Before starting school, at 3 years and 4 months, children have the 4-in-1 pre-school booster. It tops up protection against diphtheria, tetanus, whooping cough and polio, which your child first had as a baby in the 6-in-1.
Some children also have an MMRV dose at this appointment: those born between 1 July and 31 December 2024 (their second dose) and those born between 1 September 2022 and 30 June 2024 (their first).
From the official NHS schedule, last checked 16 September 2026. Reflects the schedule for a baby born in 2026. Children born earlier may follow slightly different dates during the 2024-2026 transition to the 4-dose 6-in-1, the 18-month appointment and MMRV (which now includes chickenpox) - your GP or Red Book has the exact plan.
A booster before starting school that refreshes protection against four diseases from the baby 6-in-1 course.
For children born before 2025 who have not yet had their measles-containing doses on the newer 1-year / 18-month timing, an MMRV dose is given here as a catch-up.
Preparing a three-year-old
At this age it helps to tell your child honestly, shortly beforehand, that they will have a quick scratch in the arm that might hurt for a moment. Avoid promising it will not hurt.
Bring something to distract them - a book, a video on your phone or a favourite toy - and plan a small treat or activity afterwards. Sitting on your lap with a cuddle is often easiest.
The hard lump
The 4-in-1 can leave a hard lump where it was given. This is common and usually goes after a few weeks - it is not a sign that anything is wrong.
Don't wait for school
The booster is due at 3 years 4 months, not when school starts. Having it on time means your child is protected before they mix with lots of new children. If you have not had an invitation, call your GP surgery.
What is normal afterwards
- Pain or swelling in the arm, sometimes with a hard lump that fades over a few weeks.
- Feeling tired or irritable, a headache or a high temperature for a few days.
- If MMRV is given too: the delayed rash or swelling a week or more later.
When to get help
Ask for an urgent GP appointment or call NHS 111 if your child:
- has a seizure (fit)
- has signs of an allergic reaction such as swelling of the face or difficulty breathing (very rare, and usually within minutes - the nurse is trained to treat this)
- is unwell and you are worried about them
Call 999 if your child has difficulty breathing, is floppy or unresponsive, or has a fit for the first time.
This page is general information, not medical advice. Your GP, practice nurse, health visitor or pharmacist can advise on your own child.
12 to 13 years (school year 8): HPV vaccine.
Enter your child's date of birth on our United Kingdom schedule page to see when each appointment is due, and add reminders to your phone calendar.
No. Vaccination is not compulsory in the UK and schools cannot refuse a place because of it. It is strongly recommended because it keeps protection high as children start mixing at school.
The nasal flu vaccine every year until the end of Year 11, then the HPV vaccine at 12 to 13 years and the 3-in-1 teenage booster and MenACWY at around 14.
Yes. Contact your GP surgery to catch up - it is better late than not at all.
- United Kingdom schedule - NHS / UK Health Security Agency (UKHSA)
- NHS - Vaccinations and when to have them
- NHS - 4-in-1 pre-school booster vaccine
- NHS - MMRV vaccine
- NHS - Children's flu vaccine
Checked against these NHS pages on 1 November 2026. How we research and check: our editorial policy.
Other United Kingdom appointments
8-week jabs · 12-week jabs · 16-week jabs · 1-year jabs · 18-month jabs