Childhood Vaccinations
Childhood immunisations are one more way to keep them safe. You want to do what is best for your child. You know about the importance of car seats, stair gates, and other ways to keep them safe. But, did you know that one of the best ways to protect them is to make sure they have all of their vaccinations?
Immunisation is the process of delivering a vaccination to protect a person against a disease.
Vaccine is the product given during immunisation which your body uses to fight exposure to disease.
- Immunisations can save your child’s life: some diseases continue to harm or kill children across the world. Don’t let your child be one of them.
- Vaccines are very safe and effective: vaccines are only licensed for children after long and careful development and testing by researchers and doctors. Vaccines will involve some discomfort and may cause pain, redness, or tenderness at the site of injection but this is minimal compared to the pain, discomfort, and trauma of the diseases these vaccines prevent. Fever can be expected after any vaccination, but is more common with the Men B vaccine. Giving paracetamol soon after Men B vaccination – and not waiting for a fever to develop – will reduce the risk of your child having a fever. Serious side effects following vaccination, such as severe allergic reaction, are very rare.
- Immunisation protects others you care about: some babies are too young to be protected by vaccination and others may not be able to receive certain vaccinations due to severe allergies, weakened immune systems from conditions like leukaemia, or other reasons. To help keep them safe, it is important that you and your children are fully immunized. This not only protects your family, but also helps prevent the spread of these diseases to your friends and loved ones.
- For answers to commonly asked questions about vaccines, click here.
Follow the links below for more information
Follow the links below for more information so you are fully informed as to what to expect. Please ask your Health Visitor and GP for further advice.
A guide to immunisations for babies up to 13 months of age; This page on the GOV.UK website contains information on the immunisations for babies up to 13 months of age.
A guide to Pre-school Immunisations for children from 2 to 5 years of age; This page from the GOV.UK website provides information on the immunisations for children aged 2 to 5 years.
Did you know that nurses may or may not be wearing gloves when giving vaccinations!
When should you worry?
12-18 months
12-18 MONTHS
Contact your health visitor or GP if your baby is 12-18 months and they…
- Have lost skills which they could do before
- Feel very stiff, for example:
- Hold their arms and legs in the same position, such as always pulling their arm to their chest, or always crossing their legs
- Find it difficult to change their position on their own
- You find it difficult to move your baby’s arms or legs, making it tricky to change their nappy or clothes
- Feel very floppy when they are awake
- Move their arms or legs in repetitive, jerky, or strange ways
- Use one side of their body more than the other, for example:
- Lean to the side when they sit
- Drag their leg or foot when crawling or walking
- Use one arm to pull to stand more than the other
- Rarely use one of their arms to pick up toys, or eat and drink
- Finds it hard to stand or walk, for example:
- Can’t pull to stand
- Fall over a lot when standing still
- Doesn’t cruise (walk while holding on to furniture)
- Walk on their tiptoes a lot
18-24 months
18-24 MONTHS
Contact your health visitor or GP if your baby is 18-24 months and they…
- Have lost skills which they could do before
- Feel very stiff, for example:
- Hold their arms and legs in the same position, such as always pulling their arm to their chest, or always crossing their legs
- Find it difficult to change their position on their own
- You find it difficult to move your baby’s arms or legs, making it tricky to change their nappy or clothes
- Feel very floppy when they are awake
- Move their arms or legs in repetitive, jerky, or strange ways
- Use one side of their body more than the other, for example:
- Lean to the side when they sit
- Drag their leg or foot when crawling or walking
- Use one arm to pull to stand more than the other
- Rarely use one of their arms to pick up toys, or eat and drink
- Find it hard to balance when standing still, or fall over a lot
- Can’t walk by themselves
- Walk on their tiptoes a lot
- Are suddenly unsteady when walking
2 years
2 YEARS
Contact your health visitor or GP if your baby is 2 years and they…
- Have lost skills which they could do before
- Feel very stiff, for example:
