Guidance

Supporting immunisation programmes

Updated 21 February 2024

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This publication is available at https://www.gov.uk/government/publications/health-protection-in-schools-and-other-childcare-facilities/supporting-immunisation-programmes

Immunisation means both receiving a vaccine and then becoming immune to a disease. A full dose of vaccination generally provides immunity similar to that provided by the natural infection, but without the risk of the disease or its complications. When children and young people receive all the vaccinations included in the National routine childhood immunisation programme, this has a direct positive impact on their health and wellbeing, as well as their communities.

Achieving high levels of immunity against vaccine preventable diseases is vital to reduce the spread of infection and prevent outbreaks. High levels of immunity can result in herd immunity, whereby the protection from immunisation programmes extends to individuals who cannot be vaccinated for a number of reasons.

Evidence shows that delivering immunisations in schools reduces health disparities by making access to vaccines easier for all, for example parents don’t need to take time off work to book immunisation appointments and children who are not registered with a GP are included.

The offer of the adolescent vaccines in school is an important opportunity to check that children are up to date with all their routine immunisations and to ensure they are caught up.

The role of education and childcare settings

Education and childcare settings have a vital role to play to support the routine immunisation programme through sharing of information with parents and caregivers at key points. Settings may wish to speak to their health visitor, school nurse or other setting specific health care worker about the support they can offer.

Universities and colleges are also encouraged to share information on vaccines such as measles, mumps and rubella (MMR) and meningococcal A, C, W, and Y (MenACWY) and information on the signs and symptoms of meningococcal disease with newly enrolled students, along with links to GP registration and other relevant healthcare services.

School Age Immunisation Services (SAIS) providers are commissioned by NHS England (NHSE) to deliver the school-based immunisation programmes. Home schooled children and children not in mainstream schools for other reasons are also included.

The SAIS provider is contractually and legally responsible for the school-based immunisation programmes. There are a number of school-based immunisation programmes whose success depends on close working relationships between the schools, school nurses and SAIS providers.

The setting supports the immunisation programme by hosting the SAIS team and helping them with aspects of the vaccination process, including:

  • providing space and time in the timetable for vaccination
  • reminding staff, children, and young people about the date of the immunisation session(s)
  • sharing information leaflets and consent forms with parents or carers
  • providing a list of eligible children and young people and their parent or carer’s contact details to the SAIS team

Where vaccination visits have been most successful, the team and the setting or school nurse have worked in close partnership, respecting each other’s different roles and responsibilities whilst working flexibly and planning together.

Contacting your SAIS team

You can contact the SAIS team directly if you have any queries or questions. If you do not already have contact details for your SAIS team, your regional NHSE team will be able to help you to identify which organisation in your area will be delivering the school age immunisation programme and provide contact details. NHSE regional contact details can be found on the NHS England website.

Vaccines offered in schools

Vaccine School years eligible Mode of administration and schedule Diseases protected against
Seasonal influenza vaccine Reception to year 6

Years 7, 8 and 9		 Nasal spray

One dose (unless otherwise indicated)

(Injected vaccine is available if nasal spray is unsuitable)

Offered annually in the autumn term		 Protects against the influenza virus
Human papillomavirus (HPV) vaccine Years 8 and 9 Injected

2 doses (6 to 24 months apart)		 Protects against genital warts and HPV related cancers such as cervical cancer, cancers of the head and neck and cancers of the genital area
MenACWY vaccine Year 9 Injected

One dose		 Meningococcal groups A, C, W and Y
Td/IPV (3-in-1 booster) Year 9 Injected

Final dose of the course (total of 5)		 Tetanus, diphtheria and polio
MMR check and offer At all opportunities Injected

2 doses		 Measles, mumps, rubella

Further information on vaccinations for early years settings with children prior to school age.

Young people who miss out on the adolescent immunisation sessions remain eligible in older years and should be encouraged to catch up as soon as possible through their school aged immunisation service or by being referred to their GP.

School-based immunisation programmes: what happens

Before the immunisation session

SAIS teams work closely with your setting to ensure effective planning and delivery of the service.

What the SAIS team will do

The SAIS team will contact your setting to agree on suitable days for visits. You should nominate someone in your setting to act as a link person for the SAIS team. This will help with early engagement ahead of the visit and support planning and set-up for the day of the visit.

