Sarah Brown, a registered nurse in our Health at Hand team

Vaccinations 0-4 years


5 September 2019

The vaccinations below are part of a programme which is recommended for most children in the UK. They all have proven benefits and side effects are usually mild and short-lived. 

Always inform your GP or practice nurse if your baby has a high temperature or an established allergy to discuss any concerns you may have. They will help you to decide what course of action is right for you and your child. 

Our team of experts, including midwives and pharmacists, are also available to answer your questions via oru Ask the Expert service.

6-in-1 – Infanrix Hexa

The 6-in-1 vaccine is very safe. It's killed (inactivated), which means it doesn't contain any live organisms, so there's no risk of your baby getting the diseases from the vaccine.

Why? - It protects against six diseases: Diphtheria, tetanus, whooping cough (pertussis), polio, Hepatitis B and Haemophilus influenzae Type B (known as Hib – a bacterial infection that can cause severe pneumonia or meningitis in young children )

What to expect - This is the first vaccination your child is likely to receive. It’s administered at 2, 3 and 4 months of age. There is a single injection, often injected into the baby’s thigh.  

If for any reason your baby misses having their vaccine, it’s never too late to start or continue the schedule.

This may not be suitable for all children. Talk to your GP, nurse or health adviser if your child is running a fever or has had a reaction to any other medications, or has had seizures (fits) in the past. 

Very common side effects - of this vaccine (affecting 1 in 10 babies) 

Side effects - Pain, redness and swelling at the injection site. Your child may also be irritable and tearful or run a fever. 

Most of the time, these side effects are mild and short-lived.

Pneumococcal vaccine (PCV) - Prevenar 13

Why? - This protects against 13 different strains of pneumococcal infections which can lead to pneumonia, septicaemia (blood poisoning) and meningitis. This vaccine is administered as three separate injections at 2 months, 4 months and 12-13 months of age.

Children respond very well to the PCV. The introduction of this vaccine into the NHS childhood vaccination programme has resulted in a large reduction in pneumococcal disease.

What to expect - This is usually given at  8 weeks of age and 16 weeks of age  followed by  a booster dose between 11 and 15 months of age.

Side effects may occur in the form of a mild fever, redness, hardness or swelling at injection site.

PCV is an inactivated or "killed" vaccine and does not contain any live organisms. It cannot cause the disease they protect against.

Rotavirus- (Rotarix) 

Why? - This protects against rotavirus infection, a highly infectious stomach bug and common cause of diarrhoea and vomiting, that typically affects babies and young children. Since its introduction, this vaccine has been known to prevent over 70% of cases. The vaccine contains a weakened strain of rotavirus. This helps your baby to build up immunity, so that the next time they come into contact with rotavirus they will not get the disease.

What to expect - There is no injection. There are two doses at 2 and 3 months of age. It’s administered as a liquid from a dropper directly into the baby’s mouth.

Side effects that may occur include: restlessness, irritability and mild diarrhoea. There is a lot of evidence showing that the rotavirus vaccine is safe. Rotarix has been used extensively in many countries, including Belgium, Finland, Austria and Canada, for 5 to 6 years and no safety concerns have been raised.

The vaccine should not be given to a baby that has a history of intussusception, severe combined immunodeficiency disorder or some other food intolerances. 

Meningitis B vaccine- Bexsero

Why? - Meningitis B  vaccine will protect your baby against infection by meningococcal group B bacteria, which is responsible for more than 90% of meningococcal infections in young children. 

Meningococcal infections can be very serious, causing meningitis and sepsis (blood poisoning), which can lead to severe brain damage, amputations and, in some cases, death.

The MenB vaccine used is called Bexsero. It's given as a single injection into your baby's thigh.

What to expect - First dose is given to babies aged two months, second dose aged four months and a booster at twelve months. 

Side effects - Many babies have no side effects at all and those that do run a fever, or high temperature, this tends to be mild and short-lived. Babies given the MenB vaccine alongside their other routine vaccinations at 8 and 16 weeks are likely to develop fever within 24 hours of vaccination.

It's important to give your baby liquid paracetamol following vaccination to reduce the risk of fever. Your nurse will give you more information about paracetamol at your vaccination appointment.

Other common side effects include irritability, and redness and tenderness at the injection site. The liquid paracetamol will also help with these symptoms

Measles, Mumps and Rubella -(MMR) vaccine (Priorix, MMR VaxPRO)

Why? - This protects against measles, mumps and rubella (commonly known of as German measles) and is given as a single injection. These are common and very infectious conditions that have potentially fatal complications such as meningitis, swelling of the brain (encephalitis) and deafness.

The MMR vaccine contains weakened versions of live measles, mumps and rubella viruses. 

The vaccine works by triggering the immune system to produce antibodies against measles, mumps and rubella.

