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SUMMARY
This article summarises the recommendations by the Joint Committee on Vaccination and Immunisation (JCVI) for a new UK childhood immunisation schedule following the discontinuation of the Hib/MenC vaccine by the manufacturer (currently used at 12 months of age as a booster for these antigens) and the rationale behind these changes to the schedule.
From late 2025, when the current stock of Hib/Men C vaccine runs out, Men C vaccination will no longer be offered to toddlers, as the adolescent Men ACWY vaccination programme is expected to effectively sustain herd immunity.
To improve herd immunity against polio and sustain Hib control by maintaining the current impact on Hib carriage in toddlers, an 18-month visit will be added to the vaccination schedule, where a booster dose of DTaP/IPV/Hib or DTaP/IPV/Hib/HepB will be offered.
The second MMR (measles, mumps, rubella) dose will be advanced from 40 to 18 months to improve uptake, with a recommendation that both MMR doses are offered with varicella immunisation (MMRV (measles, mumps, rubella and varicella)), as addition of varicella to the schedule has been demonstrated to be cost-effective in recent modelling reviewed by JCVI.
One of the recently licensed interventions for preventing respiratory syncytial virus (RSV) in infants (a maternal bivalent RSV prefusion F protein vaccine) will be incorporated into the new schedule, which should significantly reduce RSV burden in infants. In addition, higher-valency pneumococcal vaccines with wider serotype coverage may be introduced.
Introduction
The immunisation schedule is designed to optimise protection from serious infectious diseases by providing individual direct protection and, where appropriate, sustained population-level control through herd immunity. Recommendations for each vaccine take into account the age-specific risk for a disease/infection (often early childhood), risk of complications, vaccine efficacy and the vaccine’s potential to reduce transmission.1
Passive protection of neonates and young infants is provided through …
Footnotes
X @ajpollard1
OA and EAL contributed equally.
Contributors EAL and OA contributed equally to this paper and have been listed alphabetically. AJP devised the proof outline, with contributions from GA and MER. EAL and OA reviewed the relevant literature and wrote the draft, with the assistance of AJP, GA and MER. All authors reviewed and approved the final manuscript for submission and take responsibility for its content.
Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.
Competing interests AJP is chair of the UK Department for Health and Social Care’s Joint Committee on Vaccination and Immunisation (JCVI) and was a member of the WHO’s SAGE until 2022. Oxford University entered into a partnership with AstraZeneca for development of COVID-19 vaccines. AJP has had grants with the Gates Foundation, Wellcome, CEPI, MRC, NIHR, AstraZeneca, EC and the Serum Institute of India, all of which were paid to his institution.
Provenance and peer review Commissioned; externally peer reviewed.
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