They will provide information to support parents or carers and children and young people to make an informed decision on consent for the setting to disseminate.

The team will also provide the setting with an invitation to send to parents and carers. The letter includes information on the consent process and links to further guidance.

What you need to do

Send the invitation to parents and carers of children and young people who are eligible, in good time and with a clear deadline for response. The deadline should be at least 48 hours before the SAIS team arrives so that they can order the required amount of vaccine.

Communicate with children, young people and parents or carers to support consent and uptake.

Encourage parents, carers or staff who may be concerned or require additional guidance to speak to their health visitor, school nurse, or GP.

Encourage parents, carers or a person with parental responsibility to return the consent form, highlighting that if the consent deadline is missed, the SAIS team may not have enough vaccines for everyone who would like one on the day.

Consider what space could be made available and provide as much information as possible for the SAIS team so that they can plan their visit and be prepared on the day. Ideally, this should be a large, well-ventilated space to undertake the vaccinations – generally a sports hall or similar.

On the day of the immunisation session

What the SAIS team will do

The SAIS team will:

  • set up the venue for the immunisation session
  • provide the immunisations to children and young people on the list provided

By law, some young people may be mature enough to provide their own consent, so-called ‘Gillick competent’. The health professional will assess if a child under the age of 16 can be considered competent to understand the benefits and risks.

The team will also remove any sharp, hazardous or medical waste.

What you need to do

Ensure that the SAIS team can access the agreed space before the school day starts so they can set up.

Provide, if possible, access to a power supply with extension cables and anti-trip mats, separation screens, defibrillator, gym mats, tables and chairs.

Allow children and young people to wear loose-fitting short-sleeved tops on the day of vaccination.

Identify and support children and young people who may find the procedure stressful, in partnership with the school nurse.

If a young person wishes to be vaccinated and a consent form has not been returned, every effort should be made to contact the parent to seek their verbal consent.

Help to keep disruption and noise to a minimum.

Ensure a steady flow of children and young people throughout the school day.

Remove any household waste generated on the day.

Avoid any unscheduled fire drills and so on to be scheduled on the same day as vaccinations.

Staff immunisation

It is important that all staff are up to date with their vaccinations. Staff may wish to speak to their GP or practice nurse for support or advice.

All staff should be encouraged to check their immunisation records and contact their GP practice if they are unsure if they are up to date or if they need to catch up.

MMR vaccination

In particular, all staff should make sure that they have had 2 doses of the MMR vaccine.

The MMR vaccine is the safest and most effective way to protect yourself against measles, mumps and rubella, which are viral infections that can quickly spread and cause outbreaks.

Rubella caught in pregnancy can lead to miscarriage or cause very serious harm to the unborn baby and so all people who are considering a pregnancy should make sure they are up to date with their 2 doses of the MMR vaccine. The MMR vaccine is available for free on the NHS with no upper age limit.

Further information is available in the Thinking of getting pregnant? leaflet.

Hepatitis B vaccine

The hepatitis B vaccine is recommended for staff who are involved in the care of individuals with severe learning disability or challenging behaviour who live in institutional accommodation.

In such circumstances, it is the responsibility of the employer to conduct an occupational health risk assessment and pay for the vaccine if it is required.

Immunisation for outbreak response

Occasionally clusters and outbreaks of vaccine preventable diseases such as measles, mumps, hepatitis A and meningococcal disease are linked to children and young people settings. Suspected outbreaks should be notified to your UK Health Security Agency (UKHSA) health protection team (HPT) promptly in line with advice on Managing outbreaks and incidents.

The HPT will conduct a risk assessment and as part of the control measures may consider offering vaccination to all persons in the setting. This will require the setting to support with clear and prompt communication with parents/carers and rapid coordination of arrangements.

Immunisation resources for education settings

A wide range of immunisation resources for education settings are available. Schools are encouraged to share these with parents or carers at appropriate opportunities such as at school entry and provide reminders at the beginning of each academic year. Higher education settings are also encouraged to share relevant resources with their students at the beginning of the academic year.

Copies of printed publications and the full range of digital resources to support the immunisation programmes can be ordered through the health publications platform.

We also recommend introducing the concept of immunisation to children and young people, educating them on how vaccinations work and why they are such a critical intervention to preventing certain infections. Free lesson plans have been developed through the e-Bug programme, operated by UKHSA.

The following resources are available:

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