NHS Vaccinations Schedule
NHS vaccinations and when to have them. It’s important that vaccines are given on time for the best protection, but if you or your child missed a vaccine, contact the practice to catch up.
Extra vaccines for at-risk people
Some vaccines are only available on the NHS for groups of people who need extra protection.
Vaccines For At-risk Babies And Children
Babies born to mothers who have hepatitis B
Hepatitis B vaccine at birth, 4 weeks and 12 months
Children born in areas of the country where there are high numbers of TB cases
Children whose parents or grandparents were born in a country with many cases of TB
Children 6 months to 17 years old with long-term health conditions
Children’s flu vaccine every year
Vaccines For People With Underlying Health Conditions
Problems with the spleen, for example caused by sickle cell disease
Pneumococcal vaccine (both PCV13 and PPV)
Chronic respiratory and heart conditions, such as severe asthma or heart failure
Chronic neurological conditions, such as Parkinson’s disease or a learning disability
Chronic kidney disease
Chronic liver conditions
Weakened immune system caused by treatments or disease
Complement disorders or people receiving complement inhibitor therapies
If you’re starting college or university you should make sure you’ve already had:
- the MenACWY vaccine – which protects against serious infections like meningitis. You can still ask your GP for this vaccine until your 25th birthday.
- 2 doses of the MMR vaccine – as there are outbreaks of mumps and measles at universities. If you have not previously had 2 doses of MMR you can still ask your GP for the vaccine.
What To Expect After Vaccination
Please click below to download the information leaflet – What to expect after vaccinations
To view the ‘What to expect after vaccinations’ leaflet in different languages, please visit the following link: What to expect after vaccinations – GOV.UK (www.gov.uk)
3-in-1 teenage booster
It's a single injection given into the muscle of the upper arm.
Who should have the 3-in-1 booster?
The 3-in-1 teenage booster is free on the NHS for all young people aged 14, as part of the national immunisation programme.
It's routinely given at secondary school (in school year 9) at the same time as the MenACWY vaccine.
Schools will send a letter to parents shortly before the vaccinations are planned to ask for their or their child's consent.
Children who are home educated will also be offered the vaccine, provided they're in an eligible school age group.
How safe is the 3-in-1 booster vaccine?
The 3-in-1 teenage booster is a very safe vaccine.
As with all vaccines, some people may have minor side effects, such as swelling, redness or tenderness where the injection is given.
Sometimes a small painless lump develops, but it usually disappears in a few weeks.
The brand name of the 3-in-1 teenage booster vaccine given in the UK is Revaxis.
4-in-1 pre-school booster
The 4-in-1 pre-school booster vaccine is offered to children from the age of 3 years and 4 months to boost their protection against 4 different serious conditions:
When children should have the 4-in-1 pre-school booster vaccine
The 4-in-1 pre-school booster vaccine is routinely offered to children at the age of 3 years and 4 months old.
The vaccine further increases some of the protection your child already has from having the 6-in-1 vaccine at 8, 12 and 16 weeks old.
How the 4-in-1 pre-school booster vaccine is given
The 4-in-1 pre-school vaccine is injected into your child's upper arm.
The 4-in-1 pre-school booster can be given with other vaccines
It's safe for your child to have the 4-in-1 pre-school booster at the same time as other vaccines, such as the MMR vaccine.
When children have the 4-in-1 pre-school booster and the MMR vaccine at the same time, each vaccine will be injected into a different arm or into a different place on their arm if the same arm needs to be used.
Effectiveness of the 4-in-1 pre-school booster vaccine
Studies have shown that the 4-in-1 pre-school booster vaccine is very effective.
In clinical tests, more than 99 in every 100 children who had been given the 4-in-1 pre-school booster were protected against tetanus, diphtheria, whooping cough and polio.
The vaccine protects children against these infections until they receive their 3-in-1 teenage booster at the age of 14.
The 4-in-1 pre-school booster not only protects your child against these infections, but also stops them passing the germs on to babies who are too young to be vaccinated against these infections.
Safety of the 4-in-1 pre-school booster vaccine
The 4-in-1 pre-school booster vaccine has been thoroughly tested to ensure it's safe and effective.
The vaccine is inactivated (killed), which means it does not contain any live bacteria or viruses.
It cannot cause any of the infections it protects against.
The brand name of the 4-in-1 pre-school booster is REPEVAX. It provides a good booster response.
Side effects of the 4-in-1 pre-school booster vaccine
Some children will have side effects after having the 4-in-1 pre-school booster vaccine. These are usually mild and do not last long.
They usually happen within 48 hours of the injection.
Most children will not have any problems at all.
Your child may get some redness, swelling or tenderness where the injection was given. This will disappear on its own.
Children who cannot have the 4-in-1 pre-school booster vaccine
Most children can have the 4-in-1 pre-school booster vaccine, but there are a few who should not have it.
This includes children who:
- have a high temperature at the time of the vaccination appointment – wait until they’ve recovered
- are allergic to the vaccine or who have had a severe allergic reaction (anaphylactic reaction) to any part of the vaccine before
There's no need to postpone vaccination if your child has a minor illness, such as a cough or a cold with no temperature.
What if your child misses their 4-in-1 pre-school booster appointment
It's best for children to be vaccinated at the right age, as they're then protected against serious infections as early in life as possible.
But do not worry if your child missed having the 4-in-1 pre-school booster first time around. It's never too late to have it.
Make an appointment with your GP surgery or local child health clinic as soon as you can.
The 6-in-1 vaccine is 1 of the first vaccines your baby will have.
It's given as a single injection to protect your baby against 6 serious childhood conditions:
When babies should have the 6-in-1 vaccine
The 6-in-1 vaccine is given to babies when they're 8, 12 and 16 weeks old.
They need 3 doses to make sure they develop strong immunity to the conditions the vaccine protects against.
Every time another dose of the vaccine is given, your baby's immune response increases.
How the 6-in-1 vaccine is given
The 6-in-1 vaccine is injected into your baby's thigh.
How well the 6-in-1 vaccine works
The 6-in-1 vaccine works well.
It produces very good immunity to diphtheria, tetanus, whooping cough, Hib, polio and hepatitis B infections.
6-in-1 vaccine safety
The 6-in-1 vaccine is very safe.
It's killed (inactivated), which means it does not contain any live organisms, so there's no risk of your baby getting the conditions from the vaccine.
Side effects of the 6-in-1 vaccine
The 6-in-1 vaccine has few side effects.
Common reactions include:
- pain, redness and swelling where the injection was given
- high temperature (more common after the 2nd and 3rd doses)
- being sick
- loss of appetite
Unusual high-pitched crying and fits or seizures are rare side effects of the 6-in1 vaccine.
Very rarely, a baby may have a severe allergic reaction (anaphylaxis) after the 6-in-1 vaccine.
The brand name of the 6-in-1 vaccine is Infanrix hexa (DTaP/IPV/Hib/HepB). Read the patient information leaflet for Infanrix hexa on the electronic medicines compendium website
The 6-in-1 vaccine and other vaccines
It's safe for your baby to have the 6-in-1 vaccine at the same time as other vaccines, such as the rotavirus vaccine, pneumococcal vaccine and MenB vaccine.
Babies who should not have the 6-in-1 infant vaccine
Most babies can have the 6-in-1 vaccine, but there are a few that should not, for example, those who:
- are allergic to the vaccine
- have a high temperature at the time of the vaccination appointment – wait until they've recovered
- have a neurological problem that’s getting worse, including poorly controlled epilepsy – wait until they’ve been seen by a specialist
The 6-in-1 vaccine should not be given to babies who have had a severe allergic reaction (anaphylaxis) to a previous dose of the vaccine, or a reaction to any part of the vaccine that may be present in trace amounts, such as neomycin, streptomycin or polymixin B.
There's no need to postpone vaccination if your baby has a minor illness, such as a cough or a cold with no temperature.
If your baby has a history of fits (febrile convulsions) or has had a fit within 72 hours of a previous dose of the vaccine, speak to your GP surgery, nurse or health visitor for advice.
If you miss the 6-in-1 vaccination appointment
It's best if your baby has the 6-in-1 vaccine at the recommended age so that they’re protected from serious conditions as early in life as possible.
If your baby has missed an appointment for the 6-in-1 vaccine, it's never too late to have it. Make an appointment at your GP surgery or local child health clinic.
BCG vaccine for tuberculosis (TB)
The BCG vaccine protects against tuberculosis, which is also known as TB.
TB is a serious infection that affects the lungs and sometimes other parts of the body, such as the brain (meningitis), bones, joints and kidneys.
Who should have the BCG vaccine and when
The BCG vaccine (which stands for Bacillus Calmette-Guérin vaccine) is not given as part of the routine NHS vaccination schedule.
It's given on the NHS only when a child or adult is thought to have an increased risk of coming into contact with TB.
The BCG vaccine should only be given once in a lifetime.
