Immunization Schedule for 4 to 6 Years Old

In the United States, certain vaccines are recommended for children and adolescents starting at birth. Vaccines are usually given at various ages, according to a schedule. The schedule is designed to protect your child by:

• Giving vaccines at the best age for your child’s immune system to develop protection.
• Preventing disease at the age when your child is most likely to be at risk.
• Properly spacing doses of vaccines.

The timing of immunization doses may vary. Timing and number of doses depend on when immunizations are begun and the type of vaccine that is used.

Recommended immunizations for 4–6 years old

Hepatitis B (HepB) vaccine

• Doses should be obtained only if needed to catch up on doses your child missed in the past.

Diphtheria, tetanus, and pertussis (DTaP) vaccine

• The fifth dose of a 5-dose series should be obtained unless the fourth dose was obtained at age 4 years or older. The fifth dose should be obtained at least 6 months after the fourth dose.

Haemophilus influenzae type b (Hib) vaccine

• Children under the age of 5 years who have certain high-risk conditions or have missed doses in the past should obtain the vaccine.
• Children older than 5 years of age are usually not given this vaccine. However, children age 5 and older who have not been vaccinated, or are partially vaccinated, should obtain the vaccine if they have certain high-risk conditions.

Pneumococcal conjugate (PCV13) vaccine

• Children who have certain conditions or have missed doses in the past should obtain the vaccine as recommended.

Pneumococcal polysaccharide (PPSV23) vaccine

• Children who have certain high-risk conditions should obtain the vaccine as recommended.

Inactivated poliovirus (IPV) vaccine

• The fourth dose of a 4-dose series should be obtained at this time. The fourth dose should be obtained at least 6 months after the third dose.

Influenza (IIV or LAIV) vaccine

• Starting at age 6 months, all children should obtain the influenza vaccine every year.
• Infants and children between the ages of 6 months and 8 years who are receiving the influenza vaccine for the first time should obtain a second dose at least 4 weeks after the first dose. Thereafter, only a single annual dose is recommended.

Measles, mumps, and rubella (MMR) vaccine

• The second dose of a 2-dose series should be obtained at this time.

Varicella (VAR) vaccine

• The second dose of a 2-dose series should be obtained at this time.

Hepatitis A (HepA) vaccine

• A child who has not received the vaccine before 2 years of age should obtain the vaccine if he or she is at risk for infection or if hepatitis A protection is desired.

Meningococcal conjugate (MenACWY) vaccine

• Children who have certain high-risk conditions, are present during an outbreak, or are traveling to a country with a high rate of meningitis should obtain the vaccine.

Questions to ask your child’s health care provider:

• Is my child up to date on his or her vaccines?
• What should I do if my child missed a dose of a vaccine?
• Does my child need to delay, avoid, or skip any vaccines because of his or her health history?
• Does my child need any special vaccines or more vaccines because of his or her health history?
• Can I have a copy of my child’s vaccine record?

Contact a health care provider if your child:

• Has pain where the shot was given, and the pain gets worse or does not go away after a couple of days.
• Has a fever.
• Is fussy or does not stop crying for 3 or more hours after receiving vaccines.

Get help right away if your child:

• Has a temperature of 104°F (40°C) or higher.
• Develops signs of an allergic reaction, including:
  • Itchy, red, swollen areas of skin (hives).
  • Swelling of the face, mouth, or throat.
  • Difficulty breathing, speaking, or swallowing.

Summary

• At 4–6 years, most children should receive the fifth dose of DTaP, the fourth dose of IPV, and the second dose of MMR and VAR vaccines.
• After the age of 6 months, your child should receive the annual influenza (IIV orLAIV) vaccine. If your child is receiving IIV or LAIV for the first time, he or she should have a second dose at least 4 weeks after the first dose.
• Your child may need other vaccines based on his or her health history.
• Talk with your child’s health care provider if you have any other questions about vaccines or the vaccine schedule.