Immunisation schedule — what is due, at what age, in 2026
The England routine schedule after the July 2025 and January 2026 changes (MenB and PCV timing, no Hib/MenC, the new 18-month visit and MMRV), the selective and pregnancy programmes, adult eligibility for shingles, RSV, pneumococcal, flu and COVID-19, and how to catch up someone with an uncertain history.
Last checked: October 2026 · UKHSA complete routine immunisation schedule (from 1 January 2026) · Green Book ch. 11 (March 2026)
Two big changes since 2025. From 1 July 2025: the second MenB dose moved from 16 to 12 weeks, the first PCV dose moved from 12 to 16 weeks, and the Hib/MenC (Menitorix) booster at one year was withdrawn. From 1 January 2026: a new 18-month appointment (4th dose of the 6-in-1 vaccine), chickenpox (varicella) added as MMRV, and the second MR-containing dose brought forward from 3 years 4 months to 18 months for younger children. This page shows the England schedule; Scotland, Wales and Northern Ireland are very similar but check local letters.
Routine childhood schedule England, from 1 January 2026
| Age | Vaccines | Practical points |
|---|---|---|
| 8 weeks | 6-in-1 (DTaP/IPV/Hib/HepB) · MenB · Rotavirus | Advise prophylactic paracetamol with MenB under 2 years (three doses). Rotavirus: first dose must be given by 15 weeks of age. |
| 12 weeks | 6-in-1 · MenB (moved from 16 weeks) · Rotavirus | Rotavirus second dose must be given before 24 weeks. Paracetamol again with MenB. |
| 16 weeks | 6-in-1 · PCV (moved from 12 weeks) | One infant PCV dose, then the booster at one year. |
| 1 year on or after 1st birthday | MenB booster · PCV booster · MMRV dose 1 (born on or after 1 January 2025) | No Hib/MenC dose any more. Children born before 1 January 2025 had MMR at this visit. |
| 18 months new appointment | 6-in-1 (4th dose) · MMRV (dose 2 if born on or after 1 January 2025; dose 1 if born 1 July to 31 December 2024) | The 4th hexavalent dose replaces the Hib cover previously given by Hib/MenC. Second MMRV should not be given before 18 months unless protection is urgently needed (minimum 4 weeks between doses). |
| 2 years to Year 11 | Flu (live attenuated nasal spray), every autumn | Ages 2 and 3 at the practice; Reception to Year 11 through the school service. Injected vaccine if nasal spray is unsuitable. |
| 3 years 4 months | 4-in-1 pre-school booster (dTaP/IPV) · MMRV or MMR for older cohorts (see below) | Children born on or after 1 January 2025 should already have had both MMRV doses by now. |
| 12–13 years (Year 8) | HPV — single dose | One dose since September 2023 for routine cohorts; the immunosuppressed and people with HIV still need 3 doses. |
| 14 years (Year 9) | 3-in-1 teenage booster (Td/IPV) · MenACWY | MenACWY catch-up up to the 25th birthday for those who missed it (especially first-time students). |
Which MMR / MMRV schedule? by date of birth
| Born | 1 year | 18 months | 3 years 4 months |
|---|---|---|---|
| On or after 1 January 2025 | MMRV | MMRV | — |
| 1 July to 31 December 2024 | MMR (already given) | MMRV | MMRV |
| 1 September 2022 to 30 June 2024 | MMR (already given) | — | MMRV (instead of MMR2) |
| Before 1 September 2022 | MMR | — | MMR (if still due) |
A time-limited selective MMRV catch-up (one dose) is planned from 1 November 2026 to 31 March 2028 for older children with no history of chickenpox and fewer than two varicella doses. Check the UKHSA programme guidance for the exact birth cohorts before inviting. Anyone of any age without two documented MR-containing doses should be offered MMR (or MMRV if in an eligible cohort).
Selective programmes and pregnancy
Pertussis
dTaP/IPV in every pregnancy from 16 weeks; ideally from about 20 weeks (after the anomaly scan) to 32 weeks. Can still be given later, including up to birth, but gives less protection to the baby.
RSV (Abrysvo)
One dose from 28 weeks of every pregnancy; can be given up to birth. Offer at the 28-week contact, often alongside pertussis.
Flu and COVID-19
Inactivated flu vaccine at any stage of pregnancy during the flu season (from 1 September 2026). Pregnancy alone is not a COVID-19 eligibility group in autumn 2026 — offer only if immunosuppressed.
BCG
Infants at increased risk of TB (for example a parent or grandparent born in a country with high TB incidence) — usually by 28 days of age, once the newborn SCID screening result is known where that screening applies.
Hepatitis B
Babies of mothers with hepatitis B: monovalent dose at birth (plus immunoglobulin if high risk) and at 4 weeks, the routine 6-in-1 doses, then a monovalent dose and a blood test for HBsAg at 1 year.
Flu and others
Flu from 6 months for children in clinical risk groups. Asplenia, complement disorders and severe immunosuppression need extra pneumococcal, meningococcal and Hib doses — see Green Book chapter 7.