BCG for babies
BCG vaccination is recommended for babies up to 1 year old who:
- are born in areas of the UK where TB rates are high
- have a parent or grandparent who was born in a country where there's a high rate of TB
- live with, or are close contacts of, someone with infectious TB
If the BCG vaccine is recommended for your baby, it will usually be offered at about 28 days old.
This may be offered at a hospital, a local healthcare centre or, occasionally, at your GP surgery.
BCG for children aged 16 and under
BCG vaccination may also be recommended for older children who have an increased risk of developing TB, such as:
- children who have a parent or grandparent who was born in a country where there's a high rate of TB
- children who have recently arrived from countries with high levels of TB, including those in Africa, the Indian subcontinent, parts of southeast Asia, parts of South and Central America, and parts of the Middle East
- children who will be living with local people for 3 months or longer in countries with high rates of TB
- children who live with, or are close contacts of, someone with infectious TB
BCG for adults
BCG vaccination is rarely given to anyone over the age of 16 because there is little evidence it works very well in adults.
But it's given to adults aged 16 to 35 who are at risk of TB through their work, such as some healthcare workers, veterinary staff and abattoir workers.
If you're offered BCG vaccination as an adult, it will usually be arranged through your local occupational health department.
How the BCG vaccination is given
BCG vaccination is given as an injection into the left upper arm.
The vaccination usually leaves a small scar.
How well the BCG vaccine works
The BCG vaccine is made from a weakened strain of TB bacteria. Because the bacteria in the vaccine is weak, it triggers the immune system to protect against the infection but does not give you TB.
It provides consistent protection against the most severe forms of TB, such as TB meningitis in children.
It's less effective in preventing TB that affects the lungs in adults, so has limited impact on the spread of TB.
Side effects of the BCG vaccine
Like all vaccines, the BCG vaccine can cause side effects, but they're uncommon and generally mild.
Some common side effects may include:
- soreness or discharge from where the injection was given
- a high temperature (fever)
- swollen glands under the armpit in the arm where the injection was given
More serious complications, such as abscesses, bone inflammation and widespread TB are rare.
Most children develop a sore at the injection site. Once healed, the sore may leave a small scar. This is normal and nothing to worry about.
Serious side effects from the BCG vaccine, such as a severe allergic reaction (anaphylaxis), are very rare.
The Yellow Card Scheme allows you to report suspected side effects from a vaccine. It's run by the medicines safety watchdog, the Medicines and Healthcare products Regulatory Agency (MHRA).
Children's flu vaccine
The children's nasal spray flu vaccine is safe and effective. It's offered every year to children to help protect them against flu.
Children can catch and spread flu easily. Vaccinating them also protects others who are vulnerable to flu, such as babies and older people.
Who should have the nasal spray flu vaccine
The nasal spray flu vaccine is free on the NHS for:
- children aged 2 or 3 years on 31 August 2021 – born between 1 September 2017 and 31 August 2019
- all primary school children (reception to year 6)
- all year 7 to year 11 children in secondary school
- children aged 2 to 17 years with long-term health conditions
If your child is aged between 6 months and 2 years and has a long-term health condition that makes them at higher risk from flu, they'll be offered a flu vaccine injection instead of the nasal spray.
This is because the nasal spray is not licensed for children under 2 years.
The nasal spray vaccine offers the best protection for children aged 2 to 17 years. They will be offered the flu vaccine injection if the nasal spray vaccine is not suitable for them.
Children who should have the flu vaccine injection
Some children will be offered the injected flu vaccine if they have:
- a severely weakened immune system
- asthma that's being treated with steroid tablets or that has needed intensive care in hospital
- a flare-up of asthma symptoms (such as been wheezy in the past 72 hours or are currently wheezy) and need to use a reliever inhaler more than usual
- had an allergic reaction to a flu vaccine in the past
- a condition that needs salicylate treatment
If you're not sure, check with the school immunisation team, the nurse or GP at your surgery, or a hospital specialist.
The injected flu vaccine is given as a single injection into the muscle of the upper arm, or the thigh for children under 1 year.
Where to have the flu vaccine
|Child's age||Where to have the flu vaccine|
|From 6 months until 2 years|
(with long-term condition)
|From 2 years until child|
starts primary school
|All children at primary school||School|
|Year 7 to year 11 secondary school children||School|
|Children in reception to year 11|
(with long-term condition)
|School or GP surgery|
(same ages as reception to year 11)
Home-schooled children should be invited for vaccination by the local healthcare team. If you do not hear from them, ask your child's GP where they should go for vaccination.
School children with a long-term health condition
You can ask the GP surgery to give the vaccine instead of having it at school if you prefer.
If your child is not in reception to year 11, ask the GP surgery to give the vaccine.
How the nasal spray flu vaccine is given
The vaccine is given as a spray squirted up each nostril. It's quick and painless.
The vaccine will still work even if your child gets a runny nose, sneezes or blows their nose.
Your child will be given 2 doses if they're under 9 years old and have both:
- a long-term health condition that means they're more at risk from flu
- never had a flu vaccine before
These doses are given 4 weeks apart.
How effective is the nasal spray flu vaccine?
The nasal spray flu vaccine gives children the best protection against flu.
It may take around 2 weeks for the flu vaccine to work.
Any children who catch flu after vaccination are less likely to be seriously ill or be admitted to hospital.
Side effects of the children's flu vaccine
The nasal spray flu vaccine for children is very safe. Most side effects are mild and do not last long, such as:
- a runny or blocked nose
- a headache
- loss of appetite
If your child has the injected flu vaccine, side effects include:
- a sore arm (or thigh) where the injection was given
- a slightly raised temperature
- aching muscles
These side effects usually last for a day or 2.
Allergic reactions to the nasal spray flu vaccine
It's rare for anyone to have a serious allergic reaction to the flu vaccine. If they do, it usually happens within minutes.
The person who vaccinates you or your child will be trained to deal with allergic reactions and treat them immediately.
Gelatine, neomycin and gentamicin allergies
Let your doctor or nurse know if your child has had severe allergic reactions to:
- the antibiotics neomycin and gentamicin
The nasal spray flu vaccine has a low egg content and is safe to give in school or in a clinic to children who do not have a serious egg allergy.
Children who have previously needed intensive care in hospital for an egg allergy may be offered the nasal spray vaccine in hospital.
If you're not sure, check with the school immunisation team, the nurse or GP at your surgery, or a hospital specialist.
What's in the nasal spray flu vaccine?
The nasal spray flu vaccine contains small amounts of weakened flu viruses. They do not cause flu in children.
As the main flu viruses can change each year, a new nasal spray vaccine has to be given each year.
The brand of nasal spray flu vaccine available in the UK is called Fluenz Tetra.
The nasal spray vaccine contains small traces of pork gelatine. If this is not suitable, speak to your child's nurse or doctor about your options.
Your child may be able to have an injected vaccine instead.
You can find a full list of ingredients in the Fluenz Tetra nasal spray patient information leaflet on the emc website.
The flu vaccine is a safe and effective vaccine. It's offered every year on the NHS to help protect people at risk of getting seriously ill from flu.
This section is about the flu vaccine for adults.
The best time to have the flu vaccine is in the autumn or early winter before flu starts spreading. But you can get the vaccine later.
Who can have the flu vaccine?
The flu vaccine is given free on the NHS to people who:
- are 50 and over (including those who'll be 50 by 31 March 2022)
- have certain health conditions
- are pregnant
- are in long-stay residential care
- receive a carer's allowance, or are the main carer for an older or disabled person who may be at risk if you get sick
- live with someone who is more likely to get infections (such as someone who has HIV, has had a transplant or is having certain treatments for cancer, lupus or rheumatoid arthritis)
- frontline health or social care workers
Where to get the flu vaccine
You can have the NHS flu vaccine at:
- your GP surgery (At Manor View Practice we normally start the annual Flu Programme in September)
- a pharmacy offering the service
- your midwifery service if you're pregnant
- a hospital appointment
If you do not have your flu vaccine at your GP surgery, you do not have to tell the surgery. This will be done for you.
How to book your appointment
If you're eligible for a free flu vaccine, you can book an appointment at your GP surgery or a pharmacy that offers it on the NHS.
For those eligible we will send you an invitation to get the vaccine, but you do not have to wait for this before booking an appointment.
Everyone who is eligible for the free flu vaccine will be able to get it.
We get the flu vaccine in batches. If you cannot get an appointment straight away, ask if you can book an appointment for when more vaccines are available.
Flu vaccine for people with long-term health conditions
The flu vaccine is offered free on the NHS to anyone with a serious long-term health condition, including:
- respiratory conditions, such as asthma (needing steroid inhaler or tablets), chronic obstructive pulmonary disease (COPD), including emphysema and bronchitis
- heart conditions, such as coronary heart disease or heart failure
- being very overweight – a body mass index (BMI) of 40 or above
- chronic kidney disease
- liver disease, such as hepatitis
- neurological conditions, such as Parkinson's disease, motor neurone disease, multiple sclerosis (MS), or cerebral palsy
- a learning disability
- problems with your spleen, for example, sickle cell disease, or if you have had your spleen removed
- a weakened immune system as the result of conditions such as HIV and AIDS, or taking medicines such as steroid tablets or chemotherapy
Talk to your doctor if you have a long-term condition that is not in one of these groups. They should offer you the flu vaccine if they think you're at risk of serious problems if you get flu.
