Childhood immunisations

DTP-Hib | Polio | MMR | BCG | Hepatitis B | Alternatives | Travel

DTP-Hib vaccine

This is given when your child is 2, 3 and 4 months old. (The DT part is also given at age 3 to 5 years as a booster.) The DTP-Hib vaccine protects against three different diseases: Diphtheria, Tetanus and Pertussis (whooping cough) and against infection by the bacteria called Haemophilus influenzae type b (Hib). Your child will receive a further tetanus and diphtheria booster at age 13 to 18 years. 

What is diphtheria?
This disease begins with a sore throat and can progress rapidly to cause problems with breathing. It can damage the heart and the nervous system and in severe cases it can kill. Diphtheria has almost been wiped out in the UK, but it still exists in other parts of the world and it is on the increase in parts of Eastern Europe.

What is tetanus?
Tetanus germs are found in soil. They enter the body through a cut or burn. Tetanus is a painful disease that affects the muscles and can cause breathing problems. If it is not treated, it can kill.

And what about whooping cough (pertussis)?
Whooping cough can be very distressing. In young children it can last for several weeks. Children become exhausted by long bouts of coughing which often cause vomiting and choking. In severe cases this disease can kill.

I hadn't heard of Hib before, what is it?
Hib is an infection that can cause a number of serious illnesses including blood poisoning, pneumonia and meningitis. All of these diseases can be dangerous if not treated quickly. The Hib vaccine protects your child against this one specific type of meningitis. The Hib vaccine does not protect against any other type of meningitis.

How effective is Hib vaccine?
Before the Hib vaccine became part of the childhood immunisation programme in 1992, over 60 children a year died as a result of Hib infection. And more than twice that number were left with permanent brain damage. Since immunisation began, the number of children with Hib meningitis has dropped by more than 95%.

What are the side effects of the DTP-Hib vaccine?
It is quite normal for your baby to be miserable within 48 hours of the injection. Some babies develop a fever. Sometimes a small lump develops where the injection was given. This lump can last for several weeks.

If your child has a worse reaction to the DTP-Hib vaccine - for example, some form of fit - your doctor may not give your child any more doses of the vaccine. If this happens, talk to the doctor, nurse or health visitor. If a baby has a fit in the first 48 hours after being given the DTP-Hib vaccine at 2, 3 and 4 months, having a fit is no more common than at any other time for young babies.

But if you delay the immunisation later than 4 months, it increases the chances of fits after DTP-Hib. So, it's important to make sure your child gets vaccinated on time.

Is it true that the whooping cough vaccine can cause brain damage?
In the 1970s a study was done which seemed to show a link between the whooping cough vaccine and a few babies who suffered brain damage. More recent and reliable studies have not confirmed this theory. But the actual whooping cough disease can cause brain damage. 
[1981] British National Childhood Encephalopathy Study  [vid 1984 DPT documentary by WRC-TV] Vaccine Roulette


Polio vaccine

This is given when your child is 2, 3 and 4 months. The first booster is given when your child is between 3 and 5 years. The second booster is given when your child is between 13 and 18 years. Polio vaccine protects against the disease poliomyelitis.

What is polio?
Polio is a virus that attacks the nervous system and can cause permanent muscle paralysis. If it affects the chest muscles it can kill. The virus is passed in the faeces (poo) of infected people or those who have just been immunised against polio. Routine immunisation has meant that the natural virus no longer causes cases of polio in the UK. But polio is still around in other parts of the world, especially in India.

How is it given?
Unlike other immunisations, you take the polio vaccine by swallowing it. The doctor or nurse drops the liquid into your child's mouth.

Are there any side effects?
There is an extremely small chance of developing polio from the immunisation - the risk is of one case in more than 1.5 million doses used.

The nurse at the clinic told me to be careful about changing my child's nappy after the immunisation. Why is this?
The polio vaccine is passed into your child's nappies for up to six weeks after the vaccine is given. If someone who has not been immunised against polio changes your child's nappy, it is possible for them to be affected by the virus. There is about one case each year. This works out at about one case for every 1.5 million doses used.

You must wash your hands thoroughly to prevent this happening. If you think you have not had the polio immunisation, contact your doctor. You can arrange to have it at the same time as your child. This also goes for anyone else in the family who looks after your child.


MMR vaccine

This is given when your child is between 12 and 15 months and then again when your child is 3 to 5 years. The MMR vaccine protects your child against Measles, Mumps and Rubella (German measles).

What is measles?
The measles virus is very infectious. It causes a high fever and a rash. About one in 15 children who gets measles is at risk of complications which may include chest infections, fits and brain damage. In severe cases measles can kill.

What is mumps?
The mumps virus causes swollen glands in the face. Before immunisation was introduced, mumps was the commonest cause of viral meningitis in children under 15. It can also cause deafness, and swelling of the testicles in boys and ovaries in girls.

What is rubella?
Rubella, German measles, is usually very mild and isn't likely to cause your child any problems. However, if a pregnant woman catches it in her early pregnancy, it can harm the unborn baby.

Do children really need protection against these illnesses? I've heard they're usually mild.
Yes, they can be mild. In some children the illness may pass almost unnoticed, but others can be very ill. The most dangerous thing about these illnesses is that they can cause complications. Before the vaccine was introduced, about 90 children a year in the UK died from measles. Because of immunisation, children no longer die of measles.

Why are two doses of MMR given?
Your child will receive two doses because measles, mumps and rubella vaccines don't always work well enough on the first go. The second MMR immunisation makes sure that your child gets the best protection against these three diseases. This also gives a second chance for those children who missed out the first time around.

So, you can be sure your child is well protected before they start school. Giving a second dose of MMR is a recent improvement to children's immunisation in the UK. Two doses are already used in this way in many countries including the USA and Canada.

