Immunisation
Deciding whether to give a child the 6-in-1 and other vaccines
In the United Kingdom, it is recommended that babies have the following immunisations to protect them against several infectious diseases, including:
- diphtheria, tetanus, pertussis (whooping cough), polio, Haemophilus influenza type b (Hib), hepatitis B (DTaP/IPV/Hib/HepB or the 6-in-1 vaccine*)
- Meningococcal group B (MenB)
- rotavirus gastroenteritis (rotavirus)
- pneumococcal (PCV)
- Hib and meningococcal group C (Hib/MenC)
- measles, mumps and rubella (MMR)
More information about when these immunisations are recommended to be given may be found at GOV.UK and in our ‘What is immunisation?’ section (see also ‘Resources and Information’ and ‘Why do we immunise?’).
Making the decision about immunisation for their child
A majority of parents believe in immunisation for their children. However, also included here are the views of parents who did not believe immunisation was right for their child based on their own personal beliefs. Their views represent a proportion of the population.
The vast majority of parents we interviewed decided to have their child immunised. Many said it had not been a difficult decision to make: that they acted on the recommendations of their GP, their midwife, their health visitor and the practice nurse, and they saw no reason to be concerned with these first immunisations.
She believes the 5 in 1 vaccine is safe.
She believes the 5 in 1 vaccine is safe.
I don't know where I read but I read that actually, I can't remember, I think it was in one of the newspaper articles they were saying that the, the body can handle far more than that, what has been given. You know it's not too much for them and I think they would have looked in to it quite strongly before they actually you know, they must have tested it well, so I'm not too worried about it actually. I've read that they can handle you know many, many more antigens, many more stimulations than what they're actually going to be getting so I'm not concerned about that.
Did not see any reason not to immunise her baby with the first set of immunisations.
Did not see any reason not to immunise her baby with the first set of immunisations.
So I initially thought immunisation was compulsory. It then became clear that it was a decision we had to make. I discussed it with a number of friends. All of my friends have had their children immunised, except for a couple with whom I discussed. But it didn't seem to me that there was any compelling reasons not to immunise. And it was made clear that the medical profession believes that it is very important, and that the risks attached to these first batch of vaccination are not so important that as to make one want to hesitate. Therefore we just went ahead and had the first batch of vaccines when she was two months.
The majority of parents we spoke with believed that the consequences of not having their child immunised could be serious and they wanted peace of mind to know they had protected their child as best they could against these diseases.
The consequences of the disease are far worse than the immunisations.
The consequences of the disease are far worse than the immunisations.
Because I think as I said before, because of the consequences of him getting any of the things that he's been vaccinated against are far worse than the mild reactions that he may have to the, to the DTP jabs. You know it's a pain for a couple of days but if he contracts whooping cough or diphtheria or, or meningitis then you know it's him you know potentially life-threatening. And they're not very common and would they be diagnosed correctly and, and all those sorts of things. So for me there wasn't, there wasn't ever he wouldn't have them.
Some parents who had concerns about inflicting short-term pain on their child and not being able to explain to them why it was happening, nevertheless concluded that immunisation was the best course for their baby.
Some were worried about how their child might react to the injection, but most found that discussing their anxieties with their health visitor or practice nurse helped them to overcome their worries.
Every parent should have access to a trained health professional to talk about their concerns about vaccination. Parents can talk with health professionals about the risks of catching the diseases being immunised against and about the benefits and potential risks of immunisation for their own child, and for the population in general.
In addition to their GP, health visitor or practice nurse, there is also an immunisation advisor in each local health protection unit, whom parents can talk to about their child's immunisations (see Public Health England's website for details about local contacts).
She was anxious that her daughter might be upset having the injection but felt it was important for it to be done.
She was anxious that her daughter might be upset having the injection but felt it was important for it to be done.