Flu vaccine if you're pregnant
You should have the flu vaccine if you're pregnant to help protect you and your baby.
It's safe to have the flu vaccine at any stage of pregnancy.
Flu vaccine for frontline health and social care workers
If you're a frontline health and social care worker, your employer should offer you a flu vaccine. They may give the vaccine at your workplace.
You can also have an NHS flu vaccine at a GP surgery or a pharmacy if:
- you're a health or social care worker employed by a registered residential care or nursing home, registered homecare organisation or a hospice
- you work in NHS primary care (such as in a GP surgery, pharmacy, dental surgery or opticians) and have direct contact with patients – this includes contractors, non-clinical staff and locums
- you provide health or social care through direct payments or personal health budgets, or both
Who should not have the flu vaccine
Most adults can have the flu vaccine, but you should avoid it if you have had a serious allergic reaction to a flu vaccine in the past.
You may be at risk of an allergic reaction to the flu vaccine injection if you have an egg allergy. This is because some flu vaccines are made using eggs.
Ask a GP or pharmacist for a low-egg or egg-free vaccine.
If you're ill with a high temperature, it's best to wait until you're better before having the flu vaccine.
How effective is the flu vaccine?
The flu vaccine gives the best protection against flu.
Flu vaccines help protect against the main types of flu viruses, although there's still a chance you might get flu.
If you do get flu after vaccination, it's likely to be milder and not last as long.
Having the flu vaccine will also stop you spreading flu to other people who may be more at risk of serious problems from flu.
It can take 10 to 14 days for the flu vaccine to work.
Flu vaccine side effects
Flu vaccines are very safe. All adult flu vaccines are given by injection into the muscle of the upper arm.
Most side effects are mild and only last for a day or so, such as:
- slightly raised temperature
- muscle aches
- sore arm where the needle went in – this is more likely to happen with the vaccine for people aged 65 and over
Try these tips to help reduce the discomfort:
- continue to move your arm regularly
- take a painkiller, such as paracetamol or ibuprofen – some people, including those who are pregnant, should not take ibuprofen unless a doctor recommends it
Allergic reactions to the flu vaccine
It's very rare for anyone to have a serious allergic reaction (anaphylaxis) to the flu vaccine. If this does happen, it usually happens within minutes.
The person who vaccinates you will be trained to deal with allergic reactions and treat them immediately.
Flu vaccine ingredients
There are several types of injected flu vaccine. None of them contain live viruses so they cannot give you flu.
If you're eligible for the flu vaccine on the NHS, you'll be offered one that's most effective for you, depending on your age:
- adults aged 18 to 64 – there are different types, including low-egg and egg-free ones
- adults aged 65 and over – the most common one contains an extra ingredient to help your immune system make a stronger response to the vaccine
Children aged between 6 months and 2 years who have a long-term health condition are offered an approved injected flu vaccine instead of the nasal spray vaccine.
Hepatitis A vaccine
Vaccination against hepatitis A is not routinely offered in the UK because the risk of infection is low for most people. It's only recommended for people at high risk.
Who should have the hepatitis A vaccine
People usually advised to have the hepatitis A vaccine include:
- close contacts of someone with hepatitis A
- people planning to travel to or live in parts of the world where hepatitis A is widespread, particularly if sanitation and food hygiene are expected to be poor
- people with any type of long-term liver disease
- men who have sex with other men
- people who inject illegal drugs
- people who may be exposed to hepatitis A through their job – this includes sewage workers, people who work for organisations where levels of personal hygiene may be poor, such as a homeless shelter, and people working with monkeys, apes and gorillas
Contact your GP surgery if you think you should have the hepatitis A vaccine or you're not sure whether you need it.
Types of hepatitis A vaccine
There are 3 main types of hepatitis A vaccination:
- a vaccine for hepatitis A only
- a combined vaccine for hepatitis A and hepatitis B
- a combined vaccine for hepatitis A and typhoid fever
Talk to your GP about which vaccine is most suitable for you. All 3 types are usually available for free on the NHS.
Plan your vaccinations in advance if you're travelling abroad. They should ideally be started at least 2 or 3 weeks before you leave, although some can be given up to the day of your departure if necessary.
Extra doses of the vaccine are often recommended after 6 to 12 months if you need long-term protection.
You can find more information about the various hepatitis A vaccines on the NHS Fit for Travel website.
Side effects of the hepatitis A vaccine
Some people have temporary soreness, redness and hardening of the skin at the injection site after having the hepatitis A vaccine.
A small, painless lump may also form, but it usually disappears quickly and is not a cause for concern.
Less common side effects include:
- a slightly raised temperature
- feeling unwell
- a headache
- feeling sick
- loss of appetite
Hepatitis B vaccine
Hepatitis B vaccination is routinely available as part of the NHS vaccination schedule.
It's also offered to people thought to be at increased risk of getting hepatitis B or its complications.
Who should be vaccinated against hepatitis B
All babies should be vaccinated to protect them against hepatitis B infection.
This is because the infection can persist for many years in children and can eventually lead to complications, such as scarring of the liver or liver cancer.
The 6-in-1 vaccine offered to all babies when they are 8, 12 and 16 weeks of age includes a vaccine against hepatitis B.
Babies at risk of developing hepatitis B infection from infected mothers are given extra doses of the hepatitis B vaccine at birth, 4 weeks and 1 year of age.
Although the risk of hepatitis B is low in the UK, children and adults in high-risk groups are also offered the vaccine.
People who are at risk of getting hepatitis B or developing serious complications from it should consider being vaccinated.
These groups include:
- people who inject drugs or have a partner who injects drugs
- people who change their sexual partners frequently
- men who have sex with men
- babies born to infected mothers
- close family or sexual partners of someone with hepatitis B
- people who have regular blood transfusions or blood products, and their carers
- people with any form of chronic liver disease or chronic kidney disease
- people travelling to high-risk countries
- male and female sex workers
- people whose work puts them at risk of contact with blood or body fluids, such as nurses, prison staff, doctors, dentists and laboratory staff
- families adopting or fostering children from high-risk countries
- some foster carers
- people who live in accommodation for people with learning disabilities
- people who work with people with a severe learning disability
How to get vaccinated against hepatitis B
All babies in the UK born on or after 1 August 2017 are given 3 doses of hepatitis B-containing vaccine as part of the NHS routine vaccination schedule.
These doses are given at 8, 12 and 16 weeks of age.
Babies at high risk of developing hepatitis B infection from infected mothers are given extra doses of the hepatitis B vaccine at birth, 4 weeks and 1 year of age.
If you think you're at risk and need the hepatitis B vaccine, ask your GP to vaccinate you, or visit any sexual health or genitourinary medicine (GUM) clinic.
If your job places you at risk of hepatitis B infection, it's your employer's responsibility to arrange vaccination for you, rather than your GP. Contact your occupational health department.
What hepatitis B immunisation involves
Full protection involves having 3 injections of the hepatitis B vaccine at the recommended intervals.
Babies born to mothers with hepatitis B infection will be given 6 doses of hepatitis B-containing vaccine to ensure long-lasting protection.
If you're a healthcare worker or you have kidney failure, you'll have a follow-up appointment to see if you have responded to the vaccine.
If you have been vaccinated by your employer's occupational health service, you can request a blood test to see if you have responded to the vaccine.
Emergency hepatitis B vaccination
If you have been exposed to the hepatitis B virus and have not been vaccinated before, you should get immediate medical advice, as you may benefit from having the hepatitis B vaccine.
In some situations, you may also need to have an injection of antibodies, called specific hepatitis B immunoglobulin (HBIG), along with the hepatitis B vaccine.
HBIG should ideally be given within 48 hours, but you can still have it up to a week after exposure.
Babies and hepatitis B vaccination
Pregnant women have a routine blood test for hepatitis B as part of their antenatal care.
Babies born to mothers infected with hepatitis B need to be given a dose of the hepatitis B vaccine within 24 hours of their birth, followed by further doses at 4, 8, 12 and 16 weeks of age, plus a final dose when they're 1 year old.
Babies of mothers identified by the blood test as particularly infectious might also be given an injection of HBIG at birth on top of the hepatitis B vaccination to give them rapid protection against infection.
All babies born to mothers infected with hepatitis B should be tested at 1 year of age to check if they have become infected with the virus.
Hepatitis B vaccination in pregnancy
Hepatitis B infection in pregnant women may result in severe disease for the mother and chronic infection for the baby.
This is why the hepatitis B vaccine is recommended for pregnant women who are in a high-risk category.
