Vaccination of individuals with uncertain or incomplete immunisation status

For online Green Book, see www.gov.uk/government/collections/immunisation-against-infectious-disease-the-green-book • For other countries’ schedules, see http://apps.who.int/immunization_monitoring/globalsummary/

Infants from two months of age Children from first up Children from second up From tenth birthday
up to first birthday to second birthday to tenth birthday onwards

For children born on/after 01/01/2020 DTaP/IPV/Hib/HepB†+ PCV†† + Hib/Men C†† DTaP/IPV/Hib/HepB^ + Hib/MenC^^ + MMR Td/IPV + MenACWY* + MMR
DTaP/IPV/Hib/HepBa + MenBc + rotaviruse + MenB††† + MMR Four week gap Four week gap
Four week gap Four week gap DTaP/IPV/Hib/HepB^ + MMR Td/IPV + MMR
DTaP/IPV/Hib/HepB + PCVb + rotaviruse DTaP/IPV/Hib/HepB† Four week gap Four week gap
Four week gap Four week gap DTaP/IPV/Hib/HepB^ Td/IPV
DTaP/IPV/Hib/HepB + MenBc DTaP/IPV/Hib/HepB† + MenB†††
^DTaP/IPV/Hib/HepB is now the only suitable vaccine containing *Those aged from 10 years up to 25 years who
For children born on/before 31/12/2019 †
DTaP/IPV/Hib/HepB is now the only suitable vaccine high dose tetanus, diphtheria and pertussis antigen for priming have never received a MenC-containing vaccine
DTaP/IPV/Hib/HepBa + MenBc containing high dose tetanus, diphtheria and pertussis children of this age. For those who have had primary vaccines should be offered MenACWY
+ PCVd + rotaviruse antigen for priming children of this age. For those who have without HepB, there is no need to catch-up this antigen alone Those aged 10 years up to 25 years may be eligible
Four week gap had primary vaccines without HepB, there is no need to unless at high risk or may shortly become eligible for MenACWY.
DTaP/IPV/Hib/HepB + rotaviruse catch-up this antigen alone unless at high risk ^^All un- or incompletely immunised children only require one dose Those born on/after 1/9/1996 remain eligible for
Four week gap ††
All un- or incompletely immunised children only require of Hib and Men C (until teenage booster) over the age of one year. MenACWY until their 25th birthday
DTaP/IPV/Hib/HepB + MenBc + PCVd one dose of Hib, Men C (until teenage booster) and It does not matter if two Hib-containing vaccines are given at
a
A child who has already received one or more PCV over the age of one year. It does not matter if two the first appointment or if the child receives additional Hib at
doses of primary diphtheria, tetanus, polio Hib-containing vaccines are given at the first appointment subsequent appointments if DTaP/IPV/Hib/HepB vaccine is given Boosters + subsequent vaccination
and pertussis should complete the three dose or if the child receives additional Hib at subsequent
appointments if DTaP/IPV/Hib/HepB vaccine is given First booster of Td/IPV
course with DTaP/IPV/Hib/HepB. Any missing Preferably five years following completion of primary
doses of Hib and/or HepB can be given as
†††
Children who received less than 2 doses of MenB Boosters + subsequent vaccination course
Hib/MenC and/or, monovalent hepatitis B, in the first year of life should receive 2 doses of MenB
in their second year of life at least 8 weeks apart. Doses First booster of dTaP/IPV can be given as early as Second booster of Td/IPV
at 4 week intervals
b of MenB can be given 4 weeks apart if necessary to one year following completion of primary course to Ideally ten years (minimum five years) following
Infants born on/after 01/01/2020 who are re-establish on routine schedule first booster
aged 12 weeks or over when starting their ensure the two dose schedule is completed (i.e. if
schedule started at 22m of age) Additional doses of DTaP-containing vaccines given
primary schedule can be given their single
under three years of age in some other countries do not
infant priming dose of PCV with their first
count as a booster to the primary course in the UK and HPV vaccine
set of primary immunisations
c Boosters + subsequent vaccination should be discounted • All females who have been eligible remain so up
Doses of MenB should ideally be given
8 weeks apart but can be given 4 weeks As per UK schedule Subsequent vaccination – as per UK schedule to their 25th birthday
apart if necessary to ensure the immunisation • Males born on/after 1/9/06 are eligible up to
schedule is completed (i.e. if schedule started MMR – from first birthday onwards their 25th birthday
at 10m of age) • Doses of measles-containing vaccine given prior to 12 months of age should not be counted • Individuals commencing HPV vaccine course:
d – before age 15 yrs should follow two dose 0,
Doses of PCV should ideally be given • Two doses of MMR should be given irrespective of history of measles, mumps or rubella infection and/or age
8 weeks apart but can be given 4 weeks 6-24 months schedule
• A minimum of 4 weeks should be left between 1st and 2nd dose MMR
apart if necessary to ensure the immunisation – at age 15 yrs and above should follow three dose
schedule is completed (i.e. if schedule started • If child <3y4m, give 2nd dose MMR with pre-school dTaP/IPV unless particular reason to give earlier 0, 1, 4-6 months schedule
at 10m of age). • Second dose of MMR should not be given <18m of age except where protection against measles is urgently required

IMW186.08 Effective from January 2020 – Authorised by: Laura Craig

• For individuals who started schedule with a
e
First dose of rotavirus vaccine to be given HPV vaccine no longer/not used in the UK
only if infant is more than 6 weeks and under programme, the course can be completed with
15 weeks and second dose to be given only
Flu vaccine (during flu season)
the vaccine currently being used
if infant is less than 24 weeks old • Those aged 65yrs and older (including those turning 65 years of age during the current flu season)
• For two dose course, give second dose even if more
• Children eligible for the current season’s childhood influenza programme (see Annual Flu Letter for date of birth range)
than 24 months have elapsed since first dose or
• Those aged 6 months and older in the defined clinical risk groups (see Green Book Influenza chapter) individual is then aged 15yrs or more
Boosters + subsequent vaccination • Three dose courses started but not completed
As per UK schedule ensuring at least a four Shingles vaccine Pneumococcal polysaccharide before twenty fifth birthday should be completed
week interval between DTaP/IPV/Hib/HepB vaccine (PPV) ideally allowing 3 months between second and third
• Those aged 70yrs and 78yrs
and Hib/MenC doses, a four week interval doses (minimum one month interval if otherwise
• In addition, individuals in their 70s who have become eligible since • Those aged 65yrs and older unlikely to complete course)
between PCV priming and booster doses
the start of the shingles programme in September 2013 remain • Those aged 2yrs and older in the defined clinical risk
and an eight week interval between MenB • If three dose course commenced under 15yrs and
eligible until their 80th birthday (see eligibility on PHE website) groups (see Green Book Pneumococcal chapter)
primary and booster doses. individual has:
– only received one dose, give a second dose
6-24m later to complete a two dose course
• Unless there is a documented or reliable • Individuals coming to UK part way • If the primary course has • Plan catch-up immunisation schedule – received two doses less than six months apart, give
General verbal vaccine history, individuals through their immunisation schedule been started but not with minimum number of visits and a third dose at least three months after second dose
should be assumed to be unimmunised should be transferred onto the completed, resume the within a minimum possible timescale
principles and a full course of immunisations UK schedule and immunised as course – no need to repeat – aim to protect individual in shortest Note: BCG and Hepatitis B vaccines for those at high risk
should be given as per Green Book recommendations and
planned appropriate for age doses or restart course time possible
have therefore not been included in this algorithm