RALEIGH, N.C. — The Institute of Medicine reports that getting up to 20 vaccinations by age two does not increase a child's risk of developing diabetes or various infections. In fact, experts said that those shots are more important than ever.

The first round of immunizations starts before a newborn leaves the hospital and continues at Well Baby checkups.

The recommended vaccination schedule includes immunizations for hepatitis, polio, measles, mumps, rubella, diphtheria, tetanus and chicken pox. Prevnar, one of the newest vaccines, prevents some forms of meningitis.

Children receive most of their vaccines by age two.

North Carolina requires that a child's vaccinations be up to date before he or she starts kindergarten.

Parents or guardians must show proof of immunization against diphtheria, tetanus, whooping cough, polio, mumps, and red and German measles when registering a child for school.

"There are a few kids who slip through the cracks. I'm not sure why, but they do," said Dr. Anita Martin, a Raleigh pediatrician.

It is important that parents keep a record of their child's shots, especially if there is a change in pediatricians.

"If you can't get it from the school or your doctor's office, then it's like you've never had your shots, and we have to start all over," Martin said.

Insurance pays for most vaccines.

"If the insurance doesn't pay for them, then the North Carolina state vaccine program will provide that vaccine," Martin said.

For the first time, a government advisory panel is encouraging flu shots for children ages six months to 23 months.

New research shows children in those age groups are at an increased risk for flu-related hospitalizations.