There's no evidence of any risk from vaccinating pregnant or breastfeeding women against hepatitis B.
And, as it's an inactivated (dead) vaccine, the risk to the unborn baby is likely to be negligible (insignificant).
Hepatitis B vaccine on the NHS
A hepatitis B-containing vaccine is provided for all babies born in the UK on or after 1 August 2017. This is given as part of the 6-in-1 vaccine.
Hospitals, GP surgeries and sexual health or GUM clinics usually provide the hepatitis B vaccination free of charge for anyone at risk of infection.
GPs are not obliged to provide the hepatitis B vaccine on the NHS if you're not thought to be at risk.
GPs may charge for the hepatitis B vaccine if you want it as a travel vaccine, or they may refer you to a travel clinic for a private vaccination. The current cost of the vaccine is around £60 a dose.
Side effects of the hepatitis B vaccine
The hepatitis B vaccine is very safe.
Other than some redness and soreness where the injection was given, side effects are rare.
It's an inactivated (dead) vaccine, so it cannot cause the infection itself.
Effectiveness of the hepatitis B vaccine
The hepatitis B vaccine is very effective. About 9 in every 10 adults who have it develop protection against hepatitis B.
The vaccine can work less well in people who:
- are over 40
- are obese
- are dependent on alcohol, particularly people with advanced liver disease
If you have a weakened immune system or you're on kidney dialysis, the hepatitis B vaccine may not work as well as usual. You may need more frequent doses.
The Hib/MenC vaccine is a single injection given to 1-year-old babies to boost their protection against Haemophilus influenzae type b (Hib) and meningitis C.
Hib and meningitis C infections are serious and potentially fatal. They can both cause meningitis and blood poisoning (sepsis).
Who should have the Hib/MenC vaccine
The Hib/MenC vaccine is offered to all babies at the age of 1 year as part of the NHS vaccination schedule.
- boosts the protection your baby has already gained from their 1st course of Hib vaccine, which they received in the 6-in-1 vaccine at 8, 12 and 16 weeks old
- begins their protection against meningitis C
Safety of the Hib/MenC vaccine
The Hib/MenC vaccine is very safe.
It's inactivated, which means it does not contain any live organisms, so there's no risk of your baby catching the infections it protects against.
The vaccine also has few side effects.
Side effects of the Hib/MenC vaccine
As with all vaccines, a few babies will have side effects after having the Hib/MenC vaccine. But they're usually mild and do not last long.
Common side effects include:
- pain, redness or swelling where the injection was given
- a high temperature
- loss of appetite
A skin rash is a rare side effect of the Hib/MenC vaccine. If this happens, contact a doctor straight away.
Severe allergic reactions (anaphylaxis) can also happen with the Hib/MenC vaccine, but they're extremely rare.
Girls and boys aged 12 to 13 years (born after 1 September 2006) are offered the human papillomavirus (HPV) vaccine as part of the NHS vaccination programme.
The HPV vaccine helps protect against cancers caused by HPV, including:
- cervical cancer
- some mouth and throat (head and neck) cancers
- some cancers of the anal and genital areas
It also helps protect against genital warts.
In England, girls and boys aged 12 to 13 years are routinely offered the 1st HPV vaccination when they're in school Year 8. The 2nd dose is offered 6 to 24 months after the 1st dose.
It's important to have both doses of the vaccine to be properly protected.
If you’re eligible and miss the HPV vaccine offered in Year 8 at school, it’s available for free on the NHS up until your 25th birthday for:
- girls born after 1 September 1991
- boys born after 1 September 2006
What is HPV?
HPV is the name given to a very common group of viruses.
There are many types of HPV, some of which are called "high risk" because they're linked to the development of cancers, such as cervical cancer, anal cancer, genital cancers, and cancers of the head and neck.
Other types can cause conditions like warts or verrucas.
High risk types of HPV can be found in more than 99% of cervical cancers.
There is also a significant association between HPV and some of the anal and genital cancers, and cancers of the head and neck.
HPV infections do not usually cause any symptoms, and most people will not know they're infected.
What are the different types of HPV and what do they do?
There are more than 100 different types of HPV, and around 40 that affect the genital area.
HPV is very common and can be caught through any kind of sexual contact with another person who already has it.
Most people will get an HPV infection at some point in their lives and their bodies will get rid of it naturally without treatment.
But some people infected with a high-risk type of HPV will not be able to clear it.
Over time, this can cause abnormal tissue growth as well as other changes, which can lead to cancer if not treated.
High-risk types of HPV are linked to different types of cancer, including:
- cervical cancer
- vaginal cancer
- vulval cancer
- anal cancer
- cancer of the penis
- some cancers of the head and neck
Infection with other types of HPV may cause:
How does the HPV vaccine work?
Gardasil has been the HPV vaccine used in the NHS vaccination programme since 2012.
Sometime during the 2021 to 2022 academic year, the HPV vaccine used in the NHS programme will switch to Gardasil 9.
Gardasil 9 protects against 9 types of HPV: 6, 11, 16, 18, 31, 33, 45, 52 and 58. Between them, types 16 and 18 are the cause of most cervical cancers in the UK (more than 80%). Types 31, 33, 45, 52 and 58 cause an additional 15% of cervical cancers.
These types of HPV also cause most anal cancers, and some genital and head and neck cancers.
HPV types 6 and 11 cause around 90% of genital warts, so using Gardasil 9 helps protect girls and boys against both cancer and genital warts.
HPV vaccination does not protect against other infections spread during sex, such as chlamydia, and it will not stop girls getting pregnant, so it's still very important to practise safe sex.
Who can have the HPV vaccine through the NHS vaccination programme?
The 1st dose of the HPV vaccine is routinely offered to girls and boys aged 12 and 13 in school Year 8. The 2nd dose is offered 6 to 24 months after the 1st dose.
If you miss either of your HPV vaccine doses, speak to your school immunisation team or GP surgery and make an appointment to have the missed dose as soon as possible.
It's important to have both doses of the vaccine to be fully protected.
If you’re eligible and miss the HPV vaccine offered in Year 8 at school, it’s available for free on the NHS up until your 25th birthday for:
- girls born after 1 September 1991
- boys born after 1 September 2006
People who have the 1st dose of the HPV vaccine at 15 years of age or above will need to have 3 doses of the vaccine. This is because they do not respond as well to 2 doses as younger people do.
How has the HPV vaccination programme changed?
In July 2018, it was announced that the HPV vaccine would be extended to boys aged 12 to 13 years in England.
This decision was based on advice from the Joint Committee on Vaccination and Immunisation (JCVI), the independent body that advises UK health departments on immunisation.
Since the 2019 to 2020 school year, both 12- to 13-year-old boys and girls in school Year 8 (born after 1 September 2006) have been eligible for the HPV vaccine.
The HPV vaccination programme has been extended to prevent more boys and girls getting HPV-related cancers, such as head and neck cancers and anal and genital cancers.
A catch-up programme for older boys is not necessary as evidence suggests they're already benefiting greatly from the indirect protection (known as herd protection) that's built up from 10 years of the girls' HPV vaccination programme.
Why is the HPV vaccine given at such a young age?
HPV infections can be spread by any skin-to-skin contact and are usually found on the fingers, hands, mouth and genitals.
This means the virus can be spread during any kind of sexual activity, including touching.
The HPV vaccine works best if girls and boys get it before they come into contact with HPV (in other words, before they become sexually active).
So getting the vaccine when recommended will help protect them during their teenage years and beyond.
Most unvaccinated people will be infected with some type of HPV at some time in their life.
The virus does not usually do any harm because the person's immune system clears the infection.
But sometimes the infection stays in the body for many years, and then it may start to cause damage.
HPV vaccination for men who have sex with men (MSM)
Men who have sex with men (MSM) have not benefited in the same way from the longstanding girls' programme, so may be left unprotected against HPV.
Since April 2018, MSM up to and including 45 years of age have been eligible for free HPV vaccination on the NHS when they visit sexual health clinics and HIV clinics in England.
Ask the doctor or nurse at the clinic for more details.
HPV vaccination for transgender people
Trans women (people who were assigned male at birth) are eligible in the same way as MSM if their risk of getting HPV is similar to the risk of MSM who are eligible for the HPV vaccine.
Trans men (people who were assigned female at birth) are eligible if they have sex with other men and are aged 45 or under.
If trans men have previously completed a course of HPV vaccination as part of the girls' HPV vaccine programme, no further doses are needed.
How is the HPV vaccine given?
The HPV vaccine is given as 2 injections into the upper arm spaced at least 6 months apart.
It's important to have both doses of the vaccine to be properly protected.
If you missed the HPV vaccine offered in school Year 8, you can get it for free up until your 25th birthday.
But if you get your 1st vaccine dose at the age of 15 or over, you'll need to have 3 injections.
Men who have sex with men (MSM), and trans men and trans women who are eligible for the vaccine, will need 3 doses of the vaccine (2 if they're under 15).
