Guidance

Vaccination of individuals with uncertain or incomplete immunisation status: from 1 July 2025

Updated 3 June 2025

Applies to England

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This publication is available at https://www.gov.uk/government/publications/vaccination-of-individuals-with-uncertain-or-incomplete-immunisation-status/vaccination-of-individuals-with-uncertain-or-incomplete-immunisation-status-from-1-july-2025

General principles

Unless there is a documented or reliable verbal vaccine history, individuals should be assumed to be unimmunised and a full course of immunisations planned.

Individuals coming to the UK part way through their immunisation schedule should be transferred onto the UK schedule and immunised as appropriate for age.

If the primary course has been started but not completed, resume the course – no need to repeat doses or restart course.

Plan catch-up immunisation schedule with minimum number of visits and within a minimum possible timescale – aim to protect the individual in the shortest time possible.

Infants from 8 weeks of age up to first birthday

Leave a 4-week gap between visits.

Visit 1

Visit 2

Visit 3

Subsequent vaccination

As per UK schedule ensuring a minimum 4-week interval between MenB and PCV13 priming and booster doses.

Children from first up to second birthday

Leave a 4-week gap between visits.

Visit 1

Visit 2

Visit 3

Subsequent vaccination

All children require a dose of Hib over one year [footnote 7].

dTaP/IPV vaccine should be offered from 3 years (and at least one year after last dose of DTaP/IPV/Hib/HepB vaccine).

MMR vaccines should be offered as described below.

As per UK schedule. For more information, see:

Children from second up to 10th birthday

Leave a 4-week gap between visits.

Visit 1

Visit 2

Visit 3

Subsequent vaccination

If child is 3 years and 4 months or older, their dTaP/IPV booster can be given as early as one year following completion of primary course to re-establish on routine schedule. If a Hib-containing vaccine has not been received over one year of age, replace dTaP/IPV with DTap/IPV/Hib/HepB.

Additional doses of DTaP-containing vaccines given under 3 years of age do not replace the need to give the dose of dTaP/IPV vaccine from 3 years 4 months.

Subsequent vaccination – as per UK schedule.

For more information, see:

From 10th birthday onwards

Leave a 4-week gap between visits.

Visit 1

Visit 2

  • Td/IPV
  • MMR

Visit 3

  • Td/IPV

Subsequent vaccination

First booster of Td/IPV – preferably 5 years following completion of primary course.

Second booster of Td/IPV – ideally 10 years (minimum 5 years) following first booster.

Subsequent vaccination – as per UK schedule.

For more information, see:

Measles, mumps and rubella vaccine (MMR) – from first birthday onwards

Doses of measles-containing vaccine given prior to 12 months of age should not be counted.

Two doses of MMR should be given irrespective of history of measles, mumps or rubella infection or age.

A minimum of 4 weeks should be left between the first and second doses of MMR.

Give second MMR from 18 months of age if born on or after 1 July 2024. If born on or before 30 June 2024, to remain on previous schedule with second MMR dose due from 3 years 4 months (unless particular reason to give earlier).

Second dose of MMR should not be given if the child is less than 18 months of age except where protection against measles is urgently required.

Flu vaccine (during flu season)

Those aged 65 years and older although recommendations may change annually so always check the Annual Flu Letter.

Children eligible for the current season’s childhood influenza programme (see Annual Flu Letter for date of birth range).

Those aged 6 months and older in the defined clinical risk groups (see Green Book Influenza chapter).

Human papillomavirus vaccine (HPV)

Females (born on or after 1 September 1991) and males (born on or after 1 September 2006) remain eligible for HPV vaccine up to their 25th birthday on the adolescent programme.

Eligible immunocompetent individuals aged 11 to 25 years only require a single dose of HPV vaccine.

Eligible individuals who are HIV positive or immunosuppressed should be offered a 3 dose schedule at 0, 1, 4 to 6 months.

For details of GBMSM HPV vaccination programme, see the Green Book HPV chapter.

Any dose of Cervarix, Gardasil or Gardasil 9 given from 9 years of age would be considered valid if previously vaccinated or vaccinated abroad.

Shingles vaccine

Severely immunosuppressed individuals from 50 years of age (eligibility as defined in the Green Book Shingles chapter 28a): 2 doses of Shingrix vaccine 8 weeks to 6 months apart; no upper age limit to start or complete the course.

Immunocompetent individuals from their 65th and 70th birthday (see: Shingles: guidance and vaccination programme for eligibility): 2 doses of Shingrix vaccine 6 months to 12 months apart.

All individuals between 70 and 79 years of age are eligible for shingles vaccination if they have not received it.

Once individuals become eligible, they remain eligible until their 80th birthday. The second dose of Shingrix vaccine can be given up to 81st birthday to those who have commenced but not completed the course.

