Immunisation for children and young people

Short Text

Reducing differences in the uptake of immunisations (including targeted vaccines) among children and young people aged under 19 years


This pathway covers recommendations on how to increase immunisation uptake among children and young people aged under 19 in groups and settings where immunisation coverage is low.
It also focuses on improving uptake of the hepatitis B immunisation for babies and young children born to mothers who are chronically infected with the virus, or who have had acute hepatitis B infection during pregnancy.
The recommendations support implementation of the vaccination courses as recommended by the Joint Committee on Vaccination and Immunisation and indicated in the Green book. They also support timely vaccination according to the recommended scheduleFor details visit the DH website. .
The pathway is for commissioners, managers and professionals working in: the NHS, children's services, local authorities, education and the wider public, private, voluntary and community sectors. It is also for parents of, and those with parental responsibility for, young people aged under 19 and anyone else who is interested in the health and wellbeing of children and young people.

Source guidance

The NICE guidance that was used to create the pathway.
Reducing differences in the uptake of immunisations. NICE public health guidance 21 (2009)

Quality standards

Quality statements

Effective interventions library

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These resources include support for commissioners to plan for costs and savings of guidance implementation and meeting quality standards where they apply.
These resources will help to inform discussions with providers about the development of services and may include measurement and action planning tools.

Education and learning

NICE produces resources for individual practitioners, teams and those with a role in education to help improve and assess users' knowledge of relevant NICE guidance and its application in practice.

Pathway information

Updates to this pathway

27 January 2014 Minor maintenance update.
2 January 2014 Minor maintenance update.
11 June 2013 Minor maintenance update.
14 December 2012 Minor maintenance update.

Supporting information


Under the family nurse partnership programme, specially trained nurses visit some of the most vulnerable young mothers and their families at home, working with them from early pregnancy until the child is aged 2 years.
The term 'parent' is used throughout the recommendations to describe anyone with parental responsibility.
A person with parental responsibility may be a parent, step-parent or the parent's civil partner. In the case of looked-after children, this responsibility may have been acquired by another adult or the local authority under the Children Act.
Those with parental responsibility do not necessarily need to be present when a vaccination is given, provided they have received information about it and then arranged for another person (for example, a grandparent or childminder) to attend with the child. For further information see chapter 2 of the Green book.

Recommendations on immunisations

Recommendations on how to reduce differences in the uptake of immunisations among children and young people

Working with nurseries, schools and FE colleges

Working with nurseries, schools and further education colleges

Working with nurseries, schools and further education colleges

The Healthy Child team, led by a health visitor working with other practitioners, should check the immunisation record (including the personal child health record) of each child aged up to 5 years. They should carry out this check when the child joins a day nursery, nursery school, playgroup, Sure Start children's centre or when they start primary school. The check should be carried out in conjunction with childcare or education staff and the parents.
School nursing teams, working with GP practices and schools, should check the vaccination status of children and young people when they transfer to a new school or college. Working with the director of public health and local public health services, they should also advise young people and their parents about the vaccinations recommended at secondary school age.
If children and young people are not up-to-date with their vaccinations, school nursing teams, in conjunction with nurseries and schools, should explain to parents why immunisation is important. Information should be provided in an appropriate format (for example, as part of a question and answer session). School nursing teams should offer vaccinations to help them catch up, or refer them to other immunisation services.
Head teachers, school governors, managers of children's services and Sure Start children's centres and primary care immunisation coordinators should work with parents to encourage schools to become venues for vaccinating local children. This would form part of the extended school role.

Implementation tools

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Source guidance

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Training for those who advise on and provide immunisation services

Training for those who advise on and provide immunisation services

Who is the target population?

Those who advise on and provide immunisation services including:
  • GPs, health visitors, practice nurses, community nurses (including school nurses), midwives and nurses working in neonatal care, nurseries, child and adolescent mental health services, young offender institutions and secure units.
  • Immunisation coordinators in primary care and public health professionals.
  • Hospital and community paediatricians, nursing staff in hospital trusts and walk-in centres and pharmacists.
  • Health trainers.
  • NHS support staff, including clinic clerks and receptionists.
  • Managers of children's services and children's centres, social care workers (working with children) and those with parental responsibility for looked-after children.

Who should take action?

Professional bodies, skills councils and other organisations responsible for setting competencies and developing continuing professional development programmes for health professionals.
Health protection units.
Primary care employers and managers including GPs whose staff are involved in immunisation services.
Private and independent sector providers of immunisation services for children and young people aged under 19 years.

What action should be taken?

Ensure all staff involved in immunisation services are appropriately trained. Training should be regularly updated. It should be tailored to individual needs to ensure staff have the necessary skills and knowledge, for example, communications skills and the ability to answer questions about different vaccinations.
Ensure health professionals who deliver vaccinations have received training that complies with the National minimum standard for immunisation training.
Professional bodies should ensure health professionals working with children and young people have the appropriate knowledge and skills to give advice on the benefits and risks of immunisation. Specifically, they should be well-versed in the core topics defined in the Health Protection Agency's Core curriculum for immunisation training.
Ensure staff are appropriately trained to document vaccinations accurately in the correct records.

Source guidance

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Paths in this pathway

Pathway created: October 2011 Last updated: January 2014

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