Vaccinations
Vaccinations are the most effective way to prevent many infectious diseases. They prevent millions of deaths worldwide every year.
In the UK, the national immunisation programme is determined by the Department of Health and Social Care. The routine vaccination schedule starts from two months of age to 65 years and over. Other vaccines are available for those with complex health needs or those who are more at risk.
Routine (e.g. childhood/adult) and seasonal (e.g. influenza/Covid-19) vaccination programmes are delivered through a range of local providers such as GPs, pharmacies, hospital trusts and the school-aged immunisation service.
Uptake of vaccinations has declined in recent years, particularly since the pandemic, and World Health Organisation specified thresholds for childhood immunisations are mostly being missed. In response to this, NHS England launched its Vaccination Strategy in 2023, pledging high quality and convenient vaccination services tailored to the needs of local people.
Vaccination uptake in Nottinghamshire compares well with England and the East Midlands but mirrors the decreasing national trend. Uptake of vaccinations such as MMR (measles, mumps, rubella), HPV (human papillomavirus), the pre-school booster (diphtheria, tetanus, pertussis and polio) and influenza are now below acceptable thresholds.
Across the county there is also considerable variation between communities, among minority ethnic groups, inclusion health groups (such as people who experience homelessness) and those not registered with healthcare providers.
In health protection, we work with partners and the NHS to promote the importance of vaccination and support efforts to increase uptake.
We have created a conversation skills guide [PDF] to help spot opportunities to talk about vaccinations with staff, colleagues, family and friends. Also to help ask questions, handle misinformation and signpost to other resources.
Below is information on vaccination programmes and training resources.
Pregnant women are offered up to four vaccinations in pregnancy (depending on the time of year) to protect themselves and their baby.
Influenza vaccine
Influenza (flu) vaccinations are given in autumn when there is more of the virus circulating. Pregnant women can get a flu jab from their GP, pharmacy or hospital antenatal appointments, at any time in pregnancy.
Flu in pregnancy can be dangerous for mother and baby. During pregnancy, the immune system is weakened which makes it more difficult to fight infections, increasing the risk of complications and admission to hospital. Death rates from flu are higher in pregnant women than the general population.
There is also good evidence that if a mother catches flu when she is pregnant, it can affect her unborn baby. Babies born to women who have had flu during pregnancy are up to four times more likely to be born prematurely and have a low birth weight. Flu in pregnancy can lead to stillbirth or death in the first week of life.
The flu vaccination reduces the risk of complications caused by the virus for mothers and babies.
Covid-19 vaccine
Covid-19 vaccinations are given in autumn when there is more of the virus circulating.
Pregnant women who get Covid-19 are more likely to be seriously ill and it also increases the risk of complications such as premature labour and stillbirth. During the pandemic, 96% of the pregnant women who were hospitalised or admitted to intensive care with Covid-19 were not vaccinated. Covid-19 vaccines are safe and effective in pregnancy to protect mother and baby.
The Covid-19 vaccination is available at GPs and some pharmacies. For more information, speak to a midwife or visit the NHS Nottingham and Nottinghamshire Integrated Care Board website.
Whooping cough vaccine
The whooping cough vaccination (also called pertussis) is offered to pregnant women from 16 weeks, often at their 20-week scan. The vaccine passes from mother to baby and protects them until they are old enough to be vaccinated at eight weeks. It is needed in every pregnancy so that each baby is protected. Women can get the vaccination at their GP surgery or when they attend antenatal clinic for their scan or appointment.
Whooping cough spreads easily and can cause pneumonia and brain damage. Almost all deaths from whooping cough occur in young babies before they have been vaccinated. There is no whooping cough-only vaccine, the vaccine given will also protect against diphtheria and tetanus.
RSV vaccine
The RSV vaccination was introduced in September 2024. This vaccination protects babies against Respiratory Syncytial Virus, a virus that causes respiratory infections affecting the lungs and airways. It often causes a mild cough and cold but, in some people, can trigger pneumonia or bronchiolitis. Infants under six months are at the highest risk and could be admitted to hospital.
The vaccine boosts the pregnant woman’s immune system to produce more antibodies against the virus. These antibodies then pass through the placenta to help protect the baby from the day they are born. RSV vaccination reduces the risk of severe bronchiolitis by 70% in the first six months of life. After this age, the risk of severe RSV is much lower.
Women need to be vaccinated in every pregnancy so that each baby is protected. Women can have this vaccination after 28 weeks of pregnancy by making an appointment with their maternity hospital or on request from their GP. Some babies at high-risk of getting RSV will also be offered the vaccination just after birth. The midwife will be able to provide more information.
Summary and postcards
A summary of this information on vaccinations in pregnancy is available to download.
Download vaccinations in pregnancy summary [PDF]
Summary information postcards are also available to download in different languages.
Download English postcard [PDF]
Download Ukrainian postcard [PDF]
Download Polish postcard [PDF]
Download Romanian postcard [PDF]
Download Cantonese postcard [PDF]
Videos
With the help of local communities, videos in different languages have been created to help pregnant women understand what vaccinations are available, when and why they should have them. In the playlist below, there are videos in English, Ukrainian, Polish, Romanian, Arabic and Urdu.
