What vaccines are due for a 5-year-old child with no known medical history or previous vaccine reactions during a well visit?

Vaccines Due for a 5-Year-Old at Well Visit

A 5-year-old child at a well visit should receive DTaP (or DTP), IPV (polio), MMR, and varicella vaccines, plus annual influenza vaccine if in season. 1, 2

Primary Vaccines Due at Age 5

DTaP (Diphtheria, Tetanus, Pertussis)

• The fifth dose of DTaP is due at ages 4-6 years and should be administered today. 1, 2
• This completes the childhood DTaP series before the Tdap booster becomes due at age 11-12 years. 2

IPV (Inactivated Poliovirus Vaccine)

• The fourth dose of IPV is due at ages 4-6 years and should be given at this visit. 1, 2
• If the third dose was administered after the child's 4th birthday, the fourth dose is not needed. 1
• Verify the timing of previous doses before administering. 1

MMR (Measles, Mumps, Rubella)

• The second dose of MMR is due at ages 4-6 years, though it can be given earlier if at least 4 weeks have passed since the first dose. 1, 2
• Ensure the child has received both doses with proper spacing. 2

Varicella (Chickenpox)

• The second dose of varicella vaccine is due at ages 4-6 years, though it can be administered earlier if at least 3 months have passed since the first dose. 1, 2
• Confirm the child has no reliable history of chickenpox disease. 1

Annual Vaccination

Influenza Vaccine

• Administer the current seasonal influenza vaccine today if the visit occurs during flu season (September-December). 1, 2
• All children aged 6 months through 18 years should receive annual influenza vaccination. 1, 2
• If visiting outside flu season, schedule the child to return in September-December for influenza vaccination. 1

Catch-Up Assessment

Verify Completion of Earlier Series

• Review the child's vaccination record to ensure completion of Hepatitis B (3-dose series) and Hepatitis A (2-dose series). 2
• If any doses are missing from these series, administer the appropriate catch-up doses today. 2
• The pneumococcal conjugate vaccine (PCV) and Hib series should already be complete by age 5; if not, provide catch-up doses. 1

Simultaneous Administration

All indicated vaccines should be administered simultaneously at this single visit. 1, 3

• Administering multiple vaccines at once increases the likelihood of complete vaccination and provides timely protection. 1, 3
• The immune response to one vaccine is not negatively affected by simultaneous administration of other vaccines. 1, 3
• Use separate anatomic sites for each injection. 2
• Consider FDA-approved combination vaccines when available to reduce the number of injections. 3

Important Caveats

Contraindications to Screen For

• Defer vaccines if the child has moderate to severe acute illness, severe allergic reactions to vaccine components, or immunodeficiency. 1, 3
• Mild illness without fever is not a contraindication to vaccination. 3

Documentation Requirements

• Document all vaccines administered in the child's permanent medical record and provide the parent with an updated immunization record. 1
• This ensures continuity of care and helps track the child's vaccination status. 1

Timing Considerations

• Do not restart a vaccine series regardless of time elapsed between doses; simply continue from where the child left off. 3
• Longer-than-recommended intervals between doses do not reduce final antibody concentrations. 3
• Respect minimum intervals between doses to ensure adequate immune response. 3

Future Vaccines

• The next routine vaccines (Tdap, MenACWY, and HPV) are not due until age 11-12 years. 2
• Schedule the child for their next well visit and inform parents about upcoming adolescent vaccines. 2