The First Six Months of Vaccinations: The UK Schedule

The first six months pack in three immunisation appointments, four different vaccines, and protection against ten diseases that used to routinely kill or permanently damage children. Once you've seen the dates and what's in each visit, the whole programme stops feeling like a wall of acronyms. For a comprehensive overview, see our complete guide to child health.

Why the Timing Looks the Way It Does

Vaccine timing is a balance between three things:

• How early the baby's immune system can mount a useful response. Below about eight weeks, response to most vaccines is poor.
• How early the disease itself becomes dangerous. Whooping cough kills babies under three months; that's why the first dose lands at eight weeks, not later.
• What can be combined safely. Multiple antigens in one injection don't overwhelm anything — the immune system handles thousands of antigens daily — but the practical limit is how many separate jabs a baby gets in one sitting.

The 6-in-1 exists for that last reason: six diseases, one needle.

8 Weeks

Three things happen at the eight-week visit:

• 6-in-1 (DTaP/IPV/Hib/HepB) — diphtheria, tetanus, whooping cough, polio, Hib, hepatitis B. One injection in the thigh.
• MenB (Bexsero) — meningococcal group B. Other thigh.
• Rotavirus — oral drops. Rotavirus is the leading cause of severe diarrhoea-and-vomiting hospital admissions in under-fives; the vaccine cut UK admissions sharply after 2013.

So: two injections, one oral. Paracetamol is given on the day for the MenB component (see preparation guide).

Pneumococcal (PCV13) used to sit in the eight-week visit. The schedule changed in 2020 — it's now twelve weeks only.

12 Weeks

• 6-in-1, second dose.
• Pneumococcal (PCV13) — protects against 13 strains of Streptococcus pneumoniae, the leading cause of bacterial pneumonia, ear infection, and one of the causes of meningitis.
• Rotavirus, second dose. This one has a hard deadline: the second dose must be given before 24 weeks (six months) of age. Past that, it's not given, because of a small but real risk of intussusception in older infants.

Two injections and oral drops again.

16 Weeks

• 6-in-1, third dose — completes the primary course.
• MenB, second dose — paracetamol again.

Two injections.

By the time you walk out of this appointment, your baby has substantial protection against ten diseases. The boosters that follow keep that protection topped up.

What Comes After Six Months

For completeness:

• 12–13 months: Hib/MenC booster, MMR (first dose), MenB booster, pneumococcal booster.
• 2–11 years: annual flu vaccine (nasal spray).
• 3 years 4 months: 4-in-1 pre-school booster (DTaP/IPV) and MMR second dose.
• Adolescence: HPV, MenACWY, 3-in-1 teenage booster.

What's Normal Afterwards

After most jabs, expect: a small red lump and tenderness where the needle went, more fussiness than usual, and possibly a mild temperature for a day. After the two MenB doses specifically, fever is common enough that paracetamol is given pre-emptively — three doses, one at the time and two more at 4–6 and 8–12 hours afterwards, weight-based.

If a fever does appear:

• Strip them down to a vest — overdressing makes it worse.
• Offer milk feeds little and often.
• Paracetamol per the dosing on the bottle, from two months and 4 kg.
• Any temperature of 38°C or above in a baby under three months is its own rule and gets the same-day review treatment, regardless of whether you suspect it's the vaccine. Don't try to interpret which it is — let the GP do that.

Mild Illness and Other Common Worries

A snotty nose or a cough isn't a reason to delay. The actual contraindications are short:

• A current high fever (>38.5°C) — postpone, don't cancel.
• A confirmed severe allergic reaction to a previous dose or to a known component (egg in some flu vaccines, gelatin, neomycin).
• Specific immunocompromise — rare in healthy infants, mostly relevant for the live vaccines (MMR, rotavirus, BCG).

If you're not sure, the practice nurse will check at the appointment. Far more vaccines get unnecessarily delayed for a runny nose than need to be.

What Happens If a Visit Is Missed

You don't restart. The schedule is forgiving — a delayed dose just slots into the next available appointment, no loss of effectiveness as long as the gap doesn't run into multiple months. Phone the surgery and book the next slot. The single hard deadline is the second rotavirus dose before 24 weeks.

There's no "too late" for catch-up. The UK has structured catch-up programmes that can begin at any age, including for a child arriving in the country having missed everything to date. The earlier the better, but later is much better than never.

"Doesn't It Overwhelm the Immune System?"

A reasonable-sounding worry — and one of the most common reasons parents hesitate. The answer's clear: no. The immune system routinely processes thousands of antigens every day, from food to dust to skin bacteria. The total antigen load across the entire infant schedule is a small fraction of what your baby's immune system encountered the first morning home from hospital. Combining vaccines reduces injections, not effectiveness.

The mid-1990s schedule (single component vaccines, plus whole-cell pertussis) contained over 3,000 antigens. The current UK schedule contains roughly 150. The system is doing less work, more precisely targeted, than the schedule a generation ago.

Current UK schedule (NHS, 2024): at 8 weeks — 6-in-1, MenB, oral rotavirus. At 12 weeks — 6-in-1 (second dose), pneumococcal (PCV13), oral rotavirus (second dose, must be given before 24 weeks). At 16 weeks — 6-in-1 (third dose), MenB (second dose). The primary course is complete by 16 weeks; boosters follow at 12–13 months, 3 years 4 months, and adolescence. MenB doses get paracetamol prophylaxis. A mild cold isn't a reason to delay. Missed doses don't restart the schedule — they slot into the next available appointment.