Immunisation is the use of a vaccine to protect against disease. When a vaccine is given, the body’s immune system is stimulated to produce memory cells and substances called antibodies, which protect against future infections. Vaccines contain:
- the live germ (bacteria or virus), which has been attenuated, (toned down) so that usually it does not cause the disease or, if so, it is usually in a mild form; or
- the killed germ; or
- part(s) of the germ or things the germ produces (eg toxins).
Vaccines also contain small quantities of other substances to enable them to work properly.
The Routine Childhood Immunisation Schedule in UK (from September 2008)
| Vaccine | Recommended age of administration |
| Diphtheria, tetanus, acellular pertussis (DTaP), Inactivated polio vaccine (IPV) and Haemophilus influenzae type b (Hib) – DTaP/IPV/Hib (sometimes called the
5-in-1) | a single injection at 8 weeks |
| Pneumococcal conjugate vaccine (PCV) | 8 weeks |
| DTaP/IPV/Hib and Meningococcal C vaccine (Men C) | 12 weeks |
| DTaP/IPV/Hib, PCV and Men C | 16 weeks |
| Hib/Men C booster | 12 months |
| Measles, mumps and rubella (MMR) and PCV | 13 months |
| MMR - second dose | Any time after first dose as long as at least three months have elapsed, or one month
if the child is more than 18 months old. Usually given with pre-school booster below. |
| DTaP/IPV | Three years four months |
| HPV (three doses are needed) | 12-13 years (girls only) |
| Td/IPV | 13-18 years |
Bacillus Calmette-Guérin vaccine, which protects against tuberculosis, used to be offered to all children in secondary school, but as the pattern of disease has changed, this is no longer the case. Instead, the vaccine is offered to all babies and children who are thought to be at higher risk of catching the disease. In some areas, this will mean that all babies are offered the vaccine.
It is normal for parents to have concerns and questions about immunisation. There are very few reasons for withholding immunisation. They are usually temporary and include:
- if the child is unwell or has a fever on the day of immunisation, in which case the vaccination should be postponed
- if the child is taking any medicines that affect the immune system, including steroids or has a disease that affects the immune system
- if the child has an unstable neurological condition.
If a child has had a major allergic reaction (‘anaphylactic reaction’) to a vaccine or something in it, they should receive no further doses of the vaccine.
Side effects of immunisation include swelling or redness around the site of the injection, raised temperature or irritability.
Parents of children with special needs may have concerns relating to immunisation and their child’s specific condition. Children who have certain specific conditions may be more at risk from childhood diseases and therefore immunisation is encouraged. Where the condition affects the immune system (eg primary immunodeficiencies; see entry) vaccination may not work very well and, in some cases, live vaccines may be dangerous. In such circumstances, vaccination should always be discussed with the child’s paediatric doctor. It is always helpful for parents to discuss any concerns they may have regarding immunisations with their health visitor, practice nurse, general practitioner or with the paediatrician involved in the care and management of their child.
Medical text written June 2000 by Dr David Elliman and Dr Helen Bedford. Last updated November 2010 by Dr David Elliman, Consultant in Community Child Health, Great Ormond Street Hospital, London, UK and Dr Helen Bedford, Senior Lecturer in Children’s Health, UCL Institute of Child Health, London, UK.
Further information on the immunisation programme can be obtained from:
NHS Immunisation Information
Information for professionals:
http://www.dh.gov.uk/en/Publichealth/Immunisation/index.htm
Information for the public:
http://www.nhs.uk/Planners/vaccinations/Pages/Aboutvaccinationhub.aspx
The Health Promotion Agency for Northern Ireland
http://www.healthpromotionagency.org.uk
Health Education Board Scotland
http://www.healthscotland.com
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