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Health Checks for 4-year-olds

Public Service, Paediatrics, Other


There are a number of important health appointments that are due when your child is four years old. These are all best done close to their 4th birthday and are all FREE. If you need assistance booking your child for any of these important health checks, please contact the Uri Ririki Child Health Connection Centre team on 0800 242 737.


Immunisation helps protect tamariki/children from serious diseases that can spread quickly in schools. At 4 years of age, your tamaiti/child is due for immunisations that give them protection against diseases such as:

  • Diphtheria – a throat infection that makes it hard to breathe or swallow. Diphtheria may also affect the nerves, muscles and heart
  • Tetanus - causes muscles to stiffen and spasm, and makes it extremely hard to breathe or swallow
  • Pertussis (Whooping cough) - damages the breathing tubes, causing coughing spells and vomiting. It may lead to permanent lung damage, and can cause babies to stop breathing. Young babies are most at risk
  • Polio - can paralyse the body and make it hard to breathe.

Some tamariki/children may also still need their second dose of Measles, Mumps, Rubella (MMR) immunisation (up until 2020 this was given at 15 months and 4 years of age, but since October 2020 these vaccines are now given at 12 months and 15 months of age, with a catch up of tamariki/children who are yet to have their second dose):

  • Measles – causes a rash, a runny nose, coughing and sore, watery eyes. It may also cause pneumonia, ear infections and brain damage
  • Mumps – causes swelling around the face, a fever and a headache. Mumps may cause swelling of the brain and deafness
  • Rubella – causes a mild illness with a rash and joint pain. It is serious if a pregnant woman catches rubella early in her pregnancy. Her baby may be born with serious problems, such as deafness, blindness, heart defects and brain damage.

For the best protection, it’s best if your tamaiti/child has these immunisations close to their 4th birthday – book an appointment with your family doctor clinic today.  These immunisations are all FREE!

 For more information about immunisation:


B4 School check

The B4 School Check is a free health check of your tamaiti/child’s health and development before they start school. It’s also an opportunity for you to talk with a nurse about your tamaiti/child and ask about things that are important to you.

It’s a good idea for your child to have their check soon after their 4th birthday – that leaves enough time for any follow-up is needed before they start school. 

 To book your child’s appointment, call 0800 104 105.

 For more information about the B4 School Check:


Vision and Hearing Testing (VHT)

In the Auckland region, technicians visit kohanga reo, kindergartens (kindy) or day cares to check vision and hearing of 4 year olds for free. At this check, the VHT technician will check your tamaiti/child’s eyes and ears for any problems that may affect their school learning.

If your tamaiti/child does not go to a day care, kindy or kohanga reo, please contact the vision and hearing team to book an appointment:

  • Central Auckland – 09 639 0200 extension 27407
  • West Auckland – 09 839 0000 extension 47733
  • North Auckland – 09 839 0000 extension 43286
  • If you are unsure what DHB you are in – the Uri Ririki Child Health Connection Centre team on 0800 242 737 will be able to help


Oral Health check

Your tamaiti/child should have their teeth checked regularly by a dental therapist. At this check, the dental health therapist would check the health of your tamaiti/child’s teeth and talk to you about your tamaiti/child’s diet and teeth brushing habits.  Depending on your tamaiti/child’s age and needs this check may include x-rays to check for problems below the gum, between & inside teeth, bone areas and tissue within the mouth.

 For FREE dental care, contact 0800 TALK TEETH (0800 825 583).

 Here are some ways you can help to keep your tamaiti/child's teeth healthy:

  • Brush teeth two times a day with fluoride toothpaste
  • Give your child water to drink when thirsty, it is fresh and free
  • Keep sweet foods to mealtimes and try to give teeth a rest of 2 hours between eating
  • Give sugar-free snacks such as bread, cheese, vegemite, fresh fruit, vegetables, egg, plain crackers.

For more information:

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This page was last updated at 11:31AM on July 5, 2021. This information is reviewed and edited by Health Checks for 4-year-olds.