- Hold their arms and legs in the same position, such as always pulling their arm to their chest, or always crossing their legs
- Find it difficult to change their position on their own
- You find it difficult to move your child’s arms or legs, making it tricky to change their nappy or clothes
- Feel very floppy when awake
- Move their arms or legs in repetitive, jerky, or strange ways
- Use one side of their body more than the other, for example:
- Lean to the side when they sit
- Drag one leg or foot behind them when crawling or walking
- Rarely use one of their arms to play, eat and drink
- Find it hard to balance when standing still or fall over a lot
- Can’t walk by themselves
- Mostly walk on their tiptoes
- Are suddenly unsteady when walking
- Haven’t started to run
- Move from laying down or sitting to standing by using their hands to push off the ground, and “walk” their hands up their legs until they are standing
3 years
3 YEARS
Contact your health visitor or GP if your baby is 3 years and they…
- Have lost skills which they could do before
- Feel very stiff, for example:
- Hold their arms and legs in the same position, such as always pulling their arm to their chest, or always crossing their legs
- Find it difficult to change their position on their own
- You find it difficult to move your child’s arms or legs, making it tricky to change their clothes
- Feel very floppy when awake
- Move their arms or legs in repetitive, jerky, or strange ways
- Use one side of their body more than the other, for example:
- Lean to the side when they sit
- Drag one leg or foot behind them when walking
- Rarely uses one of their arms to play, eat and drink
- Find it hard to balance when standing still or fall over a lot
- Can’t walk by themselves
- Mostly walk on their tiptoes
- Are suddenly unsteady when walking
- Have not started to jump or run
- Move from laying down or sitting to standing by using their hands to push off the ground, and “walk” their hands up their legs until they are standing
4 years
4 YEARS
Contact your health visitor or GP if your baby is 4 years and they…
- Have lost skills which they could do before
- Feel very stiff, for example:
- Hold their arms and legs in the same position, such as always pulling their arm to their chest, or always crossing their legs
- Find it difficult to change their position on their own
- Find it tricky to change their clothes
- Feel very floppy when awake
- Move their arms or legs in repetitive, jerky, or strange ways
- Use one side of their body more than the other, for example:
- Lean to the side when they sit
- Drag one leg or foot behind them when walking
- Rarely use one of their arms to play, eat and drink
- Find it hard to balance when standing still
- Suddenly become unsteady when walking
- Find it hard going upstairs or uphill
- Trip or fall a lot
- Walk on tiptoes most of the time
- Feel pain in their arms or legs
- Move from laying down or sitting on the floor to standing by using their hands to push off the ground, and “walk” their hands up their legs until they are standing.
5 years
5 YEARS
Contact your health visitor or GP if your baby is 5 years and they…
- Have lost skills which they could do before
- Feel very stiff, for example:
- Hold their arms and legs in the same position, such as always pulling their arm to their chest, or always crossing their legs
- Find it difficult to change their position on their own
- Find it tricky to change their clothes
- Feel very floppy when awake
- Move their arms or legs in repetitive, jerky, or strange ways
- Use one side of their body more than the other, for example:
- Lean to the side when they sit
- Drag one leg or foot behind them when walking
- Rarely uses one of their arms to play, eat and drink
- Find it hard to balance, or trip or fall a lot
- Persistently walk on tiptoes
- Suddenly become unsteady when walking
- Feel pain in their arms or legs
- Move from laying or sitting on the floor to standing by using their hands to push off the ground, and “walk” their hands up their legs until they are standing.
15 months
Your Child By Fifteen Months
Social/Emotional Milestones
- Copies other children while playing, like taking toys out of a container when another child does
- Shows you an object she likes
- Claps when excited
- Hugs stuffed doll or other toy
- Shows you affection (hugs, cuddles, or kisses you)
Language/Communication Milestones
- Tries to say one or two words besides “mama” or “dada,” like “ba” for ball or “da” for dog
- Looks at a familiar object when you name it
- Follows directions given with both a gesture and words. For example, he gives you a toy when you hold out your hand and say, “Give me the toy.”
