Immunisations: introduction

Immunisation is one of the most important tools for protecting individuals and the community from serious infectious diseases. Before the development of safe and effective vaccines, a quarter of a million children were affected by measles every other year and epidemics of poliomyelitis affected many thousands in the UK.

Vaccination is used to refer to all procedures for immunisation. The aim of a vaccination programme is to reduce the incidence of, or to eliminate, a particular disease by protecting individuals against the disease. This is brought about by creating immunological memory following the delivery of the immunising agent, the vaccine. Vaccines can be live (attenuated) or inactivated (killed), both types having advantages and disadvantages. Immunisation can have both a direct and, for some vaccines, an indirect effect. The direct effect is the protection given to the individual receiving the immunising agent. The indirect effect is the reduction of the incidence of the disease in others, the so called 'herd immunity', or population protection.

Vaccination programmes can be designed to:

  • eradicate, eliminate or contain disease - mass immunisation strategy e.g. childhood immunisations, or
  • protect those at highest risk - selective immunisation strategy e.g. vaccination against hepatitis B.

The population of Scotland, and in particular children, are now protected through immunisation against a large number of infectious diseases, see Immunisation Scotland for details. It provides a comprehensive online guide to immunisation and vaccines including why immunisation is important, when to immunise, what vaccines are available and how they protect against serious diseases such as measles, meningitis, whooping cough and polio. There are also many helpful publications for individuals about specific vaccines and vaccination.

The Public Health England publication Immunisation against Infectious Diseases (the 'Green Book') details the history of immunisation and immunisation advice over the years since this kind of preventative treatment was first used in 1786 in the UK and has the latest information on vaccines and vaccination procedures, for vaccine preventable infectious diseases in the UK.

The Scottish Vaccine Update by Health Protection Scotland is the national bulletin on immunisation in Scotland. It aims to provide front line health professionals in Scotland with information and practical advice. It covers: Scottish Government policy (e.g. CMO letters), changes to immunisation programmes, information of Scottish immunisation practice, updates to 'Green Book', vaccine uptake and supply information.

NHS Education Scotland also provides information for health professionals relating to immunisation  and vaccination. See also Health Protection Scotland which is responsible for co-ordinating the Scottish Immunisation Programme, through the Scottish Health Protection Network.

Childhood immunisation programme

The routine childhood immunisation programme consists of the following vaccines, which help protect against the following diseases, see Immunisation Scotland  for full details and schedule:

  • DTaP/IPV (Infant combination vaccine, four-in-one vaccine)
    • diphtheria
    • tetanus
    • pertussis (whooping cough)
    • polio
  • DTaP/IPV/Hib (Infant combination vaccine, five-in-one vaccine)
    • as above but also including Haemophilus influenzae type b (Hib)
  • DTaP/IPV/Hib/HepB (Infant combination, vaccine six-in-one vaccine; replacing the five-in-one from October 2017)
    • as above but also including hepatitis B
  • Flu vaccine
    • influenza
  • Hib/MenC
    • Haemophilus influenzae type b
    • meningococcal C bacteria
  • HPV (girls only)
    • human papilloma virus
  • MenACWY (teenager boost)
    • meningococcal A, C, W and Y bacteria
  • MenB
    • certain meningococcal B bacteria
  • MMR
    • measles
    • mumps
    • rubella (German measles)
  • Pneumococcal conjugate vaccine (PCV)
    • some pneumococcal bacteria
  • Rotavirus
    • rotavirus
  • Td/IPV (teenager boost)
    • diphtheria
    • tetanus
    • polio

Routine immunisations for older adults

Routine immunisations for older adults in Scotland consists of the following vaccines, which help protect against the following diseases, see Immunisation Scotland for full details:

  • Flu vaccine
    • influenza
    • everyone aged 65 years and over
  • Pneumococcal polysaccharide vaccine (PPV)
    • some pneumococcal bacteria
    • those aged 65 and over
  • Shingles vaccine
    • varicella zoster (shingles)
    • offered to individuals when they reach 70 years of age, with a phased catch-up for those aged up to 80 years

Non-routine immunisations available for all ages

A range of other vaccines are available for specific risk groups in Scotland. The groups covered are periodically revised but include those listed below, however, for full and latest information see the Immunisation Scotland website:

  • BCG vaccination
    • tuberculosis (TB)
    • targeted to particular groups at risk:
      • due to their occupation, e.g. health care workers, veterinary staff, staff of prisons
      • contacts of known cases
      • those intending to live or work in high prevalence countries for extended periods
      • babies who are more likely than the general population to come into contact with someone with TB
  • Flu vaccine
    • influenza
    • recommended for:
      • pregnant women
      • those working in health care
      • adults with serious heart, chest, kidney and certain other long-term health problems
      • children with certain underlying medical conditions from 6 months of age (routine childhood vaccination is from 2 years of age)
    Hepatitis B vaccine
    • hepatitis B
    • offered to:
      • all babies whose mothers have been infected with hepatitis B
      • babies and other household contacts of those infected with hepatitis B in certain circumstances
      • prisoners
  • Hepatitis A/B vaccine
    • hepatitis A and B
    • offered to men who have sex with men (although often offered, the recommendation is just for hepatitis B)
  •  HPV
    • human papilloma virus
    • offered to:
      • men who have sex with men, aged up to and including 45 years
      • some other groups listed in the Green Book
  • Pneumococcal polysaccharide vaccine (PPV)
    • some pneumococcal bacteria
    • recommended for everyone with serious heart, chest, kidney and certain other long-term health problem
  • Travel vaccines
  • Whooping cough
    • pertussis
    • offered to pregnant women

For further details on the national childhood immunisation schedule and vaccines and other routine and non-routine immunisations and vaccines see the Immunisation Scotland website and immunisation schedule  and also the Health Scotland Immunisation site and Health Protection Scotland. For other vaccines recommended for certain at risk groups see also the Public Health England publication Immunisation against Infectious Diseases (the 'Green Book').