Vaccinations, Immunisations and Inoculations
Vaccines are the most effective way to prevent infectious diseases. They work by training your immune system to develop antibodies that protect you from disease.
All vaccines are extensively researched and tested before they are approved for use. Their effectiveness and side effects are also regularly monitored. Existing vaccines are also amended or improved to combat new or dominant strains of certain conditions.
Every year, more than 3 million lives are saved by vaccinations.
Despite this, misinformation anti-vaccine stories often circulate online, primarily through social media. These stories are often without any scientific backing.
Avoiding or delaying vaccines is detrimental to your health, especially in childhood. The World Health Organisation lists vaccine hesitancy as one of the biggest threats to world health.
NHS vaccination schedule
The NHS routine immunisation programme can change as new vaccines are brought in or eligibility changes. This is the current complete immunisation schedule as of 1st January 2026.
Routine immunisation programmes
| Age due | Diseases that vaccines protect against | Vaccine given | Trade name | Usual site [footnote 1] |
|---|---|---|---|---|
| 8 weeks old | Diphtheria, tetanus, pertussis (whooping cough), polio, Haemophilus influenzae type b (Hib) and hepatitis B | DTaP/IPV/Hib/HepB (6 in 1 vaccine) | Infanrix hexa or Vaxelis | Thigh |
| Meningococcal group B (MenB) | MenB | Bexsero | Thigh | |
| Rotavirus gastroenteritis | Rotavirus | Rotarix [footnote 2] | By mouth | |
| 12 weeks old | Diphtheria, tetanus, pertussis (whooping cough), polio, Haemophilus influenzae type b (Hib) and hepatitis B | DTaP/IPV/Hib/HepB (6 in 1 vaccine) | Infanrix hexa or Vaxelis | Thigh |
| MenB | MenB | Bexsero | Thigh | |
| Rotavirus | Rotavirus | Rotarix [footnote 2] | By mouth | |
| 16 weeks old | Diphtheria, tetanus, pertussis (whooping cough), polio, Haemophilus influenzae type b (Hib) and hepatitis B | DTaP/IPV/Hib/HepB (6 in 1 vaccine) | Infanrix hexa or Vaxelis | Thigh |
| Pneumococcal (13 serotypes) | PCV | Prevenar 13 | Thigh | |
| One year old (on or after the child’s first birthday) | Pneumococcal | PCV | Prevenar 13 | Upper arm or thigh |
| Measles, mumps, rubella and varicella (chickenpox) | MMRV | ProQuad or Priorix Tetra | Upper arm or thigh | |
| MenB | MenB | Bexsero | Upper arm or thigh | |
| 18 months old | Born on or after 1 July 2024 DTaP/IPV/Hib/HepB. Measles, mumps, rubella and varicella Born on or before 30 June 2024 No appointment | DTaP/IPV/Hib/HepB MMRV | Infanrix hexa or Vaxelis ProQuad or Priorix Tetra | Upper arm or thigh |
| 3 years, 4 months old or soon after | Born on or after 1 January 2025 Diphtheria, tetanus, pertussis and polio Born on or before 31 December 2024 Diphtheria, tetanus, pertussis and polio. Measles, mumps, rubella and varicella | dTaP/IPV MMRV | REPEVAX ProQuad or Priorix Tetra | Upper arm or thigh |
| Boys and girls aged 12 to 13 years | Cancers and genital warts caused by specific human papillomavirus (HPV) types | HPV | Gardasil 9 | Upper arm |
| 14 years old (school Year 9) | Tetanus, diphtheria and polio | Td/IPV | REVAXIS | Upper arm |
| Meningococcal groups A, C, W and Y | MenACWY | MenQuadfi | Upper arm | |
| 65 years old | Pneumococcal (23 or 20 serotypes) | Pneumococcal polysaccharide vaccine (PPV23) or Pneumococcal conjugate vaccine (PCV20) once PPV23 stock exhausted | Pneumovax 23 or Prevenar 20 | Upper arm |
| 65 years of age and older | Influenza (each year from September) | Inactivated influenza vaccine | Multiple | Upper arm |
| Individuals turning 65 from 1 Sept each year (commencing 1 Sept 2023 onwards) | Shingles | Shingles vaccine | Shingrix | Upper arm |
| 70 to 79 years of age (and those severely immunosuppressed over 18 years of age) | Shingles | Shingles vaccine | Shingrix | Upper arm |
| 75 years of age | Respiratory syncytial virus (RSV) | RSV vaccine | Abrysvo | Upper arm |
| Eligible paediatric age group See annual flu letter | Influenza (each year from September) | LAIV (Live attenuated influenza vaccine) – if LAIV is contraindicated or otherwise unsuitable, use inactivated flu vaccine (check Green Book chapter 19 for details) | Fluenz (contains porcine gelatine) | Both nostrils |
