Guidance

Changes to the routine childhood vaccination schedule from 1 July 2025 and 1 January 2026 letter

Published 30 April 2025

30 April 2025

Dear colleagues,

We are writing to inform you of significant changes to the routine childhood vaccination schedule and to the selective hepatitis B (HepB) programme occurring from 1 July 2025 and 1 January 2026, including the introduction of a new routine vaccination appointment at 18 months of age.

These changes are required as a result of the discontinuation of the manufacture of Menitorix (Hib/MenC) vaccine. This has prompted the Joint Committee on Vaccination and Immunisation (JCVI) to recommend and advise on a number of other changes to the national childhood immunisation schedule to optimise the overall protection of children in the UK.

Please share this information with all local partners involved in commissioning and delivering the programme and take action as required.

A summary of the changes to the childhood schedule from 1 July 2025 and 1 January 2026 is set out in tables 1 and 2 below.

Any children with an incomplete immunisation history for their age should be managed according to the UKHSA uncertain or incomplete immunisation algorithm, which is being updated to reflect these changes.

Table 1. Changes to the routine childhood schedule and to the selective neonatal HepB programme from 1 July 2025

No	Population affected	Change to be implemented	Rationale for the change
1	Children born on or after 1 July 24	Cessation of routine Hib/MenC (Menitorix) offer to those turning 1 year old.	The manufacturer has ceased production of Menitorix vaccine. There is no other Hib/MenC vaccine available on the UK market. (See table 2, change 1 below for replacement of Hib dose). JCVI has agreed that protection against MenC is no longer required in this age group due to the excellent population control provided by vaccination of adolescents. Sustaining coverage of MenACWY in adolescents is important to maintain indirect protection.
2	Children attending for their second routine visit at 12 weeks	Move the first PCV13 dose from 12 weeks of age to 16 weeks of age. Bring forward the second MenB dose from 16 weeks of age to 12 weeks of age.	Following a recent clinical study and a review of the epidemiology, JCVI have advised bringing forward the second dose of MenB vaccine to provide earlier protection against this serious and sometimes fatal infection. To avoid increasing the number of injections at this second visit, the first dose of PCV13 will be moved to the 16-week visit. The short delay in PCV13 is unlikely to be significant due to excellent overall control of the serotypes covered by PCV13.
3	Infants eligible for the selective neonatal HepB programme, born on or after 1 July 2024	Remove the monovalent HepB dose offered at one year from the selective neonatal HepB programme schedule. Dry Blood Spot (DBS) testing for HepB surface antigen (HBsAg) can be undertaken anytime between one year and 18 months of age.	The addition of a dose of hexavalent vaccine at 18 months from 1 January 2026 (see Table 2), replaces the need to receive a dose of monovalent HepB vaccine at one year.

Table 2: changes to the routine childhood schedule from 1 January 2026

No	Population affected	Change to be implemented	Rationale for the change
1	Children born on or after 1 July 2024	Introduction of an additional (4th dose) of DTaP/IPV/Hib/HepB (hexavalent) vaccine at a new routine appointment at 18 months.	To replace the Hib dose no longer given at the 1-year appointment. This will help to provide longer-term protection against Hib infection.
2	Children born on or after 1 July 2024	Move the second MMR dose from 3 years 4 months to the new routine 18 month appointment.	The second MMR dose is being moved forward in the schedule to help improve uptake and provide earlier protection.

1. Cessation of Hib/MenC (Menitorix) one year old dose

From 1 July 2025, children turning one year of age on or after 1 July 2025 (DOB on or after 1 July 2024) will not be offered the combined Hib-MenC vaccine Menitorix when they attend for their one-year-old vaccination appointment (see section 4 below). The other vaccines due at this appointment (MenB, PCV13 and 1st dose MMR) should be given as usual.

Children who turn one year of age on or before 30 June 2025 (DOB on or before 30 June 2024) should continue to be offered Menitorix at their one-year appointment as usual, until the supply is exhausted. Children in this age group who present late for their one-year appointment, and after Menitorix stocks are depleted, should be offered a fourth dose of Hexavalent alongside the other vaccines scheduled at one year of age (for example MenB, PCV13 and 1st dose MMR).

2. MenB and PCV13 vaccination changes

From 1 July 2025:

A. The offer of the first dose of PCV13 vaccine at 12 weeks of age will be moved later to 16 weeks of age.

B. The offer of the second dose of MenB vaccine at 16 weeks of age will be moved earlier to 12 weeks of age.

C. Children who have already received their 12 week PCV13 vaccination prior to 1 July 2025, will remain on the current schedule and be invited for their second MenB at 16 weeks.

D. Children who have not yet received their 12 week vaccinations by 1 July 2025, will be offered the vaccines in line with the new schedule. This includes children who attend late for their 12 week vaccinations.

3. Changes to the selective neonatal Hepatitis B immunisation pathway and blood test for Hepatitis B surface antigen

From 1 July 2025:

A. Eligible children turning one year of age on or after 1 July 2025 (DOB on or after 1 July 2024) should not be offered monovalent HepB vaccine when they attend for their 1 year vaccination appointment. These children will instead wait until 18 months of age to be offered an additional dose of HepB as part of the hexavalent vaccine (see section 4).

B. Eligible children who turn one year of age on or before 30 June 2025 (DOB on or before 30 June 2024) should continue to be offered a dose of monovalent HepB vaccine as usual (alongside the other vaccines given at this age) on or after their first birthday.

C. The timing of the blood test for HepB surface antigen will change as follows:

• for eligible children born on or after 1 July 2024, the blood test (usually performed as a dried blood spot test) should continue to be performed but can be undertaken at any time between 1 year and 18 months of age, for example at an opportunistic healthcare attendance or at a routine appointment

• the requirement to record the results of the baby’s blood test for HepB surface antigen in their primary care record remains unchanged

4. Introduction of a new 18 month routine vaccination appointment for a 4th hexavalent (DTaP/IPV/Hib/HepB) dose

From 1 January 2026, children turning one year of age on or after 1 July 2025 (DOB on or after 1 July 2024) will not have received the combined Hib-MenC vaccine Menitorix when they attended for their one-year-old vaccination appointment (they should still have received the other vaccines due at that age). These children should be offered a new 18 month routine vaccination appointment (starting from 1 January 2026) for a 4th dose of hexavalent (DTaP/IPV/Hib/HepB) vaccine, given alongside MMR2 (see section 5).

5. Bring forward the second MMR dose (MMR2) from 3 years 4 months to 18 months of age

From 1 January 2026:  

A. Children turning 18 months on or after 1 January 2026 (DOB on or after 1 July 2024) will be offered their 2nd MMR dose when they attend for the new 18 month appointment (see section 4).

B. Children aged 18 months to 3 years 4 months on 1 January 2026 (DOB on or before 30 June 2024) will remain on the current MMR 2nd dose schedule and be offered their 2nd MMR dose at 3 years 4 months.

C. Children who missed out on either dose remain eligible for life.

Annexe A provides information on the new routine childhood vaccination schedule.

Annexe B provides information on the changes to the selective neonatal Hepatitis B immunisation pathway for babies born to Hepatitis B positive mothers.

Annexe C provides information and resources to support the implementation of these changes.

For any operational queries, please contact your NHS England Regional Public Health Commissioning Team. For clinical queries or queries about programme resources, please email immunisation@ukhsa.gov.uk.

We would like to take this opportunity to thank everyone involved in the commissioning and operational delivery of the national immunisation programme in England.

Yours sincerely,

Dr Mary Ramsay, Director of Public Health Programmes, UK Health Security Agency

Caroline Temmink, Director of Vaccination, NHS England