Vaccinations

4-in-1 pre-school booster

The 4-in-1 pre-school booster vaccine is offered to three-year-old children to boost their protection against four different serious diseases:

Children are routinely vaccinated against these illnesses as babies by the 5-in-1 vaccine. The 4-in-1 pre-school booster vaccine increases their immunity even further.

When should children have the 4-in-1 booster vaccine?

The 4-in-1 booster vaccine is routinely offered to children at the age of three years and four months old.  

How is the 4-in-1 vaccine given?

It's injected into the child's upper arm.

Can the 4-in-1 pre-school booster vaccine be given with other vaccines?

The pre-school booster can be given at the same time as other vaccines. It's usually given at the same time as the second dose of the MMR vaccine.

This NHS leaflet tells you more about pre-school immunisations (PDF, 835kb).

How well does the 4-in-1 pre-school booster work?

Studies have shown that the pre-school booster is very effective. In clinical tests, more than 99% of children who had been given the 4-in-1 pre-school booster were protected against tetanus, diphtheria, whooping cough and polio.

The vaccine protects children from these infections until they receive their teenage 3-in-1 booster at the age of 14. 

The 4-in-1 vaccine not only protects your child against these infections, but also stops them passing the germs on to babies who are too young to have had all of their vaccinations.

How safe is the 4-in-1 booster vaccine?

Before anyone can be given a vaccine, it has to go through many tests to check that it is safe and that it works.

However, the 4-in-1 pre-school booster, like other vaccines, can have side effects in some children.

Side effects of the 4-in-1 vaccine are usually mild. Your child may get a little redness, swelling or tenderness where the injection was given that will disappear on its own.

This NHS leaflet tells you about common vaccination reactions in young children up to five years of age (PDF, 118kb).

There are two different 4-in-1 vaccines that are used in the UK – Infanrix IPV and REPEVAX.

Both vaccines provide good booster responses, so it doesn't matter which one your child is given as their pre-school booster. 

Read the patient information leaflet (PIL) for Infanrix IPV (PDF, 68kb).

Read the patient information leaflet (PIL) for REPEVAX (PDF, 30kb).

Read more about the 4-in-1 pre-school booster side effects.

Which children can't have the 4-in-1 booster vaccine?

The vast majority of children can have the 4-in-1 booster vaccine, but there are a few children who shouldn't have it.

They include children who:

  • are allergic to the vaccine
  • have a fever at the time of the vaccination appointment

The vaccine should not be given to children who have had an anaphylactic reaction (severe allergic reaction) to any part of the vaccine before.

There is no need to postpone vaccination if your child has a minor illness, such as a cough or a cold with no fever. But if your baby is ill with a fever, it's best to delay vaccination until they have recovered.

Why is inactivated polio vaccine (IPV) used rather than oral polio vaccine (OPV), as in the past?

Oral polio vaccine (OPV) was used from the 1960s because the live vaccine provided better community-wide protection against polio.

Now that polio has been wiped out from large parts of the world, the risk of polio is so low that it is an appropriate time to switch to inactivated polio vaccine, which is given as an injection and does not carry the risk of paralytic polio.

Can you get polio from the polio part of this vaccine?

The 4-in-1 pre-school booster uses inactivated polio vaccine, which cannot cause polio. 


Page last reviewed: 18/05/2016

Next review due: 18/05/2018

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