Starting School: Ages 4 Through 6

From ages 4 through 6, your child needs additional doses of some vaccines, as well as a flu vaccine every year. If your child has missed any vaccines, work with your doctor or nurse to make sure he or she gets caught up. Schedule an annual well visit with your child’s pediatrician. You may need a certificate of immunization to enroll your child in school.

Recommended Vaccines Protect Against These Diseases:

About chickenpox:

  • Chickenpox is a very contagious disease caused by the varicella-zoster virus (VZV).

  • Symptoms can include an itchy rash of blisters, tiredness, and a fever.

  • It can be serious and even life-threatening, especially in babies, adults, and people with weakened immune systems.

CDC recommends two doses of chickenpox vaccine:

Diphtheria, tetanus, and pertussis (DTaP) vaccine protects against three serious diseases.

About diphtheria:
  • Diphtheria is a serious infection caused by bacteria that spread through coughing and sneezing.

  • Diphtheria causes a thick covering in the back of the nose or throat.

  • It can lead to difficulty breathing, heart failure, paralysis, and even death.

About tetanus:
  • Tetanus is an infection caused by bacteria that usually enter the body through breaks in the skin.

  • The bacteria produce a poison that causes painful muscle stiffness and lockjaw. It can be deadly.

About pertussis (whooping cough):
  • Whooping cough, or pertussis, is known for uncontrollable, violent coughing that often makes it hard to breathe.

  • Babies may not cough very much or even at all. However, babies may have long pauses in breathing.

  • It is highly contagious and can be deadly to babies.

  • Since 2010, states report tens of thousands of whooping cough cases each year in the United States.

CDC recommends five doses of DTaP vaccine:

About the flu:

  • Flu is a potentially serious, contagious respiratory illness caused by influenza viruses. It can lead to hospitalization and even death.

  • Every year, millions of people get the flu, hundreds of thousands of people are hospitalized, and thousands or tens of thousands of people die from flu-related causes.

  • Flu vaccination can prevent illness, doctors’ visits, missed work and school, as well as flu-related hospitalizations.

  • Flu vaccination can reduce the risk of flu-associated death in children by nearly half, according to a recent CDC study.

Flu vaccine recommendations:

  • CDC recommends that everyone 6 months and older get a yearly seasonal flu vaccine by the end of October, if possible, to ensure the best available protection against flu.

  • Children 6 months through 8 years getting vaccinated for the first time and those who have only previously gotten one dose of vaccine should get two doses of flu vaccine, spaced at least 28 days apart.

To learn more about protecting you and your family from flu each year, check CDC’s annual recommendations or talk to your doctor.

Measles, mumps, and rubella (MMR) vaccine protects against three serious diseases.

About measles:

  • Measles is a highly contagious disease caused by a virus that lives in the nose and throat mucus of an infected person.

  • It can cause a fever that can get very high, a distinctive rash, a cough, a runny nose, and red eyes. In some cases, it can also cause diarrhea and ear infection.

  • It can also lead to lung infection (pneumonia), brain damage, deafness, and death.

About mumps:

  • Mumps is caused by a virus that spreads through coughing and sneezing.

  • It typically starts with a fever, headache, muscle aches, tiredness, and loss of appetite. Then, most people’s salivary glands swell, which causes puffy cheeks and a swollen jaw.

  • Mumps is pretty mild in most people but can sometimes cause lasting problems, such as deafness; meningitis (swelling of the tissue covering the brain and spinal cord); and swelling of the brain, testicles, ovaries, or breasts.

About rubella:

  • Rubella is a contagious disease caused by a virus.

  • It can cause a rash or fever, but many people have no symptoms.

  • Rubella can cause miscarriage or serious birth defects in a developing baby if a woman is infected while she is pregnant. Infected children can spread rubella to pregnant women.

CDC recommends two doses of MMR vaccine:

Infants 6 through 11 months old should have one dose of MMR vaccine before traveling abroad.

About polio:

  • Polio is a highly infectious disease caused by a virus that can invade the brain and spinal cord.

  • It can cause lifelong paralysis and even death.

  • With vaccination, polio has been eliminated in the United States, but it is still a threat in some other countries.

CDC recommends four doses of polio (IPV) vaccine:

4 year
well visit
5 year
well visit
6 year
well visit
Chickenpox (varicella) vaccine 2nd dose
Diphtheria, tetanus, and pertussis (DTaP) vaccine 5th dose
Flu vaccine Every year, by the end of October if possible.
Measles, mumps, rubella (MMR) vaccine 2nd dose
Polio (IPV) vaccine 4th dose

Did you know?

Since 2010, states report tens of thousands of whooping cough cases each year in the United States.

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