I knew what I was doing was absolutely right and I had no anxiety, I didn't have any anxiety towards whether I was doing, what I was doing was right or wrong. It was the actual harm that I was, not, the actual harm that my baby thought that I was sort of causing them. And I know at 8 weeks old they probably have absolutely no concept of that whatsoever, they just know that something's been stuck into their leg and it hurts. And then they sort of look to you to think, you know, 'Why have you let that happen?' And I think it was all that kind of sort of psychological, you know, 'I'm here to protect you and bond with you and I'm your mother and there's no...' you know, that kind of mother-child bond. And I think I was just most anxious about the fact that I was harming my child, they didn't understand why it was happening. But then I suppose, you know, it's something that they, I mean, you know, if I spoke to my daughter now she probably wouldn't have any recollection of it whatsoever, so it's probably just something that you just take on as a new mother because you've never experienced it before, you don't know how you should feel but I just think, that I mean, that's the anxiety of that, that was basically how I felt. It wasn't the actual injection, what I was injecting in to her, that didn't bother me at all because I knew what I was doing was right and it needed to be done and I'd been advised and you know, etc, etc. So that was the main reason behind it.
Views of giving their child the the 6-in-1 and other vaccines
One mother, who had her first daughter immunised in Germany, had concerns when deciding about immunisations in the UK for her second baby. She worried that the programme didn't take in to account a child's individual needs.
Minor illnesses, such as a cold without a fever, are not a reason to delay immunisation. If a baby has a fever, it is best to put off the immunisation until they have fully recovered. If parents are worried, they should discuss their concerns with the person giving the immunisation.
She believed that the immunisation schedule didn't take in to account children's individual needs.
She believed that the immunisation schedule didn't take in to account children's individual needs.
With this little one here I found, here in Britain I found it a lot more difficult with the whole immunisation because it, I don't, I didn't feel that they were actually looking at the individual child. One of my, I had a lot of friends who, whose babies got immunized, well, I found very, very young, and also when I thought they weren't completely healthy. So they had a bit of fever or a bit of snotty nose or whatever, which my GP in Germany wouldn't have immunised at. And here the nurse said, 'Oh, that's not a problem at all' and, you know, didn't even ask whether she had a fever or didn't check her at all. And, and I, I think that that is my concern. I think immunisation is such, is obviously very good and very important and has, you know, made a huge impact on, on the health of, of the population and, and children's lives. But it just seems that it's not looked, being looked at the individual child. So really they often, the nurse, the nurses or the, I, well, here it's nurses, just kind of do it very routinely and don't check whether that child is completely healthy. And that is something that I find quite concerning.
Based on their own personal beliefs, a small number of parents we spoke with said they did not believe immunisation was right for their own child and chose not to give their child these first immunisations. They stressed that it hadn't been an easy decision to make, nor one they had taken lightly. They said they continually reassessed their decision when any changes were introduced and that they may immunise when their children were older.
A few of these parents personally believed that building up their child's immune system through diet and homeopathy would make them less vulnerable to infectious diseases or would ‘make up for’ them not being immunised. There is no evidence that this practise in any way substitutes for the protection given by immunisations.
Protection against measles, mumps and the other vaccine-preventable diseases comes from antibodies (immunity) which is specific for each disease. This specific protection can be produced only if the immune system is stimulated by the vaccine or the natural infection.
General measures to strengthen the immune system do not give the protection against the disease and its complications.
A small number of these parents were concerned about the ability of their child's immune system to cope with a number of vaccines given at each stage. A few were worried that not enough was known about the long-term side effects of immunisations, or that vaccine production was driven by financial motives.
A couple of parents held a personal belief that while immunisations were good for the majority of children, some children might be adversely affected by immunisations and their child might be one of those children.
A child who has a nervous system (neurological) disease, including epilepsy, should have their condition assessed. If the condition is stable, the vaccine can be given. If the condition is not stable, immunisation should be delayed until further assessment shows the condition to be stable.
Thiomersal, a non-toxic form of mercury, (ethyl rather than methyl mercury) is not included at any stage of the production of the 6-in-1 (DTaP/IPV/Hib/HepB) vaccine. There is no evidence that thiomersal has ever done harm to the millions of babies who had received a vaccine containing it in the past, although for the occasional parent, it was an additional reason for deciding not to immunise their child.
