Childhood Immunisations

The following Q&A covers commonly asked questions relating to all childhood immunisations.

• What are the “routine” childhood vaccinations?

Immunisation is a way of protecting against serious infectious diseases. Once we have been immunised, our bodies are better able to fight those diseases if we come into contact with them.

Routine immunisations are given to children before they start school to help protect them from serious childhood diseases.

• How do vaccines work?

Vaccines contain a weakened form or small part of the bacterium or a virus that causes a disease, or tiny amounts of the chemicals that the bacterium produces. Vaccines work by causing the body’s immune system to develop memory to that infection. If your child comes into contact with the infection, the body will recognise it and can rapidly make antibodies (substances that fight off infection and disease) to protect him or her. Because vaccines have been used so successfully in the UK, diseases such as diphtheria have almost disappeared from this country.

• Which immunisations will my child have and when?

You can find the full schedule of vaccinations on the NHS website.

• Is it safe to have several vaccinations in one go?

Yes. From birth, babies’ immune systems protect them from the germs that surround them. Without this protection, babies would not be able to cope with the tens of thousands of bacteria and viruses that cover their skin, nose, throat and intestines. This protection carries on throughout life.

Studies have shown that it is safe to have several vaccinations at the same time and your baby will be protected as soon as possible from some very serious infections.

• My child is unwell – can they still go for their vaccination?

If your child has a minor illness without a fever, such as a cold, they should have their immunisations as normal.

If your child is ill with a fever, put off the immunisation until the child has recovered. This is to avoid the fever being associated with the vaccine, or the vaccine increasing the fever your child already has.

• Is natural immunity better? Will catching the disease make my child’s immune system stronger than a vaccine?

There is no other proven, effective way to immunise your child against infectious disease without experiencing the serious risk of that infection.  Childhood infections can cause serious illness, hospitalisation and life-long disabilities.

Vaccines teach your child’s immune system how to create antibodies that protect them from diseases. It’s much safer for your child’s immune system to learn this through vaccination than by catching the diseases and treating them.

Vaccines mean if your child comes into contact with the infection, the antibodies will recognise it and be ready to protect them.

• Why does my child need multiple doses of some vaccines?

Most immunisations have to be given more than once to prepare your child’s immunity. For example, 4 doses of DTaP/IPV/Hib/HepB vaccine are needed to provide protection in babies. Booster doses are then given later in life to provide longer-term protection.

• Are these immunisations necessary with such low cases of these diseases?

In the UK, these diseases, such as measles, are kept at bay by high immunisation rates. Around the world, millions of people a year die from infectious diseases with more than 5 million of these being children under the age of 5. Many of these deaths could be prevented by immunisation.

As more people travel abroad and more people come to visit this country, there is a risk that they will bring these diseases into the UK. The diseases may spread to people who haven’t been immunised, or who are still too young to be immunised.

Immunisation doesn’t just protect your child; it also helps to protect your family and the whole community, especially those children who, for medical reasons, can’t be immunised. Refer to reasons why your baby should not be immunised for details.

• How do we know that vaccines are safe?

Before a vaccine is allowed to be used, its safety and effectiveness have to be thoroughly tested. After they have been licensed, the safety of vaccines continues to be monitored. All routine vaccines in the NHS programme have been used in millions of children worldwide and have an excellent safety record.

All health authorities worldwide agree that immunisation is the safest way to protect our children’s health.

• Will there be any side effects from the vaccines?

Any side effects that occur are usually mild and short lived. Your child may get a little redness, swelling or tenderness where the injection was given that will disappear on its own. Fever can be expected after any vaccination. There is advice for parents on what to expect after vaccination here:  What to expect after vaccinations – GOV.UK (www.gov.uk)

Fever is more common after the first two doses of the Meningococcal B (Men B) vaccination, which are given at 8 weeks and 12 weeks old. There is specific advice for parents on how to prevent and treat fever after MenB vaccine at 8 and 12 weeks here: MenB vaccine and paracetamol – GOV.UK (www.gov.uk)

• I’m worried that my child may have allergies. Can they be vaccinated?