What about children who are allergic to eggs?
The MMR vaccine is prepared using egg. However it can be given to children who are allergic to eggs. If your child has had a serious reaction to eating eggs, or food containing egg, then talk to your doctor.

The usual signs of a serious allergic reaction are a rash that covers the face and body, a swollen mouth and throat, breathing difficulties and shock. In these cases your doctor can make special arrangements for the immunisation to be given safely.

Are there any side effects of the MMR vaccine?
About a week to 10 days after the MMR immunisation some children become feverish, develop a measles-like rash and go off their food for two or three days. Very rarely, a child will get a mild form of mumps about three weeks after the injection.

Your child will not be infectious at this time, so they can mix with other people as normal. Occasionally, children do have a bad reaction to the MMR vaccine. About one child in a thousand will have a fit. A child who actually has measles is 10 times more likely to have a fit as a result of the illness.

Although encephalitis (inflammation of the brain) has been reported very rarely after immunisation, the risk of children developing encephalitis after the measles immunisation is no higher than the risk of children developing encephalitis without the vaccine. But the risk of a child developing encephalitis after having measles is about one in 5000. And 1/3 of these children will be left with permanent brain damage.

A study of British children shows that during the 10 years after the measles immunisation, children had no more illnesses than children who had not been immunised - and actually had fewer because they were protected against measles and did not suffer its complications.

Your child may get a rash of small bruise-like spots after the MMR, but this is very rare. This rash is linked with the rubella part of the immunisation. If you see spots like this, show them to your doctor. Side effects from the second MMR vaccine are even rarer than after the first. Those that do happen are most likely in children who did not respond to the first vaccine. These are the children who need the immunisation most. There are no new side effects of a second MMR vaccine.


BCG vaccine

This is given when your child is between 10 and 14 years. It is sometimes given to babies shortly after they are born. The BCG vaccine gives protection against TB (tuberculosis).

What is TB?
TB is an infection that usually affects the lungs. It can also affect other parts of the body such as the brain and bones.

I didn't think you could get TB in this country.
Although TB is no longer common in this country, there are between 5,000 and 6,000 cases a year. TB is on the increase in Asia, Africa and some Eastern European countries.

When do children normally have the BCG vaccine?
Most children have the BCG injection when they are between 10 and 14 years. Your child will have a skin test to see if they already have immunity to TB. If not, the immunisation is given. Babies under three months who are having the immunisation don't need to have the skin test.

Are there any side effects of the BCG immunisation?
A small blister or sore appears where the injection is given. This is quite normal. It gradually heals leaving a small scar.

New information about the recent TB outbreaks
See the DoH web site.


Hepatitis B vaccine

This vaccine gives protection against hepatitis B.

What is hepatitis B?
There are several different types of hepatitis and they all cause inflammation of the liver. The hepatitis B virus is passed through infected blood and may also be sexually transmitted. Some people carry the virus in their blood without actually having the disease itself.

If a pregnant woman is a hepatitis B carrier, or gets the disease during pregnancy, she can pass it on to her child. The child may not be ill but has a high chance of becoming a carrier and developing liver disease later in life.

Can this be prevented?
Yes, many pregnant women are tested for hepatitis B during their ante-natal care. Babies born to infected mothers should receive a course of vaccine to prevent them getting hepatitis B and becoming a carrier. The first dose should be given within two days of birth, and two more doses should be given before the child is six months.

Are there any side effects?
Side effects of the vaccine tend to be quite mild. The injection site is often red and can be sore for a few days afterwards.

If a mother has hepatitis B is it still safe to breastfeed?
Yes, you are still safe to breastfeed as long as the baby is immunised.


Alternatives to immunisation

Is immunisation voluntary?
In the UK parents can choose whether to have their children immunised. Children who are not immunised run a risk of catching diseases and having complications. Immunisation is the safest way to protect your child.

Having children immunised at an early age means they are well protected by the time they start playgroup or school where they are in contact with lots of children. If you have any doubts or questions about immunisation, talk to your health visitor, practice nurse or doctor.

Can homeopathic vaccines protect against infection?
No, there is no proven, effective alternative to conventional immunisation. Homeopathic medicine has been tried as an alternative to the whooping cough vaccine but it was not effective. The Council of the Faculty of Homeopathy (the registered organisation for doctors qualified in homeopathy) advises parents to have their children immunised with conventional vaccines.


Travel immunisations

Do children need additional immunisations if they are travelling abroad?
Children may need extra immunisations depending on their age, which country you are visiting and how long you plan to stay. You should contact your doctor or a travel clinic for up-to-date information on the immunisations your child may need. If you are travelling to an area where there is malaria, your child will need protection. This is one of the most serious health problems in tropical countries.

There isn't an immunisation against malaria, but some anti-malarial drugs can be given to children. It is essential to do all you can to avoid getting bitten by mosquitoes. Insect repellent, mosquito nets soaked in repellent and making sure arms and legs are covered between dusk and dawn will all help. Be careful not to use too much repellent on your child's skin.

Need more information?

You can get Health advice for travellers (T5), an information leaflet produced by the Department of Health, from the post office. Or call the freephone number for the Health Literature Line on 0800 555 777 at any time.

Stay Healthy Abroad, a Health Promotion England publication, gives advice and information for each country. You can get this from bookshops and Health Promotion England by phoning 0171 413 1995.

Health Information for Overseas Travel, produced by the Department of Health and published by HMSO, contains advice and information for each country. Your doctor's practice should have a copy from which they can give you advice.

You can also visit some of the travel immunisation sites on our links page.

All the information on this page is taken from The Guide to Childhood Immunisations.


Published by Health Promotion England for the NHS and the Department of Health.
Crown Copyright 2001
Terms and conditions of use