The proposed upcoming changes to the General Practitioner (GP) contract for 2025/26 (Annex E) will bring significant adjustments to the routine childhood immunisation schedule. These changes aim to streamline delivery, improve protection against vaccine-preventable diseases, and align the UK more closely with global best practices.
Below, we explore what’s changing, why these updates are being made, and how they’ll be implemented in practice.
1. Advancement of the Second MMR Dose
What’s Changing?
- Currently, the second dose of the Measles, Mumps, and Rubella (MMR) vaccine is given at 3 years 4 months. However, from the 1st January 2026, it has been recommended that this is brought forward to 18 months.
Why the Change?
- Improved measles protection: The UK has seen a resurgence in measles cases due to suboptimal coverage. Providing the second MMR dose earlier offers better protection during a critical window of susceptibility.
- Alignment with Hib and Varicella: Moving the MMR dose to 18 months allows for co-administration with the new 4th Hexavalent (6 in 1) dose and potentially the new MMRV (which includes varicella) – simplifying the schedule (more on both of these shortly).
- Global consistency: Many countries such as the US and Australia administer the second MMR dose between 15–18 months, aligning with global immunisation strategies.
- Higher uptake: Parents are more likely to attend routine appointments during the second year of life. Offering the dose at 18 months reduces the chance of children missing out later.
How Will the Change Work in Practice?
- From 1st January 2026: Children turning 18 months will be offered their second MMR dose at their new 18-month appointment.
- Children aged 18 months to 2 years 6 months on 1st January 2026 will be invited for an earlier appointment for their second MMR between January and October 2026.
- Children aged 2 years 7 months to 3 years 4 months on 1st January 2026 will receive their second MMR dose at the existing 3 years 4 months appointment before October 2026.
2. Discontinuation of the Hib/MenC Vaccine at 12 Months
What’s Changing?
- From 1st July 2025, the Hib/MenC vaccine (Menitorix®) given at 12 months will be removed from the schedule. Instead, a 4th dose of the Hexavalent (6-in-1) vaccine will be offered at a new 18-month appointment from 1st January 2026.
Why the Change?
- Improving immunity: Studies show that moving the Hib dose to 18 months leads to better long-term immunity by ensuring stronger immune system responses at an older age. Modelling has also shown that delaying the Hib dose by six months will not result in an increase in Hib cases.
- No alternative monovalent Hib vaccine: With Menitorix® discontinued, the only available alternative is the Hexavalent vaccine, which also provides a timely 4th dose of Hepatitis B – aligning with common international Hep B schedules (0, 1, 2, 12 months).
- Simplification: Consolidating doses at the 18-month visit – in combination with MMR or MMRV – reduces the number of injections at different appointments.
How Will the Change Work in Practice?
- Children who turn 12 months on or before 30th June 2025 will remain eligible for Menitorix® while supplies last. If unavailable, a Hexavalent (6 in 1) vaccine will be offered instead.
- Children turning 12 months on or after 1st July 2025 will no longer receive the Hib/MenC dose at that time, but will instead receive the Hexavalent (6 in 1) vaccine at 18 months, starting 1st January 2026.
3. Possible Introduction of the Varicella Vaccine
What Changes Are Being Proposed?
- Subject to a final policy decision, a routine Varicella (chickenpox) vaccination programme is under consideration to launch from the 1st January 2026.
Why the Change?
- Reducing chickenpox burden: Chickenpox is highly contagious and can cause severe complications, especially in immunocompromised children and pregnant women.
- Herd immunity loss post-lockdown: COVID-19 restrictions reduced population exposure to varicella, particularly in older children who missed natural infection. With immunity gaps widening, this cohort is now more vulnerable – and chickenpox tends to be more severe with age.
- Following global best practice: Many countries, including the US, Canada, and Germany, have successfully integrated varicella vaccination, leading to sharp declines in hospitalisations and severe cases.
- Cost-effectiveness: The introduction of a routine varicella vaccine reduces the economic burden of missed workdays, GP visits, and hospital admissions caused by chickenpox outbreaks.
How Will the Change Work in Practice?
- From 1st January 2026, children turning 12 months will receive two doses of MMRV (Measles, Mumps, Rubella, Varicella) at 12 and 18 months.
- Children turning 18 months on or after that date will receive a single MMRV to complete the new schedule.
- Children aged 18 months to 3 years 4 months on 1st January 2026 will be invited for one MMRV dose instead of their second MMR, with catch-up completed by 31st October 2026.
- Children aged 3 years 4 months to under 6 years will be offered a single universal MMRV catch-up dose by 31st March 2027.
- Children aged 6 to under 11 years with no chickenpox history will be invited for a single MMRV dose, also to be completed by 31st March 2027.
- From 1st April 2027, opportunistic or on-request single-dose offers will be available for unvaccinated children aged 3 years 4 months to under 11 years with no chickenpox history.
How Can We Prepare For These Changes?
To ensure a smooth and effective transition to the updated childhood immunisation schedule and the introduction of the MMRV vaccine, we need to take proactive steps across several areas:
1. Stay Informed and Up to Date
Keeping abreast of the latest guidance is crucial. Subscribe to UK Health Security Agency (UKHSA) blogs and news posts, the Vaccine Update newsletters, and NHS England bulletins. These sources provide timely information on changes in vaccine policy, training resources, clinical updates, and key implementation timelines.
2. Train and Equip Healthcare Teams
Frontline healthcare professionals should receive thorough training on the revised schedule, including the introduction of the combined MMRV (Measles, Mumps, Rubella, and Varicella) vaccine. This includes understanding dosing intervals, eligibility criteria, contraindications, and how to handle patient questions. Providing accessible training materials, e-learning modules, and Q&A sessions can help build confidence and consistency across practices.
3. Engage and Communicate with Parents and Guardians
Clear, empathetic communication with families is vital to maintain public trust and encourage vaccine uptake. Develop communication plans that explain the benefits of the changes, address common concerns (such as safety and side effects), and offer reassurance. Outreach should include reminder systems for appointments, informative leaflets, digital content, and direct conversations during clinical visits.
4. Coordinate with Local NHS and Public Health Teams
Effective implementation depends on strong local coordination. Practices should work closely with NHS supply teams and public health leads to ensure adequate vaccine stock levels, manage distribution logistics, and respond quickly to any emerging challenges. Establishing local working groups or forums can support collaboration and troubleshooting during the rollout.
5. Monitor Progress and Feedback
Collect data on vaccine uptake and feedback from both staff and patients. This helps identify early issues, gauge public response, and refine communication and delivery strategies as needed. Sharing insights across networks can also drive improvements and innovation.
Final Thoughts
These upcoming UK immunisation schedule changes represent a significant step in improving vaccine coverage and child health outcomes. By understanding the updates and preparing ahead, healthcare teams can be prepared and be able to support families through a smooth transition.
Stay Up To Date
Stay informed and up to date with the latest developments by enrolling in one of our comprehensive Immunisation courses. You can choose the format that suits your schedule best – join us live online via Zoom for an interactive experience, or complete the course at your own pace through our flexible E-learning platform. Whether you’re refreshing your knowledge or new to the field, our expert-led updates ensure you’re equipped with the most current information and best practices in the field.
