Childhood vaccination
From Ganfyd
See main Vaccination article for general information on vaccination.
See Childhood vaccination schedule for the detailed schedule of routine vaccinations.
_Contents |
_ Routine childhood vaccination in the UK comprises vaccination against:
(For comments on the specific vaccines used for the above, see below.)
(The above are protected against using MMR vaccine.)
- Meningococcal disease group B
Diphtheria, tetanus, pertussis, polio, and Haemophilus influenzae type B
The following vaccines are now available and use in the UK:
| Stage | Brand name | Components | Notes |
|---|---|---|---|
| Primary vaccination | Pediacel | DTaP5/IPV/Hib | For primary vaccination of infants. Not suitable for vaccination of >10s as Hib not required, and contains high dose diphtheria component |
| Pre-school booster | Repevax | dTaP5/IPV | No Hib; not suitable for primary vaccination at age ≤10 as contains low dose diphtheria component |
| Ditto | Infanrix IPV | DTaP3/IPV | No Hib; not suitable for primary vaccination as contains only three-component pertussis vaccine; not suitable for vaccination of >10s as contains high dose diphtheria component |
| Subsequent boosters | Revaxis | Td/IPV | Recommended for primary vaccination after the age of 10, and for boosters after a primary course and (where relevant) pre-school booster. Not suitable for use at age ≤10 as contains low dose diphtheria component. |
NB:
- D and d refer to the high and low dose diphtheria toxoid components respectively.
- Prior to the age of 10 years three doses of high dose diphtheria toxoid are required to ensure adequate immunity. Subsequent boosters below the age of can use low or high dose diphtheria toxoid, but only after a primary course of three doses of a vaccine containing the high dose component.
- People aged 10 or more are at risk of a reaction if they receive high dose diptheria vaccine, and at this age only the low dose vaccines should be used.
- T refers to tetanus toxoid.
- aP refers to acellular pertussis vaccine. In order to acheive adequate immunity (comparable to using whole-cell pertussis vaccine) UK experts advise that a 5-component acellular pertussis vaccine (aP5) is used; although after a course of three doses of aP5, boosting with 3-component vaccine (aP3) is thought to be sufficiently effective.
- IPV refers to inactivated polio vaccine, which replaced oral polio vaccine in the routine schedule in 2004 -
See CMO letter PL CMO (2004)3 : New vaccinations for the childhood immunisation programme and the relevant chapters of the Green Book for explanations of the changes made to the routine schedules in 2004.
Common questions about childhood vaccination
How can I obtain vaccines that aren't offered routinely?
It is very difficult to obtain vaccines that are not licensed in the UK. The NHS offers vaccines that are safe and effective; but, to keep costs down, it doesn't offer vaccines that are not needed. There is no need, for example, for separate measles, mumps, and rubella vaccines, as there is overwhelming evidence that giving these in combination is safe, and giving them separately only delays providing protection against these diseases. While there may be existing licenses for some single component vaccines, there may not be products still in production that meet the licenses.
Similarly, the new acellular pertussis-containing vaccines have been shown in trials to induce no more adverse reactions than otherwise identical vaccines without the pertussis components: unlike the whole-cell vaccine, which contained many antigens (and potentially reaction causing substances), the acellular vaccines are very clean.
Where there is a licensed product it may be provided "free" for use as part of the national schedules. For use outside the schedules such products can be prescribed in the usual way. Interesting questions may arise if a vaccine is safe, effective, but not part of a national schedule - unless explicitly blacklisted, it is likely that such vaccines may, and conceivably must, be prescribed on request, if the prescriber believes them to be indicated. HPV vaccine, for example, is effective, but expensive, and is likely to be licensed in the UK before the end of 2006. See rationing
