Selective varicella (chickenpox) catch-up vaccination programme from 1 November 2026 (WHC/2026/032)

Status: 

Action

Category:

Public health

Title:

Guidance on the NHS varicella (chickenpox) vaccination selective catch-up programme running November 2026 to March 2028.

Date of expiry:

31 March 2028

For action by:

• Chief executives, health boards or trusts
• Immunisation leads, health boards or trusts
• Immunisation coordinators, health boards
• Vaccination operational leads, health boards or trusts
• Medical directors, health boards or trusts
• Directors of primary care, health boards or trusts
• Nurse executive directors, health boards or trusts
• Chief pharmacists, health boards or trusts
• Directors of public health, health boards or trusts
• National Director Health Protection and Screening Services and Executive Medical Director 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 or 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:

Professor Isabel Oliver, Chief Medical Officer 

HSSG Welsh Government Contact

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

Dear Colleagues,

I am writing to provide you with operational guidance for the selective varicella vaccination catch-up referenced in WHC/2025/046 which will be implemented from November 2026 following a recommendation by the Joint Committee on Vaccination and Immunisation (JCVI).

The NHS in Wales has managed the implementation of the childhood programme changes over the past years with professionalism and diligence. 

The final part of this change process is the introduction of a time limited selective MMRV catch-up programme from 1 November 2026 for older children, without a history of chickenpox or two prior varicella vaccinations. 

This catch-up programme will help accelerate disease control and further reduce the transmission of chickenpox within the population.

We ask that you share this information with all parties involved in the planning, promotion and delivery of this activity in Wales. It is essential that you take appropriate action.

Varicella selective catch-up programme - starting on 1 November 2026

A one-dose MMRV selective catch-up programme will be offered to any children with dates of birth between 1 January 2020 to 31 August 2022 (those aged over 3 years 4 months to under 6 years old on 1 January 2026) who have not had a chickenpox infection or 2 doses of varicella vaccination. 

There is no requirement for practices to check the history of chickenpox infection, by undertaking serology testing in those who respond to the offer.

Children in this cohort presenting for vaccination, who may have missed routine vaccinations should also be brought up to date using the UKHSA uncertain or incomplete immunisation algorithm.

Programme ambitions

Whilst chickenpox is very common amongst the catch-up age group and a proportion will have acquired the infection naturally, there will remain children who would benefit from receiving varicella vaccination.

Practices will not be required to send appointments to all in the eligible age group.

Participating providers must notify parents and guardians of the eligibility for the programme, signpost them to information explaining who would benefit from vaccination, and facilitate inbound requests from those wishing to take up the offer. 

Notification of eligibility should be issued to parents and guardians by 31 March 2027 at the latest (for example, within 5 months of the start of the programme). 

Whilst the programme commences in November 2026, it is recognised that this is the time of year where practices will also be managing increased pressures associated with winter activity. 

The programme will cease on 31 March 2028. 

Equity should be embedded in the design and delivery of services to promote universal accessibility, alongside tailored interventions to understand and overcome the specific barriers faced by different population groups. 

Evidence demonstrates that barriers to access are the most common reason for not taking up the offer of vaccination. Inequalities persist for some communities and groups and that with appropriate interventions most will accept the offer of vaccination. 

Whilst this is not a call-recall programme, providers should ensure that the approach to notifying eligible families does not inadvertently widen existing inequalities. 

Additional consideration should be given to families who may be less likely to respond to standard communications alone, and supplementary approaches should be considered where appropriate. 

For operational queries, please contact Vaccination Programme Wales at: VPW.Enquiries@wales.nhs.uk. 

For clinical queries or questions relating to programme resources, please contact: phw.vaccines@wales.nhs.uk. 

Thank you very much for your support to this programme. I am conscious that planning for this activity comes at a time when the NHS is under significant pressure and your commitment to protecting health through effective vaccination programmes is greatly appreciated. 

Yours sincerely,

Professor Isabel Oliver
Chief Medical Officer

Date of birth

1 January 2020 to 31 August 2022

Age on 1 January 2026

3 years and 4 months to under 6 years old

New programme

Selective catch-up from 1 November 2026 to 31 March 2028 for those who have not yet had chickenpox infection or two doses of varicella vaccination. 

Please note: There is no requirement for practices to check the history of chickenpox infection, for those who respond to the offer, by undertaking serology testing.

Child’s full schedule for MMR or MMRV

• 12 months – MMR
• 3 years and 4 months – MMR
• MMRV catch-up offer

Please note: Any child with an incomplete immunisation history for their age should be managed according to the UKHSA uncertain or incomplete immunisation algorithm.