If you need 3 doses of the vaccine:
- the 2nd dose should be given at least 1 month after the 1st dose
- the 3rd dose should be given at least 3 months after the 2nd dose
It's important to have all 3 vaccine doses to be properly protected.
How long does the HPV vaccine protect for?
Studies have shown that the vaccine protects against HPV infection for at least 10 years, although experts expect protection to last for much longer.
But because the HPV vaccine does not protect against all types of HPV that can cause cervical cancer, it's important that all women who receive the HPV vaccine also have regular cervical screening once they reach the age of 25.
"Fresher" students going to university for the first time should make sure they've had the MenACWY vaccine to prevent meningitis and septicaemia, which can be deadly.
The MenACWY vaccine is also routinely offered to teenagers in school Years 9 and 10.
If you're starting college or university you should make sure you've already had:
- the MenACWY vaccine – which protects against serious infections like meningitis. You can ask a GP for this vaccine until your 25th birthday, if you missed having it at school or before coming to the UK to study
- 2 doses of the MMR vaccine – as there are outbreaks of mumps and measles at universities. If you have not previously had 2 doses of the MMR vaccine, you can ask a GP for the vaccine
What is the MenACWY vaccine?
The MenACWY vaccine is given by a single injection into the upper arm and protects against 4 strains of the meningococcal bacteria – A, C, W and Y – which cause meningitis and blood poisoning (septicaemia).
The MenACWY vaccine is called Nimenrix.
At what age should teenagers and young people have the vaccine?
Children aged 13 to 15 (school Years 9 or 10) are routinely offered the MenACWY vaccine in school alongside the 3-in-1 teenage booster.
Anyone born on or after 1 September 1996 who was eligible but missed their teenage MenACWY vaccine can still have the vaccine up to their 25th birthday.
If they're still at school, they should talk to their school nurse.
If they've left school (including people who have started apprenticeships or joined the armed forces), they should make an appointment with their GP practice.
Any university student born on or after 1 September 1996 who was eligible but missed their teenage MenACWY vaccine can still have the vaccine up to their 25th birthday.
Students going to university or college for the first time, including overseas and mature students, who have not yet had the MenACWY vaccine remain eligible, as freshers (first-year students), up to their 25th birthday.
Students should contact their GP to have the MenACWY vaccine before starting university or college. If that's not possible, they should have it as soon as they can after they begin university.
Why teenagers and students should have the MenACWY vaccine
Meningococcal disease (meningitis and septicaemia) is a rare but life-threatening disease caused by meningococcal bacteria.
Older teenagers and new university students are at higher risk of infection because many of them mix closely with lots of new people, some of whom may unknowingly carry the meningococcal bacteria at the back of their nose and throat.
Anyone who is eligible for the MenACWY vaccine should have it, even if they have previously had the MenC vaccine.
The MenACWY vaccine is highly effective in preventing illness caused by the 4 meningococcal strains, including the extremely harmful MenW strain.
The dangers of meningococcal disease
Meningococcal disease is rare but very serious. It requires urgent hospital treatment.
It can lead to life-changing disabilities, such as amputations, hearing loss and brain damage.
The MenACWY vaccine was previously recommended only for people at increased risk of meningococcal disease, including people who have had their spleen removed, or have a spleen that does not work properly, for Hajj pilgrims, and for travellers to countries with high rates of meningococcal disease, including parts of Africa and Latin America.
MenACWY vaccine effectiveness
The MenACWY vaccine is highly effective against serious infections caused by 4 different strains of meningococcal (A, C, W and Y).
The vaccine contains only the sugar coating found on the surface of the 4 types of meningococcal bacteria. It works by triggering the body's immune system to develop antibodies against these sugar coatings without causing disease.
MenACWY vaccine side effects
Like all vaccines, the MenACWY vaccine can cause side effects, but they are generally mild and soon pass.
The most common side effects seen in teenagers and young people are redness, hardening and itching at the injection site, a high temperature (above 38C), headache, feeling sick (nausea) and tiredness (fatigue). These symptoms should last no longer than 24 hours.
Sometimes a small, painless lump develops, but this usually disappears after a few weeks.
Who should not have the MenACWY vaccine?
You should not have the MenACWY vaccine if you are allergic to the vaccine or any of its ingredients.
You should also check with the doctor or nurse before having the MenACWY vaccine if you:
- have a bleeding problem, such as haemophilia, or bruise easily
- have a high temperature
- are pregnant or breastfeeding
How do meningococcal bacteria spread?
Meningococcal disease is caused by 13 different groups of meningococcal bacteria.
In the UK, the disease is almost always caused by 1 of 4 meningococcal groups commonly known as MenB, MenC, MenW or MenY. These can be prevented with vaccination.
MenA disease is rare in the UK, but it's more common in other parts of the world. It can also be prevented by vaccination.
The meningococcal bacteria live in the back of the nose and throat in about 1 in 10 people without causing any symptoms or illness.
Older teenagers are most likely to carry and spread the meningococcal bacteria.
The bacteria are spread from person to person by prolonged close contact – such as coughing, kissing or sneezing – with someone who is carrying the bacteria.
Very occasionally, the meningococcal bacteria can cause serious illness, including meningitis and septicaemia, which can rapidly lead to sepsis.
Meningococcal infections can happen at any age, but babies, young children and teenagers are especially vulnerable.
Babies, older people and the MenACWY vaccine
The MenACWY vaccine is currently recommended for teenagers as they are most likely to carry the meningococcal bacteria at the back of their noses and throats.
The MenACWY vaccine protects teenagers when they're most at risk of meningococcal disease. It also stops them carrying and spreading the bacteria to other people.
Vaccinating teenagers should also help protect other people, including babies and older people, against meningococcal disease, including the extremely harmful MenW strain.
How to spot meningococcal disease
Symptoms of meningococcal disease (meningitis and septicaemia) can start like a bad case of flu but they get worse very quickly. Early treatment can be lifesaving.
Other symptoms of meningococcal disease can include:
- a headache
- a stiff neck
- muscle and joint pain
- a high temperature
- cold hands and feet
- drowsiness or difficulty waking up
A rash may also appear that can develop into a purple, bruise-like rash that does not fade under pressure – for instance, when gently pressing a glass against it (the "glass test").
If you, or a child or adult you know, has any of these symptoms, get urgent medical help. Do not wait for the rash to develop. Early diagnosis and treatment with antibiotics are vital.
Although meningococcal disease commonly causes meningitis and septicaemia, which can trigger sepsis, it can also more rarely cause other illnesses. These include pneumonia and joint infections (septic arthritis).
Find out more about meningitis.
Other vaccines against meningococcal disease
Several bacteria can cause meningitis and septicaemia, some of which can be prevented through vaccination.
The Hib/MenC vaccine is offered as part of the NHS vaccination programme to all babies after their 1st birthday.
The MenB vaccine (Bexsero) is offered as part of the NHS childhood vaccination programme to all babies at 8 and 16 weeks, with a booster after their 1st birthday.
The MenB vaccine will protect your baby against infection by meningococcal group B bacteria.
These bacteria are responsible for about 9 in every 10 meningococcal infections in young children.
Meningococcal infections can be very serious, causing meningitis and sepsis. This can lead to severe brain damage, amputations and, sometimes, death.
The UK was the first group of countries in the world to introduce a MenB vaccine into its national programme using the Bexsero vaccine.
Who can have the MenB vaccine and when
The MenB vaccine is offered as part of the NHS vaccination schedule.
It's given to babies at:
- 8 weeks
- 16 weeks
- 1 year
How to get the MenB vaccine
We will send you an appointment for your baby to have their MenB vaccination along with their other routine vaccinations.
If you cannot get to the clinic, contact the surgery to make another appointment.
How the MenB vaccine is given
In the UK, Bexsero is the MenB vaccine that's used. It's given as a single injection into your baby's thigh.
MenB vaccine safety
Like all vaccines, the MenB vaccine can cause side effects, but studies suggest they're generally mild and do not last long.
Almost 8,000 people, including more than 5,000 babies and toddlers, have had the MenB vaccine during clinical trials to test its safety.
Since the vaccine was licensed in 2015, almost 5 million doses have been given to children in the UK.
The MenB vaccine and other vaccines
The MenB vaccine can be given at the same time as other routine baby vaccinations, such as the 6-in-1 vaccine and pneumococcal vaccine.
Side effects of the MenB vaccine
Babies given the MenB vaccine alongside their other routine vaccinations at 8 and 16 weeks are likely to develop a high temperature within 24 hours of vaccination.
It's important to give your baby liquid paracetamol following vaccination to reduce this risk. Your nurse will advise you about using children's paracetamol at your vaccination appointment.
Other common side effects of the MenB vaccine include:
- pain, swelling or redness where the injection was given
- diarrhoea or being sick
- crying and irritability
The liquid paracetamol will also help with these symptoms.
