Baby · Vaccines
Vaccine Catch-Up
UK Green Book vaccination schedule from 8 weeks. Catch-up safe at any age — doses already given still count. Premature babies vaccinated by chronological (not corrected) age.
Last reviewed 2 June 2026
Vaccine catch-up overview
What’s missing and what’s next?
Vaccines NOT up to date
Key catch-up principles
- Catch up — don’t restart. Doses already given count.
- Most vaccines need minimum intervals between doses; don’t give earlier than the minimum.
- Live vaccines (MMR, VZV, rota) generally separated from each other by ≥ 4 wk OR given together same day.
- Rotavirus: age cut-offs are STRICT (first dose by 15 wk, last by 8 mo) due to intussusception age window.
- BCG, MenB, MenACWY, HPV indications vary by country — check local schedule.
What does this mean?
Vaccination remains one of the highest-impact public-health interventions in history — preventing an estimated 4 million child deaths per year globally (WHO 2024). When a child falls behind, the universal rule is: catch up, don’t restart — doses already given count and the immune memory is durable. Minimum intervals between doses must be respected (early doses don’t boost as well), but maximum intervals are very forgiving for most vaccines. The two age-bound exceptions are rotavirus (first dose ≤ 14 weeks, last dose ≤ 8 months, due to intussusception risk window) and most country-specific school-entry requirements. The catch-up consultation is also a chance to: review allergies, screen for immunodeficiency, discuss vaccine hesitancy with empathy (not contempt), opportunistically capture overdue siblings, and update travel-related items (yellow fever, typhoid, hepatitis A). For exact intervals, use the country’s official catch-up tool linked above.
UK schedule (NHS Green Book)
- 8 wk: 6-in-1, Rotavirus, MenB.
- 12 wk: 6-in-1 (2nd), Rotavirus (2nd), PCV13.
- 16 wk: 6-in-1 (3rd), MenB (2nd).
- 1 yr: Hib/MenC, MMR (1st), PCV13 booster, MenB booster.
- 2-15 yr: annual flu nasal.
- 3 yr 4 mo: 4-in-1, MMR (2nd).
- 12-13 yr: HPV.
- 14 yr: 3-in-1, MenACWY.
Why catch up matters
- Protects your child.
- Protects community (herd immunity).
- School / nursery requirements.
- Travel requirements.
- Missed = increased disease risk.
Late vaccination
Safe at any age. UK Green Book catch-up schedules apply. Doses already given still count — never restarted from scratch.
Lost Red Book
- Ask GP for electronic records.
- NHS Digital paediatric immunisation records.
- Previous GP if moved.
- Person-led catch-up if unverifiable.
Vaccines from abroad
Count if documented. GP reviews + matches UK schedule. Catch-up fills gaps. Some countries use MMRV (adds varicella), different formulations.
BCG
Not routine UK since 2005 — targeted to high-risk groups (areas with high TB, family from high-prevalence country, family TB history). One dose lifetime.
Premature babies
Vaccinated by chronological (not corrected) age. 8 weeks chronological → first dose. Specialist advice if NICU follow-up.
Live vaccines + immunocompromised
- Avoid live in immunocompromised: MMR, Rotavirus, BCG, Varicella.
- Siblings of immunocompromised: mostly still vaccinated.
- Specialist team advice for individual cases.
Illness + vaccine timing
- Minor illness: vaccinate.
- Fever >38°C: defer.
- Reschedule 1-2 weeks.
- Missed dose: continue catch-up.
Safety
Very safe. Common: site soreness, mild fever 24-72h. Uncommon: febrile seizure after MMR 5-12d (benign). Rare: anaphylaxis 1 in 1M. Benefits far outweigh risks.
Different scenarios
Scenario 1: 8-month-old missed all vaccinations
Catch-up: 6-in-1 series at intervals; MMR at 12 months; rotavirus not used past 24 weeks.
Scenario 2: New baby from Ukraine with vaccine record
Compare to UK schedule; catch-up gaps. GP / immunisation lead.
Scenario 3: 2-year-old with measles outbreak nearby + no MMR
MMR catch-up urgent. Earlier doses possible from 6 months if outbreak risk.
Scenario 4: Preterm baby 32 wk, now 8 weeks chronological
Vaccinate by chronological age. Monitor for apnoea episodes.
Scenario 5: Sibling on chemotherapy
Family generally vaccinated for protection. Specialist advice for live vaccines.
Care guidance
- Keep Red Book updated.
- Catch up missed safely.
- Premature: chronological age.
- Defer if febrile.
- Monitor for reactions.
- Vaccinate siblings for community.
Sources
- UK Green Book (Immunisation against infectious disease).
- NHS. NHS vaccinations and when to have them.
- WHO. Vaccination position papers.
Frequently asked questions
What is the UK childhood vaccination schedule?