- Points to ask for something or to get help
Cognitive Milestones (learning, thinking, problem-solving)
- Tries to use things the right way, like a phone, cup, or book
- Stacks at least two small objects, like blocks
Movement/Physical Development Milestones
- Takes a few steps on his own
- Uses fingers to feed herself some food
18 months
Your Child By Eighteen Months
Social/Emotional Milestones
- Moves away from you, but looks to make sure you are close by
- Points to show you something interesting
- Puts hands out for you to wash them
- Looks at a few pages in a book with you
- Helps you dress him by pushing arm through sleeve or lifting up foot
Language/Communication Milestones
- Tries to say three or more words besides “mama” or “dada”
- Follows one-step directions without any gestures, like giving you the toy when you say, “Give it to me.”
Cognitive Milestones (learning, thinking, problem-solving)
- Copies you doing chores, like sweeping with a broom
- Plays with toys in a simple way, like pushing a toy car
Movement/Physical Development Milestones
- Walks without holding on to anyone or anything
- Scribbles
- Drinks from a cup without a lid and may spill sometimes
- Feeds himself with his fingers
- Tries to use a spoon
- Climbs on and off a couch or chair without help
2 years
Your Child By Two Years
Social/Emotional Milestones
- Notices when others are hurt or upset, like pausing or looking sad when someone is crying
- Looks at your face to see how to react in a new situation
Language/Communication Milestones
- Points to things in a book when you ask, like “Where is the bear?”
- Says at least two words together, like “More milk.”
- Points to at least two body parts when you ask him to show you
- Uses more gestures than just waving and pointing, like blowing a kiss or nodding yes
Cognitive Milestones (learning, thinking, problem-solving)
- Holds something in one hand while using the other hand; for example, holding a container and taking the lid off
- Tries to use switches, knobs, or buttons on a toy
- Plays with more than one toy at the same time, like putting toy food on a toy plate
Movement/Physical Development Milestones
- Kicks a ball
- Runs
- Walks (not climbs) up a few stairs with or without help
- Eats with a spoon
2.5 years
Your Child By Thirty Months
Social/Emotional Milestones
- Plays next to other children and sometimes plays with them
- Shows you what she can do by saying, “Look at me!”
- Follows simple routines when told, like helping to pick up toys when you say, “It’s clean-up time.”
Language/Communication Milestones
- Says about 50 words
- Says two or more words together, with one action word, like “Doggie run”
- Names things in a book when you point and ask, “What is this?”
- Says words like “I,” “me,” or “we”
Cognitive Milestones (learning, thinking, problem-solving)
- Uses things to pretend, like feeding a block to a doll as if it were food
- Shows simple problem-solving skills, like standing on a small stool to reach something
- Follows two-step instructions like “Put the toy down and close the door.”
- Shows he knows at least one color, like pointing to a red crayon when you ask, “Which one is red?”
Movement/Physical Development Milestones
- Uses hands to twist things, like turning doorknobs or unscrewing lids
- Takes some clothes off by himself, like loose pants or an open jacket
- Jumps off the ground with both feet
- Turns book pages, one at a time, when you read to her
3 years
Your Child By Three Years
Social/Emotional Milestones
- Calms down within 10 minutes after you leave her, like at a childcare drop off
- Notices other children and joins them to play
Language/Communication Milestones
- Talks with you in conversation using at least two back-and-forth exchanges
- Asks “who,” “what,” “where,” or “why” questions, like “Where is mommy/daddy?”
- Says what action is happening in a picture or book when asked, like “running,” “eating,” or “playing”
- Says first name, when asked
- Talks well enough for others to understand, most of the time
Cognitive Milestones (learning, thinking, problem-solving)
- Draws a circle, when you show him how
- Avoids touching hot objects, like a stove, when you warn her
Movement/Physical Development Milestones
- Strings items together, like large beads or macaroni
- Puts on some clothes by himself, like loose pants or a jacket
- Uses a fork
4 years
Your Child By Four Years
Social/Emotional Milestones
- Pretends to be something else during play (teacher, superhero, dog)
- Asks to go play with children if none are around, like “Can I play with Alex?”
- Comforts others who are hurt or sad, like hugging a crying friend
- Avoids danger, like not jumping from tall heights at the playground
- Likes to be a “helper”
- Changes behavior based on where she is (place of worship, library, playground)
Language/Communication Milestones
- Says sentences with four or more words
- Says some words from a song, story, or nursery rhyme
- Talks about at least one thing that happened during her day, like “I played soccer.”
