The UK has updated its childhood immunisation schedule. For parents who had already mapped out their child’s vaccination appointments in their heads, the announcement might have come as an unwelcome surprise.
The changes include routine protection against chickenpox through the combined MMRV vaccine, the removal of the Hib/MenC vaccine (which helps protect against two of the causes of meningitis and blood poisoning) from the one-year appointment, and a new vaccination visit at 18 months – bringing forward the MMRV vaccine, and adding a different Hib containing vaccine.
If you’re a parent, you might be wondering why the schedule you’d been expecting has suddenly changed. It’s natural to feel uncertain when something that seemed settled becomes unfamiliar. But changes like these are actually a routine part of how vaccination programmes work – and understanding why they happen can be reassuring rather than worrying.
When vaccination schedules stay the same for years, they fade into the background of family life. You know when appointments are due, your health visitor or GP knows the routine, and immunisation becomes just another part of early childhood – like weaning or starting nursery. It’s only when things change that we really notice the system at all.
Why schedules change
Vaccination schedules aren’t meant to stay frozen in time. In the UK, an expert committee called the Joint Committee on Vaccination and Immunisation (JCVI) regularly reviews evidence from clinical trials, safety monitoring, disease tracking and studies of how vaccines perform in real life. When the evidence shows a better way to protect children that is also cost-effective, recommendations are updated.
The addition of chickenpox vaccination is a good example (the “V” in MMRV stands for varicella, the virus that causes chickenpox). Many of us remember having chickenpox as children and might assume it’s always mild. But the evidence shows it can lead to serious complications, such as skin infections, pneumonia or brain swelling, sometime requiring treatment in a hospital. It also causes disruption through school absence and parents having to take time off work.
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Delivering chickenpox protection through the combined MMRV vaccine makes practical sense too. Combination vaccines are widely used around the world – MMRV has been standard in Canada, Australia and Germany for years – and are designed to reduce the number of injections and clinic visits without compromising safety or effectiveness.
The new 18-month visit came about for different reasons and shows how one change can ripple through the whole schedule. The manufacturer of the Hib-MenC vaccine (Menitorix), given at one year, told the JCVI it would stop making it for commercial reasons.
The committee looked at the evidence and concluded that a MenC booster is no longer needed in infancy because the UK has a good control of meningococcal C disease, thanks to the MenACWY vaccine. It is given to teenagers, but can protect the whole population through herd immunity.
But children still need continued protection against Haemophilus influenzae type b (Hib), a serious bacterial infection. So an extra dose of the six-in-one vaccine – which protects against diphtheria, tetanus, whooping cough, polio, Hib and hepatitis B – is now given at 18 months.
The new appointment also allows the second MMRV dose to be given earlier, increasing protection against measles, mumps, rubella and chickenpox at a younger age. This matters because of recent outbreaks. Some parts of London have been offering the second MMR dose earlier, between 15 and 18 months, since the early 2000s. This approach led to higher overall uptake by age five compared with later appointments.
Vaccination programmes tend to work best when they’re unremarkable – when they just happen in the background of family life. A new visit, a new vaccine or a new combination brings the schedule back into view and prompts people to look again at a system they’d previously taken for granted.
This isn’t unique to vaccination. Any kind of infrastructure becomes most noticeable when it’s adjusted – think of roadworks or changes to school term dates. In vaccination, these moments can prompt questions about why change is happening, how decisions are made, and what’s different from before. These questions aren’t a sign of mistrust. They show people engaging with health systems exactly as they should.
New vaccines are developed, existing ones are made more effective, and diseases become more or less common. The latest changes to the UK immunisation schedule aren’t exceptional – they’re part of the continuing work needed to keep a complex public health system functioning over time.
Moments of change briefly reveal the work that routine usually hides. They show that vaccination programmes aren’t fixed systems, but ones that are constantly fine-tuned to keep children and adults protected.
