Guidance

A quick guide to childhood vaccinations for the parents of premature babies

Updated 3 June 2025

Applies to England

Immunisation

Immunisation is a way of protecting ourselves from serious diseases. There are some diseases that can kill children or cause lasting damage to their health. Immunisations are given to prepare your child’s immune system (their natural defence system) to fight off those diseases when your child comes into contact with them.

‘The 2 public health interventions that have had the greatest impact on the world’s health are clean water and vaccines’ – World Health Organization.

Timing of immunisation

It is important that your baby has their vaccinations at the right age (see routine childhood immunisation schedule). This will help to keep the risk of your baby catching a serious disease as low as possible. The risk of side effects from some vaccines may increase if you put them off.

Vaccines are offered at the right time for your baby when they most need to develop the protection. Having the vaccines on time, helps to give them the best protection from these infectious diseases.

Timing of first immunisation for premature babies

Premature babies have a higher risk of infection. They should be immunised in line with the recommended schedule from 8 weeks after birth, no matter how premature they were. This may happen whilst your baby is in hospital, you will need to discuss this with your doctor.

Appointment

The doctor or nurse will explain the immunisation process to you, and answer any questions you have. The vaccine is injected into the muscle of the thigh. If your baby was born very prematurely then they may still be in hospital when the first routine immunisation is due.

Reasons why your baby should not be immunised

There are very few reasons why babies cannot be immunised. The vaccines should not be given to babies who have had:

• a confirmed anaphylactic reaction (severe allergic reaction) to a previous dose of the vaccine
• a confirmed anaphylactic reaction to neomycin, streptomycin, or polymyxin B (antibiotics used in vaccines)
• who are suspected to have Severe Combined Immunodeficiency (SCID) or have a positive SCID test result

If your baby’s immune system is ‘suppressed’ (because they are having treatment for a serious condition such as a transplant or cancer) or if you have taken certain medications whilst pregnant which suppressed your immunity, then your baby may not be able to have certain vaccines such as Rotarix for rotavirus. Your doctor or practice nurse should get advice from a specialist.

There are no other medical reasons why these vaccines should definitely not be given.

Dealing with common side effects

There may be redness, soreness or tenderness where the injection is given and a few babies may develop a mild fever. Make sure you keep your child cool by:

• giving them plenty of fluids
• giving infant liquid paracetamol – check the dose with your doctor
• making sure they don’t have too many layers of clothes or blankets on

If your child’s face feels hot to the touch, or if your child becomes ill, trust your instincts and ask your doctor for advice. Or call NHS 111.

For more information about side effects, see a guide to vaccinations at one year of age.

Watch out for meningitis and septicaemia (blood poisoning)

Haemophilus influenzae type b (Hib), meningococcal B (MenB) and pneumococcal vaccines protect against the most important bacteria causing meningitis and septicaemia in children and young people. However, as these diseases can be caused by many other bacteria and viruses, it is important to know the signs and symptoms of these illnesses.

Early symptoms of meningitis include fever, being irritable and restless, vomiting and refusing food – symptoms that are also common with colds and flu. But a baby with meningitis or septicaemia can become seriously ill within hours.

Look out for one or more of the following symptoms:

• a high-pitched, moaning cry
• irritable when picked up
• drowsy, difficult to wake
• stiff with jerky movements (convulsions/fits)
• pale, blotchy skin or turning blue
• fever, with cold hands and feet
• red or purple spots that do not fade under pressure (do the glass test explained below). On dark skin, check inside the eyelids or roof of the mouth where the spots may be more visible.

If your child becomes ill with one or more of the signs or symptoms described above, contact your doctor urgently. If you are still worried after getting advice, trust your instincts and take your child to your nearest hospital with an emergency department.

Glass test

Press the side of a clear glass against the rash and see if the rash fades and loses colour. If it doesn’t, contact your doctor immediately. On dark skin, check inside the eyelids or roof of the mouth where the spots may be more visible.

Immunisation schedule

See the routine childhood immunisation schedule for the latest schedule.

Further information

A guide to vaccinations at one year of age contains more detailed information about the routine childhood immunisation programme including the types of vaccine. Ask your health visitor for a copy if you were not given one soon after the birth of your baby.

From birth onwards, children born prematurely should also continue to follow the normal schedule see the leaflets:

• a guide to vaccinations for children aged 18 months
• pre-school vaccinations: guide to vaccinations from 2 to 5 years
• immunisations for young people

You can also visit NHS.UK.

Each vaccine has a Patient Information Leaflet, available to view or download.

Order or download print copies

Paper copies of this guide are available free to order or download.