MRCEM Notes

Immunisation

In addition to the requirements set out in the pharmacology section of the syllabus the RCEM advises that candidates need to know the usual UK immunisation schedules for the following vaccines:

  • Diphtheria, pertussis, tetanus
  • Haemophilus influenzae type b
  • Polio (inactivated)
  • MMR
  • Varicella

Additional immunisation schedules:
  • Hepatitis B
  • Tetanus
  • Influenza

The 2025 UK immunisation schedules are shown below:

Routine immunisation schedule
WhenDiseases protected againstVaccine givenTrade nameUsual site
8 weeks oldDiphtheria, tetanus, pertussis, polio, Hib, hepatitis BDTaP/IPV/Hib/HepBInfanrix hexa or VaxelisThigh
8 weeks oldMeningococcal group BMenBBexseroLeft thigh
8 weeks oldRotavirus gastroenteritisRotavirusRotarixBy mouth
12 weeks oldDiphtheria, tetanus, pertussis, polio, Hib, hepatitis BDTaP/IPV/Hib/HepBInfanrix hexa or VaxelisThigh
12 weeks oldPneumococcal (13 serotypes)PCVPrevenar 13Thigh
12 weeks oldRotavirusRotavirusRotarixBy mouth
16 weeks oldDiphtheria, tetanus, pertussis, polio, Hib, hepatitis BDTaP/IPV/Hib/HepBInfanrix hexa or VaxelisThigh
16 weeks oldMeningococcal group BMenBBexseroThigh
1 year oldHib and MenCHib/MenCMenitorixUpper arm or thigh
1 year oldPneumococcal (booster)PCV boosterPrevenar 13Upper arm or thigh
1 year oldMeasles, mumps, rubellaMMRMMRvaxPro or PriorixUpper arm or thigh
1 year oldMenB (booster)MenB boosterBexseroLeft thigh
Eligible paediatric age groupInfluenzaLAIVFluenz TetraBoth nostrils
3 years 4 monthsDiphtheria, tetanus, pertussis, poliodTaP/IPVREPEVAXUpper arm
3 years 4 monthsMeasles, mumps, rubellaMMRMMRvaxPro or PriorixUpper arm
12 to 13 years oldHPV types (cancer & genital warts)HPVGardasil 9Upper arm
14 years oldTetanus, diphtheria, polioTd/IPVREVAXISUpper arm
14 years oldMeningococcal A, C, W, YMenACWYMenQuadfiUpper arm
65 years oldPneumococcal (23 serotypes)PPV23Pneumovax 23Upper arm
65+ yearsInfluenza (annually from Sept)Inactivated influenza vaccineMultipleUpper arm
65+ from Sept 2023ShinglesShingles vaccineShingrixUpper arm
70–79 years oldShinglesShingles vaccineZostavax or ShingrixUpper arm
75 years oldRespiratory syncytial virus (RSV)RSV vaccineAbrysvoUpper arm

Selective immunisation programmes
Target groupAge and scheduleDiseaseVaccines required
Babies born to hepatitis B infected mothersAt birth, 4 weeks and 12 months oldHepatitis BHepatitis B (Engerix B/HBvaxPRO)
Infants in areas with TB incidence ≥ 40/100,000Around 28 days oldTuberculosisBCG
Infants with a parent or grandparent from high incidence countryAround 28 days oldTuberculosisBCG
Children in a clinical risk groupFrom 6 months to 17 yearsInfluenzaLAIV or inactivated flu vaccine
Pregnant women (flu season)Any stage during flu seasonInfluenzaInactivated flu vaccine
Pregnant womenFrom 16 weeks gestationPertussisTdap (ADACEL)
Pregnant womenFrom 28 weeks gestationRSVRSV vaccine (Abrysvo)

Additional vaccines for individuals with underlying medical conditions
Medical conditionDiseases protected againstVaccines required
Asplenia or splenic dysfunction (incl. sickle cell & coeliac disease)Meningococcal A, B, C, W, YMenACWY, MenB
Asplenia/PneumococcalPCV13 (up to 10 yrs), PPV23 (from 2 yrs)
Asplenia/InfluenzaAnnual flu vaccine
Cochlear implantsPneumococcalPCV13 (up to 10 yrs), PPV23 (from 2 yrs)
Chronic respiratory & heart conditionsPneumococcalPCV13 (up to 10 yrs), PPV23 (from 2 yrs)
Chronic respiratory/InfluenzaAnnual flu vaccine
Chronic neurological conditions (e.g. Parkinson’s, MND, LD)Pneumococcal (if aspiration risk)PCV13 (up to 10 yrs), PPV23 (from 2 yrs)
Neurological/InfluenzaAnnual flu vaccine
DiabetesPneumococcalPCV13 (up to 10 yrs), PPV23 (from 2 yrs)
Diabetes/InfluenzaAnnual flu vaccine
Chronic kidney disease (CKD)Pneumococcal (stage 4/5)PCV13 (up to 10 yrs), PPV23 (from 2 yrs)
CKD/Influenza (stage 3–5)Annual flu vaccine
CKD/Hepatitis B (stage 4/5)Hepatitis B
Chronic liver conditionsPneumococcalPCV13 (up to 10 yrs), PPV23 (from 2 yrs)
Liver/InfluenzaAnnual flu vaccine
Liver/Hepatitis AHepatitis A
Liver/Hepatitis BHepatitis B
HaemophiliaHepatitis AHepatitis A
Haemophilia/Hepatitis BHepatitis B
Immunosuppression (disease or treatment)PneumococcalPCV13 (up to 10 yrs), PPV23 (from 2 yrs)
Immunosuppression/ShinglesShrix (over 50 yrs)
Immunosuppression/InfluenzaAnnual flu vaccine
Complement disorders (incl. complement inhibitor therapy)Meningococcal A, B, C, W, YMenACWY, MenB
Complement/PneumococcalPCV13 (up to 10 yrs), PPV23 (from 2 yrs)
Complement/InfluenzaAnnual flu vaccine
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