- Answers simple questions like “What is a coat for?” or “What is a crayon for?”
Cognitive Milestones (learning, thinking, problem-solving)
- Names a few colors of items
- Tells what comes next in a well-known story
- Draws a person with three or more body parts
Movement/Physical Development Milestones
- Catches a large ball most of the time
- Serves herself food or pours water, with adult supervision
- Unbuttons some buttons
- Holds crayon or pencil between fingers and thumb (not a fist)
5 years
Your Child By Five Years
Social/Emotional Milestones
- Follows rules or takes turns when playing games with other children
- Sings, dances, or acts for you
- Does simple chores at home, like matching socks or clearing the table after eating
Language/Communication Milestones
- Tells a story she heard or made up with at least two events. For example, a cat was stuck in a tree and a firefighter saved it
- Answers simple questions about a book or story after you read or tell it to him
- Keeps a conversation going with more than three back-and-forth exchanges
- Uses or recognizes simple rhymes (bat-cat, ball-tall)
Cognitive Milestones (learning, thinking, problem-solving)
- Counts to 10
- Names some numbers between 1 and 5 when you point to them
- Uses words about time, like “yesterday,” “tomorrow,” “morning,” or “night”
- Pays attention for 5 to 10 minutes during activities. For example, during story time or making arts and crafts (screen time does not count)
- Writes some letters in her name
- Names some letters when you point to them
Movement/Physical Development Milestones
- Buttons some buttons
- Hops on one foot
Advice and Guidance
The Current UK Vaccine schedule
2 months:
- 6-in-1 vaccine (diphtheria, tetanus, pertussis (whooping cough), polio, hepatitis B and Haemophilis influenzae type B - Hib)
- Rotavirus vaccine
- Men B vaccine
3 months:
- 6-in-1 vaccine (diphtheria, tetanus, pertussis (whooping cough), polio, hepatitis B and Hib)
- Pneumococcal (PCV) vaccine
- Rotavirus vaccine second dose
4 months:
- 6-in-1 vaccine (diphtheria, tetanus, pertussis (whooping cough), polio and Hib) (2nd dose)
- Men B vaccine (2nd dose)
12-13 months:
- Hib/Men C vaccine
- MMR vaccine (Babies aged 6-12 months of age travelling to a country with high rates of circulating measles or to an area where there is a current measles outbreak, who are likely to be mixing with the local population, should receive a dose of MMR vaccine before 12 months of age. This is because of the increased risk of severe measles disease in young children, including brain infection (SSPE). As the response to MMR in infants is sub-optimal where the vaccine has been given before one year of age, immunisation with two further doses of MMR should be given at the normal recommended ages.)
- Pneumococcal (PCV) vaccine (2nd dose)
- Men B booster (3rd dose)
2 years to 13 years:
- Children's flu vaccine (annual)
3 years and 4 months:
- MMR vaccine second dose
- 4-in-1 booster (diphtheria, tetanus, pertussis (whooping cough) and polio)
12-13 years (boys and girls):
- HPV vaccine, which protects against cervical cancer and genital warts - two injections given 6-24 months apart
14 years:
- Teenage booster (tetanus, diphtheria and polio)
- Men ACWY vaccine
Keep up-to-date with your child’s vaccinations using this vaccination planner.
How do I check my child is up to date?
- Your child should have a personal child health record or ‘Red Book’. You can check this to see if your child is up to date or missing any immunisations from the routine schedule.
- If you have the NHS app and your child’s profile is linked to your own profile, you may be able to check your child’s records via the NHS app.
- If you don’t have a red book or you can’t find it, then contact your GP and ask them to check your child’s records for any gaps in immunisations.
How do I book an appointment for my child's vaccinations?
- If your child is missing any vaccinations or you are unsure about whether they need any, speak to your GP to book an appointment.
Flu vaccination is important because flu can be dangerous and even life threatening for some people, particularly those with certain health conditions and young children.