Selective immunisation programmes
| Target group | Age and schedule | Disease | Vaccines required | |
|---|---|---|---|---|
| Babies born to women with hepatitis B infection [note 1], [note 2] | At birth, 4 weeks if born before 1 July 2024 give additional dose at 12 months old [note 1] | Hepatitis B | Hepatitis B (Engerix B/HBvaxPRO) | |
| Infants in areas of the country with tuberculosis (TB) incidence at least 40 per 100,000 | Around 28 days old [note 4] | Tuberculosis | BCG | |
| Infants with a parent or grandparent born in a high incidence country [note3] | Around 28 days old [note 4] | Tuberculosis | BCG | |
| Children in a clinical risk group | Age under 2 years • if first ever flu vaccine give second dose at 4 weeks | Influenza | inactivated flu vaccine | |
| Age under 2 years • if first ever flu vaccine give second dose at 4 weeks | Influenza | LAIV or inactivated flu vaccine if contraindicated to LAIV | ||
| Age 9 to 17 years • one dose required each flu season | Influenza | LAIV or inactivated flu vaccine if contraindicated to LAIV | ||
| Pregnant women | At any stage of pregnancy during flu season | Influenza | Inactivated flu vaccine | |
| From 16 weeks gestation [note 5] | Pertussis | Tdap (ADACEL) | ||
| From 28 weeks gestation | RSV | RSV vaccine (Abrysvo) |
Notes
Note 1. Take blood for HBsAg on or after 12 months to exclude infection. For children born on or after 1 July 2024, test anytime between 12 and 18 months.
Note 2. In addition hexavalent vaccine (Infanrix hexa or Vaxelis) is given at 8, 12 and 16 weeks and, for children born on or after 1 July 2024, also at 18 months.
Note 3. Where the annual incidence of TB is 40 per 100,000 or higher – see TB incidence by country.
Note 4. Check SCID screening outcome before giving BCG.
Note 5. Ideally before 32 weeks gestation but may still be given after 32 weeks.
Additional vaccines for individuals with underlying medical conditions
| Medical condition | Diseases protected against | Vaccines required [note 1] |
|---|---|---|
| Asplenia or splenic dysfunction (this also includes individuals with coeliac disease who are diagnosed with splenic dysfunction and all haemoglobinopathies including homozygous sickle cell disease) | Meningococcal groups A, B, C, W and Y | MenACWY MenB |
| Pneumococcal | PCV13 (up to 10 years of age) [note 2] PPV23 (from 2 years of age) | |
| Influenza | Annual flu vaccine | |
| Cochlear implants | Pneumococcal | PCV13 (up to 10 years of age) [note 2] PPV23 (from 2 years of age) |
| Chronic respiratory and heart conditions (such as severe asthma, chronic pulmonary disease, and heart failure) | Pneumococcal | PCV13 (up to 10 years of age) [note 2] PPV23 (from 2 years of age) |
| Influenza | Annual flu vaccine | |
| Chronic neurological conditions | Pneumococcal (only if the individual is also at increased risk of aspiration) | PCV13 (up to 10 years of age) [note 2] PPV23 (from 2 years of age) |
| Influenza | Annual flu vaccine | |
| Diabetes | Pneumococcal | PCV13 (up to 10 years of age) [note 2] PPV23 (from 2 years of age) |
| Influenza | Annual flu vaccine | |
| Chronic kidney disease (CKD) (including haemodialysis) | Pneumococcal (stage 4 and 5 CKD) | PCV13 (up to 10 years of age) [note 2] PPV23 (from 2 years of age) |
| Influenza (stage 3, 4 and 5 CKD) | Annual flu vaccine | |
| Hepatitis B (stage 4 and 5 CKD) | Hepatitis B | |
| Chronic liver conditions | Pneumococcal | PCV13 (up to 10 years of age) [note 2] PPV23 (from 2 years of age) |
| Influenza | Annual flu vaccine | |
| Hepatitis A | Hepatitis A | |
| Hepatitis B | Hepatitis B | |
| Haemophilia | Hepatitis A | Hepatitis A |
| Hepatitis B | Hepatitis B | |
| Immunosuppression due to disease or treatment [note 4] | Pneumococcal | PCV13 (up to 10 years of age) [note 2] [note 3] PPV23 (from 2 years of age) |
| Shingles vaccine | Shingrix – from 18 years of age [note 5] | |
| Influenza | Annual flu vaccine | |
| Complement disorders (including those receiving complement inhibitor therapy) | Meningococcal groups A, B, C, W and Y | MenACWY MenB |
| Pneumococcal | PCV13 (up to 10 years of age) [note 2] PPV23 (from 2 years of age | |
| Influenza | Annual flu vaccine |