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Correspondence to Dr Emily A Lees; [email protected]
SUMMARY
This article summarises the recommendations by the Joint Committee on Vaccination and Immunisation (JCVI) for a new UK childhood immunisation schedule following the discontinuation of the Hib/MenC vaccine by the manufacturer (currently used at 12 months of age as a booster for these antigens) and the rationale behind these changes to the schedule.
From late 2025, when the current stock of Hib/Men C vaccine runs out, Men C vaccination will no longer be offered to toddlers, as the adolescent Men ACWY vaccination programme is expected to effectively sustain herd immunity.
To improve herd immunity against polio and sustain Hib control by maintaining the current impact on Hib carriage in toddlers, an 18-month visit will be added to the vaccination schedule, where a booster dose of DTaP/IPV/Hib or DTaP/IPV/Hib/HepB will be offered.
The second MMR (measles, mumps, rubella) dose will be advanced from 40 to 18 months to improve uptake, with a recommendation that both MMR doses are offered with varicella immunisation (MMRV (measles, mumps, rubella and varicella)), as addition of varicella to the schedule has been demonstrated to be cost-effective in recent modelling reviewed by JCVI.
One of the recently licensed interventions for preventing respiratory syncytial virus (RSV) in infants (a maternal bivalent RSV prefusion F protein vaccine) will be incorporated into the new schedule, which should significantly reduce RSV burden in infants. In addition, higher-valency pneumococcal vaccines with wider serotype coverage may be introduced.
Introduction
The immunisation schedule is designed to optimise protection from serious infectious diseases by providing individual direct protection and, where appropriate, sustained population-level control through herd immunity. Recommendations for each vaccine take into account the age-specific risk for a disease/infection (often early childhood), risk of complications, vaccine efficacy and the vaccine’s potential to reduce transmission.1
Passive protection of neonates and young infants is provided through established maternal programmes for Bordetella pertussis, influenza and SARS-CoV-2. This is particularly important for pertussis given the high infant morbidity, with a case fatality ratio as high as 3% in the neonatal period.2 This is of current relevance, as the UK faces a resurgence of pertussis, after a period of exceptionally low activity due to the measures introduced to control the spread of...