In a child, how many doses of inactivated polio vaccine (IPV), measles‑mumps‑rubella (MMR), varicella, pneumococcal conjugate vaccine (PCV13), and diphtheria‑tetanus‑acellular pertussis (DTaP) are required by age 10?

Childhood Vaccination Doses Required by Age 10

By age 10, children require 5 doses of DTaP, 4 doses of IPV, 2 doses of MMR, 2 doses of varicella, and 4 doses of PCV13. 1

DTaP (Diphtheria-Tetanus-Acellular Pertussis): 5 Doses Total

• Doses 1-4: Administered at 2,4,6, and 15-18 months of age 1, 2
• Dose 5 (booster): Given at 4-6 years of age 1, 2
• The fifth dose is critical for maintaining long-term immunity and must be administered regardless of the number of doses received before the fourth birthday 2
• Minimum intervals: 4 weeks between doses 1-3, with 6 months between dose 3 and dose 4 (though 8-week intervals are preferred) 1

IPV (Inactivated Poliovirus Vaccine): 4 Doses Total

• Doses 1-3: Given at 2,4, and 6-18 months of age 1
• Dose 4 (booster): Administered at 4-6 years of age 1
• The final dose at 4-6 years is essential for maintaining long-term immunity to polio and should be given at least 6 months after the previous dose 1
• If the third dose was administered at age ≥4 years, a fourth dose is not necessary 1
• Minimum intervals: 4 weeks between doses 1-3, and 6 months between doses 3 and 4 1

MMR (Measles-Mumps-Rubella): 2 Doses Total

• Dose 1: Given at 12-15 months of age 1
• Dose 2: Routinely recommended at 4-6 years but may be administered earlier if desired, with a minimum 4-week interval from dose 1 1
• Both doses must be completed by age 10 for adequate protection 1

Varicella: 2 Doses Total

• Dose 1: Administered at 12-15 months of age 1
• Dose 2: Routinely given at 4-6 years of age 1
• For children <13 years, doses should be at least 3 months apart (minimum 28 days acceptable) 1
• Both doses are required for optimal immunity against varicella 1

PCV13 (Pneumococcal Conjugate Vaccine): 4 Doses Total

• Doses 1-3: Given at 2,4, and 6 months as part of the primary series 1
• Dose 4 (booster): Administered at 12-15 months of age 1
• The standard schedule for PCV13 consists of a 3-dose primary series followed by a booster dose 1

Important Clinical Considerations

Combination Vaccines

• DTaP-IPV combination vaccines may be used for doses at 2,4,6, and 15-18 months, but are not licensed for the 4-6 year booster 1
• If DTaP-IPV/Hib is inadvertently given after age 5, it should still be counted as a valid dose 1
• Vaccination should not be deferred if the specific vaccine brand previously administered is unavailable or unknown 3

Catch-Up Schedules

• Minimum 4-week intervals are acceptable for catch-up schedules, though 8-week intervals are preferred 1, 3
• There is no need to restart a vaccine series regardless of the time elapsed between doses 1
• The final doses at 4-6 years (DTaP and IPV) are critical and should not be omitted even if earlier doses were delayed 1, 2

Common Pitfalls to Avoid

• Do not skip the 4-6 year boosters: Both DTaP and IPV require a dose at this age for long-term immunity, regardless of previous vaccination history 1, 2
• Do not use DTaP-IPV/Hib for children >5 years: This combination is not licensed for the school-entry booster 1
• Ensure proper spacing: The minimum 6-month interval between the third and fourth doses of DTaP and IPV is essential for adequate immune response 1