An allergic reaction is a rare side effect of the MenB vaccine. This may be a rash or itching that affects part or all of the body.
Very rarely, a baby may have a severe allergic reaction (anaphylaxis) after having the MenB vaccine.
Meningitis B is a killer
Meningococcal group B bacteria are a serious cause of life-threatening infections worldwide, including meningitis and sepsis.
They're also the leading infectious killer of babies and young children in the UK.
There are 12 known groups of meningococcal bacteria, and group B (MenB) is responsible for about 9 in every 10 meningococcal infections in the UK.
Meningitis and sepsis caused by meningococcal group B bacteria can affect people of any age but are most common in babies and young children.
While most young children recover from MenB, around 1 in 20 die from the infection.
Many of those who survive have a permanent disability, such as brain damage, epilepsy, hearing loss, or the loss of limbs (amputation).
MenB vaccine protection
There are hundreds of different strains of meningococcal group B bacteria around the world.
Some tests predict that the MenB vaccine protects against almost 9 in every 10 types of meningococcal group B bacteria circulating in the UK.
However, it's not yet clear how this will relate to lives saved or cases prevented.
How the MenB vaccine works
The MenB vaccine is made from 3 major proteins found on the surface of most meningococcal bacteria, combined with the outer membrane of 1 MenB strain.
Together, they stimulate the immune system to protect against future exposures to meningococcal bacteria.
For more detailed information about the ingredients of the MenB vaccine, read the patient information leaflet for Bexsero (PDF, 226kb).
Different types of meningitis vaccines
There are 2 other vaccines against common strains of meningococcal disease:
- the MenACWY vaccine against meningococcal groups A, C, W and Y – offered on the NHS to 14-year-olds and first-time students
- the Hib/MenC vaccine against haemophilus influenza type B and meningococcal group C – for babies at 1 year old
MMR (measles, mumps and rubella) vaccine
The MMR vaccine is a safe and effective combined vaccine.
It protects against 3 serious illnesses:
- rubella (german measles)
These highly infectious conditions can easily spread between unvaccinated people.
Getting vaccinated is important, as these conditions can also lead to serious problems including meningitis, hearing loss and problems during pregnancy.
2 doses of the MMR vaccine provide the best protection against measles, mumps and rubella.
Why are babies given the MMR vaccine at 1 year, plus 3 years and 4 months?
MMR at 1 year
Newborn babies have antibodies passed on from their mother at birth. This helps protect them for a short time against measles, mumps and rubella.
These antibodies make the MMR vaccine less effective if it's given to a newborn.
By the time a child is 1 year old, the antibodies are almost gone, and the MMR vaccine will be effective.
MMR at 3 years and 4 months
The 2nd dose is given at around 3 years and 4 months, before a child starts school.
Having both doses gives long-lasting protection against measles, mumps and rubella.
Is the MMR vaccine ever given to babies earlier?
Babies over 6 months old are sometimes given the MMR vaccine earlier than usual if:
- they may have been exposed to the measles virus
- there is an outbreak of measles
- they are travelling abroad to a country where measles is common
The 2 usual doses of MMR will still be needed when they're older to ensure full protection.
How will I know when my child is due for a vaccine?
You'll usually be contacted by your GP surgery when your child is due for a routine vaccination. This could be a letter, text, phone call or email.
You may also receive a letter from the Child Health Information Service to let you know your child is due for a vaccination.
If you know your child is due for a vaccination, it's best to speak to your GP surgery to book the appointment. You do not need to wait to hear from them.
When older children and adults should have the MMR vaccine
Anyone who has not had 2 doses of the MMR vaccine should ask their GP surgery for a vaccination appointment.
It's important to check you've had both doses if you:
- are about to start college or university
- are going to travel abroad
- are planning a pregnancy
- are a frontline health or social care worker
- were born between 1970 and 1979, as you may have only been vaccinated against measles
- were born between 1980 and 1990, as you may not be protected against mumps
How do I check if I've had both doses of the MMR vaccine?
Your GP surgery should be able to check whether you've had both doses of the MMR vaccine.
You may also be able to access your vaccination record online through GP online services.
Can I have the MMR vaccine if I'm pregnant?
As a precaution, the MMR vaccine is not recommended for pregnant women.
You should also avoid becoming pregnant for 1 month after having the MMR vaccine.
It's best to let your GP or midwife know if you had the MMR vaccine while you were pregnant.
Evidence suggests there will be no harm to your baby, but it's better to let them know.
Can I have the MMR vaccine if I have a weakened immune system?
The MMR vaccine is not recommended for people with a severely weakened immune system. For example, people receiving chemotherapy.
If you have a medical condition, or are taking medicine that may affect your immune system, check with your healthcare provider if it's safe for you to have the MMR vaccine.
How the MMR vaccine is given
The MMR vaccine is given as 2 doses of a single injection into the muscle of the thigh or upper arm.
2 doses of the vaccine are needed to ensure full protection.
Can my child have single measles, mumps or rubella vaccines?
Single vaccines for measles, mumps and rubella are not available on the NHS and are not recommended.
Combined vaccines like the MMR vaccine are safe and help to reduce the number of injections your child needs.
The benefits include:
- avoiding any delay between injections that could risk illness
- reducing discomfort for your child
- reducing the number of appointments needed
Effectiveness of the MMR vaccine
The MMR vaccine is very effective.
After 2 doses:
- around 99% of people will be protected against measles and rubella
- around 88% of people will be protected against mumps
People who are vaccinated against mumps, but still catch it, are less likely to have serious complications or be admitted to hospital.
Protection against measles, mumps and rubella starts to develop around 2 weeks after having the MMR vaccine.
Side effects of the MMR vaccine
The MMR vaccine is very safe. Most side effects are mild and do not last long, such as:
- the area where the needle goes in looking red, swollen and feeling sore for 2 to 3 days
- around 7 to 11 days after the injection, babies or young children may feel a bit unwell or develop a high temperature for about 2 or 3 days
Some children might also cry and be upset immediately after the injection. This is normal and they should feel better after a cuddle.
It's important to remember that the possible complications of infectious conditions, such as measles, mumps and rubella, are much more serious.
Common side effects of the MMR vaccine
As there are 3 separate vaccines within a single injection, different side effects can happen at different times.
Measles vaccine side effects
Around 7 to 11 days after the injection, some children get a very mild form of measles. This includes:
- a rash
- a high temperature
- loss of appetite
- a general feeling of being unwell for about 2 or 3 days
These symptoms are not infectious, so your child will not pass anything on to non-vaccinated children.
Mumps vaccine side effects
Around 3 to 4 weeks after the injection, 1 in 50 children develop a mild form of mumps. This includes swollen glands in the cheeks, neck or under the jaw which can last for up to 2 days.
These symptoms are not infectious for other people.
Rubella vaccine side effects
Around 1 to 3 weeks after the injection, some adult women experience painful, stiff or swollen joints for up to 3 days.
Rare side effects of the MMR vaccine
Rarely, a child may get a small rash of bruise-like spots about 2 weeks after having the MMR vaccine.
This side effect is linked to the rubella vaccine and is known as idiopathic thrombocytopenic purpura (ITP).
It's been estimated that ITP develops in 1 in every 24,000 doses of the MMR vaccine given. However, the risk of developing ITP from measles or rubella infection is far greater than from having the vaccine.
ITP usually gets better without treatment but, as with any rash, you should get advice from your GP as soon as possible.
There's a small chance of having a seizure (fit) 6 to 11 days after the MMR vaccine. This can be caused by having a high temperature in response to the measles vaccine virus.
It may sound alarming but having a seizure after the MMR vaccine is rare. They happen in about 1 in every 1,000 doses given.
In fact, MMR-related seizures are less frequent than seizures that happen as a direct result of a measles infection.
Allergic reactions to the MMR vaccine
It's rare for anyone to have a serious allergic reaction to a vaccine. If this does happen, it’s usually within minutes.
The person who vaccinates you or your child will be trained to deal with allergic reactions and treat them immediately. With fast treatment, you or your child will make a good recovery.
Gelatine and neomycin allergies
Let your doctor or nurse know if you or your child has had severe allergic reactions to:
- an antibiotic called neomycin
The MMR vaccine is safe for children and adults with a severe egg allergy.
This is because the MMR vaccine is grown on chick cells, not the egg white or yolk.
MMR vaccine ingredients
There are 2 different brands of MMR vaccine available in the UK. These are called Priorix and MMRVaxPro.
The main ingredient of the MMR vaccine is a small amount of weakened measles, mumps and rubella viruses.
The MMR vaccine does not contain mercury (thiomersal).
MMRVaxPro contains porcine gelatine to ensure the vaccine remains safe and effective during storage.
The pneumococcal vaccine protects against serious and potentially fatal pneumococcal infections. It's also known as the pneumonia vaccine.
Pneumococcal infections are caused by the bacterium Streptococcus pneumoniae and can lead to pneumonia, blood poisoning (sepsis) and meningitis.