She personally believes that injecting several vaccines in to a young baby cannot be beneficial.
She personally believes that injecting several vaccines in to a young baby cannot be beneficial.
I suppose basically my gut instinct is that to me whatever evidence they come up with I think I will always find it impossible to accept that you can inject an eight-week old baby with a cocktail of diseases and vaccines against those diseases and not damage them. Because naturally the chances of anyone contracting all those diseases at the same time are, I would say, nil and the response that a body has towards a vaccine is different to the response it has towards the disease if it's contracted naturally.
BCG Vaccine for tuberculosis (TB)
The BCG vaccine for TB is not routinely given to children as part of the UK NHS vaccination schedule. It's only recommended if the following apply:
- they live in an area of the UK where there is a higher risk of getting TB
- they have a parent or grandparent born in a country where there is a higher risk of getting TB
- they'll be going to live or stay in a country where there is a higher risk of getting TB
- they have been living with, or in regular close contact with, someone who has or had TB
A midwife, health visitor, local health centre or hospital will usually let parents know if the BCG vaccine is recommended for their baby. It will usually be given at around 28 days old. A few of the parents we interviewed were oftered this vaccination and several decided to have their child immunised against TB because they believed that their child might be at risk of contracting this disease.
She gave her daughter BCG because she may be exposed to the tuberculosis through visiting, and having visitors from Ecuador.
She gave her daughter BCG because she may be exposed to the tuberculosis through visiting, and having visitors from Ecuador.
I even have given her the TB vaccine. And that is because I come from Ecuador, where there is a high incidence of this. We will be visiting shortly my parents. Also we would be receiving sometimes visitors from Ecuador. So she might be more exposed than other children to TB. I knew the TB vaccine, the BCG, can have, can give some nasty side-effects. And actually the vaccine itself is not very nice. It takes ages to heal up. It actually took about two months from the moment they applied the vaccine and for it to start giving any signs that it was doing something. So it just flared up about two months after and then it took perhaps two months to heal up. It was a very nasty, suppurating spot there, that came and, you know, it kept coming and going. But eventually it was, it’s all completely healed. It will leave of course a permanent mark, but that’s a very small price to pay I believe compared to the advantages of, you know, at least having some protection towards such a horrible disease. I definitely agree with trying to protect a child against these major problems.
One mother declined the BCG because she felt her child was not at a sufficient level of risk.
Deciding to continue with the immunisation programme after their child had a reaction
A small number of parents whose child had experienced a reaction following one of the first immunisations felt anxious about what decision to make about completing the course.
Talking to a specialist, referred through their GP, had given these parents the information and reassurance they needed and they decided to continue with the immunisation schedule.
Advice from the consultant helped her to decide to give her daughter further immunisations after she had a reaction to the first set.
Advice from the consultant helped her to decide to give her daughter further immunisations after she had a reaction to the first set.
We did hesitate for the second batch of vaccinations. But because of the reaction that she had, she was seen by specialist, who reassured us and said that the reaction she's had was a strong, but not an abnormal reaction to the vaccines, and that he didn't foresee that there would be any problem, with having her second and third batch of vaccinations. Therefore we decided to continue. And we had the second and the third batch and they were absolutely no problem.
Well I was afraid that the episode, after the first vaccination, was going to have permanent consequences. If it was just a, a fever and just being very tired because of the shock to the system, I don't have a problem with that. But I was very concerned that there would be permanent consequences. Either because of having had a very high fever or because what I had witnessed was actually a reaction, which was demonstrating that something else was going on. So I was extremely concerned and, and I was not going to have the, we were not going to have her, have the second and third round of immunisations, unless we were reassured by a specialist, that it was perfectly fine, which we were and so we just went ahead.
And can you remember what the specialist said?
Yes. He said that, because this was just at the time, when the old vaccines were being phased out and replaced with the new vaccines. And he told us that what had happened was that, this type of reaction, did occur, not with very high frequency, but did occur with the old vaccine. There was a reaction to the pertussis vaccine, I believe. And this is why that, that vaccine was being phased out. And that therefore, we shouldn't have any concern with, with the other vaccines because it was the new one, which didn't carry that risk.
