Vaccinations and immunisations

What are the “routine” childhood vaccinations?

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

Routine immunisations 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 here.

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.  

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.

How do we know that vaccines are safe?

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

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

Will there be any side effects from the vaccines? 

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

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. A recent study has shown that there is 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 fu 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 surgery 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 surgery 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.