All Change: The UK Vaccine Programme 2025

The only certainty about the vaccine programme is that it will change!  The programme is continually evolving and developing in response to the changing epidemiology of the diseases it is designed to protect against.

While it can often cause anxiety or even confusion for practitioners when changes are introduced, change is positive and ensures babies and children are provided with optimum protection.  All changes to the programme are informed by advice and recommendations from the Joint Committee of  Vaccination and Immunisation (JCVI): read the minutes here.

JCVI’s remit is to carefully scrutinise the programme.  Changes invariably mean that the vaccines are working. This also comes with assurance of effective scrutiny of the evidence for potential new vaccines and on the wider impact of the vaccine programmes.

Keeping up to date

Keeping up to date is key for all vaccinators. The newly published National Minimum Standards and Core Curriculum for Vaccination Training specify that all those involved in vaccination should have core training and then annual updates so they can be confident in the programme and imparting information to the public.

So what’s changed?

Over the last year there have been several amendments to the programme. This blog is focussed on the changes to the childhood programme which has come in from 1^st July 2025.

These changes stem from the manufacturer’s decision to discontinue Menitorix® (Hib/MenC) vaccine which necessitated a thorough review of the routine childhood schedule by the JCVI.

The UKHSA has produced numerous resources to support health care professionals’ understanding of these changes, see the Slides online webinar recording and supporting information. Many chapters of the Green Book ‘Immunisation against infectious diseases’ have been updated to reflect the changes.

In summary:

• Menitorix© is no longer manufactured – The Hib/MenC combination is not used in any other countries’ programme. UK stock will be depleted by mid-2025
• JCVI have reviewed the need for both Meningococcal C (MenC) and Haemophilus influenzae B (Hib) vaccines in infancy.

They concluded:

• Vaccination with MenC in early childhood is no longer necessary. This is a positive result of the Men C vaccine programme, we now see very low levels of meningococcal C disease. Ongoing wider protection for the population will be maintained by the teenage vaccine programme for meningococcal ACWY vaccine. As teenagers are most likely to carry the organism and transmit it, protecting them provides wider population protection.
• Vaccination against Hib in the second year of life needs to continue. The modelling indicates that while Hib disease remains at low levels, as toddlers are the group most likely to carry this particular organism, a booster in the second year of life is needed to ensure long term protection and reduce the likelihood of the infection being transmitted. Many countries around the world offer a 4^th dose of these vaccines at this age.
• A Hib containing hexavalent vaccine, seems the most sustainable option and would best be administered at a new vaccination appointment at age 18 months.
• The new 18-month appointment – provides an opportunity for the second dose of MMR vaccine to be moved from 3 years 4 months to 18 months of age. This is already done in many areas of London to support improved overall uptake for 2 doses of MMR, see Lacy et al 2022.

As with all changes to the programme there needs to be a start date.

• From 1 July 2025 Menitorix® will no longer be offered at 12 months.

These infants will turn 18 months from 1^st January 2026

• From 1 January 2026, an additional dose of DTaP/IPV/Hib/HepB vaccine will be offered at the new 18-month appointment.
• Children will be offered their 2^nd MMR at this appointment
• Those infants previously eligible for monovalent hepatitis B vaccine (HBV) at 12 months will no longer need it as they will receive an additional dose of HBV as part of the hexavalent vaccine at the new 18-month visit. These infants will however, need to have the dry blood spot test at some point between 12 months and 18 months to check they haven’t been infected with hepatitis b, see DBS testing.
• All children will still need the pre-school booster of diphtheria tetanus acellular pertussis and polio vaccine (dTaP/IPV) at 3 years and 4 months.
• The overall review has also considered the impact of other vaccines. Since the introduction of the Bexsero Meningococcal B vaccine in 2015, there has been a general reduction in the overall incidence of all meningococcal disease. For Men B, while the overall number of cases has declined, the peak age for infection has shifted from 5-6 months to 1-3 months, with many cases occurring before infants get their second dose at 16 weeks. Moving the second dose of MenB vaccine to 12 weeks will offer earlier protection.
• From 1 July 2025, the order of vaccines in the infant schedule will change to optimise the schedule:
• The 2 doses of MenB vaccine to be given at 8 and 12 weeks and the single dose of PCV13 at 16 weeks. This is a switch in the timing, the number of doses for each remains the same.
• There is very low incidence of cases caused by the pneumococcal serotypes in the PCV13 vaccine and infants will be protected by this wider herd immunity until 16 weeks. It means than infants won’t have to have too many injections at any one visit.

The introduction of routine varicella (chicken pox) vaccine has been recommended by the Joint Committee on Vaccination and Immunisation (JCVI), at the time of writing, this change is still awaiting final approval.  When it is introduced, it will be offered in combination with MMR as MMRV vaccine with a dose at 12 and 18 months. There will also be a catch-up programme for older children.

Health Messaging

Health professionals and the public will understandably have questions about these changes. The overall message must be that in general they are in response to the positive impact of the vaccines reducing the burden of disease; due to the low incidence of disease, the Men C vaccine is no longer needed for infants and has been removed.

There is lots of advice for specific scenarios that might crop up in: Childhood schedule changes from 1 July 2025: information for healthcare practitioners

A calculator MS excel file enables you to  enter the child’s birthdate and calculator shows which vaccines should be given and when. The calculator is based on children coming on time.

The up to date routine programme is available here.

If any vaccinations are missed, delayed or incomplete, the UKHSA algorithm document with guidance on what should be given and when has also been updated to reflect the new schedule. The general principle being that there is no harm in giving additional doses to make sure people are up to date.

Changes to the childhood vaccination programme: why are they happening lists a range of leaflets which are free to order to help explain the programme to parents and the public. Do make sure you read the leaflets too; they are a good source of information and its important you are aware of the information available for parents.

The introduction of a ‘new’ vaccine, such as varicella vaccine will inevitably raise questions about its safety, effectiveness and necessity. While the varicella vaccine is new as a routine vaccine in the UK, many countries have included in their schedules for decades and so there is vast experience to support its safety and effectiveness.

While vaccination change is inevitable, it means the programmes are working! Other changes include for example, introduction of vaccines in sexual health for Mpox and gonorrhoea as outlined here:  special edition (360) – Vaccine Update , extension of the RSV vaccine to older adults JCVI advice 16^th July 2025 and the monoclonal antibody  Nirsevimab to protect premature infants against RSV.

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Helen Donovan, MEd. BSc. RN, RHV, Queen’s Nurse, FRSPH is an Independent Nurse Consultant and Immunisation Specialist Nurse