Childhood immunisations

The MMR vaccine is a safe and effective combined vaccine. It protects against three serious illnesses:

•    measles
•    mumps
•    rubella (german measles)

These highly infectious conditions can easily spread between unvaccinated people. In some children it can be very serious and lead to hospitalisation – and in rare cases tragically can cause death. Getting vaccinated is important, as these conditions can also lead to serious problems including meningitis, hearing loss and problems during pregnancy.

Having two doses of the Measles, Mumps, Rubella (MMR) vaccine at the right time (dose 1 from 12 months and dose 2 from 3 years 4 months) is the best way to protect your child and help prevent it spreading, especially to those most vulnerable. Two doses of the MMR vaccine give you excellent lifelong protection.

If you have any questions about vaccinations, you can:

•    ask your GP surgery or other healthcare professionals for advice
•    read more about why vaccination is safe and important

Visit the NHS child vaccination pages to see which vaccinations are given to your children and when

 

Getting vaccinated

The MMR vaccine is given to babies and young children as part of the NHS vaccination schedule.

However, If you think your child might be behind on their MMR or any other vaccination you can check your child’s health record (red book) or contact your GP practice to see if they are up to date. If the MMR vaccine has been missed, it can still be given at any age.

It’s important to catch up on any missed vaccines. You can still ask your GP practice for the MMR vaccine if your child has missed either of these 2 doses.

 

What to do if you think you have measles

Measles usually starts with cold-like symptoms, followed by a rash a few days later. Some people may also get small spots in their mouth.

Measles symptoms to be aware of include:

•    high fever
•    sore, red, watery eyes
•    coughing
•    aching and feeling generally unwell
•    a blotchy red brown rash, which usually appears after the initial symptoms

Anyone with symptoms of measles is advised to stay at home and phone their GP practice or NHS 111 for advice. 

Stay off nursery, school or work for at least 4 days from when the rash first appears. Also try to avoid close contact with babies and anyone who is pregnant or has a weakened immune system.

More information about measles is available on the NHS website.

 

Whooping cough can affect people of all ages, but for very young infants it can be particularly serious. Babies who are too young to start their vaccinations are at greatest risk.

Young babies with whooping cough often become very unwell and most will be admitted to hospital. When whooping cough is particularly severe, they can die.

Pregnant women can help protect their babies by getting vaccinated.

You should usually have the whooping cough vaccine between 20 and 32 weeks, but you can have it from 16 weeks, and you should still get the vaccine if you are further along in your pregnancy.

If you have any questions about vaccinations, you can:

•    ask your GP surgery or other healthcare professionals for advice
•    read more about why vaccination is safe and important

Visit the NHS vaccination page to see which other vaccinations can help protect you and your baby

Getting vaccinated

To give your baby the best protection against whooping cough, you should have the vaccine before 32 weeks of pregnancy. This maximises the chance that your baby will be protected from birth, through the transfer of your antibodies before they are born.

If for any reason you miss having the vaccine before 32 weeks, you can have it later, even after you give birth. However, this is not ideal, as your baby is less likely to get protection from you. At this stage, 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 whooping cough vaccine safe in pregnancy?

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. The Medicines and Healthcare products Regulatory Agency (MHRA) carefully monitors the ongoing safety of all medicines.

The MHRA's study of around 20,000 vaccinated women published in the British Medical Journal (BMJ) found no evidence of risks to pregnancy or babies.

A number of other countries, including the US, Argentina, Belgium, Spain, Australia and New Zealand, recommend vaccination against whooping cough in pregnancy.

Read more about why vaccinations are important and the safest way to protect you and your baby.

 

The children's flu vaccine helps protect against flu. It's offered to children aged 2 to 3 years, school-aged children (Reception to Year 11) and children with certain long-term health conditions.

Why children are offered the flu vaccine
Flu can be very unpleasant for children and can sometimes cause serious problems, such as pneumonia.

Each winter in the UK, thousands of children who do not have a health condition need hospital care because of flu.

Children can catch and spread flu easily. Vaccinating them also helps protect others who are at higher risk of getting seriously ill from flu, such as babies, anyone who's pregnant and older people.

Video: Vaccines – are they safe for my child?
In this video, a GP reassures a parent about vaccinations for her child.

Who should have the children's flu vaccine?
The children's flu vaccine is offered on the NHS every year in autumn or early winter.

It's recommended for:

• children aged 2 or 3 years
• school-aged children (Reception to Year 11)
• children aged 6 months to 17 years with certain long-term health conditions

See the  Green Book Influenza chapter 19  for full details on eligible groups.

You can find out more information about the flu vaccine on our flu page

The COVID-19 vaccine is offered to persons aged 6 months to 64 years in a clinical risk group, as defined in tables 3 and 4 of the COVID-19 chapter of the UK Health Security Agency (UKHSA) Green Book on immunisation against infectious disease. 

See the Green Book 14a tables 3 and 4 for full details on eligible groups.

Why children are offered the COVID-19 vaccine?
COVID-19  can be very unpleasant for children and can sometimes cause serious problems. Although most people with COVID-19 feel better within a few days or weeks of their first symptoms and make a full recovery within 12 weeks, for some people, symptoms can last longer.

