For thousands of children heading back to school this fall, the obligatory visit to the doctor’s office may leave them feeling less like a pincushion than in previous years.

This is due in large part to the growing trend of combining vaccines and booster shots into one or two injections, says Stephen Aronoff, M.D., chair and professor of pediatrics at Temple University’s School of Medicine.

Currently, children who are starting kindergarten (between ages 4 and 6) need a total of five shots: vaccines for diphtheria, tetanus and pertussis (DTaP); polio; measles, mumps and rubella (MMR); chickenpox; and hepatitis A. Children who are in day care need these plus an additional vaccine against Haemophilus influenza b (Hib).

“No one likes getting shots, but for young children especially, that’s a lot of needles,” Aronoff said.

In addition, before starting junior high or middle school (around age 11), children need to receive booster shots of all of these, and it is recommended they also have the vaccine for bacterial meningitis.

Aronoff says the recent federal approval of Pentacel and Kinrix, two new combination vaccines that immunize infants and children against multiple diseases, will make it easier to fulfill school requirements with less stress to the patient.

Pentacel is a five-in-one vaccine meant to protect infants and children against diphtheria, tetanus, pertussis (whooping cough), polio and Hib. Kinrix is a four-in-one booster vaccine that is given to protect against diphtheria, tetanus, pertussis and polio.

While these vaccinations can be combined, Aronoff notes that there are still other vaccinations that children will need to get separately:

• Flu vaccine: every year
• Chickenpox: unless they have already contracted it or have gotten the required two doses
• Meningitis
• TDaP: if it has been more than five years since the last booster

He adds that at age 12, girls should get the Gardasil vaccine, which prevents the four major types of the human papillomavirus that can lead to cervical cancer.

“Previously, you couldn’t just mix vaccines together into one syringe; the volume would be much too big and many of the ingredients would counteract each other,” Aronoff said.

“But now we’re definitely going to see more about how vaccinations and booster shots can be combined. It’s more convenient and much easier for a child to sit still for one shot as opposed to four or five.”