At their worst, they can cause permanent brain damage, or even kill.
Who should have the pneumococcal vaccine
Anyone can get a pneumococcal infection. But some people are at higher risk of serious illness, so it's recommended they're given the pneumococcal vaccination on the NHS.
- adults aged 65 or over
- children and adults with certain long-term health conditions, such as a serious heart or kidney condition
Babies are offered 2 doses of pneumococcal vaccine, at 12 weeks and at 1 year of age.
People aged 65 and over only need a single pneumococcal vaccination. This vaccine is not given annually like the flu jab.
If you have a long-term health condition you may only need a single, one-off pneumococcal vaccination, or a vaccination every 5 years, depending on your underlying health problem.
The different types of pneumococcal vaccine
The type of pneumococcal vaccine you're given depends on your age and health. There are 2 types.
Pneumococcal conjugate vaccine (PCV) is used to vaccinate children under 2 years old as part of the NHS vaccination schedule. It's known by the brand name Prevenar 13.
Pneumococcal polysaccharide vaccine (PPV) is given to people aged 65 and over and people at high risk because they have long-term health conditions.
Children at risk of pneumococcal infections can have the PPV vaccine from the age of 2 years onwards. The PPV vaccine is not very effective in children under the age of 2.
How the pneumococcal vaccine works
Both types of pneumococcal vaccine encourage your body to produce antibodies against pneumococcal bacteria.
Antibodies are proteins produced by the body to neutralise or destroy disease-carrying organisms and toxins.
They protect you from becoming ill if you're infected with the bacteria.
More than 90 different strains of the pneumococcal bacterium have been identified, although most of these strains do not cause serious infections.
The childhood vaccine (PCV) protects against 13 strains of the pneumococcal bacterium, while the adult vaccine (PPV) protects against 23 strains.
Effectiveness of the pneumococcal vaccine
Children respond very well to the pneumococcal vaccine.
The introduction of this vaccine into the NHS childhood vaccination schedule has resulted in a large reduction in pneumococcal disease.
The pneumococcal vaccine given to older children and adults is thought to be around 50 to 70% effective at preventing pneumococcal disease.
Both types of pneumococcal vaccine are inactivated or "killed" vaccines and do not contain any live organisms. They cannot cause the infections they protect against.
Who should not have the pneumococcal vaccine
Occasionally, you or your child may need to delay having the pneumococcal vaccine or avoid it completely.
Tell your GP if you or your child has had a bad reaction to any vaccination in the past.
If there's been a confirmed severe allergic reaction (anaphylaxis) to the pneumococcal vaccine or any ingredient in the vaccine, it may not be possible for you to have it.
But if it was only a mild reaction, such as a rash, it's generally safe to have the vaccine.
Fever at the vaccination appointment
If you or your child are mildly unwell at the time of the vaccination, it's safe to have the vaccine.
But if you or your child are more seriously ill (for example, with a high temperature and feeling hot and shivery), it's best to delay the vaccination until after recovery.
Pregnancy and breastfeeding
Having the pneumococcal vaccine is thought to be safe during pregnancy and while you're breastfeeding.
But as a precaution, you may want to wait until you’ve had your baby if you're pregnant, unless the benefits of having the vaccine outweigh the risks to your child.
Side effects of the pneumococcal vaccine
Like most vaccines, the childhood and adult versions of the pneumococcal vaccine can sometimes cause mild side effects.
- a slightly raised temperature
- redness where the injection was given
- hardness or swelling where the injection was given
There are no serious side effects listed for either the childhood or adult versions of the vaccine, apart from an extremely rare risk of a severe allergic reaction (anaphylaxis).
An oral vaccine against rotavirus infection is given to babies as part of their routine childhood vaccinations.
The vaccine is given as 2 doses, 4 weeks apart. Usually the first dose is given at 8 weeks, and the second dose at 12 weeks.
The vaccine is given as a liquid straight into the baby's mouth for them to swallow.
Why the rotavirus vaccine is offered
Rotavirus is a highly infectious stomach bug that typically affects babies and young children, causing diarrhoea and vomiting, tummy ache and a high temperature.
Most children recover at home within a week. But some children may need to see a doctor.
Occasionally, treatment in hospital is needed for complications such as severe dehydration.
When babies can have the rotavirus vaccination
Rotavirus vaccination is available routinely on the NHS as part of the childhood vaccination programme for babies aged 8 weeks and 12 weeks.
Your baby needs 2 rotavirus vaccinations at least 4 weeks apart to be fully protected.
If they miss the 1st dose, they can have it at up to 15 weeks. If they miss the 2nd dose, they can have it at up to 24 weeks.
How the rotavirus vaccine works
The vaccine contains a weakened version of rotavirus.
This helps your baby build up immunity, so that the next time they come into contact with rotavirus they will not get the infection.
Effectiveness of the rotavirus vaccine
The rotavirus vaccine is very effective and gives good protection against rotavirus infection.
It’s possible for a baby to get a rotavirus infection after being vaccinated. But this is uncommon and it’s usually milder than it would have been if they had not been vaccinated.
Since its introduction into the vaccination programme, the rotavirus vaccine has significantly reduced the number of children who have diarrhoea and vomiting, and reduced the number of severe rotavirus infections.
It’s not known exactly how long it lasts, but research has shown that 2 doses of the vaccine can protect a child for several years.
Safety of the rotavirus vaccine
There's a lot of evidence showing that the rotavirus vaccine is safe.
The brand name of the vaccine used in the UK is Rotarix. This vaccine has been used in many countries for more than 10 years.
It’s given routinely to children in the US and many other countries around the world in Europe, Asia and Latin America.
Side effects of the rotavirus vaccine
Most babies do not have any problems at all after having their rotavirus vaccination.
Some babies who have the vaccine may become restless and irritable, and some may develop mild diarrhoea in the days following vaccination.
Very rarely, the vaccine could cause a severe allergic reaction (anaphylaxis) or a blockage in a baby’s intestine (intussusception).
A vaccine to prevent shingles, a common, painful skin disease, is available on the NHS to people in their 70s.
The shingles vaccine is given as an injection into the upper arm. Unlike the flu vaccine, you'll only need to have the vaccination once and you can have it at any time of the year.
Most people will only need 1 dose, but some people who cannot have the routine vaccine for health reasons will need 2 doses.
The shingles vaccine is expected to reduce your risk of getting shingles. If you do go on to have the disease, your symptoms may be milder and the illness shorter.
Shingles can be very painful and uncomfortable. Some people are left with pain lasting for years after the initial rash has healed. Shingles can also be fatal for around 1 in 1,000 over-70s who develop it.
It's fine to have the shingles vaccine if you've already had shingles. The shingles vaccine works very well in people who have had shingles before, and it will boost your immunity against further shingles attacks. Your GP will tell you how long to wait after you recover from shingles before having the shingles vaccine. This may be up to 1 year.
Who can have the shingles vaccination?
You're eligible for the shingles vaccine if you are aged 70 to 79.
The shingles vaccine is not available on the NHS to anyone aged 80 or over because it seems to be less effective in this age group.
Find out more about who can have the shingles vaccine.
How do I get the shingles vaccine?
Once you become eligible for shingles vaccination a GP or practice nurse will offer you the vaccine when you attend the surgery for general reasons.
If you are worried that you may miss out on the shingles vaccination, contact your GP surgery to arrange an appointment to have the vaccine.
What is the brand name of the shingles vaccine?
There are 2 shingles vaccines used in the UK:
- Zostavax, a live vaccine given as 1 dose
- Shingrix, a non-live vaccine given as 2 doses, 2 months apart
Most people will have the Zostavax vaccine. The Shingrix vaccine is recommended if Zostavax is not suitable for you, for example if you have a condition that affects your immune system.
You can read more about the shingles vaccines in the patient information leaflets:
How does the shingles vaccine work?
The vaccine recommended for most people is a live vaccine called Zostavax. It contains a weakened chickenpox virus (varicella-zoster virus). It's similar, but not identical, to the chickenpox vaccine.
People with a weakened immune system cannot have live vaccines. They will be offered a non-live vaccine called Shingrix. It activates the immune system but also contains an ingredient called an adjuvant, which helps to boost the response to the vaccine.
Very occasionally, people develop chickenpox following shingles vaccination (fewer than 1 in 10,000 individuals). Talk to a GP if this happens to you.
How long will the shingles vaccine protect me for?
It's difficult to be precise, but research suggests the shingles vaccine will protect you for at least 5 years, probably longer.
How safe is the shingles vaccine?
There is a lot of evidence showing that the shingles vaccine is very safe. Both types of vaccine have already been used in several countries, including the US and Canada, and no safety concerns have been raised. The vaccine also has few side effects.
Read more about shingles vaccine side effects.
What is shingles?
Shingles, also known as herpes zoster, is a painful skin rash caused by the reactivation of the chickenpox virus (varicella-zoster virus) in people who have previously had chickenpox.
