophilus influenzae type b (Hib)

3 of 4

 

Hepatitis B (HepB)

3 of 3

Can be given from 6 to 18 months of age
 

Pneumococcal (PCV)

3 of 4

 

Polio (IPV)

3 of 4

Can be given from 6 to 18 months of age
 

Rotavirus

3 of 3, if needed


6 months and older

Flu (influenza)

Yearly

One dose each year. Children younger than 9 years of age may need 2 doses depending on when they started getting this yearly immunization.

12 months

Chickenpox (varicella)

1 of 2

Can be given from 12 to 15 months of age
 

Haemophilus influenzae type b (Hib)

4 of 4

Can be given from 12 to 15 months of age
 

Hepatitis A (HepA)

1 of 2

Can be given from 12 to 23 months of age
 

Measles, mumps, rubella (MMR)

1 of 2

Can be given from 12 to 15 months of age
 

Pneumococcal (PCV)

4 of 4

Can be given from 12 to 15 months of age

15 months

DTaP

4 of 5

Can be given from 15 to 18 months of age

Can be given from 12 months of age, if at least 6 months after the 3rd dose

 

18 months

Hepatitis A (HepA)

2 of 2

Given at least 6 months after the 1st dose

 

4 years

Chickenpox (varicella)

2 of 2

Given at 4 to 6 years of age; can be given earlier, if at least 3 months after the 1st dose

 
 

DTaP

5 of 5

Can be given from 4 to 6 years of age

 
 

MMR

2 of 2

Can be given from 4 to 6 years of age

 
 

Polio (IPV)

4 of 4

Can be given from 4 to 6 years of age

 

9 years and older

Human papillomavirus (HPV)

1, 2, or 3

Given at 9 to 14 years of age. Two doses are given within 6 months. A three-dose series is given at 15 years or older.

 
 

Meningococcal

1 and 2

Preferred given at 11 or 12 years of age. A second dose given at age 16.

Teens ages 13 to 18 who haven't had the shot should get it as soon as possible.

 
 

Tetanus, diphtheria, pertussis (Tdap)

1 of 1

Given at 11 or 12 years of age.

Teens who haven't had the shot should get it as soon as possible.

 

Other shots

Depending on where you live and your child's health, your doctor may recommend other shots. Talk to your doctor about whether your child needs any of the following shots.

Age

Immunization

Notes

2 years and older

Hepatitis A (HepA)

Your child may need this shot if he or she has not already had the vaccination series and:

  • Hepatitis A is found in your area.
  • You and your child travel to countries with a high rate of hepatitis A. These include Mexico and countries in Central or South America, the Caribbean, Asia (except Japan), Africa, and eastern Europe.
  • Your child needs medicine to help the blood clot.

Others at risk for hepatitis A include people who use "street" drugs, men who have sex with men, and people who work with animals that have the disease or who work with the hepatitis A virus in a lab. If your child has contact with these groups of people, your child may also be at risk.

Two shots are given. The two shots must be at least 6 months apart.

2 years and older

Pneumococcal (PPSV)

Your child may need this pneumococcal shot when older than age 2 if he or she:

  • Has sickle cell disease.
  • Has a damaged spleen or has had the spleen removed.
  • Has a disease or condition that affects the immune system, such as diabetes or HIV.
  • Takes medicine that affects the immune system, such as chemotherapy or corticosteroids.
  • Has a long-lasting disease, such as heart disease, lung disease, kidney disease, or diabetes.

6 weeks to 10 years

Meningococcal

Your child may need at least 2 shots before age 11 if he or she:

  • Is in an area where an outbreak has occurred.
  • Has a damaged spleen or has had the spleen removed.
  • Has certain immune system problems.
  • Travels or lives in areas of the world where meningococcal disease is common, such as certain parts of Africa or Saudi Arabia during the Hajj.

Talk to your doctor about whether booster shots are needed.

Missed doses: If your child has missed any shots, talk to your doctor about the best way to make them up.

Travel: If you are traveling or if you live outside of the United States, your child may need other shots. Talk to your doctor several months before your trip.

