Vaccination is a powerful and dynamic weapon in reducing the impact of infectious diseases in children. The field and schedules are constantly evolving, with significant changes resulting in new and exciting vaccines almost yearly. Special cases in pediatrics represent unique challenges and differences in vaccinations. Health care providers need to be knowledgable about the current vaccines and to remain up to date with the constant evolution, as well as be aware of the latest recommendations, warnings, and news about vaccines and their use. This article updates and discusses current but ever-changing routine pediatric vaccination programs.