Age groups and vaccines - 4 to 6 years | The Children's Hospital of Philadelphia

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Age Groups and Vaccines — 4 to 6 Years

Right around the time your child is starting school, there will be another opportunity to protect him or her from several diseases. Typically, children receive additional doses of DTaP, MMR, chickenpox and polio during this period. These additional doses "remind" your child's immune system that it has seen these viruses and bacteria before and the protective response becomes even stronger.

Preparing for vaccines
After the vaccines
An issue for this age group: Getting "caught up" on vaccines

Preparing for vaccines

By this age, your child has received several vaccines, but it probably still doesn't feel entirely comfortable watching him or her get more. Most likely your child has not had negative consequences before and that is likely to be the case again. If your child has had a negative experience previously, be sure to discuss that event with your child's doctor before it is time for the next vaccine to be given. Also, remember that your child will take the lead from you. If you are feeling comfortable that this is an important and necessary thing to do, your child will also be more comfortable.

To prepare yourself

To prepare your child

Remember, taking your children to get vaccines is an act of love. You are protecting them from something much worse than the pain of the vaccine.


After the vaccines

When you get home, give your child comfort and realize that your child may be more tired or cranky than usual. He or she may want to be held more and may be sore in the arm or leg where the shot was given. You can administer a pain reliever as directed by the doctor. If the area where the shot was given is red, tender or swollen, you can use a cool wet cloth on the area. You can also give your child a lukewarm sponge bath if he or she has a fever. Give your child plenty of fluids and be aware that he or she may be less interested in food over the next 24 hours.

Watch your child for signs of a reaction from the vaccine including a rash, prolonged fever, or unusual behaviors. If you have any reason for concern, call the doctor. He or she can tell you what to expect and what to do.

While most side effects are minor, if your child has a severe reaction, you or the child's doctor can file a report to the Vaccine Adverse Events Reporting System or VAERS.


An issue for this age group: Getting "caught up" on vaccines

School entrance is also a good time to make sure your child is caught up on all of his or her vaccines. Even if you have taken your child to all of the required well-baby visits, there are reasons why your child may need to be "caught up," as indicated below:

A vaccine was in short supply

During shortages, recommendations often change temporarily to make the best use of available vaccines. Sometimes, the recommendations change more than once during a shortage. 

Because shortages of the vaccine for Haemophilus influenzae type b (Hib) occurred between 2007 and 2009, it is possible that your 4- to 6-year old has not received all doses.

Often, the healthcare provider will set up a recall system for reaching children after shortages; however, not all offices have the staff to do this and it is difficult to recall all patients who missed vaccine doses following a shortage.

A vaccine recommendation changed between well-baby visits

When a vaccine is developed, scientists and experts in academia and at the Centers for Disease Control and Prevention (CDC) review all of the information that is available about the vaccine and the disease it is preventing. These groups then try to determine how the disease will best be prevented. Specifically, they look at which age group of people get the disease, which age group of people need to get a vaccine, how long those people will be protected, and how many doses of the vaccine they will need to be best protected.

For example, after the hepatitis B vaccine was licensed, it was given to groups of people that were at the highest risk, so the vaccine was originally recommended (in 1982) for intravenous drug users, men who have sex with men and those who have heterosexual relations with many partners. However, because many people do not know that they have hepatitis B and because even casual contact such as sharing a toothbrush with an infected person can spread the disease, this strategy didn't work. Every year, about 18,000 children under 10 years old got infected with hepatitis B virus. So, the experts changed the recommendation in 1991 to include immunizing all children. Now, liver disease caused by hepatitis B has been virtually eliminated in children and with continued vaccine use, it is possible that in the future these conditions will be completely eliminated from our population. If a child was born immediately prior to the change in hepatitis B recommendations, he or she may not have been immunized as an infant, but could be eligible for the vaccine and the protection it affords.

In 2006 hepatitis A vaccine was recommended for all children in the US beginning at 1 year of age. Older children (up to 18 years old) should get this vaccine if they did not have it previously.

A new vaccine became available since your last well-baby visits

Every day researchers around the world are working to develop vaccines that will protect mankind from dreaded illnesses.


Updated: January 2013

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Book: The Saturday Shot

The book "The Saturday Shot" tells the story of a young girl facing her fear of getting immunized.