If your child does get flu, they may need treatment in hospital and may also transmit it to other members of your family who may become unwell (children are super-spreaders of flu). After the elderly (aged over 75 years), children under the age of 5 years have the greatest risk of being admitted to hospital with flu. Flu also increases the risk of them developing a bacterial chest infection (including group A strep pneumonia) and other bacterial infections (such as pneumococcal disease) - children that receive the flu vaccine appear less likely to become unwell with Gp A strep and have lower rates of invasive pneumococcal disease. Find out more about Flu on the NHS Website.
Fortunately, your child can be protected from flu by having a flu vaccine each year. The children's flu vaccine is given to children through their nostrils. A nasal spray is used as it is the safest and effective way to give children the vaccine. The flu vaccine is offered every year to children from the age of two years (on 31st August) at your GP practice, in primary school or community clinics for children aged 5 to 11 years (reception to year 6), and from this year to all secondary school children.
Children at primary and secondary school will be offered the vaccine though the NHS school-aged immunisation service. If your child misses their vaccine at school; it is likely that they can attend a community clinic to have it given; simply contact your local school-aged vaccination service (your child’s school will have the contact details). If your child is not yet in school, your GP practice will be able to give them the vaccine.
To learn more about flu and how it is spread watch this short video from Dr Ranj:
Flu vaccinations are also recommended for some adults who are more likely to get seriously ill if they get flu. You are eligible for a free flu vaccine if you are pregnant, over 50, or have certain health conditions – click here for more information to see who is eligible.
Commonly asked questions about flu and the flu vaccine
'Flu isn't serious, so my child doesn't need a flu vaccine' and 'My children never get ill, so they don't need the vaccine'
It is tempting to think that flu is no worse than a bad cold, but in fact it is a serious disease which can infect anyone. Although most children do not become severely unwell with flu, in children with other medical conditions (heart or lung problems or weakened immune systems), flu can lead to hospitalisation or even death. In addition, children are superspreaders of flu, which means that even if they are mildly affected, they can easily infect other family members, such as grandparents or people with medical conditions who may become extremely unwell.
'My child is outside of the age range for routinely receiving the flu vaccine. Should I arrange for them to have it anyway?'
Although the flu vaccine is recommended for all children aged 2 years and over (aged 2 on 31st August), there are some children aged 6 months-2 years of age who should also have it. This is because they have medical conditions that mean that they are at higher risk of getting severe infection if they are infected with flu. This includes children with:
- Respiratory (lung) diseases, including asthma
- Heart disease, kidney disease or liver disease
- Neurological (brain or nerve) conditions including learning disability
- Diabetes (see a short film of a woman with Type 1 diabetes talking about why she gets the flu vaccine)
- A severely weakened immune system (immunosuppression), a missing spleen, sickle cell anaemia or coeliac disease
- Being seriously overweight (BMI of 40 and above)
If your child falls into any of these categories, please book them in to your GP practice to have it given (pharmacies are unable to give the flu vaccine to children aged under 18 years). If your child misses their vaccine at school; it is likely that they can attend a community clinic to have it given; simply contact your local school-aged vaccination service (your child’s school will have the contact details).
'The nasal spray that children get is a live vaccine - I'm worried that if my child has it they will infect relatives/grandparents'
There is no evidence that healthy unvaccinated people can catch flu from the nasal flu spray (either from airborne spray droplets in the room where the vaccine is given, or from vaccinated individuals ‘shedding’ the virus).
It is known that vaccinated children shed the virus for a few days after vaccination (through sneezing or coughing). However, the vaccine virus is weakened (it is “cold adapted” which means it dies at 37°C), so cannot infect the lungs (and so cannot cause breathing issues) and so isn't really able to spread from person to person. The amount of virus that children shed is normally below the levels needed to pass on infection to others. The virus does not survive for long outside the body.
It is therefore not necessary for children to be excluded from school during the period when the vaccine is being given. The only exception is the very small number of children who are extremely immunocompromised (for example, those who have just had a bone marrow transplant).
