GPAtlas🧭 When to suspect under-immunisation
Immunisation is one of the few primary-care interventions that protects an individual child and the wider population at once.
• Review status at every relevant contact, not only at booked clinics.
• The children most likely to be under-protected are precisely those who attend least predictably.
Suspect under-immunisation whenever records are incomplete, unavailable, or unverified. Raise particular suspicion in:
• New entrants to the UK (migrants, asylum seekers, internationally adopted children)
• Looked-after children
• Gypsy, Roma and Traveller families
• Households that move frequently
• The children of vaccine-hesitant parents
Where overseas records are missing or untranslatable, the safest assumption is that the child is unimmunised and should enter a catch-up pathway.
The schedule was substantially restructured across 2025–2026:
• The combined MMRV (measles, mumps, rubella, varicella) vaccine replaced MMR
• A new 18-month appointment was added
• The Hib/MenC booster was withdrawn
• The timings of meningococcal group B vaccine (MenB) and pneumococcal conjugate vaccine (PCV) in the primary course were changed
So you need to:
• Know the current schedule
• Distinguish true from false contraindications
• Catch up safely
• Never miss anaphylaxis
| Age due | Vaccines offered (routine schedule, born from 1 Jan 2025) |
|---|---|
| 8 weeks | 6-in-1 (DTaP/IPV/Hib/HepB) · MenB · Rotavirus (oral) |
| 12 weeks | 6-in-1 (2nd) · MenB (2nd) · Rotavirus (2nd) |
| 16 weeks | 6-in-1 (3rd) · PCV (1st) |
| 1 year | MMRV (1st) · PCV (booster) · MenB (booster) – no Hib/MenC |
| 18 months (new) | 6-in-1 (4th dose) · MMRV (2nd) |
| 3 years 4 months | 4-in-1 pre-school booster (dTaP/IPV) |
| 12–13 years (Year 8) | HPV – single dose |
| 14 years (Year 9) | Td/IPV (3-in-1 teenage booster) · meningococcal groups A, C, W and Y vaccine (MenACWY) |
| Annual (eligible children) | Live attenuated nasal flu (inactivated if unsuitable) |
Source: UKHSA Green Book · Routine childhood immunisation schedule
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