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Baby immunisations and vaccinations

We look at the early baby immunisations and vaccinations schedule. Here’s what you need to know and why it matters.

You might wonder why babies need extra protection or any immunisations in the first place. Before they’re born, babies receive antibodies against infections from the mother via the placenta. This gives your newborn immediate protection for up to four months (Baxter, 2007).

But by four months (at most) that short-term immunity wears off and your baby is no longer protected from infections. This is where the immunisations programme comes in. 

Vaccinations have made formerly common childhood diseases rare (CDC, 2018). But in August 2019, England lost its 'measles-free' status with the World Health Organization. This was due to 231 confirmed cases of measles in the first three months of 2019 (New Scientist, 2019). Experts are pointing to 'sub-optimal' take-up of MMR for this (Gov.uk, 2019).

Here’s what you need to know about vaccinations and baby immunisations.

Your child’s schedule of baby immunisations

Every baby and child in the UK is offered a schedule of routine immunisations starting from when they’re two months old. The Department of Health, Public Health England and NHS England all recommend these immunisations to help protect your baby from what would otherwise be common childhood diseases.

In some areas, your baby will be offered a BCG tuberculosis (TB) vaccination in the first day or so. This will also be the case if your baby has family members visiting from countries that have high rates of TB (NHS, 2019a).

Immunisations are timed to reduce the chance of your child catching a serious disease. Premature babies can be weaker and so at greater risk of a serious reaction to disease (NHS, 2015).

You’ll be given a personal child health record (PCHR) that’s called a ‘red book’. It’s called that because the cover is usually red and it’s for recording your child’s health. In some areas this has now moved or is moving to a digital app. It contains details of the schedule for immunisations. Your baby’s GP might also send you reminders for when their immunisations are due.

If something happens to delay or interrupt the schedule, you can pick it up again at any time. 

Here’s what the current schedule for immunisations in the UK looks like.

At two months (eight weeks)

  • 6-in-one vaccine (DTaP/IPV/Hib/HepB) – this provides protection for the following diseases: diptheria, tetanus, pertussis (whooping cough), polio, Haemophilus influenzae type b (Hib) and hepatitis B.

(GOV.UK 2020, NHS, 2019b)

At three months (twelve weeks)

  • 6-in-one vaccine (DTaP/IPV/Hib/HepB) (second dose)
  • Rotavirus (second dose)
  • Pneumococcal or pneumo jab (PCV) – this provides protection against some types of pneumococcal infection. 

(GOV.UK 2020, NHS, 2019b)

At four months (sixteen weeks)

  • 6-in-one vaccine (DTaP/IPV/Hib/HepB) (third dose)
  • Men B (second dose)

(GOV.UK 2020, NHS, 2019b)

One year old (on or after the child’s first birthday)

  • Hib and MenC (Hib/MenC): this jab is given as a single dose and provides protection against Meningitis C (first dose) and HiB (fourth dose)
  • Pneumococcal (PCV) (booster)
  • Men B (third dose)
  • Measles, mumps and rubella (German measles) (MMR): this jab is given as a single dose and provides protection against measles, mumps and rubella.

(GOV.UK 2020, NHS, 2019b)

At two years old (and older)

  • Influenza (available each year from September) (GOV.UK 2020, NHS, 2019b).

Risks and myths about baby immunisations

Some parents decide not to vaccinate their babies because of concerns about the potential side effects they might cause. Understandably, they want to balance the benefits of having a vaccine against the chances of harm.

Risks

While every medicine has side effects, vaccines are among the safest of medicines. The majority of side effects that vaccinations cause are mild and don’t last long (NHS, 2019c).

Common side effects of vaccinations in babies include redness or swelling around the injection site, and a slight temperature that normally disappears within a couple of days. Extremely rare side effects (less than one in a million) include anaphylactic reaction, which needs to be treated promptly (NHS, 2019c). This is why vaccinations are given in GP surgeries.

Myths

You might be worried about links between vaccinations and other health conditions. Be aware that lots of anti-vaccine stories are spread online and they're not based on scientific evidence. For example, you might have read about a link between the MMR vaccination and autism but a lot of good-quality research has found no evidence that any link exists (Taylor et al, 2014; Hviid et al, 2019; NHS, 2020).

If you have any concerns, do have a chat with your GP or health visitor to make sure you're making your decision based on reliable information.

Breastfeeding and immunity

Breastfeeding gives babies short-term protection from infection mostly through antibodies in breastmilk. Breastmilk also contains live cells and other factors which help confer longer term immunity (Witkowska-Zimny & Kaminska-El-Hassan, 2017; Cacho, 2017). Research has shown Covid antibodies are present in human breastmilk from mothers who have previously had Covid 19 (Fox et al, 2020)

The protective effect of breast milk increases the longer the baby is breastfed. It protects against specific illnesses and strengthens the immune system, including the baby's response to vaccines (Hanson, 1999). The same vaccination schedule is recommended however you feed your baby.