Very rarely, children can have an allergic reaction soon after immunisation. This reaction may be a rash or itching affecting part or all of the body. The doctor or nurse giving the vaccine will know how to treat this. It does not mean that your child should stop having immunisations.

• Anaphylactic reaction

Even more rarely, children can have a severe reaction, within a few minutes of the immunisation, which causes breathing difficulties and can cause the child to collapse. This is called an anaphylactic reaction. Anaphylactic reactions to vaccines are extremely rare, with only 1 anaphylactic reaction in about a million immunisations.

An anaphylactic reaction is a severe and immediate allergic reaction that needs urgent medical attention. The people who give immunisations are trained to deal with anaphylactic reactions and most children recover completely with treatment.

• What if my child has an underlying health condition?

There are very few reasons why babies cannot be immunised. Vaccines should not be given to babies who have had a confirmed anaphylactic reaction to either a previous dose of the vaccine, or to any contents of that vaccine.

• Immunosuppressed children

In general, children who are ‘immunosuppressed’ should not receive certain live vaccines.

Children who are immunosuppressed include those whose immune system does not work properly because they are undergoing treatment for a serious condition such as a transplant or cancer, or who have any condition which affects the immune system, such as severe primary immunodeficiency. Primary immunodeficiencies are very rare diseases that mean you are more likely to catch infections. They are usually caused by a faulty gene and are diagnosed soon after birth.

If this applies to your child, you must tell your doctor, practice nurse or health visitor before the immunisation. These children can be best protected by ensuring those around them, for example their siblings, are fully vaccinated.

They will need to get specialist advice on using live vaccines such as MMR, rotavirus vaccine and Bacillus Calmette-Guérin vaccine (BCG).

There are no other reasons why vaccines should definitely not be given.

• What about the MMRV and nasal spray flu vaccine? Are there any other reasons why my child should not receive these?

The MMRV and nasal flu vaccines are live attenuated vaccines (that is, they contain viruses that have been weakened). Children who are ‘immunosuppressed’ may not be able to receive live vaccines. Children who are immunosuppressed include those:

• • whose immune system is suppressed because they are undergoing treatment for a serious condition such as a transplant or cancer, or
  • who have any condition which affects the immune system, such as severe primary immunodeficiency. If this applies to your child, you must tell your doctor, practice nurse or health visitor before the immunisation. They will get specialist advice.

 

• Can I check my child is up to date with their vaccinations?

If you are not sure if your child has had all their routine vaccinations, check their personal health record (red book) or contact your GP practice.

If your child is going abroad, make sure their routine immunisations are up to date. Your child may also need extra immunisations and you may also need to take other precautions.

• How will I know when my baby’s immunisations are due?

Your doctor’s practice or clinic will send you an appointment for you to bring your baby for their immunisations. Most surgeries and health centres run special immunisation or baby clinics. If you can’t get to the clinic, contact the practice to make another appointment. All childhood immunisations are free. You can also find details in your child’s red book.

• How can I catch up if my child has missed any vaccinations?

If you miss the appointment or need to delay the immunisation, make a new appointment. You can pick up the immunisation schedule where it stopped without having to start again.

Rotavirus vaccine can only be started in babies up to 15 weeks of age and no dose of the vaccine can be given over 24 weeks of age.

• Do any routine childhood vaccines contain pork?

Gelatine is a substance derived from the collagen of animals such as chickens, cattle, pigs and fish. Porcine gelatine is used in some vaccines as a stabiliser. This is to ensure that the vaccine remains safe and effective during storage. Porcine gelatine is found in two of the vaccines routinely given to children: the MMRV vaccine and the nasal influenza vaccine.

In the UK we have two MMRV vaccines. Both work very well, one contains porcine gelatine and the other doesn’t. If you want your child to have the porcine gelatine free vaccine, discuss it with your practice nurse or GP.