The Joint Committee on Vaccination and Immunisation (JCVI)

At its meeting in October 2023, the JCVI recommended that a universal 2-dose varicella (chickenpox) vaccination programme offering vaccination at 12 and 18 months of age using the combined MMRV (measles, mumps, rubella and varicella) vaccine be introduced into the routine childhood schedule and that this change should be aligned with the other childhood vaccination schedule changes in 2025 if possible.

Furthermore, at the February 2024 main JCVI meeting following additional cost-effectiveness analysis of a 1 dose varicella catch up programme, the JCVI advised a universal varicella catch-up programme for all children aged up to and including 5 years. 

The Committee also advised a targeted catch-up programme should be undertaken for children aged from 6 years and up to and including 10 years with no history of chickenpox infection (based on parental recall) or prior varicella vaccination. 

In March 2025, following the outcome of the MMRV tender process, it was determined that the original JCVI recommendations were not feasible due to limited vaccine availability within the planned window of implementation. 

The JCVI therefore advised a modified routine and catch-up (from 3 years 4 months up to 6 years) varicella programme based on the best use of available MMRV vaccine for public health at its June 2025 main committee meeting.

Funding and service arrangements

The selective catch-up, which begins on 1 November 2026, attracts an item of service fee at the current rate and also an administration processing fee to be claimed via a new Directed Supplementary Service, which has been agreed by the General Practitioners Committee Wales (GPC(W)) of the British Medical Association.

The Directed Supplementary Service directs local health boards to engage GMS contractors to undertake this service. The service specification sets out the service requirements. 

Digital support

GMS contractors or cluster lead practices should issue notifications of eligibility in the first instance via text message, signposting to the Public Health Wales landing page, or by arranging suitable alternative such as using the Public Health Wales template letter. 

All vaccination activity should be recorded in GP systems with notification to the local child health office in line with the usual processes.

Vaccine coverage data collection

Vaccine coverage data for the Varicella catch-up programme will be sourced from the National Community and Child Health Dataset (NCCHD) which is populated using the Children and Young Persons Integrated System (CYPrIS).  

Public Health Wales Vaccine Preventable Disease Programme (VPDP) will produce a monthly enhanced surveillance report to cover the period of programme and uptake for this cohort will not be reflected in the national COVER report surveillance.

Vaccine Supply

The vaccines for the catch-up programme will be available to order in the usual way online via the ImmForm website. 

Providers should ensure that local stocks of vaccine are rotated in fridges so that wastage is minimised. It is recommended that practices hold no more than two weeks’ worth of stock.

See Green Book chapter 3 for more information on storage, distribution and disposal of vaccines.

Remaining MMR vaccine held in fridges can be used for any person with an incomplete immunisation history for their age, in accordance with the UKHSA uncertain or incomplete immunisation algorithm, where they are not eligible for varicella vaccination. This product will continue to be available to order for this purpose.

Patient Group Directions (PGDs)

UKHSA have developed a PGD template for MMRV as a reference resource for health boards to develop and authorise for use locally.

Immunisation against Infectious Disease (the Green Book)

As this is a time limited targeted catch-up, the routine schedule published by Public Health Wales will not be updated to reflect this activity.

Detailed clinical guidance on varicella and MMRV vaccination is covered in the following chapters of the Green Book:

• Measles: Chapter 21
• Mumps: Chapter 23
• Rubella: Chapter 28
• Varicella: Chapter 34

Training and information resources for healthcare practitioners

Staff must be trained and competent to undertake activities within their scope of practice to support the vaccination programmes.

A training slide set outlining the MMRV selective catch-up campaign will be available to support local training. 

To promote awareness and provide additional information about the MMRV selective catch-up campaign, the Vaccine Preventable Disease Programme will be hosting a live Q&A webinar. 

The Q&A webinar will take place on Wednesday 7 October 2026 from 12:30 to 13:30.

The slides and the recording will be available to view on the Public Health Wales website after the event.

Reserve your place here: MMRV Selective Catch-Up Q&A Webinar

Vaccine information for healthcare professionals and a template letter can be found on Public Health Wales.

Patient facing resources 

Patient facing information resources will be made available on the Public Health Wales website.

Resources can be ordered for free at: Health Information Resources - Public Health Wales.

Consent

Guidance on informed consent can be found in chapter 2 of the Green Book. 

Reporting suspected adverse reactions

Healthcare professionals and those vaccinated are asked to report suspected adverse reactions through:

• the online Yellow Card scheme
• downloading the Yellow Card app
• calling the Yellow Card scheme on 0800 731 6789 from 9am to 5pm, Monday to Friday

Responding to vaccine incidents 

Guidance for those involved in supporting immunisation services to decide the appropriate response to vaccine incidents is available on GOV.UK. 

Programme change evaluation

Evaluation will be in the form of operational feedback from health boards to Vaccination Programme Wales and the monthly enhanced surveillance report produced by Public Health Wales.