UK immunisation

The routine childhood schedule

• 8 weeks: 6-in-1 (diphtheria, tetanus, pertussis, polio, Hib and hepatitis B), MenB and rotavirus.
• 12 weeks: 6-in-1, MenB and rotavirus.
• 16 weeks: 6-in-1 and PCV.
• 1 year: MMRV, the MenB booster and the PCV booster.
• 18 months: the fourth 6-in-1 dose and the second MMRV.
• 3 years 4 months: the 4-in-1 pre-school booster (diphtheria, tetanus, pertussis and polio).
• 12 to 13 years: HPV, a single dose, for girls and boys in school.
• 14 years: the 3-in-1 teenage booster (tetanus, diphtheria and polio) and MenACWY.
• Flu: nasal flu vaccine every year from age 2 through school.

What changed

• July 2025: the second MenB dose moved to 12 weeks, and PCV moved to 16 weeks and 1 year.
• January 2026: MMRV replaced MMR at 1 year and 18 months, adding chickenpox protection. A new 18-month appointment gives the fourth 6-in-1 dose, and the Hib/MenC booster was dropped.

Babies at higher risk

• Mother with hepatitis B: hepatitis B vaccine at birth (with immunoglobulin if she is highly infectious) and at 4 weeks, then the routine 6-in-1 doses, including the 18-month dose, with a blood test between 1 year and 18 months.
• BCG: babies in areas of high TB incidence, or with a parent or grandparent from a high-incidence country.
• Premature babies are vaccinated by chronological age, starting 8 weeks after birth, not by corrected age.
• Paracetamol after MenB: under 1 year, give paracetamol with the vaccine and two more doses 4 to 6 hours apart, to prevent fever.

Rotavirus

• The first dose must be given before 15 weeks, and the course completed by 24 weeks.
• It is not given after intussusception or to babies with severe combined immunodeficiency.

In pregnancy

• Whooping cough: in every pregnancy from 16 weeks, ideally before 32 weeks.
• RSV: from 28 weeks, in every pregnancy, to protect the baby in its first months.
• Flu: in season, at any stage of pregnancy.
• No live vaccines. A woman who is not immune to rubella has MMR after the birth.

Adults

• Shingles: at 65 and from 70 to 79, and for adults with severe immunosuppression.
• Flu: every year from 65, and for people with long-term conditions.
• Pneumococcal: at 65, and for people with long-term conditions such as heart failure or COPD.
• Without a working spleen: extra pneumococcal and meningococcal vaccines, and advice on penicillin.

Live vaccines and who must not have them

• Live vaccines in the UK programme: rotavirus, MMR and MMRV, nasal flu and BCG (and yellow fever for travel).
• Not given to people with severe immunosuppression or in pregnancy. Avoid for 6 months after chemotherapy and 12 months after biological therapy.
• The only true contraindication to any vaccine is confirmed anaphylaxis to a previous dose or a component.

Not reasons to delay

• Egg allergy is not a reason to withhold MMR.
• A cold without fever is not a reason to delay. Postpone only for an acute illness with fever.
• A course that was interrupted is carried on where it stopped. Never restart it.
• An unknown history: assume the child is unvaccinated and follow the UKHSA catch-up guidance.
• Nasal flu contains porcine gelatine. If a family declines it for that reason, offer an injected vaccine.

Consent and safety

• A parent can consent for a child, and a child under 16 who is Gillick competent can consent for themselves.
• Every vaccination session must have adrenaline and staff trained to treat anaphylaxis.
• Tetanus-prone wounds: a high-risk wound with incomplete vaccination needs a tetanus-containing vaccine and tetanus immunoglobulin.
• Measles exposure: MMR within 72 hours for susceptible contacts who can have a live vaccine; human normal immunoglobulin for babies, non-immune pregnant women and others who cannot.