What immunizations are due for a 4-year-old child?

Immunizations Due for a 4-Year-Old Child

A 4-year-old child should receive the DTaP (5th dose), IPV (4th dose), MMR (2nd dose), and Varicella (2nd dose) vaccines at their well-child visit. 1

Recommended Vaccines at 4 Years of Age

DTaP (Diphtheria, Tetanus, and acellular Pertussis)

• The 5th dose of DTaP is recommended at 4-6 years of age to provide continued protection during early school years 1
• This is the final dose in the DTaP series for children under 7 years 1
• A fifth dose is not necessary if the fourth dose was administered on or after the fourth birthday 1
• The DTaP vaccine is preferred over whole-cell DTP due to fewer local reactions, fever, and other systemic events 1

IPV (Inactivated Poliovirus Vaccine)

• The 4th dose of IPV should be administered at 4-6 years of age 1
• This completes the polio vaccination series

MMR (Measles, Mumps, and Rubella)

• The 2nd dose of MMR is recommended at 4-6 years of age 1
• The second dose may be administered earlier, provided at least 24 weeks have elapsed since the first dose 1

Varicella (Chickenpox)

• The 2nd dose of varicella vaccine is recommended at 4-6 years of age 1
• This dose may be administered earlier, provided 2-3 months have elapsed since the first dose 1

Important Considerations

Simultaneous Administration

• All of these vaccines can be safely administered during the same visit at different injection sites 1
• Simultaneous administration of vaccines has been shown to be safe and effective with no interference between routinely recommended childhood vaccines 1

Common Side Effects and Management

• DTaP may cause more injection site reactions (redness, swelling, pain) at the 5th dose compared to earlier doses 2, 3
• Large injection site reactions (≥50mm redness/swelling) occur more frequently after the fifth dose of DTaP 3
• These reactions are generally transient and resolve without sequelae

Special Circumstances

• If a child has missed previous doses, catch-up vaccination should be provided according to the recommended schedule
• Ensuring children receive all recommended doses is critical, as undervaccination is associated with higher disease risk, particularly for pertussis 4
• For children with specific medical conditions or immunocompromise, additional vaccines may be recommended (consult specific guidelines)

Vaccine Documentation

• All administered vaccines should be documented in the child's immunization record
• Parents should be informed about potential side effects and when to seek medical attention
• The next recommended vaccines will be due at 11-12 years of age (Tdap, MCV4, HPV) 1

Remember that timely vaccination is crucial for optimal protection against vaccine-preventable diseases. Even short delays can increase the risk of disease exposure during vulnerable periods.