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4-in-1 pre-school booster overview

The 4-in-1 pre-school booster vaccine is offered to children from the age of 3 years and 4 months to boost their protection against 4 different serious diseases:

Children are routinely vaccinated against these illnesses as babies through the 6-in-1 vaccine.

The 4-in-1 pre-school booster vaccine increases their immunity even further.

When should children have the 4-in-1 pre-school booster?

The 4-in-1 pre-school booster vaccine is routinely offered to children at the age of 3 years and 4 months old.

How is the 4-in-1 pre-school booster given?

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

Can the 4-in-1 pre-school booster be given at the same time as other vaccines?

It's safe for your child to have the 4-in-1 pre-school booster at the same time as other vaccines, such as the MMR vaccine.

When children have the 4-in-1 pre-school booster and the MMR vaccine at the same time, each vaccine will be injected into a different arm or into a different place on their arm if the same arm needs to be used.

This NHS leaflet tells you more about pre-school immunisations (PDF, 693kb).

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

Studies have shown that the 4-in-1 pre-school booster vaccine is very effective.

In clinical tests, more than 99% of children who'd been given the 4-in-1 pre-school booster were protected against tetanus, diphtheria, whooping cough and polio.

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

The 4-in-1 pre-school booster not only protects your child against these infections, but also stops them passing the germs on to babies who are too young to have protection against these diseases through vaccination.

How safe is the 4-in-1 pre-school booster?

The 4-in-1 pre-school booster has been thoroughly tested to ensure it's safe and effective.

The vaccine is inactivated (killed), which means it does not contain any live bacteria or viruses. It cannot cause any of the diseases it protects against.

The brand name of the 4-in-1 pre-school booster is REPEVAX. It provides a good booster response.

Read the patient information leaflet for REPEVAX

What about side effects?

Some children will have side effects. These are usually mild and do not last long.

They usually happen within 48 hours of the injection.

Most children will not have any problems at all.

Your child may get some redness, swelling or tenderness where the injection was given. This will disappear on its own.

This NHS leaflet tells you about common vaccination reactions in young children up to the age of 5.

Find out more about the 4-in-1 pre-school booster side effects

Which children cannot have the 4-in-1 pre-school booster?

The vast majority of children can have the 4-in-1 pre-school booster, but there are a few who should not have it.

This includes children who:

  • have a high temperature (fever) of 38C at the time of the vaccination appointment – wait until they have recovered
  • are allergic to the vaccine or who have had a severe allergic reaction (anaphylactic reaction) to any part of the vaccine before

There's no need to postpone vaccination if your child has a minor illness, such as a cough or a cold with no temperature.

What if I miss the 4-in-1 pre-school booster vaccination appointment?

It's best for children to be vaccinated at the right age, as they're then protected against serious diseases as early in life as possible.

But do not worry if your child missed having the 4-in-1 pre-school booster first time around. It's never too late to have it.

Make an appointment with your GP surgery or local child health clinic as soon as you can.

Page last reviewed: 27 June 2019
Next review due: 27 June 2022