Age Groups and Vaccines: 4 to 6 Years

Preparing for vaccines

By this age, your child should have received several vaccines, but it probably still doesn't feel entirely comfortable watching them get more. Most likely your child has not had a negative experience 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

  • Bring your child's immunization record to the visit with you.
  • Write down any questions you have and bring the list with you to the visit. You can also use the free Vaccines on the Go mobile app for recording your questions (in the “Connect” section under “Save notes or questions”).
  • Be sure to ask vaccine-related questions before the office staff comes in with the vaccine. Usually, vaccines are given after a physical exam and discussion with the parents.
  • Read the Vaccine Information Sheets and any other materials that the office staff provides to you.

To prepare your child

  • Talk to your child in advance of the visit about what to expect. This interactive guide from the CHOP Child Life, Education and Creative Arts Therapy Department may help.
  • Be honest with your child, explaining that it may hurt a bit, but it will not be for long. And the vaccine will keep them healthy.
  • Reassure your child that it is all right to cry if it hurts and that it will be over quickly.
  • Bring along a favorite toy or blanket or book.
  • Talk reassuringly to your child during the appointment. Also, make eye contact with, smile at, and cuddle your child leading up to and immediately following the shots.
  • Engage your child in a conversation or storybook.
  • You may want to have the office staff rub an alcohol pad on the back of your child’s hand or arm immediately before giving the shot. When the shot is ready to be given, have your child blow on the alcohol-swabbed spot. The action of blowing on the alcohol will produce a feeling of cold that will lessen the sensation of pain. It will also help your child to think about something else and feel more like they are in control. Some healthcare professionals can help by asking the child for help and by describing what the child should do.

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 shot.

After the vaccines

When you get home, provide comfort for your child and realize that they may be more tired or cranky than usual. Children who were recently vaccinated may want to be held more and may be sore in the arm or leg where the shot was given. If the area where the shot was given is red, tender or swollen, you can use a warm wet cloth on the area. You can also give your child a lukewarm sponge bath if they have a fever. Give your child plenty of fluids, and be aware that they may be less interested in food over the next 24 hours.

Because fevers are part of the immune response, treatment is most often not recommended. If you have questions, talk with your child’s doctor. Find out more about fevers on this Q&A sheet.

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 your child’s doctor who 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 your 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 vaccines. Even if you have taken your child to all of the required well 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 might change to make the best use of available vaccines. Sometimes, the recommendations change more than once during a shortage.

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 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 prevents. 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 did not do enough to prevent disease in the general population.

Every year, about 18,000 children younger than 10 years of age 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.

A new vaccine became available since your baby's last well visit

Every day, researchers around the world are working to develop vaccines that will protect humankind from dreaded illnesses. It is possible that a new vaccine became available, and if your child was not in the initially recommended age group, the vaccine was not mentioned. A recent example would be the COVID-19 vaccine, which is recommended for children 6 months of age and older.

Other resources

Reviewed by Paul A. Offit, MD on November 10, 2022

Materials in this section are updated as new information and vaccines become available. The Vaccine Education Center staff regularly reviews materials for accuracy.

You should not consider the information in this site to be specific, professional medical advice for your personal health or for your family's personal health. You should not use it to replace any relationship with a physician or other qualified healthcare professional. For medical concerns, including decisions about vaccinations, medications and other treatments, you should always consult your physician or, in serious cases, seek immediate assistance from emergency personnel.