If you are catching up your child who was born before 31 December 2019, there are also two MMR vaccines which work very well, one containing porcine gelatine and one without.

A flu vaccine injection is available that does not contain gelatine. If you would like your child to have the injection, speak to the person vaccinating your child or ask for the flu vaccine injection on the school consent form.

MMRV

• What is the MMRV vaccine?

The MMRV vaccine will offer protection against measles, mumps, rubella, and chickenpox (clinically known as varicella). On 1 January 2026, the MMRV vaccine was introduced into the routine childhood immunisation schedule in the UK. When your child will be offered this vaccine depends on their date of birth.

The MMRV vaccine has been safely used for over a decade and is already part of the routine childhood vaccine schedule in several countries, including Canada, Australia and Germany.

• What is measles?

Measles is caused by a virus that spreads very easily. Symptoms include high fever, rash, sore red eyes, cough and runny nose. Children can be off school for 10 days and 1 in 5 people with measles will be admitted to hospital.

Complications include chest infections, fits, encephalitis (infection of the brain) and brain damage. It is more severe in babies under one year old, pregnant women, and people with weakened immune systems. Around 1 in 5,000 people who catch measles die from the complications.

• What is mumps?

Mumps is caused by a virus. Symptoms include fever, headache and painful, swollen glands in the face, neck and jaw.

Complications include hearing loss, meningitis, encephalitis, and painful swelling of the testicles and ovaries.

• What is rubella?

Rubella is caused by a virus. In children it is usually mild and can cause a rash, swollen glands and a sore throat.

If pregnant women catch rubella it can affect their unborn baby, causing serious damage to their sight, hearing, heart and brain.

• What is chickenpox (varicella)?

Chickenpox is a very infectious disease caused by the varicella zoster virus. It is very common in young children and causes a fever and an itchy, spotty rash. These spots can be painful and appear all over the body.

Some children have serious complications including chest infection, fits, and encephalitis. It is more severe in adults, especially pregnant women and people with weakened immune systems.

Later in life, the chickenpox virus can re-activate and cause a painful rash. This is called shingles. It is worse in older people and in people with weakened immune systems.

• Why does my child need to be protected against chickenpox?

Chickenpox is a highly infectious disease that is very common in young children. It causes an itchy, spotty rash, and a fever. Most children with chickenpox will have a mild illness and recover after around a week. However, some children will have a more serious illness and need to be admitted to hospital. In rare cases, children can develop complications such as bacterial infections, brain and lung inflammation, and stroke. The vaccination will help prevent severe cases of chickenpox and the serious complications that can occur.

•  When will my child get the MMRV vaccine?

If your child was born on or after 1 January 2025 they will be offered:

• • their first dose of MMRV at 12 months old

• • their second dose of MMRV at 18 months old

If your child was born between 1 July 2024 and 31 December 2024, they should have already had one dose of MMR at 12 months. They will be offered:

• • their first dose of MMRV at 18 months

• • a second dose of MMRV at 3 years and 4 months

These children will receive 3 doses of a vaccine that protects against measles, mumps and rubella. There are no concerns with this additional dose, and it allows children in this age group to receive 2 doses of a vaccine that protects against chickenpox, helping to ensure they have good protection.

If your child was born between 1 September 2022 and 30 June 2024:

• • they should have already had their first dose of MMR at 12 months

• • they’ll be offered one dose of MMRV at 3 years and 4 months (instead of their second MMR)

These children will be offered 1 dose of a vaccine that protects against chickenpox, which provides very good protection against severe disease.

•  Will there be a catch-up programme for older children?

A one-dose MMRV catch-up will be offered to children born between 1 January 2020 and 31 August 2022 (children aged under 6 years old on 31 December 2025). These children will be offered a catch-up MMRV vaccine between November 2026 and March 2028, if they haven’t already had chickenpox or been vaccinated against it.