COVID-19 spreads very easily through close contact with people who have the virus. When someone with COVID-19 breathes, speaks, coughs or sneezes, they release small droplets containing the virus. You can catch it by breathing in these droplets, or by touching surfaces covered in them and then touching your eyes, nose or mouth.

Children can catch and spread COVID-19 easily. Vaccinating them also helps protect others who are at higher risk of getting seriously ill from flu, such as babies, anyone who's pregnant and older people.

Video: Vaccines – are they safe for my child?
In this video, a GP reassures a parent about vaccinations for her child.

Visit the COVID-19 page for more information about the vaccine

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

How safe are the vaccines?

Before a vaccine is allowed to be used, its safety and effectiveness have to be thoroughly tested. After they have been licensed, the safety of vaccines continues to be monitored. Any rare side effects that are discovered can then be assessed further.

All medicines can cause side effects, but vaccines are among the very safest. Research from around the world shows that immunisation is the safest way to protect your child’s health.

What are the “routine” childhood vaccinations?

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

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

How do vaccines work?

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

 

Which immunisations will my child have and when?

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

 

Is it safe to have several vaccinations in one go?

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

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

 

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

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

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

 

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

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

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

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

 

Why does my child need multiple doses of some vaccines?

Most immunisations have to be given more than once to prepare your child’s immunity. For example, 3 doses of DTaP/IPV/Hib/HepB vaccine are needed to provide protection in babies. Booster doses are then given later in life to provide longer-term protection.

 

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

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

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

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

 

Will there be any side effects from the vaccines?

Any side effects that occur are usually mild and short lived. Your child may get a little redness, swelling or tenderness where the injection was given that will disappear on its own.

Fever can be expected after any vaccination. There is advice for parents on what to expect after vaccination here: What to expect after vaccinations.

Fever is more common after the first two doses of the Meningococcal B (Men B) vaccination, which are given at 8 weeks and 16 weeks old. There is specific advice for parents on how to prevent and treat fever after MenB vaccine at 8 and 16 weeks here: MenB vaccine and paracetamol 

 

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

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

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

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

 

What if my child has an underlying health condition?

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

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

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

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

They will need to get specialist advice on using live vaccines such as MMR, rotavirus vaccine and Bacillus Calmette-Guérin vaccine (BCG). There are no other reasons why vaccines should definitely not be given.

 

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

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

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

 

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

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

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

 

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

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

 

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

If you miss the appointment or need to delay the immunisation, make a new appointment. You can pick up the immunisation schedule where it stopped without having to start again. Rotavirus vaccine can only be started in babies up to 15 weeks of age and no dose of the vaccine can be given over 24 weeks of age.

 

Do any routine childhood vaccines contain pork?

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

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

 

What is the MMR vaccine?

The MMR vaccine protects against measles, mumps and rubella. These three serious illnesses that are highly infectious and can spread easily between unvaccinated people.

Getting vaccinated is important to protect against these conditions and the potential complications they can cause. Vaccination is free on the NHS as part of the National Vaccination Programme.

 

Is MMR linked to autism?

No. Some years ago, there were stories suggesting a link between the MMR vaccine and autism. All medical authorities worldwide agree that no such link exists.

 

How many doses of MMR vaccine does my child need?

Immunising your child with two doses of the MMR vaccine will give them the best protection. Some children who have only one dose of the vaccine might not be fully protected against one or more of the diseases.

Thanks to immunisation, the number of cases of measles, mumps and rubella have been reduced. However these diseases have not gone away and there have been outbreaks of measles in recent years. Two doses of the MMR vaccine are routinely given across the whole of Europe as well as in the USA, Canada, Australia and New Zealand.

 

Why are two doses of the MMR vaccine needed?

Two doses of the MMR vaccine will give your child the best long lasting protection against measles, mumps and rubella. The first dose of the MMR vaccine is given at the age of 12 months and the second dose at around 3 years and 4 months.

Some children who have only one dose of the vaccine might not be fully protected against one or more of the diseases. The second dose boosts this to give better protection.

Two doses of the MMR vaccine are routinely given across Europe as well as in the US, Canada, Australia and New Zealand.

 

Can my child have MMR as single vaccines?

Using single vaccines for the diseases would be experimental, and no country uses this approach. It’s unclear how long a gap to leave between each vaccine, as there’s limited evidence on giving all of these vaccines separately.

Single vaccines are less safe than MMR because they leave children vulnerable to dangerous diseases for longer, and potentially increases the risk of allergic reactions. Giving 6 separate doses at spaced out intervals would mean that, after the first injection, the child still has no immunity to the other 2 diseases.

No country recommends vaccination with the 3 separate vaccines. Some single vaccines are available in other European countries, where they may be used in special circumstances. For example, in France measles vaccine is used for nursery school children aged 9 to 12 months. These children usually have the MMR vaccine 6 months later.

 

 

The following pages contain further information:

• NHS England: Childhood vaccinations
• NHS England: Why vaccination is important and the safest way to protect yourself
• UKHSA blog: Protecting your children through vaccination - UK Health Security Agency
• Department for Education blog: What to do if you think your child has measles and when to keep them off school 

UKHSA further information:

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