Availability: Shots may sometimes not be available or may be in short supply. In this case, talk with your doctor about the best thing to do for your child.

Reactions: List any reactions your child has had to vaccines.

Print out a copy of your child's schedule and keep it up to date. It is very important to keep accurate records of your child's shots. When you enroll your child in day care or school, you may need to show proof of immunizations. Also, your child may need the record later in life for college, employment, or travel. Take the schedule with you when you visit your doctor. Your doctor may need to change the schedule based on your child's special needs. Keep the record in a safe place with other important documents, and never throw it away. It is an important part of your child's lifelong medical records.

Put notes on your calendar to remind you when a shot is coming up. You also may want to ask your doctor to send you notices when shots are due.

This information is based on the immunization schedule recommended by the Advisory Committee on Immunization Practices (ACIP) and other medical organizations. It is based on your child's birth date. The schedule is available from the U.S. Centers for Disease Control and Prevention website at www.cdc.gov/vaccines/schedules/index.html.

Some diseases or treatments for disease affect the immune system. For children with these diseases or children receiving these treatments, the schedule may need to be modified. Your child's health, environment, and lifestyle may also affect the shot schedule. Always talk to your doctor about the best schedule for your child.

Credits

Current as of: April 30, 2024

Author: Ignite Healthwise, LLC Staff
Clinical Review Board
All Healthwise education is reviewed by a team that includes physicians, nurses, advanced practitioners, registered dieticians, and other healthcare professionals.

Current as of: April 30, 2024

Author: Ignite Healthwise, LLC Staff

Clinical Review Board
All Healthwise education is reviewed by a team that includes physicians, nurses, advanced practitioners, registered dieticians, and other healthcare professionals.

Dear patient

I am excited to announce that I will be relocating my practice to Houston Methodist DeBakey Cardiology Associates. Starting November 4, 2024, my new address will be:

Houston Methodist DeBakey Cardiology Associates
6550 Fannin St.
Smith Tower, Suite 1901
Houston, TX 77030

Please note that my phone number and fax number will also change to the following:
24-Hour Telephone: 713-441-1100
Fax: 713-790-2643
Clinical Support Telephone (M-F, 8-5): 713-441-3515

I am excited about caring for you in my new office and hope you will make the transition with me. I will also continue to refill your medications as I have in the past. To assist, please provide your pharmacy with my new contact information.

Please consider checking your prescription refills to verify that you have enough medication on hand to last you until your next visit. Please note that your medical records will remain at my former office until you authorize their transfer. If you choose for me to continue providing your medical care, please complete and sign the enclosed “Authorization for Release of Medical Records” form and fax it to 713-790-2643. Once we receive your authorization, we will be happy to process the request for you.

Thank you for entrusting me with your medical care. My new team and I are dedicated to making this transition as seamless as possible. For help scheduling an appointment and transitioning your care, please call my new office number above.

I look forward to continuing your care at my new location.

Sincerely,
Gopi A. Shah, MD

Dear patient

Dr. Albert Raizner, Dr. Michael Raizner, and Dr. Mohamed El-Beheary are excited to announce that our practice, Houston Cardiovascular Associates, will merge with Houston Cardiovascular Associates on November 1, 2024.

Our new offices are similarly located in Houston, near the Texas Medical Center and in Sugar Land. Our in-hospital care will continue at Houston Methodist Hospital in the Texas Medical Center and Houston Methodist Sugar Land Hospital. Importantly, our new offices expand our services with state-of-the-art equipment and amenities. Our core values will always be, as they began over 40 years ago when Dr. Albert Raizner founded HCA:

Integrity – Compassion – Accountability

Our new address and contact information are:

Your medical records are confidential and remain available at our new locations. We consider it a privilege to serve as your cardiologists and look forward to your continuing with us. However, should you desire to transfer to another physician, you may request a copy of your records by contacting us at our new addresses and phone numbers listed above.

We thank you for your trust and loyalty. As always, we will continue to be here to take care of you. Please do not hesitate to contact us if you have any questions or concerns.

Sincerely,

Dr. Albert Raizner,
Dr. Michael Raizner,
Dr. Mohamed El-Beheary