You don’t need to worry about checking your child’s medical history. When you’re contacted about the catch-up programme, you can let the healthcare team know if your child has already had chickenpox or 2 doses of the chickenpox (varicella) vaccine. There are no safety concerns if a child gets the MMRV vaccine after having chickenpox, so if you can’t remember if your child has already had chickenpox, or if you are unsure, it is better that they get the vaccine, if they’re eligible.

Children aged 6 or over at the end of 2025 won’t be offered the MMRV vaccine as part of the routine programme or catch-up offers. They should have already received 2 doses of the MMR vaccine at 12 months and 3 year and 4 months of age. They can still get the MMR vaccine if they haven’t already had both doses. Most children in this age group will have already had chickenpox infection.

• Why is the varicella (chickenpox) being combined with MMR?

The MMRV vaccine provides greater protection against all four diseases.

• • The MMRV vaccine has been shown to create long lasting protection against all four diseases.

• • Using a combined vaccine for both the first and second dose means fewer injections are needed in a single immunisation visit.

• • Previous attitudinal work has suggested that having fewer injections is preferred among parents, and a recent study among UK parents indicated that a combined varicella vaccine was preferred to separate vaccines.⁸

• • Countries that have introduced programmes have observed a significant impact on cases of varicella and resulting hospitalisations. In countries introducing a 2-dose schedule, younger cohorts not eligible for vaccination have also seen reduced incidence because of reduced community transmission

• What if my child has already had chickenpox?

Even if your child has already had chickenpox, there are no safety concerns if a child gets the MMRV vaccine. This will protect them against measles, mumps and rubella, as well as chickenpox.

• Are there any side effects from the MMRV vaccine?

Vaccines offered by the NHS are thoroughly tested to assess how safe and effective they are. All medicines can cause side effects, but vaccines are among the safest.  Common side effects do not usually last long and are mild, such as a sore arm, fever, and a rash around the site of the injection.

• How will my child be offered the MMRV vaccine? 

You’ll usually be contacted by your GP practice when your child is due for a routine vaccination like MMRV. This could be a letter, text, phone call, or email.

If you know your child is due for a vaccination and you have not been contacted, you can speak to your GP practice to book the appointment.

• Which vaccines are available? Is there a porcine gelatine free version?

There are 2 MMRV vaccines which work equally well: ProQuad and Priorix Tetra. ProQuad contains porcine gelatine (gelatine from pigs) and Priorix Tetra does not. If you want your child to have the vaccine without gelatine, talk to your practice nurse or GP.

• Why can’t my child have the vaccines separately?

Only the MMRV vaccine will be used in the routine vaccination programme, as this offers the best available protection against four diseases with 2 doses. Having the vaccines separately would mean 8 injections, and fewer children would be protected sooner against these diseases. If children don’t have protection against all 4 of these diseases, the risk of the resurgence of the infections rises.

• Could this vaccine overload my child’s immune system?

Giving your child the MMRV vaccine alongside the other vaccines given at the same age will not overload their immune system. From birth, a baby’s immune system protects them from the germs that surround them. Studies show it is safe to have several vaccinations at the same time.

• Does the chickenpox vaccine protection last for life?

MMRV is a simple way to protect your child against measles, mumps, rubella and chickenpox. Since the MMR vaccine was introduced in 1988, cases of measles, mumps and rubella have all fallen to extremely low levels. MMRV offers the same protection as MMR (measles, mumps and rubella), but adds protection against chickenpox. In countries where children already get a chickenpox vaccine, cases of chickenpox have also fallen dramatically. Studies so far show that the protection given by 2 doses of vaccine does not reduce over time.

• NHS England: Childhood vaccinations
• NHS England: Why vaccination is important and the safest way to protect yourself

 

UKHSA further information:

• Immunisation
• Immunisations: babies up to 13 months of age
• Immunisations at one year of age
• Pre-school vaccinations: guide to vaccinations from 2 to 5 years
• What to expect after vaccinations
• Vaccines and porcine gelatine
• Use of human and animal products in vaccines
• Immunisation information for migrants