UK Routine Immunisation Schedule – What’s New in 2025?

Date: July 2025

Author: FRCPathPrep Editorial Team

Category: Vaccines | Public Health | Exam Updates

💡 Why This Matters

The UK routine immunisation schedule evolves regularly based on JCVI recommendations, surveillance data, and emerging disease threats. If you're preparing for the FRCPath Medical Microbiology Part 2, staying up to date is essential — especially for SAQs, public health vivas, and clinical infection scenarios.

📌 Key Changes in the UK Immunisation Schedule (2024–2025)

🔄 1. MenACWY Replaces MenC at 12 Weeks

• Before: MenC was given at 12 weeks

• Now: MenACWY replaces MenC at this visit

• Rationale: W and Y strains now account for a higher proportion of invasive meningococcal disease (IMD) in infants

📚 FRCPath Tip: Be ready to explain the shift in circulating serogroups and *vaccine epidemiology-based policy changes

💉 2. Hexavalent Vaccine Timing Updated

• Hexavalent vaccine (DTaP/IPV/Hib/HepB) now explicitly labelled as:

  • 8 weeks

  • 12 weeks

  • 16 weeks

✅ No change in content — but timing clarified to emphasise 8-week start.

📚 FRCPath Tip: Hepatitis B is now part of universal infant schedule — don't forget!

🧫 3. Influenza Vaccine Eligibility Expanded

• Nasal flu vaccine (LAIV) now extended to:

  • All children aged 2–11 years

  • Previously, coverage was only up to age 10

• LAIV remains contraindicated in:

  • Severe immunosuppression

  • Egg anaphylaxis (depending on severity and vaccine brand)

📚 FRCPath Tip: Know the difference between LAIV (Fluenz) vs IIV (QIVe/QIVc) — and when to use each

🧪 4. MMR: Enhanced Catch-Up Efforts

• Due to falling uptake, there is enhanced school-based MMR catch-up at:

  • Age 5 (school entry)

  • Secondary school if unvaccinated

🧠 Why? Measles resurgence due to MMR coverage dipping below 90% in some regions.

📚 FRCPath Tip: Be familiar with post-exposure prophylaxis (PEP) for measles — includes MMR within 72 hrs or HNIG if immunosuppressed.

👵 5. Shingles Vaccine: Now Recombinant (Shingrix®)

• Shingrix (non-live recombinant) replaces Zostavax (live) in:

  • Adults aged 65–70

  • Also 50+ years in immunosuppressed individuals

• Two-dose schedule (0 and 2–6 months)

📚 FRCPath Tip: Live vaccines are contraindicated in immunosuppressed patients. Shingrix is preferred even if more expensive.

🌍 6. HPV Vaccine: One Dose Only (Under 25s)

• **JCVI now recommends a single dose of HPV vaccine for:

  • Individuals under 25

  • Non-immunocompromised

• Two-dose schedule still applies for:

  • Immunocompromised

  • Over 25 starting late

📚 FRCPath Tip: This aligns with WHO recommendation and cost-effectiveness modelling

🦠 7. Pneumococcal Vaccination Streamlined

• PCV13 remains for infants (12 weeks + booster)

• PPV23 continues for:

  • 65+ years

  • At-risk groups (asplenia, CKD, etc.)

✅ Future JCVI review may recommend PCV20 in adults — watch this space!

🧾 Where to Find the Latest Schedule

🔗 Green Book – Chapter 11: Immunisation schedule (gov.uk)

📘 Summary Table (2025 Key Changes)

Vaccine	Change	Applies To
MenACWY	Replaces MenC at 12 weeks	Infants
Hexavalent	Timing clarified (8, 12, 16 weeks)	Infants
Flu (LAIV)	Now for 2–11 yrs	Children
MMR	Catch-up at school entry	5–18 yrs
Shingles	Recombinant (Shingrix) replaces live	65–70 yrs & immunosuppressed
HPV	Single dose if <25 yrs	Adolescents
PCV/PPV	No change yet	Infants / 65+

🎯 FRCPath Part 2 Exam Tips

Be prepared to answer:

✅ What vaccine to offer after a needle-stick injury?

✅ Which vaccines are contraindicated post-transplant?

✅ What to do after measles exposure in unvaccinated healthcare staff?

✅ How vaccine policy is shaped by epidemiological surveillance

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