diff --git a/engine/src/main/java/com/google/android/fhir/db/impl/ResourceDatabase.kt b/engine/src/main/java/com/google/android/fhir/db/impl/ResourceDatabase.kt
index 3502ab0b8e..83cae93e4e 100644
--- a/engine/src/main/java/com/google/android/fhir/db/impl/ResourceDatabase.kt
+++ b/engine/src/main/java/com/google/android/fhir/db/impl/ResourceDatabase.kt
@@ -109,7 +109,26 @@ val MIGRATION_4_5 =
   object : Migration(4, 5) {
     override fun migrate(database: SupportSQLiteDatabase) {
       database.execSQL(
-        "ALTER TABLE `ResourceEntity` ADD COLUMN `lastUpdatedLocal` INTEGER DEFAULT NULL",
+        "CREATE INDEX IF NOT EXISTS `index_DateTimeIndexEntity_resourceType_index_name_resourceUuid_index_from_index_to` ON `DateTimeIndexEntity` (`resourceType`, `index_name`, `resourceUuid`, `index_from`, `index_to`)"
+      )
+      database.execSQL(
+        "CREATE INDEX IF NOT EXISTS `index_DateIndexEntity_resourceType_index_name_resourceUuid_index_from_index_to` ON `DateIndexEntity` (`resourceType`, `index_name`, `resourceUuid`, `index_from`, `index_to`)"
+      )
+      database.execSQL(
+        "CREATE INDEX IF NOT EXISTS `index_TokenIndexEntity_resourceType_index_name_index_system_index_value_resourceUuid` ON `TokenIndexEntity` (`resourceType`, `index_name`, `index_system`, `index_value`, `resourceUuid`)"
+      )
+      database.execSQL("DROP INDEX IF EXISTS `index_DateTimeIndexEntity_index_from`")
+      database.execSQL(
+        "DROP INDEX IF EXISTS `index_DateTimeIndexEntity_resourceType_index_name_index_from_index_to`"
+      )
+      database.execSQL(
+        "DROP INDEX IF EXISTS `index_DateIndexEntity_resourceType_index_name_index_from_index_to`"
+      )
+      database.execSQL(
+        "DROP INDEX IF EXISTS `index_TokenIndexEntity_resourceType_index_name_index_system_index_value`"
+      )
+      database.execSQL(
+        "ALTER TABLE `ResourceEntity` ADD COLUMN `lastUpdatedLocal` INTEGER DEFAULT NULL"
       )
     }
   }