So that was one thing. And the other thing he said, was given the symptoms, of what I had described, it was not something which would leave permanent traces, that it was just a high fever episode. So…we were reassured with that as well.
Talking to a paediatric immunologist helped her to decide to allow her daughter to continue with the immunisation schedule, which she believed was the right decision.
Talking to a paediatric immunologist helped her to decide to allow her daughter to continue with the immunisation schedule, which she believed was the right decision.
So I went back to my GP and he was extremely helpful. And he did give me the number of a paediatric immunologist. And the person I spoke to, called me back very quickly and he was, basically, he was able to provide me with enough information, to make what I feel was the right decision.
Firstly, because I'd found out the facts and I can't remember who told me this, but the five-in-one injection, has only been around for a few months. But apparently, a very similar form have been used in Canada, for about seven years, so it wasn't as if this was a new vaccination and no one really knew what was going, you know, what reaction it could have. It had been tried and tested somewhere else for sometime, although it wasn't identical.
The other thing was the fact that which was key, was the fact that if you only have two out of the three sets, you really can't, it's not as if you can say, well that almost covers you, the third is just a safety check. You know, you cannot say that you've got sufficient cover after having two. So they always recommend that you have all three, if you possibly can. So that was really helpful.
And a third thing was, that he reiterated the fact that any severe reaction would happen very quickly. So I would actually be in hospital at that time.
One of the other things, I did try and find out when I first went to the hospital, whether or not, you are able to get, either go back to the three-in-one or have the jabs separately, because I assumed that you could just have one at a time. And I believe they're not available anyway. So the choice is either you have all five-in-one, or you might be able to have it without the whooping cough, but I'm not even sure if you can do that now. So it wasn't as if you could just have one, and even if you could have them separately as I think it was the specialist who told me, you could end up with five separate reactions. And obviously I didn't want to put my daughter through that, and I thought that doesn't really actually help at all because I'd be on tethered hooks for five times and eventually you know, will have the actual injection, which will cause the reaction. So I decided, my husband and I decided to go ahead with immunisation.
She decided not to continue with the immunisation programme after her daughter had a reaction to the first set.
She decided not to continue with the immunisation programme after her daughter had a reaction to the first set.
My second son had his first, second and third primary jabs. My third son, he had his first and second, and had such a reaction to the second he never had his third. And my little girl, she had her first and hasn't had her second or the third, because she was very, very, very distressed for a good fortnight afterwards. And, it sounds terrible, but the fear of God is in you, when you see your baby come away from the doctor's surgery and to be so distressed. And you're living it on a day-to-day basis. And if it was like a case of she, you know, any of the children came home and they were like cross or, or upset for a couple of hours, but Calpol is working. But when you go into the next day your heart is in your mouth, and when you go into the next day again it, even more so. And then you're just permanently sitting there just waiting, waiting to have to get an ambulance, waiting to have to go to hospital and...
And what was she like?
She was just cross and she was miserable and she had swellings on her legs that were absolutely unbelievable. I mean, and upset, didn't want her bottles, didn't want any love, just wasn't consolable. And, and then I suppose you just get to the point where you're like, 'Oh, is this happening all over again? Am I going to have to do this all again? And this is my baby and look what I've done. I've done this because I've allowed her to go there as, as I did with my second or my third son. I've allowed this to happen, you know'. And then sort of you come out the other side. After sort of a week, ten days things are getting a little bit better and then after two weeks everything's back to normal and you're like, 'Thank God'. And then it's like, 'Right, the next one's due' and you're like, 'Oh, God, no, I can't go through that again. I can't do it'. And then obviously I know I'm opening the children to infection. I know, I am a hundred per cent aware of that. But the fear in me that my children are going to have the problems that their oldest brother has got is so overwhelming that I just can't do it.
Feelings about their decision about immunisation for their child
Most parents said that after their child had been immunised, that they were happy with the decision they had made. The couple of parents whose child had had a reaction still felt they had made the right decision because they now had peace of mind that their child was protected against several infectious diseases.