'Last year my children had the flu vaccine but they got ill anyway, so it doesn't work'
No vaccine is 100% effective, including the flu vaccine. The strains of circulating flu change each year which is why the vaccine needs to be changed each year to offer the best protection. However, the vaccine usually prevents about half of all flu cases. For people who get flu after being vaccinated, the disease is often less severe than it would have been. It is important to remember that the flu vaccine only protects against flu, but there are other illnesses which have flu-like symptoms which you can still catch after getting the flu vaccine. It takes up to two weeks for the vaccine to take effect, so you could still catch flu if you are exposed to the virus during this time. Getting vaccinated as early as possible in the season can help to prevent this.
Use this video to explain to your child why they are having the flu vaccine
The MMR vaccine
Measles is a highly infectious viral disease which can lead to serious complications such as pneumonia and encephalitis (inflammation of the brain). Mumps can cause a wide range of complications, some very serious, including meningitis and encephalitis (inflammation of the brain). Rubella (or German measles) is very dangerous for pregnant women because it can cause miscarriage or serious abnormalities in the unborn baby.
The MMR vaccine should be given at 12 months of age and then again at 3 years 4 months of age. One vaccine results in over 90% protection for your child and having both vaccines means that it is almost impossible for your child to get measles.
Unfortunately, as these vaccine preventable infections become less and less common, media coverage on vaccines increasingly focuses on their side effects and adverse reactions. Although there is absolutely no evidence to suggest that the MMR vaccine is associated with an increased risk of autism, misinformation about this has directly resulted in unnecessary parental anxiety and a significant drop in MMR vaccine uptake. Unfortunately, we are now seeing an increasing number of cases of measles in the UK and across Europe. This has resulted in severe illness and even deaths in a number of adults and children. Even if you think your child will be protected by herd immunity (other people being vaccinated around them), this is no longer the case with MMR because less than the required 95% of the population are being vaccinated. In addition, if your child was to travel to another country (even when they are an adult) or come into contact with someone with measles who is visiting from abroad, they will be completely unprotected and may contract the infection. Unfortunately, measles is highly infectious and is spread by aerosolised particles and droplets coughed or sneezed by infected individuals.
For more information about the safety of the MMR vaccine and parent stories, click here
Babies aged 6-12 months of age travelling to a country with high rates of circulating measles or to an area where there is a current measles outbreak, who are likely to be mixing with the local population, should receive a dose of MMR vaccine before 12 months of age. This is because of the increased risk of severe measles disease in young children, including brain infection (SSPE). As the response to MMR in infants is sub-optimal where the vaccine has been given before one year of age, immunisation with two further doses of MMR should be given at the normal recommended ages.
Frequently asked questions about vaccines
It’s normal to have questions about any medication that you’re giving to your child and vaccines are no exception. The most common questions that parents ask are:
Why should I have my child vaccinated? Won’t herd immunity protect them?
Herd immunity does not protect against all diseases. The best example of this is tetanus, which is caught from bacteria in the environment, not from other people who have the disease. In addition, for herd immunity to work properly, most people in the population need to be vaccinated. There are low vaccination rates in some parts of the UK and in some communities, as well as in many overseas countries. This means that if your child is not vaccinated, it is quite likely that many of the people they come into contact with will not be vaccinated either. So if one person gets an infectious disease, it can spread quickly through all the unvaccinated people in the group (this happened during the 2013 measles outbreak in Wales).
A guide to immunisations for children upto 5 years of age is available in various languages - click here
Won’t having several vaccines at the same time overload my baby’s immune system?
Parents often worry that a child’s immune system will not be able to cope with several vaccines at once. In fact, even a tiny baby’s immune system can cope easily. Starting from birth, babies come into contact with millions of germs every day. It is estimated that the human body contains enough white blood cells to cope with thousands of vaccines at any one time. If a child was given 11 vaccines at once, it would only use about a thousandth of the immune system. It is not a good idea to delay vaccinations to ‘spread the load’, because it leaves the child unprotected against serious diseases for longer.
How do I know that vaccines are safe?
All vaccines go through a long and thorough process of development and testing before they are licensed for use. Vaccines have to be tested on adults and children separately before they can be used for different age groups; this is because vaccines that work in adults may not work so well in children. No vaccines are tested on children before they have been fully tested on adults. Click here for more information about vaccine safety and side effects.
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