(NHS UK Green Book): (1) 8 WEEKS: 6-in-1 (DTaP/IPV/Hib/HepB), Rotavirus, MenB. (2) 12 WEEKS: 6-in-1 (2nd), Rotavirus (2nd), Pneumococcal (PCV13). (3) 16 WEEKS: 6-in-1 (3rd), MenB (2nd). (4) 1 YEAR: Hib/MenC, MMR (1st), PCV13 (booster), MenB (booster). (5) 2-15 YEARS: Annual flu nasal. (6) 3 YR 4 MO: 4-in-1 (DTaP/IPV), MMR (2nd). (7) 12-13 YR: HPV. (8) 14 YR: 3-in-1 (Td/IPV), MenACWY. SUBJECT to change — check NHS.
Why is catching up important?
(1) PROTECTS your child from serious diseases (measles, whooping cough, meningitis, polio, HepB); (2) PROTECTS COMMUNITY (herd immunity); (3) SCHOOL entry sometimes requires certain vaccinations; (4) TRAVEL requirements; (5) MISSED vaccines = increased disease risk. CATCH-UP schedules designed to safely + efficiently complete protection.
Can vaccines be given late?
YES — UK Green Book catch-up schedules allow late vaccination at any age. GP / nurse calculates appropriate catch-up schedule based on: (1) AGE at presentation; (2) VACCINES already received (Red Book records); (3) MISSED VACCINES; (4) MINIMUM intervals between doses. NEVER restarted from scratch — doses already given still count.
What if Red Book / records are lost?
(1) ASK GP / surgery if they have records electronically; (2) PAEDIATRIC immunisation records may be obtainable from PCT / NHS digital; (3) ASK previous GP if moved; (4) PERSON-LED CATCH-UP based on what you can remember + presumed schedule. SOMETIMES re-vaccination from scratch needed if records unverifiable + child young. UK rare to require restart in older children.
Moving from abroad — do their vaccines count?
YES — vaccines given anywhere (with documentation) count. GP / immunisation lead reviews records + compares to UK schedule. CATCH-UP fills any gaps with UK schedule equivalents. CONSIDER: some countries use different vaccines; some require revaccination if documentation incomplete. RED BOOK / vaccination passport important.
What about the new MMR-equivalent abroad?
MMR (UK) covers measles, mumps, rubella. Some countries: MMRV (adds varicella/chickenpox); MR (no mumps); single component vaccines. UK schedule: 2 MMR doses. CATCH-UP: ensure 2 MMR doses total; document earlier doses. PRIVATE varicella sometimes done at age 1-3 alongside if not covered by NHS.
BCG (TB vaccine) catch-up?
UK: BCG no longer routine for all infants since 2005 — targeted to high-risk groups. ELIGIBILITY: babies in areas with high TB rates; family from high-prevalence country; family history TB. CATCH-UP: yes, can be given any age if eligible. CHECK Red Book / GP referral. ONE dose lifetime protection.
Premature babies — same schedule?
YES — preterm babies vaccinated by CHRONOLOGICAL age (NOT corrected). 8 weeks chronological → first dose. Reasoning: their immune system responds; benefit of protection outweighs minimal extra reactivity. POSSIBLE: apnoea episodes after first dose in very preterm; monitored. Specialist immunisation advice if NICU follow-up.
Live vaccines + immunocompromised?
LIVE vaccines AVOIDED in immunocompromised: MMR, Rotavirus, BCG, Varicella, MenB (live yellow fever, oral polio). REASONS: virus can replicate; may cause disease. ALTERNATIVES: passive immunoglobulin for high-risk exposure (e.g. measles-Ig). PROFESSIONAL advice from immunology / paediatric infectious diseases. SIBLINGS of immunocompromised: usually still vaccinated except with oral polio.
Family with sibling immunocompromised — vaccinate?
Mostly YES — vaccinating siblings PROTECTS the immunocompromised child. EXCEPTION: oral polio (not used UK; IPV used — safe). Live vaccines (MMR, rotavirus, varicella): safe for siblings; theoretical small shed risk — precautions (handwashing after nappies for rotavirus 2-4 weeks). MMR: shed virus negligible. CONSULT specialist team for individual advice.
What if my child misses a dose due to illness?
(1) MINOR illness (cold, mild diarrhoea, low-grade temperature): GO AHEAD with vaccination usually. (2) MODERATE-SEVERE illness or fever >38°C: usually deferred until well. (3) RESCHEDULE within 1-2 weeks. (4) MISSED dose doesn’t need restart — just continue catch-up. UK Green Book sets out specifics.
Are vaccines safe? Side effects?
Generally very safe. COMMON: site soreness, redness, mild swelling, mild fever, irritability, fatigue (24-72h). UNCOMMON: febrile seizure (after MMR 5-12d post-vaccination; benign). RARE: anaphylaxis (1 in 1,000,000); managed with adrenaline at clinic. BENEFITS far outweigh risks. /calculators/vaccine-reaction.
Can I refuse + still send my child to school?
UK: vaccination not mandatory for state schools (currently). PRIVATE schools may have own policies. NURSERY / chickenpox outbreaks may exclude unvaccinated. MEASLES outbreaks: unvaccinated may be excluded. RECOMMENDED to vaccinate for community + child protection. INFORMED CHOICE supported but rare for vaccinations to be skipped without good reason.
How does this relate to other calculators on BumpBites?
Companion: /calculators/vaccine-reaction; /calculators/baby-fever; /calculators/baby-age; /calculators/baby-percentile; /calculators/asq-3.