Childhood vaccinations

Common questions

Will I be told when my baby's vaccinations are due?

Your doctor's surgery or clinic will automatically send you an appointment for you to bring your baby for their vaccination.

Most surgeries and health centres run special immunisation or baby clinics. If you can't get to the clinic, contact your surgery to make another appointment. All childhood vaccinations are free.

Read this NHS guide to the complete immunisation schedule.

Do babies need to be vaccinated before going swimming?

You can take your baby swimming at any time before and after their immunisations.

Can I refuse my baby's vaccinations?

As a parent, you can refuse any of your child's recommended vaccinations.

You should be asked for your consent before each vaccination and, if you refuse, this will be recorded in your child's medical notes.

Bear in mind that there's lots of evidence that vaccinations do much more good than harm, and that vaccines will protect your child for many years against a range of serious illnesses.

Read more about why vaccination is safe and important.

If my child misses a vaccination, can they still continue the course?

If you missed the appointment or delayed the immunisation, make a new appointment as soon as possible. You can usually (though not always) pick up the immunisation schedule where it stopped without having to start again.

Read more about booking vaccination appointments.

Will my baby have side effects from vaccination?

Some babies will have side effects, but they're generally mild and short-lived. These include:

• redness, swelling or tenderness where they had the injection (this will slowly disappear on its own)
• a bit of irritability and feeling unwell
• a high temperature (fever)

If your baby develops a fever, you can treat them with paracetamol or ibuprofen.

This NHS leaflet tells you about common side effects of vaccinations in babies and children up to five years of age.

Will the vaccination hurt my baby?

Your baby may cry and be upset for a few minutes, but they'll usually settle down after a cuddle.

Read these vaccination tips for parents.

Can babies with an allergy have vaccinations?

Asthma, eczema, food intolerances and allergies do NOT prevent your child having any of their vaccinations. If you have any questions, speak to your doctor, practice nurse or health visitor.

Could my baby have an allergic reaction to a vaccine?

It's very rare for babies to have an allergic reaction to a vaccination - but it can happen. The important thing to remember is that it's completely treatable.

Signs of an allergic reaction to a vaccination are a rash or itching of part or all of the body. If this happens, the doctor or nurse giving the vaccine will know how to treat it.

In very rare cases, children can have a severe reaction within a few minutes of the injection, which causes breathing difficulties and, sometimes, they can collapse. This is called an anaphylactic reaction.

Anaphylactic reaction only happens about once in every million immunisations. Again, the people who give vaccinations are trained to deal with anaphylactic reactions on the spot and children recover completely with treatment.

Read more about the safety of vaccinations.

If my baby is ill, should I postpone their vaccination?

If your baby has a minor illness without a fever, such as a cold, they can have their vaccinations as normal. If your baby is ill with a fever, put off the vaccination until they have recovered.

If your baby has either:

• a bleeding disorder (such as haemophilia)
• a fit not associated with fever

speak to your doctor, practice nurse or health visitor before your child has any immunisations.

My baby was premature - should they wait until they're older for their routine vaccinations?

Premature babies may be at higher risk of catching infections, so it's really important that they have their vaccinations on time, i.e. from eight weeks of age, no matter how premature they were.

It may seem very early to give a vaccination to such a tiny baby, but many scientific studies have shown that it's a good time to give them vaccines. Postponing vaccination until they're older leaves premature babies vulnerable to diseases.

Read this vaccination guide for parents of premature babies.

The 4-in-1 pre-school booster vaccine is offered to three-year-old children to boost their protection against four different serious diseases:

• Diphtheria
• Tetanus
• Whooping cough
• Polio

Children are routinely vaccinated against these illnesses as babies through the 6-in-1 vaccine. The 4-in-1 pre-school booster vaccine increases their immunity even further.

When should children have the 4-in-1 booster vaccine?

The 4-in-1 booster vaccine is routinely offered to children at the age of three years and four months old.

How is the 4-in-1 vaccine given?

It's injected into the child's upper arm.

Can the 4-in-1 pre-school booster vaccine be given with other vaccines?

The pre-school booster can be given at the same time as other vaccines. It's usually given at the same time as the second dose of the MMR vaccine.