Premature babies and immunisations

Premature babies are at a higher risk of infection. This is why they are offered the same immunisation schedule schedule starting from when they’re two months old, regardless of how early they were born. It could be possible that they start their immunisation when they are still at hospital but your doctor will be able to advise you on this (NHS, 2015).

Protecting your child

Diseases like meningitis and measles have not vanished, though vaccination has lowered the risk of outbreaks (CDC, 2018). If you decide not to vaccinate your baby, you need to think about how you are going to manage their exposure to potentially disabling or fatal diseases (NHS, 2019c)

This page was last reviewed in March 2021.

Further information

Our support line offers practical and emotional support with feeding your baby and general enquiries for parents, members and volunteers: 0300 330 0700.

You might find attending one of NCT's Early Days groups helpful as they give you the opportunity to explore different approaches to important parenting issues with a qualified group leader and other new parents in your area.

Make friends with other parents-to-be and new parents in your local area for support and friendship by seeing what NCT activities are happening nearby.

Further information on immunisation for children can be found at NHS Choices.

Healthtalk.org, shares people’s experiences of health and illness based on qualitative research, posts a wide range of information on immunisation.

Baxter D. (2007) Active and passive immunity, vaccine types, excipients and licensing. Occupational Medicine. 57(8):552-556. Available at: https://doi.org/10.1093/occmed/kqm110 [Accessed 24th March 2021]

CDC. (2018) What would happen if we stopped vaccinations? Available at: https://www.cdc.gov/vaccines/vac-gen/whatifstop.htm [Accessed 24th March 2021]

Fox A, Marino J, Amanat F, Krammer F, Hahn-Holbrook J, Zolla-Pazner S, Powell R. (2020) Robust and Specific Secretory IgA Against SARS-CoV-2 Detected in Human Milk. iScience. Available from: https://www.sciencedirect.com/science/article/pii/S2589004220309329 [Accessed 24th March 2021]. 

GOV.UK. (2019) Measles in England. Available at: https://publichealthmatters.blog.gov.uk/2019/08/19/measles-in-england/ [Accessed 24th March 2021]. 

GOV.UK. (2020) Complete routine immunisation schedule. Available at: https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/899423/PHE_Complete_Immunisation_Schedule_Jun2020_05.pdf  [Accessed 24th March 2021]

Hanson LA. (1999) Breastfeeding provides passive and likely long-lasting active immunity. Ann Allergy Asthma Immunol. 81(6):n523-33. Available at: https://www.ncbi.nlm.nih.gov/pubmed/9892025 [Accessed 24th March 2021]

Hviid A, Hansen JV, Frisch M, Melbye M. (2019) Measles, mumps, rubella vaccination and autism: a nationwide cohort study. Ann Intern Med. 170(8):513-520. Available at: https://www.acpjournals.org/doi/10.7326/M18-2101 [Accessed 23rd March 2021]

New Scientist. (2019) The UK has lost its World Health Organization ‘measles-free’ status. Available at: https://www.newscientist.com/article/2213764-the-uk-has-lost-its-world-health-organization-measles-free-status/ [Accessed 24th March 2021].

NHS. (2015) A quick guide to childhood immunisations for the parents of premature babies. Available at: http://webarchive.nationalarchives.gov.uk/20150711065044/https://www.gov.uk/government/publications/a-quick-guide-to-childhood-immunisation-for-the-parents-of-premature-babies [Accessed 24th March 2021]

NHS. (2019a) BCG tuberculosis (TB) vaccine. Available at: https://www.nhs.uk/conditions/vaccinations/bcg-tuberculosis-tb-vaccine/#when-is-the-bcg-vaccination-given [Accessed 24th March 2021]. 

NHS. (2019b) NHS Vaccines and when to have them. Available at https://www.nhs.uk/conditions/vaccinations/nhs-vaccinations-and-when-to-have-them/ [Accessed 24th March 2021]. 

NHS. (2019c) Why Vaccination is safe and important. Available at: https://www.nhs.uk/conditions/vaccinations/benefits-and-risks/ [Accessed 24th March 2021]. 

NHS. (2020) MMR Vaccine. Available at: https://www.nhs.uk/conditions/vaccinations/mmr-vaccine/[ Accessed 24th March 2021]. 

Patient. (2018) Immunisations. Available at: https://patient.info/health/immunisation [Accessed 24th March 2021]

Taylor LE, Swerdfeger AL, Eslick GD. (2014) Vaccines are not associated with autism: an evidence-based meta-analysis of case-control and cohort studies. Vaccine. 32(29):3623-3629.  Available at: https://www.ncbi.nlm.nih.gov/pubmed/24814559 [Accessed 24th March 2021]   

Witkowska-Zimny, M., & Kaminska-El-Hassan, E. (2017). Cells of human breast milk. Cellular & molecular biology letters, 22, 11. https://doi.org/10.1186/s11658-017-0042-4 [Available at https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5508878/]                                          

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