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Vaccinations at 4 months

Key facts

  • Three vaccines are recommended for your baby at four months of age. These include: 

    • a combined vaccine that protects against diphtheria, tetanus, pertussis (whooping cough), Hib, polio, and hepatitis B
    • a vaccine that protects against pneumococcal disease
    • a vaccine that protects against rotavirus.
Last updated on 15 June 2023.
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What vaccines are recommended for my baby?

When your baby is four months old, three vaccines are recommended. The technical names for the vaccines are:

  • DTPa-Hib-IPV-HepB (also called ‘combined’ or ‘hexavalent’), which protects against diphtheria, tetanus, pertussis (whooping cough), Hib, polio and hepatitis B
  • 13vPCV, which protects against pneumococcal disease
  • Rotavirus vaccine which protects against rotavirus.

The combined DTPa-Hib-IPV-HepB and 13vPCV vaccines are given as needles, usually in your baby’s thigh. The rotavirus vaccine is given as drops that are put into your baby’s mouth to swallow.

What diseases do the vaccines protect babies against?

The vaccines recommended for your baby at four months of age will strengthen their immunity to the diseases described below.

Diphtheria is a very serious disease. It can cause a membrane (or skin) to grow over a child’s throat, which stops them from breathing. You may not have heard of it because it is so rare in Australia now. The vaccine is still used here so that children can’t catch diphtheria from people who have travelled to places where it is more common, including nearby holiday destinations in Asia and the South Pacific.1

Learn more about diphtheria and diphtheria vaccination > 

Tetanus is sometimes called ‘lockjaw’. Tetanus affects all the muscles in a child’s body, including the ones they use for breathing. The germ that causes tetanus lives in the soil, which means children can get tetanus through a cut, a burn, a bite or even just a prick from something like a nail or a thorn.1

Learn more about tetanus and tetanus vaccination >

Pertussis is usually called ‘whooping cough’. It spreads very easily from one person to another through the air, like a cold. When someone who already has the disease coughs or sneezes, the pertussis germs float through the air on tiny droplets. If a child breathes in those droplets, they can catch pertussis, too. Pertussis irritates the airways, which causes long coughing fits that can be very severe. Small babies can die from whooping cough.1

Learn more about pertussis and pertussis vaccination >

Hib (Haemophilus influenzae type b) causes a variety of serious illnesses, including swelling around the brain (meningitis), blood poisoning (sepsis), swelling in the throat and lung infections (pneumonia). Babies can die from the diseases caused by Hib. Those who survive often have brain damage. Hib spreads from person to person through the air, like a cold.1

Learn more about Hib and Hib vaccination >

Polio causes muscle paralysis in the limbs and can also affect the heart and the muscles that control breathing. It is rare in Australia but still common in countries including Pakistan, Afghanistan and Nigeria. Polio germs are spread through contact which means children can catch polio when they put things like hands or toys in their mouth after someone with polio has been touching them.1 A person with polio can pass on the disease before they even know they are sick.

Learn more about polio and polio vaccination >

Hepatitis B is a liver infection. Babies usually don’t look or feel sick when they first catch hepatitis B, but it can cause serious liver diseases, including liver cancer, later in life. It spreads from person to person through open wounds or sores. This can happen in households or even childcare settings. People infected with hepatitis B can pass on the disease without even knowing they have it.1

Learn more about hepatitis B and hepatitis B vaccination >

Pneumococcal disease is caused by germs (bacteria) that can cause swelling around the brain (meningitis), infection in the lungs (pneumonia), ear infections that can damage babies' hearing, and other serious diseases. Babies and children can catch it from each other just like they catch colds.1

Learn more about pneumococcal disease and pneumococcus vaccination >

Rotavirus causes diarrhoea and vomiting (gastroenteritis) that can make babies so sick they need to go to hospital for treatment. Babies and children catch rotavirus when they put contaminated objects like hands or toys into their mouths.1 A person with rotavirus can pass on the disease even before they know they are sick.

Learn more about rotavirus and rotavirus vaccination >

What do I need to do before the vaccination?

There’s no need to do anything special to get your baby ready for vaccination.

Most parents take their babies to be vaccinated at their local general practice or at a vaccination clinic. You will need to take your baby’s health record booklet with you so your doctor or nurse can make notes about the vaccinations your baby has had.

No matter how gentle your doctor or nurse is, needles hurt! And most babies cry at least a little after they get a needle. The good news is there are some things you can do for your child to make needles feel less painful.

What do I need to do after the vaccination?

Some babies could feel a little unwell or unsettled for a day or two after they get their vaccinations. Most of the common reactions will last between 12 and 24 hours and then get better, with just a little bit of love and care from you at home.

Serious side effects are very rare, but they can happen and some parents want to know more about them before they vaccinate their children.

If your baby doesn’t seem to be getting better, or you are worried about them, you can get help from:

  • your doctor
  • your nearest emergency department
  • or by calling Health Direct on 1800 022 222.
When do we come back for more vaccinations?

More vaccinations are recommended when your baby is six months old. These will strengthen your baby's immunity to diphtheria, tetanus, polio, pertussis, Hib and hepatitis B.

From six months of age, it is also recommended that your baby gets the influenza vaccine during influenza season.

It is important that babies and children get vaccinated on time to make sure they are protected as early as possible.

What if I still have questions?

If you still have some questions about vaccinations for your baby, write them down and make an appointment with your nurse, your doctor, or your health worker so you can ask them.

  1. Australian Technical Advisory Group on Immunisation (ATAGI). Australian Immunisation Handbook, Australian Government Department of Health, Canberra, 2018, immunisationhandbook.health.gov.au