It begins with a burning sensation in the skin, followed by a rash of very painful fluid-filled blisters that can then burst and turn into sores before healing. Often an area on just one side of the body is affected, usually the chest but sometimes the head, face and eye.
Read more about the symptoms of shingles.
How is shingles spread?
You do not "catch" shingles – it comes on when there's a reawakening of chickenpox virus that's already in your body. The virus can be reactivated because of a range of issues, including advancing age, medicine, illness or stress.
Anyone who has had chickenpox can get shingles. It's estimated that around 1 in 5 people who have had chickenpox go on to develop shingles.
Read more about the causes of shingles.
Who's most at risk of shingles?
People tend to get shingles more often as they get older, especially over the age of 70. And the older you are, the worse it can be. The shingles rash can be extremely painful, such that sufferers cannot even bear the feeling of their clothes touching the affected skin.
The pain of shingles can also linger long after the rash has disappeared, even for many years. This lingering pain is called post-herpetic neuralgia (PHN).
Whooping cough vaccine
Whooping cough (pertussis) rates have risen sharply in recent years and babies who are too young to start their vaccinations are at greatest risk.
Young babies with whooping cough are often very unwell and most will be admitted to hospital because of their illness. When whooping cough is particularly severe, they can die.
Pregnant women can help protect their babies by getting vaccinated – ideally from 16 weeks up to 32 weeks pregnant. If for any reason you miss having the vaccine, you can still have it up until you go into labour.
Why are pregnant women advised to have the vaccine?
Getting vaccinated while you're pregnant is highly effective in protecting your baby from developing whooping cough in the first few weeks of their life.
The immunity you get from the vaccine will pass to your baby through the placenta and provide passive protection for them until they are old enough to be routinely vaccinated against whooping cough at 8 weeks old.
When should I have the whooping cough vaccine?
The best time to get vaccinated to protect your baby is from 16 weeks up to 32 weeks of pregnancy. This maximises the chance that your baby will be protected from birth, through the transfer of your antibodies before he or she is born.
If for any reason you miss having the vaccine, you can still have it up until you go into labour. However, this is not ideal, as your baby is less likely to get protection from you. At this stage of pregnancy, having the vaccination may not directly protect your baby, but would help protect you from whooping cough and from passing it on to your baby.
Is the vaccine safe in pregnancy?
It's understandable that you might have concerns about the safety of having a vaccine during pregnancy, but there's no evidence to suggest that the whooping cough vaccine is unsafe for you or your unborn baby.
Pertussis-containing vaccine (whooping cough vaccine) has been used routinely in pregnant women in the UK since October 2012, and the Medicines and Healthcare products Regulatory Agency (MHRA) is carefully monitoring its safety. The MHRA's study of around 20,000 vaccinated women has found no evidence of risks to pregnancy or babies.
To date, around 69% of eligible pregnant women have received the whooping cough vaccine with no safety concerns being identified in the baby or mother.
A number of other countries, including the US, Argentina, Belgium, Spain, Australia and New Zealand, currently recommend vaccination against whooping cough in pregnancy.
Is whooping cough vaccination in pregnancy working?
Yes, it is. Published research from the UK vaccination programme shows that vaccinating pregnant women against whooping cough has been highly effective in protecting young babies until they can have their first vaccination when they are 8 weeks old.
Babies born to women vaccinated at least a week before birth had a 91% reduced risk of becoming ill with whooping cough in their first weeks of life, compared to babies whose mothers had not been vaccinated.
An additional benefit is that the protection the mother receives from the vaccination will lower her own risk of infection and of passing whooping cough on to her baby.
Which whooping cough vaccine will I be given?
As there is no whooping cough-only vaccine, the vaccine you'll be given also protects against polio, diphtheria and tetanus. The vaccine is called Boostrix IPV.
Boostrix IPV is similar to the 4-in-1 vaccine – the pre-school booster that's routinely given to children before they start school.
You can read the manufacturer's patient information leaflet for Boostrix IPV (PDF, 91kb).
The manufacturer's leaflet says there's no information on the use of Boostrix IPV in pregnancy. Should it be used in pregnancy?
The licence for Boostrix IPV allows for its use in pregnancy when clearly needed, and when the possible benefits outweigh the possible risks.
It is standard practice with most medicines not to test them on pregnant women. This is why the manufacturer's information leaflet includes this statement, and not because of any specific safety concerns or evidence of harm in pregnancy.
Whooping cough-containing vaccine has been used routinely in pregnant women in the UK since October 2012, and the Medicines and Healthcare products Regulatory Agency (MHRA) is carefully monitoring its safety. The MHRA's study of around 20,000 women vaccinated with Repevax, the whooping cough vaccine previously offered to pregnant women, found no evidence of risks to pregnancy or pregnancy outcome.
Boostrix (similar to Boostrix IPV, but without the polio component) is one of the vaccines routinely recommended in the US for immunisation of pregnant women. There have been no reported safety concerns in the US with the use of the vaccine in pregnancy.
There is no evidence of risk to the pregnant woman or unborn child with inactivated vaccines like Boostrix IPV. An inactivated vaccine is one that does not contain "live" vaccine.
What are the side effects of the whooping cough vaccine?
You may have some mild side effects such as swelling, redness or tenderness where the vaccine is injected in your upper arm, just as you would with any vaccine. These only last a few days. Other side effects can include fever, irritation at the injection site, swelling of the vaccinated arm, loss of appetite, irritability and headache. Serious side effects are extremely rare.
What is whooping cough?
Whooping cough (medically known as pertussis) is a serious infection that causes long bouts of coughing and choking, making it hard to breathe. The "whoop" is caused by gasping for breath after each bout of coughing, though babies do not always make this noise.
Read more about whooping cough symptoms.
Should I be concerned about whooping cough?
Whooping cough is a highly infectious, serious illness that can lead to pneumonia and brain damage, particularly in young babies. Most babies with whooping cough will need hospital treatment, and when whooping cough is very severe they may die.
Research from the vaccination programme in England shows that vaccinating pregnant women against whooping cough has been highly effective in protecting young babies until they can receive their own vaccinations from 8 weeks of age.
In keeping with usual disease patterns, which see cases increasing every 3 to 4 years in England, whooping cough cases have fallen in all age groups since 2012. The greatest fall has been in young babies targeted by the pregnancy vaccination programme.
Cases of whooping cough in older age groups are still high compared to pre-2012 levels. The number of cases was particularly high in 2016, in line with the typical 3- to 4-yearly peak in disease rates.
Babies can be infected by people with whooping cough in these older age groups, so it is still important for pregnant women to be vaccinated to protect their babies.
But are babies not vaccinated against whooping cough to protect them?
Yes, they are, but the babies that have been getting whooping cough are generally too young to have started their normal vaccinations, so they are not protected against the disease.
So, how can I protect my baby?
The only way you can help protect your baby from getting whooping cough in their first few weeks after birth is by having the whooping cough vaccination yourself while you are pregnant.
After vaccination, your body produces antibodies to protect against whooping cough. You will then pass some immunity to your unborn baby.
Will the whooping cough vaccine in pregnancy give me whooping cough?
No. The whooping cough vaccine is not a "live" vaccine. This means it does not contain whooping cough (or polio, diphtheria or tetanus), and cannot cause whooping cough in you, or in your baby.
Will my baby still need to be vaccinated at 8 weeks if I've had the vaccine while pregnant?
Yes. Whenever you have the whooping cough vaccine, your baby will still need to be vaccinated according to the normal NHS vaccination schedule when they reach 8 weeks old. Babies are protected against whooping cough by the 6-in-1 vaccine.
Can I have the whooping cough vaccine at the same time as the flu jab?
Yes, you can have the whooping cough vaccine when you get the flu vaccine, but do not delay your flu jab so that you can have both at the same time.
How can I get the whooping cough vaccination?
The vaccine is available from your GP, though some antenatal clinics also offer it. You may be offered the vaccination at a routine antenatal appointment from around 16 weeks of your pregnancy.
If you are more than 16 weeks pregnant and have not been offered the vaccine, talk to your midwife or GP and make an appointment to get vaccinated.
I was vaccinated against whooping cough as a child, do I need to get vaccinated again?
Yes, because any protection you may have had through either having whooping cough or being vaccinated when you were young is likely to have worn off and will not provide sufficient protection for your baby.
I was vaccinated against whooping cough in a previous pregnancy, do I need to be vaccinated again?
Yes, you should get re-vaccinated from 16 weeks in each pregnancy to maximise protection for your baby.
How do I spot whooping cough in my baby?
Be alert to the signs and symptoms of whooping cough, which include severe coughing fits that may be accompanied by difficulty breathing (or pauses in breathing in young infants) or vomiting after coughing, and the characteristic "whoop" sound.
If you are worried your baby may have whooping cough, contact your doctor immediately.
Read more about whooping cough vaccination in the leaflet Whooping cough and pregnancy (PDF, 183kb) from Public Health England.