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Childhood immunisations

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Most immunisations (also known as vaccinations) are given during childhood, and they are usually given by injection. Immunisation programmes have dramatically improved the health of the UK population.
Brought to you by NHS Choices



The immunisation programme for children mainly takes place over the course of five years. Most immunisations are given before a child is one year old.

Immunisations are used to protect children from diseases such as:

  • Tetanus.
  • Polio.
  • Pneumococcal infections.
  • Diphtheria.
  • Meningitis C.
  • Measles, mumps and rubella (MMR).

Immunisations are often given more than once to make sure the protection continues. This is known as a booster immunisation. Children usually need booster immunisations when they have reached pre-school age (five years old), and again before they leave school (between 13 and 18 years of age).

Why it is necessary

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Why childhood immunisation is necessary

Childhood immunisation is necessary to protect all children from potentially dangerous diseases. All the diseases that babies and children are vaccinated against have the potential to cause serious disabilities. Some can be fatal.

Immunisation also reduces the potential spread of diseases in the community. Childhood immunisation has had a dramatic effect on improving the health of the population in the UK and worldwide.

Childhood immunisation prevents a large variety of diseases. These include:

Tetanus. An infection found in the soil that causes severe muscle contractions and breathing difficulties.

Polio (short for poliomyelitis). A virus that first attacks the gut (bowel) but then travels to the nervous system. Polio can cause paralysis (when you can’t move your limbs) in one or more parts of your body.

Pneumococcal infections. These can affect anyone, but young children are at an increased risk of developing serious complications such as meningitis.

Diphtheria. A highly contagious disease caused by a bacterium called Corynebacterium diphtheriae. It causes a serious throat and chest infection.

Meningitis C. Caused by the meningococcus group c bacterium. In rare cases it can lead to blood poisoning and serious types of meningitis.

Hib (full name is haemophilus influenzae type b). A bacterium that can cause pneumonia and meningitis.

Whooping cough (pertussis) - causes prolonged coughing that can be very distressing. In children, complications can include brain damage.

Measles. Caused by the measles virus and can result in a serious fever and rash. In severe cases, measles can be fatal.

Mumps. Caused by the mumps virus. Mumps usually leads to inflammation and swelling of the salivary glands (the glands located just below the ears). In severe cases this can cause deafness.

Rubella (also know as German measles). Caused by the rubella virus and can lead to a mild illness and rash. In later life rubella can be serious to an unborn child as it can potentially lead to several birth defects.

Other immunisations

Some children may require additional immunisations that are not part of the childhood immunisation programme.

Your GP will be able to advise you if your child requires any further immunisations. These may include immunisations if your child has a chronic condition.

Other vaccinations may be required if you and your child plan to travel outside the UK. Your GP will be able to advise you on what travel immunisations are needed. If you have any further concerns you can call NHS Direct on 0845 4647.

How it works

How do childhood immunisations work

Newborn babies have what is called a ‘passive immunity’ to several diseases, such as measles and rubella. This is because the antibodies that protect them from disease are passed on from their mothers. However, ‘passive immunity’ only lasts for a few months, so immunisation is very important.

Immunisations for your child will mean they have ‘active immunity’. They will be protected against some diseases for life.

How do vaccines work?

Vaccines contain a small dose of the inactive disease that your child is being immunised against. Because it is inactive, it means your child cannot get the disease.

Your child’s body will then begin to make antibodies, or immune cells (white blood cells), against that particular disease. This means that antibodies or immune cells will attack the bacteria or virus that causes that particular disease if it gets into the body in the future.

Who can use it

Your GP surgery will send you an appointment when your child’s immunisation is due. It is very important that your child has their immunisation at the right time to reduce their risk of catching any harmful diseases.

Premature babies should also be immunised from the age of two months, regardless of how premature they were.

Health record book

A complete record of your child’s immunisation will be kept in their health record book. Vaccinations given at a health clinic or their school will not necessarily be added to your child’s GP records. Therefore it is important you keep your child’s health record book in a safe place so that you can update it.

The details contained in your child’s health record book are usually useful later on in life. For example, if boosters are needed or evidence of their immunisation for travel purposes is required.

Who should not be immunised?

Only certain vaccines will be given to your child if their immune system does not work properly. For example, if they are receiving chemotherapy treatment. These vaccines will be given under the supervision of their GP or hospital consultant.

Also, if your child has previously had a serious reaction to a vaccine, your GP may decide not to give it to them again.

Your GP will be able to discuss all your child’s immunisation options with you and answer any concerns that you may have.

When it should be done

When a child should be immunised

The recommended timetable for childhood immunisations is detailed below.

Children at two months old:

  • Diphtheria, tetanus, pertussis (whooping cough), polio and Hib (DTaP/IPV/Hib) all in one injection.
  • Pneumococcal conjugate vaccine (PCV) in a separate injection.

Children at three months old:

  • Diphtheria, tetanus, pertussis (whooping cough), polio and Hib (DTaP/IPV/Hib) all in one injection.
  • Meningitis C (MenC) in a separate injection.

Children at four months old:

  • Diphtheria, tetanus, pertussis (whooping cough), polio and Hib (DTaP/IPV/Hib) all in one injection.
  • Meningitis C in a separate injection.
  • Pneumococcal conjugate vaccine (PCV) in a separate injection.

Children at 12 months old:

  • Hib and meningitis C (Hib/MenC) booster dose in a combined injection.

Children at around 13 months old:

  • Measles, mumps and rubella (MMR) all in on injection.
  • Pneumococcal conjugate vaccine (PCV) in a separate injection.

Children at three years, four months to five years old (pre-school):

  • Diphtheria, tetanus, pertussis (whooping cough) and polio (DTaP/IPV) all in on injection.
  • Measles, mumps and rubella (MMR) in a separate injection.

Children at 13 to 18 years old:

  • Diphtheria, tetanus and polio (Td/IPV) in a combined injection.

Between immunisations

It is important that your child’s body has at least one month’s gap between each vaccination of the same type. This allows their body to build up immunity to the bacteria or virus.

Forgotten or delayed immunisation

If your child’s immunisation schedule has been interrupted or delayed for any reason, it can be resumed again at any time. You do not have to start the schedule from the beginning.

It is always recommended that you try to stick to the correct immunisation dates because the earlier your child is immunised the better protected they are.

If you miss an immunisation appointment, make sure that you reschedule a new appointment with your GP surgery as soon as possible.

Side effects

Side effects of childhood immunisations

Side effects from immunisations are usually minor. For example, swelling around the site of the injection, or a slight redness to the skin. The type of side effect your child may experience depends on the vaccination they have been given.

Other side effects may include:

  • Fever.
  • Sickness.
  • Diarrhoea.
  • Swollen glands.
  • A small lump where the injected was given. This may last for a few weeks.

Severe reactions

Severe reactions (anaphylactic reactions) to a vaccine are extremely rare.

Call 999 immediately if your child finds it difficult to breathe, or develops a rash that is not related to the area where the injection was given.

A baby who is having a severe reaction to an immunisation may cry in a different way than they might normally do. For example, they may cry in a high-pitched tone.

In a recent study, it was found that an anaphylactic reaction only occurs in one in every million immunisations. However, if treated quickly, your child is likely to make a full recovery.

Useful links

NHS Choices links

External links

This article was first published by NHS Choices

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