Routine Childhood Immunisation

Immunisation has caused dramatic improvements in health. Because of immunisation, diseases such as diphtheria, tetanus, whooping cough, measles and polio which used to be major causes of ill health are now rare in many countries.

Normal immunisation schedule for children in the UK

AGE
-
Immunisation (Vaccine Given)
2 months
-
Diphtheria, Tetanus, Pertussis (DTP)
Haemophilus Influenza B (Hib)
Meningococcus Group C
Polio
3 months
-
Repeat as above. That is, the second dose of:
Diphtheria, Tetanus, Pertussis (DTP)
Haemophilus Influenza B (Hib)
Meningococcus Group C
Polio
4 months
-
Repeat as above. That is, the third dose of:
Diphtheria, Tetanus, Pertussis (DTP)
Haemophilus Influenza B (Hib)
Meningococcus Group C
Polio
12-18 months
-
Measles, Mumps and Rubella (MMR)
4-5 years
-
'Pre-school' booster of:
Diphtheria, Tetanus, Pertussis (DTP)
Measles, Mumps and Rubella (MMR)
Polio
10-14 years
-
BCG (which protects against tuberculosis - TB)
14-18 years
-
Booster of
Diphtheria and Tetanus
Polio

Note:

What if I forget about or delay immunisations?

If the usual schedule is interrupted or delayed for any reason, it can be resumed at any time. There is no need to start again. However, it is best to have the immunisations at the correct time as the earlier the child is protected, the better.

Some exceptions to this rule are:

Who should NOT be immunised?

There are very few reasons why children should not receive their full course of immunisations. Immunisations are generally safe and effective. For some immunisations the two commonest reasons why it might not be advisable are:

But, see the notes for individual immunisations for details.

Which diseases are prevented with childhood immunisations?

Diphtheria is caused by the bacterium Corynebacterium diphtheriae. It causes a serious throat and chest infection. Since immunisation was started in the 1950s, diphtheria has now become very rare in the UK.

Haemophilus influenzae b (Hib) is a bacterium which can cause pneumonia and meningitis. Children under the age of 4 are most at risk. Before the introduction of the vaccine in 1992, 1 in 600 children developed some form of invasive Hib disease before their fifth birthday. It is now rare.

Measles is caused by the measles virus. It causes a miserable feverish illness with a rash, and complications such as pneumonia, convulsions or encephalitis (brain inflammation) occur in some cases. Before the introduction of a measles vaccine in 1968, measles was a common childhood illness. It is now rare in the UK.

Mumps is caused by the mumps virus. The infection typically causes inflammation and swelling of the salivary glands. Complications occur in some cases such as pancreatitis, orchitis (inflammation of the testes) meningitis and encephalitis. Mumps may cause permanent deafness in one ear. Again, mumps is now rare in the UK due to immunisation.

Rubella (german measles) is caused by the rubella virus. It causes a mild illness with a rash. However, if a pregnant women has rubella, the virus is likely to cause serious damage to the unborn child. The child is likely to be born with multiple defects (Congenital Rubella Syndrome). The aim of rubella immunisation is to eliminate the rubella virus from the community as much as possible. Since rubella vaccination was introduced in 1970 there has been a dramatic fall in the number of babies born with the Congenital Rubella Syndrome.

Meningococcus group C is a bacterium which is one cause of meningitis and septicaemia (severe blood poisoning). There are other types of meningococcus, but cases of meningitis and septicaemia caused by group c have fallen since immunisation was introduced.

Pertussis (whooping cough) is caused by a bacterium called Bordetella pertussis. This causes a prolonged and distressing cough. Some infected children develop complications such as pneumonia or brain damage. There used to be regular epidemics of whooping cough before immunisation became available. Pertussis is now uncommon in UK children.

Poliomyelitis (polio) is a serious illness caused by the polio virus. The virus first infects the gut, but then travels to the nervous system and can cause a meningitis-like illness. This can sometimes leave permanent damage to some nerves. This can lead to wasting of muscles and sometimes paralysis of one or more of the limbs. The illness can seriously affect breathing in some people and may lead to death. In 1955, before the introduction of polio immunisation, there were nearly 4,000 reported cases of polio in England and Wales. As a result of immunisation it is now rare in the UK.

Tetanus is an infection caused by a bacterium called Clostridium tetani which is found in the soil. It causes severe and agonising muscle contractions and is often fatal. Between 1984 and 1995 there were 145 notifications of tetanus in England and Wales. Deaths from tetanus in the UK are mainly in people over the age of 45 years who have not been immunised as immunisation was introduced in the 1950s.

Tuberculosis (TB) is a bacterial infection caused by Mycobacterium tuberculosis. Most cases in the UK affect the lungs. The number of cases in the UK is rising mainly due to immigration and to people with HIV who are more susceptible to TB.

How does immunisation work?

The body is given a vaccine which is small dose of an inactive form of a bacterium or virus (germ), or a toxin (poison) made by the germ. As it is inactive it does not cause infection. However, the body makes antibodies against the germ or toxin. Antibodies are proteins in the bloodstream that attack infecting germs. Once we are immunised the antibodies are ready to attack the germ if it begins to invade our body. More antibody can quickly be made from cells which have previously made the particular antibody.

For some bacteria and viruses it has been difficult to produce a vaccine, but technology is advancing and new vaccines will be available in the future.

A new-born baby has 'passive' immunity to several diseases such as measles, mumps and rubella, from antibodies passed from its mother via the placenta. This passive immunity of babies usually only lasts for a few weeks or months, but for measles, mumps and rubella it lasts up to one year. Immunisation with vaccines is called 'active' immunity and provides long-term immunity.

Further information

Information on immunisation from the NHS aimed at the general public - www.immunisation.org.uk

Immunisation Against Infectious Disease (The Green Book) - www.doh.gov.uk/greenbook/
From the Department of Health. Aimed at health professionals but of interest to all.


© EMIS and PIP 2004   Updated February 2004   PRODIGY Validated