Adults England 2026/27
| Programme | Who is eligible | Notes |
|---|---|---|
| Shingles (Shingrix, 2 doses) | Immunocompetent: people turning 65 (on or after 1 September 2023) and people aged 70 to 79; remain eligible until their 80th birthday. Severely immunosuppressed: from age 18 (since 1 September 2025), no upper age limit. | Immunocompetent: second dose 6 to 12 months after the first. Immunosuppressed: 8 weeks to 6 months apart. The routine age falls to 60 in a second phase from September 2028. Immunosuppression is defined in Green Book chapter 28a. |
| RSV (Abrysvo, 1 dose) | Routine at 75, catch-up to the 80th birthday. From 1 April 2026: everyone aged 80 and over and older-adult care home residents not yet vaccinated. From 1 September 2026: adults aged 65 to 74 in certain clinical risk groups (including immunosuppression). | Single dose, not repeated annually. Can be given at any time of year. |
| Pneumococcal | Age 65 and over; clinical risk groups from age 2. | PCV20 is replacing PPV23 from early 2026 — use PPV23 until local stock runs out. Revaccination and asplenia schedules: Green Book chapter 25. |
| Flu (annual) | 65 and over; 18 to 64 in clinical risk groups; pregnant; care home residents; carers; close contacts of immunocompromised people; frontline social care workers without an employer scheme. | 2026/27 cohorts unchanged from last year. Adults from 1 October 2026; pregnant people and children from 1 September 2026. |
| COVID-19 (autumn 2026) | 75 and over (by 31 March 2027); older-adult care home residents; immunosuppressed people aged 6 months and over. | Usually no earlier than about 6 months after the last dose. Spring 2027 is for the same groups. |
| Other routine | MMR at any age if fewer than 2 doses; Td/IPV to complete 5 lifetime doses; HPV catch-up to the 25th birthday for eligible cohorts (gay, bisexual and other men who have sex with men up to 45 through sexual health services); MenACWY to the 25th birthday if missed. | Occupational vaccines (for example hepatitis B for healthcare workers) are the employer's responsibility. |
Catch-up and uncertain status
- Unless there is reliable written or verbal evidence, assume the person is unimmunised and vaccinate in line with the UK schedule for their age. Extra doses are not harmful.
- Never restart an interrupted course — carry on where it stopped, keeping minimum intervals (usually 4 weeks between primary doses).
- Use the UKHSA algorithm for individuals with uncertain or incomplete immunisation status (updated September 2026) to build an age-appropriate catch-up plan. From age 10, use Td/IPV rather than the 6-in-1 or 4-in-1 vaccines.
- Arrivals from abroad: compare their record with the UK schedule (the WHO publishes each country's schedule), offer MMR, polio-containing and MenACWY doses as needed, and consider BCG, TB screening, hepatitis B testing and HIV testing on risk.
- Contraindications are few: confirmed anaphylaxis to a previous dose or component; live vaccines (MMRV, MMR, LAIV, rotavirus, BCG, yellow fever) are contraindicated in significant immunosuppression and, for adults, in pregnancy. See Green Book chapter 6.
Green Book chapters to keep open
- The Green Book (full collection) — chapter 11 (UK schedules, updated 30 March 2026), chapter 6 (contraindications), chapter 7 (immunosuppressed and asplenia).
- Chapter 34 (varicella / MMRV), 28a (shingles), 27a (RSV), 25 (pneumococcal), 19 (influenza), 14a (COVID-19), 24 (pertussis), 18 (hepatitis B), 32 (tuberculosis / BCG).
Sources (checked October 2026)
- UKHSA. Complete routine immunisation schedule from 1 January 2026. gov.uk
- DHSC / UKHSA / NHS England. Changes to the routine childhood vaccination schedule from 1 July 2025 and 1 January 2026 (letter). gov.uk
- UKHSA. Introduction of a routine varicella (MMRV) programme for children at one year and at 18 months; MMRV information for healthcare professionals. gov.uk
- UKHSA. Green Book chapter 11, UK immunisation schedule (30 March 2026). gov.uk
- UKHSA. Algorithm for vaccination of individuals with uncertain or incomplete immunisation status (September 2026). gov.uk
- NHS England. General practice shingles vaccination programme technical guidance (severely immunosuppressed from 18, September 2025). england.nhs.uk
- NHS England. RSV programme expansion to 80+ and care home residents (April 2026); UKHSA letter: expansion to adults aged 65 to 74 in clinical risk groups (from 1 September 2026). england.nhs.uk
- UKHSA. PCV20 patient group direction template (v2.0, 2026) and devolved CMO letters on PCV20 replacing PPV23. gov.uk
- DHSC / UKHSA / NHS England. National flu immunisation programme 2026 to 2027 letter (February 2026). gov.uk
- DHSC. Advice accepted on autumn 2026 COVID-19 vaccination programme (March 2026); JCVI statement on autumn 2026 and spring 2027. gov.uk