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Get MN Child Care Immunization Record 2007-2024

D a combined shot (like Hib-hep B), write the date in all the boxes that apply. Diphtheria, Tetanus, Pertussis (DTP) • 3 doses during 1st year (at 2-month intervals) • 4th dose at 12-18 months • 5th dose at 4-6 years or at school entrance Indicate vaccine type: DTaP or DT. Vaccine Polio (IPV and/or OPV) • 3 doses at 2-18 months • 4th dose at 4-6 years or at school entrance Vaccine Haemophilus influenzae type b (Hib) • 3-4 doses for children at 2-15 months • 1 dose ≥12 months.

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