Introduction

Immunisation is the process whereby a person is made resistant or immune to an infectious disease, typically by the administration of a vaccine.   Vaccines teach your immune system how to create antibodies that protect you from diseases. It is much safer for your immune system to learn this through vaccination than by catching the diseases and treating them. Once your immune system knows how to fight a disease, it can often protect you for many years.

Vaccination is the most important thing we can do to protect ourselves and our children against ill health. They prevent up to 3 million deaths worldwide every year. Since vaccines were introduced in the UK, diseases like smallpox, polio and tetanus that used to kill or disable millions of people are either gone or seen very rarely. Other diseases like measles and diphtheria have been reduced by up to 99.9% since their vaccines were introduced. However, if people stop having vaccines, it is possible for infectious diseases to quickly spread again.

Having a vaccine also benefits your whole community through "herd immunity". If enough people are vaccinated, it is harder for the disease to spread to those people who cannot have vaccines. For example, people who are ill or have a weakened immune system. All vaccines are thoroughly tested to make sure they will not harm you or your child.

Children’s 0-5 years immunisations are given in primary care usually by the practice nurse. Immunisations due in older childhood are usually given in school by the immunisation team.  Immunisation rates are often referred to as coverage, this is because vaccination coverage is the best indicator of the level of protection a population will have against vaccine preventable diseases. Coverage tells us how many people in that specific cohort have received the vaccination by a point in time for example how many children have had both MMR vaccines by the time they turn five.  Vaccination uptake is also referenced, which is the number of people vaccinated in a certain time such as how many two-year-olds received the flu vaccine that winter.

The NHS Constitution advises that individuals have the right to receive the vaccinations that the Joint Committee on Vaccination and Immunisation recommends that you should receive under an NHS-provided national immunisation programme. The Director of Public Health role for immunisation programmes includes providing the appropriate challenge and to advocate for an emphasis on reducing health inequalities and improving access in underserved groups in the work of commissioners, providers, and other key stakeholders.

Setting the foundations for health and wellbeing during pregnancy and the early years is crucial to ensure we give every child the very best start in life as possible. Childhood immunisation in particular helps to prevent disease and promote child health from infancy, creating opportunities for children to thrive and get the best start in life. This JSNA topic will focus on childhood immunisations administered to preschool and adolescent children and young people in the UK in accordance with the NHS vaccination schedule. Table 1 lists the childhood immunisation programmes.

Table 1: Childhood immunisation schedule and the diseases they protect against

Age Due Vaccine Given

Disease protected against

Eight weeks old DTaP/IPV/Hib/HepB Diphtheria, tetanus, pertussis (whooping cough), polio, Haemophilus influenzae type B (Hib) and hepatitis B
  Men B Meningococcal group B (MenB)
  Rotavirus Rotavirus gastroenteritis
Twelve weeks old DTaP/IPV/Hib/HepB Diphtheria, tetanus, pertussis, polio, Hib and hepatitis B
  Pneumococcal conjugate vaccine (PCV) Pneumococcal (13 serotypes)
  Rotavirus Rotavirus
Sixteen weeks old DTaP/IPV/Hib/HepB Diphtheria, tetanus, pertussis, polio, Hib and hepatitis B
  Men B Men B
One year old (on or after the child’s first birthday) Hib/Men C Hib and Men C
  PCV booster Pneumococcal
  MMR Measles, mumps and rubella (German measles)
  Men B booster Men B
Three years fourth months old or soon after DTaP/IPV Diphtheria, tetanus, pertussis, and polio
  MMR Measles, mumps and rubella
Boys and girls aged twelve to thirteen years HPV (two doses 6-24 months apart) Cancers and genital warts caused by specific human papillomavirus (HPV) types
  Td/IPV Tetanus, diphtheria, and polio
Fourteen years old (school Year 9) Men ACWY

Meningococcal groups A, C, W and Y

Children aged 2, 3 years, all primary school (reception to year 6), all year 7 to year 11 children in secondary school, children aged between 6months and 17 years with long term health conditions Flu vaccine injection or nasal spray flu vaccine depending on eligibility Flu