Allergies & Anaphylaxis – pre-school
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Dr Anna Maw
Consultant pediatrician at Cambridge University NHS Trust in the UK. A child doctor specializing in brain development and neurology. She has three children.
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Toddler care & health

Immunisations timeline

These are the routine vaccinations that are offered free of charge on the NHS to all babies and children in the UK.
In Short

Common side effects after an immunization

After an immunisation, your baby may cry for a little while, but that usually settles soon with a breastfeed or a cuddle. Most babies don’t have any other reaction.

Reactions at the site of the injection

Some babies have some swelling, redness or a small hard lump where the injection was given and it may be tender. This usually only lasts a few days and doesn’t need any medical treatment.


A fever is a temperature over 37.5°C

If your baby has a fever after an immunisation:

make sure they don’t have too much clothing or bedding on them, and

give them plenty of cool fluids

do not put them in a bath, sponge them down or put a fan on them

A summary of the routine and optional vaccinations offered free on the NHS in the UK (Source: NHS Choices).

8 weeks

6-in-1 vaccine, given as a single jab containing vaccines to protect against six separate diseases: diphtheria; tetanus; whooping cough (pertussis); polio; Haemophilus influenzae type b, known as Hib, a bacterial infection that can cause severe pneumonia or meningitis in young children; and Hepatitis B.

Rotavirus vaccine oral application

MenB vaccine

12 weeks

6-in-1 vaccine, second dose

Rotavirus vaccine, oral application, second dose

Pneumococcal conjugate vaccine (PCV13)

16 weeks

6-in-1 vaccine, third dose

MenB vaccine second dose

1 year

Hib/MenC vaccine, given as a single jab containing vaccines against meningitis C (first dose) and Hib (fourth dose)

Measles, mumps and rubella (MMR) vaccine, given as a single injection

Pneumococcal conjugate vaccine (PCV13), second dose

MenB vaccine, third dose

Primary School Age Children (including children in reception class to school year 6)

Children’s flu vaccine (annual nasal spray, unless child is in a clinical risk group and have inactivated flu vaccine instead)

3 years and 4 months

Measles, mumps and rubella (MMR) vaccine, second dose injection

4-in-1 pre-school booster, given as a single injection containing vaccines against: diphtheria, tetanus, whooping cough (pertussis) and polio

12-13 years

HPV vaccine, two injections given 6-12 months apart which protects against cancers caused by HPV, including:

cervical cancer
some mouth and throat (head and neck) cancers
some cancers of the anal and genital areas
It also helps protect against genital warts.

In England, girls and boys aged 12 to 13 years will be routinely offered the first HPV vaccination when they’re in school Year 8.

The second dose is normally offered 6 to 12 months after the first (in school Year 8 or Year 9).

It’s important to have both doses to be protected.

Those who missed their HPV vaccination in school Year 8 can continue to have the vaccine up to their 25th birthday.

14 years

3-in-1 teenage booster, given as a single jab containing vaccines against diphtheria, tetanus and polio

MenACWY vaccine, given as a single jab containing vaccines against meningitis A, C, W and Y

There will hopefully be a vaccination included for COVID-19 when an immunisation becomes available. It is not yet know if this will be an annual immunisation or if it can be given less frequently.

Optional vaccinations

These vaccinations are offered on the NHS in addition to the routine programme to “at-risk” groups of babies and children

Chickenpox vaccination

Protects against: chickenpox

Who needs it: siblings of children who have suppressed immune systems and are susceptible to chickenpox, for example, because they’re having cancer treatment or have had an organ transplant.

Given: from one year of age upwards. Children receive two doses of chickenpox vaccine given four to eight weeks apart.

BCG (tuberculosis) vaccination

Protects against: tuberculosis (TB)

Who needs it: babies and children who have a high chance of coming into contact with tuberculosis

Given: from birth to 16 years of age

Flu vaccination

Protects against: flu

Who needs it: children with certain medical conditions or a weakened immune system, which may put them at risk of complications from flu

Given: for children between the ages of six months and two years as a single jab every year in September/November.

For children aged two to 17 years of age as a nasal spray every year in September/November

Hepatitis B vaccination

Protects against: hepatitis B

Who needs it: children at high risk of exposure to hepatitis B, and babies born to infected mothers

Given: at any age, as four doses are given over 12 months – a baby born to a mother infected with hepatitis B will be offered a dose at birth, one month of age, two months of age and one year of age.

Common side effects after the MenB immunisation

Fever can be expected after any vaccination but is very common when the MenB vaccine is given. The good news is that this fever shows the baby’s body is responding to the vaccine, although not getting a fever doesn’t mean it hasn’t worked.

The level of fever depends on each individual baby and does not reflect how well the vaccine has worked. Giving liquid paracetamol will reduce the risk of fever, irritability and general discomfort (including pain at the site of the injection) after vaccination.

After each of the two MenB immunisations, you will need to give your baby a total of three doses of paracetamol (2.5ml of infant paracetamol 120mg/5ml suspension) to help prevent and reduce any potential fever.

  • Give the first dose of paracetamol as soon as possible after the immunization is given.
  • Then give the second dose 4-6 hours later.
  • Give the third dose 4-6 hours after the second dose.

Common side effects after the MMR immunisation

MMR is made up of three different vaccines/immunisations (measles, mumps and rubella) and each can each cause reactions at different times after the injection.

  • 6-10 days later the measles vaccine starts to work and may cause a fever, a measles-like rash, and loss of appetite. Individuals with vaccine-associated symptoms are not infectious to others.
  • 2-3 weeks after the injection the mumps vaccine may cause mumps-like symptoms in some children (fever and swollen glands).
  • 12-14 days later, the rubella vaccine may cause a brief rash and possibly a slightly raised temperature, however, a rash may also rarely occur up to six weeks later.

If you are worried about your child, trust your instincts. Speak to your doctor or call the NHS on 111.

Call the doctor immediately if, at any time, your child has a temperature of 39-40°C or above, or has a fit.

If the surgery is closed and you can’t contact your doctor, trust your instincts and go to the nearest hospital with an emergency department.

If you are still worried about your baby’s reaction to any vaccination, speak to your practice nurse or GP.

Vaccine safety

Before vaccines are introduced, they have to be licensed by the Medical and Healthcare products Regulatory Agency which assesses their safety and efficacy.

Once they have been introduced into the programme of scheduled immunisations on the NHS, their safety continues to be constantly monitored so that any new side effects are quickly noticed and investigated.

If you would like more information on the safety of vaccines/immunisations visit –

Here is a link to information on side effects –

Can I take my baby swimming around their immunisations

You can take your baby swimming at any age, both before and after they have been vaccinated. It doesn’t matter if they haven’t yet completed their course of vaccinations.

Last reviewed April 2020. Next review January 2021.

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This article is for information only and should not be used for the diagnosis or treatment of medical conditions. Essential Parent has used all reasonable care in compiling the information from leading experts and institutions but makes no warranty as to its accuracy. Consult a doctor or other health care professional for diagnosis and treatment of medical conditions. For details click here.