Further information
Visit the NHS website for more information on vaccinations in pregnancy
Visit the GOV.UK website for guidance on pregnancy: how to help protect you and your baby
Visit the Oxford University website for vaccination and pregnancy information
Visit the BUMPS website: Best Use of Medicines in Pregnancy
It is important that babies have vaccinations at the right age to protect them from potentially serious diseases as early as possible. The first are given at 8 weeks old with further vaccines offered at 12 weeks, 16 weeks and 1 year. All childhood vaccinations are free.
Most vaccines have to be given more than once to prepare a child’s immunity. Booster doses are also given later in life to provide longer-term protection.
If a baby misses a vaccine, they can pick up the vaccination schedule where it stopped without having to start again.
Below is information on the vaccination programme for babies. Details can also be found in a child's personal child health record (PCHR) or red book.
Vaccinations at 8 weeks old
At 8 weeks old, babies will have vaccinations against:
- diphtheria
- tetanus
- pertussis (whooping cough)
- polio
- Haemophilus influenzae type b (Hib)
- hepatitis B
- rotavirus
- meningococcal group B disease (MenB)
These will be given as two injections and drops in the mouth.
Vaccinations at 12 weeks old
At 12 weeks old, babies will have vaccinations against:
- diphtheria
- tetanus
- pertussis (whooping cough)
- polio
- Hib
- hepatitis B
- pneumococcal disease
- rotavirus
These will be given as two injections and drops in the mouth.
Vaccinations at 16 weeks old
At 16 weeks old, babies will have vaccinations against:
- diphtheria
- tetanus
- pertussis (whooping cough)
- polio
- Hib
- hepatitis B
- MenB
These will be given as two injections.
Vaccinations at 1 year old
At 1 year old old, babies will have vaccinations against:
- Hib/Meningococcal group C (MenC)
- MenB
- measles, mumps, rubella (MMR)
- pneumococcal disease
Further information
Visit the NHS website for information on your baby's health and development reviews
Visit the NHS website for information on why vaccination is important including a video on the safety of vaccines for children.
Preschool
Boosters are given to preschool aged children to top up immunity from the vaccinations given to babies. Immunity can decrease over time so it’s important to have the booster, even if the child was vaccinated as a baby.
It is best to give the vaccination on time but children can have it any time up to the age of 10 if they miss it.
Age 2 - 3 years
Influenza vaccine
One dose annually protects against influenza (flu). The vaccine is given each winter because the virus changes and new strains appear.
Age 3 years, 4 months
4-in-1 preschool booster vaccine
One dose protects against diphtheria, polio, tetanus and whooping cough.
MMR vaccine
One dose protects against measles, mumps and rubella
School aged children
Boosters are given to school aged children to top up immunity which can decrease over time, so they are important even if a child had a vaccination as a baby or toddler.
Reception to year 11
Influenza vaccine
One dose annually protects against influenza (flu). The vaccine is given as a nasal spray each winter because the virus changes and new strains appear. The nasal spray contains a small amount of porcine but there is an injectable alternative available on request.
School years offered a flu vaccination vary depending on annual advice from the Joint Committee on Vaccination and Immunisation (JCVI).
Age 12 to 13 (Year 8)
HPV vaccine
One dose protects against human papillomavirus (HPV). HPV is very common and most strains do not cause symptoms but some can cause genital warts and others can lead to cancer.
Girls under 25 and boys born after 1 September 2006 who missed having the vaccine at school can have the HPV vaccination at their GP surgery.
Age 14 (Year 9)
3-in-1 teenage booster vaccine
One dose protects against tetanus, diphtheria and polio. The booster vaccine tops up immunity which may have decreased since the preschool booster.
MenACWY vaccine
One dose protects against bacteria linked to meningitis. Anyone who missed their MenACWY vaccination can have it up to age 25 at their GP surgery.
Meningitis is an infection of the protective membranes that surround the brain and spinal cord (meninges). It can affect anyone but is most common in babies, young children, teenagers and young adults.
Meningitis can be very serious if not treated quickly and can cause life-threatening blood poisoning (sepsis) and result in permanent damage to the brain or nerves.
The immune system changes throughout life and becomes less efficient with age. This means that older people can get more serious infections which take longer to recover from. For example, older people are more at risk of serious complications, hospitalisation and death from flu compared to younger people.
The NHS offers a number of free vaccinations to help protect people as they age.
65 years old
Pneumococcal polysaccharide vaccine (PPV)
One dose protects against pneumonia and meningitis.
Shingles vaccine
Two doses 6-12 months apart reduces the risk of getting shingles and the risk of serious problems if shingles is caught. Anyone aged 70-79 who has not had shingles will be offered a single dose vaccine.
65 years and older
Influenza vaccine
One dose annually protects against influenza (flu). The vaccine is given annually because the virus changes and new strains appear.
Covid-19 seasonal booster vaccine
Immunity from Covid-19 can decrease over time so a one dose booster vaccine is given to help maintain strong protection from Covid-19.
The Joint Committee on Vaccination and Immunisation (JCVI) will recommend the frequency of vaccination depending on the circulating strains of the Covid-19 virus.
75 years and older
RSV vaccine
One dose protects against Respiratory Syncytial Virus (RSV) which is a major cause of respiratory illness. The virus typically leads to mild, cold-like symptoms but can cause bronchiolitis and pneumonia. In severe cases, it can require hospitalisation and intensive care.
Further information
British Society for Immunology: A guide to vaccinations for adults over 65 [PDF]
UKHSA/NHS easy read guide to shingles vaccination [PDF]
Below is a useful training resource if you would like to learn more about vaccinations.
NHS England elearning for healthcare: Immunisation programme
