4in1 and MMR

When your child is in Junior Infants, they will be offered two vaccines:

  • the 4 in 1 vaccine to protect against diphtheria, polio, tetanus and whooping cough (pertussis)
  • a second dose of the MMR vaccine to protect against measles, mumps and rubella.

These vaccines are given by a HSE doctor or nurse in primary school to Junior Infants, or in Donegal, Sligo and Leitrim by your GP.

If a child misses the vaccinations in school because they are sick, the HSE will arrange for the student to be vaccinated at a HSE clinic. If your child missed their vaccine in school contact the schools immunisation programme office in your area to request an appointment at a HSE clinic. 

In Ireland, all the recommended childhood vaccines listed in the schools immunisation programme are free.

We have compared the possible complications of developing Diphtheria, Polio, Tetanus, Whooping Cough, Measles, Mumps or Rubella with the possible side effects of getting the 4 in 1 and MMR vaccine.

Disease Effects of Disease Side Effects of the Vaccine
Diphtheria- contagious bacteria that is spread by close contact with an infected person or carrier and cause a sore throat and severe breathing difficulties.

If 1000 people get diphtheria

  • 50 will die

The bacteria release a toxin (poison) which can lead to paralysis and heart failure.

If 1000 people get vaccinated

  • 100 will have discomfort, redness and swelling where the injection was given or have a fever.
Polio - a contagious virus that is spread by close contact with an infected person or their faeces (poo). It causes fever, headache and vomiting and may progress to paralysis.

If 1000 people get polio:

  • up to 10 will become paralysed

Of these 10 people with paralysis:

  • 5 will be permanently paralysed; and
  • 1 may die.

If 1000 people are immunised:

  • 100 will have discomfort redness and swelling where the injection was given or will have a fever
Tetanus - bacteria from soil which release a toxin and causes painful muscle spasms, convulsions and lockjaw.

If 1000 people get tetanus:

  • 100 will die

The risk is greatest for the very young or old.

If 1000 people are immunised:

  • 100 will have discomfort, redness and swelling where the injection was given or will have a fever.
Pertussis (Whooping Cough) - contagious bacteria that spread by close contact with an infected person and cause a "Whooping" cough and vomiting. The diseases can last up to three months.

If 1,000 people get whooping cough:

  • 2 will die from pneumonia or brain damage (almost all deaths are in children under the age of 6 months)
  • 10 will have fits (15 if under 6 months old)
  • 1 will get encephalitis (2 if under 6 months old);
  • 50 will get pneumonia (100 if under 6 months old)
  • 200 will need to go into hospital

If 1000 people are immunised:

  • 100 will have discomfort, redness and swelling where the injection was given or will have a fever

4 in 10,000 will cry for more than three hours after immunisation; and

1 in 10,000 will have a convulsion (fit).

Measles - a highly contagious virus that is spread by close contact with an infected person and causes fever, a cough and a rash.

If 1000 people get measles

  • 1 or 2 will die
  • 50 will get an ear infection
  • 40 will get pneumonia or bronchitis
  • 5 will have convulsions (fits)
  • 160 will get diarrhoea
  • 1 will develop encephalitis (swelling of the brain) For every 10 children who develop encephalitis - 1 will die and - up to 4 will have brain damage.

1 in 8000 children under two years of age get SSPE (brain degeneration), which may be many years after measles and is always fatal.

1 in 6000 will get a blood clotting problem.

If 1000 people are immunised:

  • 100 will have discomfort, redness and swelling where the injection was given or will have a fever.
  • 50 will get a rash six to ten days later (this is not contagious)
  • 1 will have a febrile convulsion (fit)

1 in 10 million may develop encephalitis (inflammation of the brain)

1 in 22,000 will get a temporary blood clotting problem.

Reactions are much less common after the second MMR vaccine.

Mumps - a contagious virus that is spread by close contact with an infected person and causes swollen neck glands and a fever.

If 1000 people get mumps:

  • 50 will get viral meningitis
  • 1 will get encephalitis (brain inflammation)
  • 400 men who have mumps will get swollen testicles
  • 300 will get fever, a headache, and swollen salivary glands under the jaw, and

1 in 20000 may become deaf.

Mumps can also rarely cause infertility in men.

If 1000 people are immunised:

  • 100 will have discomfort, redness and swelling where the injection was given or will have a fever
  • 10 may develop swelling of the salivary glands under the jaw (this is not contagious)
  • 1 in 10 million may develop encephalitis (inflammation of the brain).
  • Reactions are much less common after the second MMR vaccine.
Rubella (German Measles) - a contagious virus that is spread by close contact with an infected person and causes a rash, fever and swollen glands. It may cause major birth defects in the baby if the mother gets rubella in early pregnancy.

If 1000 mothers develop rubella in early pregnancy:

  • 900 babies will have a major birth defect (such as deafness, blindness, brain damage or heart defects) if the mother got rubella in early pregnancy.

If people get rubella:

1 in 3000 get thrombocytopenia (bruising or bleeding of the skin)

1 in 6000 get encephalitis (inflammation of the brain)

1 in 2 will get a rash and painful swollen glands; and

More than half of women with rubella get painful joints.

If 1000 people are immunised:

  • 100 will have discomfort, redness and swelling where the injection was given or will have a fever
  • 50 get swollen glands, a stiff neck, or joint pains
  • 50 get a rash (which is not contagious)
  • 1 in 25,000 get bruising or bleeding; and
  • 1 in 10 million may develop encephalitis (inflammation of the brain).
  • Reactions are much less common after the second MMR vaccine.

 

Further information is also available on the following pages of our website

Name of the vaccines

The 4 in 1 vaccine used in the school programme is called Tetravac. It is manufactured by Sanofi Pasteur.

Two MMR vaccines are used in the school programme. The MMR vaccines used in the school programme are called Priorix and MMRVaxPro. Priorix is manufactured by GSK. MMRVaxPro is manufactured by MSD Ireland (Human Health).

The licensed documents for each vaccine (the Summary of Product Characteristics and the Patient Information Leaflet) are available from the HPRA Website (you will be directed to the HPRA website). 

The following information materials are available for parents of children in Junior Infants of primary schools.

Information booklet

English (822KB) | Irish (797KB) | Arabic (171KB) | French (134KB) | Polish (160KB) | Lithuanian (177KB) | Latvian (180KB) | Pashto (218KB) | Albanian (131KB) | Romanian (173KB) | Russian (188KB) | Ukrainian (188KB) | Somali (137KB) | Dari (147KB) | Georgian (183KB) | Urdu (190KB)

Consent form

English (175KB) | Irish (184KB) | Ukrainian (396.5KB)

Letter to parents and guardians

English (111KB) | Irish (107KB)

Post Vaccination Advice

English (556KB) | Irish (560KB) | Ukrainian (211KB) | Russian (212KB)

If you have any other queries please contact the schools immunisation programme office in your area. 

The following information is available for healthcare professionals carrying out this programme.

This page was updated on 8 February 2024