Changes depending on availability (and cost) of new vaccines, changes in epidemiology. And levels of public acceptance! Recommendations made by JCVI (Joint committee on vaccines and immunization). Most recent change is introduction of MenB (Bexsero).
- At, 2, 3 and 4 months, a 5 in 1 vaccine containing diphtheria/tetanus/pertussis with polio and Hib is given (Pediacel).
- Prevnar (pneumococcal conjugate, PCV-13) is given at 2 and 4 months with a booster at 12-13 months
- MenC now given at 3 months only (other 2 doses dropped), in between Prevnar, with a booster at MMR time.
- Oral rotavirus vaccine is now given at 2 and 3 months.
- Bexsero (MenB) vaccine is given at 2 and 4 months, with booster at 12-13 months.
At 12-13 months, MMR – along with boosters of Hib/MenC (Menitorix), Prevnar and MenB
Annual nasal influenza vaccines are being phased in over next few years, currently all primary school and ages 2-4yrs. Will eventually be all up to 16.
At 3yrs 4 months- 5yrs, preschool booster – DTP/Polio (Repevax, no Hib) and MMR again.
At 13yrs, BCG has been dropped as a universal vaccine. There is now a booster of MenC, along with Tetanus, diphtheria (low dose) and polio (no pertussis, Revaxis).
Girls between 12 and 14yrs get 2 doses of HPV vaccine, at least 6/12 apart.
Over 65s get scheduled PPV (pneumococcal polysaccharide, once) and annual influenza.
Over 70s get a single Shingles vaccine.
The acellular pertussis vaccine (3 or 5 antigens cf 3000 in whole cell) is associated with less reactions (but less effective and immunity shorter lasting); IPV (injectable) polio vaccine has same efficacy as OPV (oral, live, Sabin, herd immunity), plus no vaccine associated disease.
These newer vaccines have fewer reactions, and do not contain thiomersal. Not that there’s any evidence against mercury, but plan to eliminate it has been in place for several years.
There was also an issue with loss of Hib efficacy when using 3 in 1 DTP for primary immunizations, which is not seen with Pediacel.
No individual boosters for tetanus are available. Choice is between Infanrix (DTaP), Repevax or Revaxis.
Instead of BCG for all adolescents, risk factor approach introduced: BCG will be offered to all infants in health boards with incidence over 40/10 000 (none in Scotland), and to those with parent or grandparent from high incidence area.