If you or your child then comes into contact with one of the diseases, the immune system will recognise it and immediately produce the antibodies needed to fight it. 

It's not possible for people who have recently had the MMR vaccine to infect other people.

What to expect - The full course requires two doses. It’s administered as a single injection into the muscle of the thigh or upper arm. First dose is normally given to babies aged 12-13 months. The second dose at 3 years 4 months as part of the pre-school booster.

Usually babies don’t need to be vaccinated for MMR before 6 months because antibodies are transferred and retained from the mother at birth. These maternal antibodies reduce in number with age and are almost gone by the time this vaccine is due.

This vaccine can sometimes be administered from 6 months of age if there’s evidence of exposure to the measles virus or throughout a measles outbreak. 

Common side effects include a very mild form of measles (includes a rash, fever, decreased appetite) which may occur for a week or so following the injection. Three to four weeks after vaccination, 1 in 50 children may contract a mild form of mumps, with swelling of the glands in the cheek, neck or under the jaw, which may last for a few days.

There has been no established link between the MMR vaccine and autism or bowel disease.

Hib/MenC  vaccine- Menitorix

Why? The Hib/MenC vaccine is a single injection given to 1-year-old babies to boost their protection against Haemophilus influenzae type b (Hib) and meningitis C.

Hib and meningitis C infections are serious and potentially fatal. They can both cause meningitis and blood poisoning (septicaemia).

The vaccine boosts the protection your baby has already gained from their first course of Hib vaccine, which they received in the 6-in-1 vaccine at 8, 12 and 16 weeks old, and begins their protection against meningitis C.

The Hib/MenC vaccine contains bits of the bacteria that cause the diseases it protects against.

If your child comes into contact with these germs, the antibodies their body produces after vaccination will fight the infection to stop the disease taking hold.

Children’s flu vaccine (Fleunz Tetra)

Why? - For most people, flu is an unpleasant illness, but it's not serious. If you are otherwise healthy, you will usually recover from flu within a week.

The NHS currently offers the vaccine to those who are more likely to develop potentially serious complications of flu, such as bronchitis and pneumonia. These people are advised to have a flu jab each year. 

The vaccine contains live but weakened flu viruses that do not cause flu in children. It will help your child build up immunity to flu in a similar way as natural infection, but without the symptoms.

Because the main flu viruses change each year, a new nasal spray vaccine has to be given each year, in the same way as the injectable flu vaccine.

Visit the NHS website for up-to-date information on the flu vaccination programme for children this 2020-21.

What to expect - The vaccine is given as a single spray squirted up each nostril. Not only is it needle-free – a big advantage for children – the nasal spray is quick, painless, and works even better than the injected flu vaccine.

The vaccine is absorbed very quickly. It will still work even if, after the vaccination, your child develops a runny nose, sneezes or blows their nose.

The injectable flu vaccine will continue to be offered to children aged 6 months to 2 years with long term health conditions (particularly heart disease, respiratory disease, diabetes, asthma and weakened immune system). Since the nasal vaccine is known to be more effective than the flu injection, children within the risk group who are aged between 2-17 years will be offered the nasal vaccine. However, children aged between 6 months and 2 years will continue to be offered the annual injectable flu vaccine. The nasal vaccine not being licensed for this age group.

Side effects of flu nasal spray vaccine: slightly runny nose for a short period, and less commonly: fever, headache, low appetite. 

Children may not be able to have the nasal spray flu vaccine if they have:

  • a severely weakened immune system
  • severe egg allergy with anaphylaxis that has led to intensive care hospital admission
  • severe asthma – that is, those being treated with steroid tablets or have needed intensive care due to asthma
  • are currently wheezy or have been wheezy in the past 72 hours
  • an allergy to any of the vaccine ingredients, such as neomycin
  • a condition that requires salicylate treatment.

Side effects of injectable flu vaccine:  fever, swelling, redness and small hard lump at injection site. These usually pass within a 2 days.

4-in-1 pre-school booster- Repevax

The 4-in-1 pre-school booster vaccine is offered to children from the age of 3 years and 4 months to boost their protection against 4 different serious diseases:

  • diphtheria
  • tetanus
  • whooping cough
  • polio.

Children are routinely vaccinated against these illnesses as babies through the 6-in-1 vaccine.

The 4-in-1 pre-school booster vaccine increases their immunity even further.

The 4-in-1 pre-school booster vaccine is routinely offered to children at the age of 3 years and 4 months old. It is injected into the child’s upper arm.

The 4-in-1 pre-school booster has been thoroughly tested to ensure it's safe and effective.

The vaccine is inactivated (killed), which means it does not contain any live bacteria or viruses. It cannot cause any of the diseases it protects against.

The brand name of the 4-in-1 pre-school booster is REPEVAX. It provides a good booster response.

Further information

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