Changes to routine childhood and selective neonatal hepatitis B vaccinations (WHC/2025/019)

Status:

Action.

Category:

Public health.

Title:

Changes to the routine childhood vaccination schedule and to the selective hepatitis B vaccination programme from 01 July 2025.

Date of expiry / review:

Not applicable.

For action by:

• Chief executives, health boards/trusts.
• Immunisation leads, health boards/trusts.
• Immunisation coordinators, health boards.
• Vaccination operational leads, health boards/trusts.
• Medical directors, health boards/trusts.
• Directors of primary care, health boards/trusts.
• Nurse executive directors, health boards/trusts.
• Chief pharmacists, health boards/trusts.
• Directors of public health, health boards/trusts.
• Executive director of public health, Public Health Wales.
• Head Vaccine Preventable Disease Programme, Public Health Wales.
• Director of Vaccine Delivery, Vaccination Programme Wales, NHS Executive.
• Community paediatricians, health boards.
• Heads of midwifery, health boards / trusts.
• Midwifery teams, health boards.
• Secondary care paediatricians, health boards.
• Consultant virologists, health boards.
• Health protection teams, health boards.
• General Practitioner Committee, Wales.
• General practitioners.
• Digital Health and Care Wales.

Sender:

Dr Keith Reid, Deputy Chief Medical Officer (Public Health).

HSSG Welsh Government Contact(s):

Vaccination Division,
Welsh Government,
Cathays Park,
Cardiff.
CF10 3NQ. 
Email: wg.vaccinationsprogrammeteam@gov.wales

Dear Colleagues,

I am writing to inform you of planned changes to vaccine schedules, to optimise the protection of children in Wales.

The changes relate to the: 

• routine childhood vaccination schedule
• selective hepatitis B (HepB) programme

The changes will come into effect from 1 July 2025, with further changes from 1 January 2026.

The Joint Committee on Vaccination and Immunisation (JCVI) has considered and recommends several changes to the national childhood immunisation schedule, due to the discontinuation of the manufacture of Menitorix® (Hib/MenC) vaccine.

From 1 July 2025:

• the routine Hib/MenC (Menitorix®) offer to those turning 1 year old will cease.
• the second MenB (meningococcal group B bacteria), which is currently administered during the 16-week appointment, will move to the 12-week appointment.
• the first PCV13 (Pneumococcal conjugate vaccine) dose, currently administered in the 12-week appointment, will move to the 16-week appointment.
• the monovalent HepB dose offered at one year from the selective neonatal HepB programme schedule will be removed from the schedule.

From 1 January 2026:

• introduction of an additional (4th dose) of DTaP/IPV/Hib/HepB (hexavalent) vaccine at a new routine appointment at 18 months.
• movement of the second MMR (Measles Mumps Rubella) dose from 3 years 4 months to the new routine 18-month appointment.

We ask that you share this information with all parties involved in the planning, promotion and delivery of the vaccination programme in Wales. It is essential that you take appropriate action. The information and changes are complex and will require careful planning to ensure there are no gaps in vaccine protection.

New routine childhood vaccination schedule

Practitioners must follow the new routine childhood vaccination schedule from 1 July 2025 onwards. This schedule supersedes the previous vaccination schedule.

New selective neonatal Hep B schedule

Practitioners must follow the new selective neonatal Hepatitis B immunisation pathway from 1 July 2025 onwards. This schedule supersedes the previous immunisation pathway.

Changes from 1 July 2025

Change 1: cessation of Hib/MenC (Mentorix®)

Children born on or after 1 July 2024 will no longer be offered Hib/MenC (Mentorix®)

Rationale for this change

The manufacturer is ceasing production of Menitorix® vaccine. There is no other Hib/MenC vaccine available on the UK market.

JCVI has agreed that direct protection against MenC is no longer required in this age group due to the excellent population control provided by vaccination of adolescents. Sustaining coverage of MenACWY in adolescents is important to maintain indirect protection.

Additional information

Children who turn one year of age on or before 30 June 2025 (DOB on or before 30.06.2024) who present late for their one-year appointment i.e. on or after 1st July 2025, should be offered a fourth dose of Hexavalent alongside the other vaccines scheduled at one year of age (i.e. MenB, PCV13 and 1st dose MMR).

Change 2: children attending their second routine visit at 12 weeks

For children attending their second routine visit at 12 weeks of age:

• administer the second MenB dose at 12 weeks
• delay the first PCV13 dose until 16 weeks of age

Rationale for change

Following a recent clinical study and a review of the epidemiology, JCVI has recommended bringing forward the second dose of MenB vaccine to provide earlier protection against this serious and sometimes fatal infection.

To avoid increasing the number of injections at this second visit, the first dose of PCV13 will be moved to the 16-week visit. The short delay in PCV13 is unlikely to be significant due to excellent overall control of the serotypes covered by PCV13.

