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Vaccinations at 4 years

Key facts

  • At four years, it is recommended that your child has another dose of the combined vaccine that protects against diphtheria, tetanus, pertussis (whooping cough), and polio. 

  • It is also recommended that your child is vaccinated against influenza before the influenza season. Influenza vaccines are free for all children aged six months to under five years, and can be given at the same time as age-specific vaccines. 

Last updated on 9 June 2023.
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What vaccines are recommended for my child?

When your child is four years old, one age-specific vaccine is recommended: a combined DTPa/IPV vaccine. This vaccine strengthens their immunity to diphtheria, tetanus, pertussis and polio.

It is also recommended that your child gets an influenza vaccine before the start of the influenza season. An influenza vaccine is one of the best ways to protect your child against influenza, sometimes called ‘the flu’. The influenza vaccine is free and can be given at the same time as the combined DTPa/IPV vaccine.

Both vaccines are given as needles, usually in your child’s arm.

What diseases do the vaccines protect my child against?

Diphtheria is a very serious disease. It can cause a membrane (or skin) to grow over a child’s throat, which stops them from breathing. You may not have heard of it because it is so rare in Australia now. The vaccine is still used here so that children can’t catch diphtheria from people who have travelled to places where it is more common, including nearby holiday destinations in Asia and the South Pacific.1

Learn more about diphtheria and diphtheria vaccination > 

Tetanus is sometimes called ‘lockjaw’. Tetanus affects all the muscles in a child’s body, including the ones they use for breathing. The germ that causes tetanus lives in the soil, which means children can get tetanus through a cut, a burn, a bite or even just a prick from something like a nail or a thorn.1

Learn more about tetanus and tetanus vaccination >

Pertussis is usually called ‘whooping cough’. It spreads very easily from one person to another through the air, like a cold. When someone who already has the disease coughs or sneezes, the pertussis germs float through the air on tiny droplets. If a child breathes in those droplets, they can catch pertussis, too. Pertussis irritates the airways, which causes long coughing fits that can be very severe. Small babies can die from whooping cough.1

Learn more about pertussis and pertussis vaccination >

Polio causes muscle paralysis in the limbs and can also affect the heart and the muscles that control breathing. It is rare in Australia but still common in countries including Pakistan, Afghanistan and Nigeria. Polio germs are spread through contact which means children can catch polio when they put things like hands or toys in their mouth after someone with polio has been touching them.1 A person with polio can pass on the disease before they even know they are sick.

Learn more about polio and polio vaccination >

Influenza is an illness caused by influenza viruses. Although some of the symptoms are similar, influenza is different from the common cold. Influenza is usually more severe and lasts longer. Even if your child is usually healthy, influenza can make them very unwell. It can lead to serious conditions like severe lung infection (pneumonia) or inflammation in the brain (encephalitis). Babies and children under the age of five are more likely to get severe influenza than adults and other children. They are also more likely than adults and older children to need treatment in hospital.1

Learn more about influenza and influenza vaccination >

What do I need to do before the vaccination?

There’s no need to do anything special to get your child ready for vaccination.

Most parents take their children to be vaccinated at their local general practice or at a vaccination clinic. If possible, take your child’s health record booklet with you so your doctor or nurse can make notes about the vaccinations they have had.

No matter how gentle your doctor or nurse is, needles hurt! And most children cry at least a little after they get a needle. The good news is there are some things you can do for your child to make needles feel less painful.

What do I need to do after the vaccination?

Some children could feel a little unwell or unsettled for a day or two after they get their vaccinations. Most of the common reactions will last between 12 and 24 hours and then get better, with just a little bit of love and care from you at home.

Serious side effects are very rare, but they can happen and some parents want to know more about them before they vaccinate their children.

If your child doesn’t seem to be getting better, or you are worried about them, you can get help from:

  • your doctor
  • your nearest emergency department
  • or by calling Health Direct on 1800 022 222.
When do we come back for more vaccinations?

If your child has had an influenza vaccine for the first time, they will need a second dose four weeks later. After that, it is recommended that your child gets one dose of an influenza vaccine every year before influenza season.

The next age-specific vaccinations are recommended for teenagers. Teens need booster doses of some of the vaccines they have already had, plus a vaccine to protect them from the human papillomavirus (HPV). HPV can cause cancers of the mouth, throat and reproductive organs.

What if I still have questions?

If you still have some questions about vaccinations for your child, write them down and make an appointment with your nurse, your doctor, or your health worker so you can ask them.

  1. Australian Technical Advisory Group on Immunisation (ATAGI). Australian Immunisation Handbook, Australian Government Department of Health, Canberra, 2018,