Pneumococcal polysaccharide vaccine (PPV)

Those aged 65 years and older.

Those aged 2 years and older in the defined clinical risk groups (see the Green Book Pneumococcal chapter).

Respiratory syncytial virus (RSV) vaccine

Routinely from 75th birthday (eligible until 80th birthday).

One-off catch-up campaign for those already aged 75 to 79 on 1 September 2024 (see the RSV vaccination programme).

At-risk groups

Individuals who are pregnant, at high risk or with specific underlying medical conditions may require additional vaccinations. Refer to individual Green Book chapters.

UK and international immunisation schedules.

The complete routine schedule and routine childhood schedule for the UK are available to download. Translated versions of the complete routine schedule are available to download.

Information on other countries’ immunisation schedules is available from the World Health Organization.

Download print copies

The vaccination of individuals with uncertain or incomplete immunisation status publication is available to download in PDF format.

  1. If an individual has received any OPV in another country since April 2016, these doses should be discounted as it is unlikely that they will protect against all 3 polio types. Most countries who still use OPV have a mixed OPV and IPV schedule so if sufficient IPV doses have been received for age, no additional IPV doses are needed. See Green Book Polio chapter for individuals who have received fractional doses of IPV (fIPV).  ↩ ↩2 ↩3 ↩4

  2. A child who has already received one or more doses of primary diphtheria, tetanus, polio and pertussis should complete the 3-dose course with DTaP/IPV/Hib/HepB. Where a child is only missing any doses of HepB, these can be given as monovalent hepatitis B at 4 week intervals.  ↩

  3. Children require 2 doses of MenB (at least 4 weeks apart) and one dose of PCV 13 in the first year of life.  ↩ ↩2 ↩3

  4. First dose of rotavirus vaccine to be given only if child is more than 6 weeks and under 15 weeks and second dose to be given only if child is less than 24 weeks old.  ↩ ↩2

  5. Children who are aged 16 weeks or over when starting their primary schedule can be given their single infant priming dose of PCV13 with their first set of primary immunisations. If a child has received PCV10 vaccine abroad, they should be offered one dose of PCV13 (at least 4 weeks after PCV10 was given and once they are 16 weeks of age). A dose of PCV13, PCV15 or PCV20 given abroad from 12 weeks of age counts as a valid dose.  ↩

  6. Children born from 1 August 2017 who received primary vaccines without HepB should be opportunistically offered a 3-dose course of monovalent HepB vaccine. If they are in a high-risk group or are exposed to hepatitis B, they should be proactively offered a hepatitis B vaccine course.  ↩ ↩2 ↩3

  7. All children require a dose of Hib over the age of one year. If they have received all 3 primary doses of hexavalent vaccine over one year of age, and were born on or before 30 June 2024, they should be offered the combined Hib/MenC vaccine now (or hexavalent if Hib/MenC vaccine not available) ensuring a minimum 4 week interval between this and the primary DTaP/IPV/Hib/HepB doses given in their first year of life. If they have received all 3 primary doses of hexavalent vaccine over one year of age, and were born on or after 1 July 2024, they should be offered the hexavalent vaccine at 18 months (or now if older than 18 months).   ↩ ↩2

  8. All children require a dose of PCV over the age of one year. If a child has received PCV10 vaccine abroad, they should be offered one dose of PCV13 (at least 4 weeks after PCV10 was given). PCV15 or PCV20 given abroad over one year of age counts as a valid dose. ↩

  9. All children require a dose of MenB over the age of one year. However, children who received less than 2 doses of MenB in the first year of life should receive 2 doses of MenB in their second year of life (given 4 weeks apart). ↩ ↩2

  10. For children from first up to second birthday, see MMR section regarding timing of second dose ↩

  11. DTaP/IPV/Hib/HepB is the only suitable vaccine containing high dose tetanus, diphtheria and pertussis antigen for priming children of this age. Children born from 1 August 2017 who received primary vaccines without HepB should be opportunistically offered a 3-dose course of monovalent HepB vaccine. If they are in a high-risk group or are exposed to hepatitis B, they should be proactively offered a hepatitis B vaccine course.  ↩ ↩2 ↩3

  12. All children require a dose of Hib over the age of one year. If they received all 3 primary doses of hexavalent vaccine in their first year of life but no dose of hib-containing vaccine over one year of age, they should be offered the combined Hib/MenC vaccine now (or hexavalent if Hib/MenC vaccine not available). If the hexavalent vaccine is given, there should be a 12-month interval before the dTaP/IPV booster is administered. ↩

  13. MenACWY is routinely offered around 14 years of age. There is no requirement to give it earlier than this unless particular indication (for example, travel, post exposure). Individuals who have not received it at this age remain eligible for MenACWY until their 25th birthday. Doses of MenACWY vaccine already received from 10 years of age count as valid doses and do not need to be repeated. ↩

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