Additional information

Children who have already received their 12-week PCV13 vaccination prior to 1 July 2025, will remain on the current schedule and be invited for their second MenB at 16 weeks.

Children who have not yet received their 12-week vaccinations by 1 July 2025, will be offered the vaccines in line with the new schedule. This includes children who attend late for their 12-week vaccinations.

Change 3: selective vaccination and testing of infants for Hep B

For infants eligible for the selective neonatal HepB programme born on or after 1 July 2024:

• administer the 18 month hexavalent vaccine (in place of the 12 month monovalent dose)
• testing for HepB surface antigen (HBsAg) can be undertaken any time between one year and 18 months of age

Rationale for change

The addition of a dose of hexavalent vaccine at 18 months from 1 January 2026 replaces the need to receive a dose of monovalent HepB vaccine at one year. It is very important that babies on the selective neonatal HepB schedule receive this 18 month dose.

Additional information

Eligible children who turn one year old on or before 30 June 2025 (born on or before 30 June 2024) should continue to be offered a dose of monovalent HepB vaccine (alongside the other vaccines given at this age), on or after their first birthday.

Changes from 1 January 2026

Change 4: Additional dose of DTaP/IPV/Hib/HepB at 18 months

Children born on or after 1 July 2024 to be administered an additional (4^th) dose of DTaP/IPV/Hib/HepB (hexavalent) vaccine at a new routine 18 month appointment.

Rationale for change

To replace the Hib dose no longer given at the 1 year appointment. This will help provide longer term protection against Hib infection.

Additional information

From 1 January 2026, children turning one year of age on or after 1 July 2025 (born on or after 01 July 2024) will not have received the combined Hib-MenC vaccine Menitorix® when they attended for their one-year-old vaccination appointment (they should still have received the other vaccines due at that age).

Change 5: administering the second MMR dose at 18 months

For children born on or after 1 July 2024, move the second MMR dose forward from 3 years 4 months to the new routine 18 month appointment.

Rationale for change

The second MMR dose is being moved forward in the schedule to help improve uptake and provide earlier protection.

Additional information

Children turning 18 months on or after 1 January 2026 (born on or after 1 July 2024 will be offered their second MMR dose when they attend for the new 18-month appointment.

Children aged 18 months or older on 1 January 2026 (born on or before 30 June 2024) will remain on the current MMR second dose schedule at 3 years 4 months.

Children who missed out on either dose remain eligible for life.

Any children with an incomplete history for their age should be managed according to the UKHSA uncertain or incomplete immunisation algorithm, which is being updated to reflect these changes.

We have compiled a collection of helpful information and resources to support the implementation of these changes within your area of work.

Programme ambitions

Childhood immunisations form part of unified services under the GMS contract.

GPs and health boards are expected to:

• maximise vaccine uptake
• minimise vaccine waste
• retain their focus on reaching the most vulnerable
• understand and address inequity by ensuring equitable access for all eligible children

The following principles should be applied to the programme in line with the expectations set out in the National Immunisation Framework for Wales.

Vaccination Equity

GPs, health boards and those involved with childhood vaccination should make every effort to maximise uptake, with a particular focus on a patient centred service, ensuring vaccination equity, for example by seeking to ensure uptake rates are similarly high in the most deprived areas of the health board compared to the least; and that facilitation is considered for other ‘under-served’ groups to access vaccinations.

Digitally Enabled Vaccination

Digital Health and Care Wales (DHCW) has responsibility for developing digital solutions to support the childhood schedule programme changes. This includes implementing the agreed workplan to enable the required digital changes to the Child Health Information System (known as CYPrIS), ensuring the system supports accurate and timely issuing of appointments and recording of vaccines given.

Eligibility

Every child should benefit from the vaccination protection given by the robust child immunisation schedule that is applied across all the UK nations. Appropriate communications and engagement with parents and carers are necessary to ensure an understanding of the changes to ensure all children have fair access and fair opportunity to take up the offer of vaccination. This may mean health boards offering additional support to GPs in areas where vaccination uptake has been lower, to reduce inequity.

Deployment

Health boards should work closely with their GP practices to coordinate these plans. Planning support and assurance will be provided by Vaccination Programme Wales (VPW) with clinical guidance and support from Public Health Wales.

For any operational queries, please contact Vaccination Programme Wales by emailing VPW.Enquiries@wales.nhs.uk.

For clinical queries or queries about programme resources, please email phw.vaccines@wales.nhs.uk.

I am very conscious that planning for these changes will need to be undertaken by teams at pace, and alongside preparations for other routine respiratory vaccinations in 2025 and 2026.

Your hard work and commitment in making these programmes a success is very much appreciated.

Yours sincerely,

Dr Keith Reid 
Deputy Chief Medical Officer (Public Health)