Short term worry that her daughter might have another reaction from the DTaP/IPV/Hib vaccines was worth it for the peace of mind that the immunisations give.
Short term worry that her daughter might have another reaction from the DTaP/IPV/Hib vaccines was worth it for the peace of mind that the immunisations give.
It's difficult because ultimately I would rather go through a short-term worry for a long term peace of mind. And if in, I just can't, if I decided not to immunise her then I think I would always be worried that she would pick something up, because you know, she might go travelling when she's eighteen. She goes to, we may not have these illnesses in this country, but she could go somewhere abroad and you don't know what she's going to come in contact with and that's why I think it's quite, it's quite a high-risk strategy not to immunise, unless you really feel very sure that something could you know, could harm your child. I think that you should, well, it's up to the individual parent but I think it's safer to immunise, myself.
But I just think that they've been immunising children for years and years and then this is the problem that you have in all these countries, isn't it? With children dying. And I suppose decades ago in this country lots of children dying for illnesses that we're very fortunate today they don't die of. And I think you're playing a bit fast and loose with, I don't, I think it is very dangerous to stop immunising children. But I don't think people appreciate how prevalent these illnesses were before. And how often children died, basically.
The small number of parents who chose not to immunise their children also generally felt that they had made the right decision. Some said they had days when they didn't know for sure, but they were ‘fairly sure that they had’ made the right decision.
They are fairly convinced that they made the right decision not to immunise their children.
They are fairly convinced that they made the right decision not to immunise their children.
Mother: And so you do have to question, and my belief is quite strongly that not every child is affected in a negative way from immunisation but there's certainly a type of child that will be. I am absolutely convinced that with my son he would be the type that would be affected by vaccination and it's purely because he has skin problems and maybe in later life he may get asthma, but I'm hoping having not had him vaccinated that he won't have any other severe reactions.
And now you feel that you made the right decision?
Father: Don't know. You'd like to think that you have but you can't pat yourself on the back because you don't know what's around the corner. All I know is that our children have illnesses and they get over them and they look healthy, they play well, they sleep well and our daughter who's six, is the youngest but one in her class and she's the tallest in the class. So I personally think her growth hasn't been inhibited by any foreign bodies and so on. Whether, because we're not excessively tall parents so where is she getting that from? Maybe she hasn't had that setback that the immune system's had throughout her life. That's what I think, I could be completely wrong, I don't know.
Mother: They are happy and healthy children and you never know whether you've made a right decision with regards to immunisation it, I don't know exactly what would have happened had I had the children immunised. I mean they could have been exactly how they are now we don't know for sure how they would have turned out anyway, but from our point of view certainly we're fairly convinced that it's been the right decision so far for our children.
A couple of parents personally believed that their un-immunised child had suffered fewer childhood ailments than their other immunised children. The scientific evidence suggests that immunised children are healthier than un-immunised children.
Believes her children's immune system is stronger through not having any immunisations.
Believes her children's immune system is stronger through not having any immunisations.
I strongly feel that my daughter had a worse childhood through having them. And I can't be absolutely sure, but she did suffer a lot as I've said before with ear infections and bladder infections. And in fact when she was 20 months she actually contracted pneumonia and was very poorly in hospital. And we, you, we just couldn't be sure that, although we couldn't link it directly obviously with being immunised, her immune system just did seem very weak and very poor. Whereas with my sons as I've said they had, perhaps even one of them had measles. And certainly my middle son had an ear infection last week and within two days he was actually back up on his feet. We had no question that we were going to give him antibiotics. And he had homeopathic remedies and was much, much stronger. And we feel again that his immune system hasn't been weakened and we feel that it stays strong and it can be strengthened by, you know, by other means and actually keeping them stronger. So it hasn't, doesn't necessarily have day-to-day implications but we feel happier that the boys react better, their own bodies react better.
*The 6-in-1 vaccine was called the 5-in-1 vaccine at the time of these interviews.
See also ‘Deciding to give a child the MMR vaccine’ and 'Deciding not to give a child the MMR vaccine'.
Last reviewed: April 2025.
Last updated: April 2025.
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