How well does the 4-in-1 pre-school booster work?

Studies have shown that the pre-school booster is very effective. In clinical tests, more than 99% of children who had been given the 4-in-1 pre-school booster were protected against tetanus, diphtheria, whooping cough and polio.

The vaccine protects children from these infections until they receive their 3-in-1 teenage booster at the age of 14.

The 4-in-1 vaccine not only protects your child against these infections but also stops them passing the germs on to babies who are too young to have had all of their vaccinations.

How safe is the 4-in-1 booster vaccine?

Before anyone can be given a vaccine, it has to go through many tests to check that it is safe and effective.

However, the 4-in-1 pre-school booster, like other vaccines, can have side effects in some children.

Side effects of the 4-in-1 vaccine are usually mild. Your child may get a little redness, swelling or tenderness where the injection was given. This will disappear on its own.

This NHS leaflet tells you about common vaccination reactions in young children up to five years of age.

Read more about the 4-in-1 pre-school booster side effects.

Which children can't have the 4-in-1 booster vaccine?

The vast majority of children can have the 4-in-1 booster vaccine, but it should not be given to children who have had an anaphylactic reaction (severe allergic reaction) to any part of the vaccine before.

There's no need to postpone vaccination if your child has a minor illness, such as a cough or a cold with no fever. But if your child is ill with a fever, it's best to delay vaccination until they have recovered.

Why is inactivated polio vaccine (IPV) used rather than oral polio vaccine (OPV), as in the past?

OPV was used from the 1960s because the live vaccine provided better community-wide protection against polio.

Now that polio has been eradicated from large parts of the world, the risk is so low that it's an appropriate time to switch to IPV, which is given as an injection and does not carry the risk of paralytic polio.

Can you get polio from the polio part of this vaccine?

The 4-in-1 pre-school booster uses inactivated polio vaccine, which cannot cause polio.

The teenage booster, also known as the 3-in-1 or the Td/IPV vaccine, is given as a single injection into the upper arm to boost your child's protection against three separate diseases: tetanus, diphtheria and polio.

Who should have the 3-in-1 booster?

The 3-in-1 teenage booster, is available routinely on the NHS for all young people aged 14 (school year 9).

It is generally given at secondary school at the same time as the Men ACWY vaccine. As a parent, you will be sent a letter from your child's school a week or so before the vaccinations are planned to ask for your or your child's consent.

The brand name of the 3-in-1 teenage booster given in the UK is REVAXIS.

Read the patient information leaflet (PIL) for REVAXIS.

Read more about which children should have the 3-in-1 teenage booster jab.

How safe is the 3-in-1 booster vaccine?

The 3-in-1 teenage booster is a very safe vaccine but, as with all vaccines, some children may have minor side effects, such as swelling, redness or tenderness where you have the injection. Sometimes, a small painless lump develops, but it usually disappears in a few weeks.

Read more about the possible side effects of the 3-in-1 vaccination.

Read answers to the common questions that parents ask about the 3-in-1 teenage booster jab.

When your baby or child is due for a routine vaccination, you may receive a notice in the post, detailing an appointment.

You should let your GP practice know if you are unable to attend the vaccination appointment. They will be able to rearrange your child's appointment, but it is important that your child is vaccinated at the right ages, as detailed in the vaccination schedule.

Before the vaccination appointment

Check the appointment notice to see whether the appointment is at your GP practice or at a different local child health clinic.

You should also remember to take your Personal Child Health Record (PCHR) to the appointment. In England, this usually has a red cover and is often called the "red book".

At the vaccination appointment

• Report to reception, so they know you're there

The nurse or doctor will check:

• Your child's general health, and what medicines they may be taking
• Which vaccines your child is going to have
• That you know which diseases the vaccinations protect against
• That you know what side effects may occur and how to treat them
• That you're happy to go ahead

After the vaccination

Make sure that the type of injection (and where it was given) is noted down in your red book and in your child's GP records. Your child may need this information later in life - for example, when applying for certain jobs or going to live or study abroad.

What to do if you miss a vaccination appointment

Don't panic. You don't have to start the course of vaccines again, just make a new appointment as soon as you can.

For more information, read tips on preparing your child for a vaccination.