Vaccinations at 18 months

Key facts

  • At 18 months, three age-specific vaccines are recommended for your child. These include: 

    • a combined vaccine that protects against measles, mumps, rubella, and varicella (chickenpox)
    • a combined vaccine that protects against diphtheria, tetanus, and pertussis (whooping cough) 
    • a vaccine that protects against Hib.

  • It is also recommended that your child is vaccinated against influenza every year before the influenza season. Influenza vaccines are free for all children aged six months to under five years, and can be given at the same time as age-specific vaccines.

Last updated on 9 June 2023.

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What vaccines are recommended for my child?

Three age-specific vaccines are recommended for children when they are 18 months old. The technical names for the vaccines are:

  • combined DTPa vaccine, which strengthens children’s immunity to diphtheria, tetanus and pertussis (whooping cough)
  • combined MMRV vaccine, which strengthens children’s immunity to measles, mumps and rubella, and protects them from varicella (chickenpox)
  • Hib vaccine, which strengthens children's immunity to Haemophilus influenzae type b (Hib).

It is also recommended that your child gets an influenza vaccine every year before the influenza season. An influenza vaccine is one of the best ways to protect your child against influenza, sometimes called ‘the flu’. Influenza vaccines are free and can be given at the same time as age-specific vaccines.

What diseases do the vaccines protect my child against?

The vaccines recommended for your baby at 18 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 >

Measles is best known as a disease that causes a red and blotchy rash. It spreads from person to person just like a cold, even before the rash starts. Measles can be very serious. It causes lung infections (pneumonia), blindness, bleeding (thrombocytopenia) and brain diseases including meningitis and subacute sclerosing panencephalitis or SSPE. SSPE is very rare, but always fatal.1

Learn more about measles and measles vaccination >

Mumps is a virus that spreads from person to person. It causes headaches, sore throat, fevers (high temperatures), aching muscles and painful swellings in the jaw area. Rarely, mumps causes brain infections such as meningitis or encephalitis.1

Learn more about mumps and mumps vaccination >

Rubella is sometimes called ‘German measles’ because it causes a rash that looks like the one caused by measles, but it is a different disease. Rubella is usually a very mild illness, but it spreads easily from one person to another. If a pregnant woman catches rubella, her baby will almost certainly be born with serious birth defects such as deafness, blindness or brain damage. Vaccinating children against rubella helps protect mothers and their babies against the disease.1

Learn more about rubella and rubella vaccination >

Varicella Is usually called chickenpox. It is a virus that spreads easily from person to person like a cold or flu. It causes fever and itchy red spots that become blisters. The condition is usually mild for children but can be very serious for adults. Pregnant women who get chickenpox can get pneumonia, encephalitis (brain swelling), and hepatitis (liver disease). Their babies may be born underweight, with scars on their skin, or with arms, legs and brains that do not develop normally. These babies can also get a painful disease called shingles in the first few years of their lives. Vaccinating children against varicella helps protect mothers and babies.1

Learn more about varicella and varicella 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 >

Influenza is an illness caused by influenza viruses. Although some of the symptoms are similar, influenza is different from the common cold. Influenza is usually more severe and lasts longer. Even if your child is usually healthy, influenza can make them very unwell. It can lead to serious conditions like severe lung infection (pneumonia) or inflammation in the brain (encephalitis). Babies and children under the age of five are more likely to get severe influenza than adults and other children. They are also more likely than adults and older children to need treatment in hospital.1

Learn more about influenza and influenza vaccination >

What do I need to do before the vaccination?

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

Most parents take their children to be vaccinated at their local general practice or at a vaccination clinic. If possible, take your child’s health record booklet with you so your doctor or nurse can make notes about the vaccinations they have had.

No matter how gentle your doctor or nurse is, needles hurt! And most children 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 children 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 child 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?

When your child is four years old, a combined DTPa/IPV vaccine is recommended to strengthen their immunity to diphtheria, tetanus, pertussis, and polio.

If your child has had an influenza vaccine for the first time, they will need a second dose four weeks later. After that, it is recommended that your child gets one dose of an influenza vaccine every year before influenza season.

It is important that 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 child, 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