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A guide to immunisation for teenagers and young people (text version)

Updated 15 July 2024

Applies to England

This guide is for young people in school years 7 to 13 and their parents or guardians. It outlines and explains:

• the vaccines that are given to young people usually when they are still at school
• why these vaccines are needed
• what side effects they might have

This guide also answers some of the most common questions about these immunisations. In particular, it describes the human papillomavirus (HPV) vaccine that protects against HPV related cancers, the tetanus, diphtheria and inactivated poliomyelitis (Td/IPV) vaccine that boosts the protection you got as a child and the meningococcal A, C, W and Y (MenACWY) vaccine.

If you have any questions or want more information, talk to your doctor, school nurse or the practice nurse at your doctor’s surgery.

Pre-school immunisations

There are some vaccines you should have had before you before your reach primary school age. These vaccines are shown in the table below.

Vaccine	How	When	Comments
Diphtheria, tetanus, pertussis (whooping cough) and polio (dTaP/IPV or DTaP/IPV)	One injection	3 years and 4 months of age	This vaccine helps boost your protection against these diseases and should be your fourth dose of vaccine that targets these diseases. You will need a final fifth dose when you are 14 or 15 years old
Measles, mumps and rubella (MMR)	One injection	3 years and 4 months of age	This is a second dose of the MMR vaccine. (If you have not had the first dose yet, it should be given now and the second dose one month later

If you have missed out on these or any other vaccines and have already started school you can catch up at any time, ideally as soon as you can and, if possible, before you reach secondary school age. Please speak to your GP practice to make an appointment.

You can also get the flu vaccine each winter, normally through your School Aged Immunisation Service (SAIS).

Importance of immunisation

The national immunisation programme has meant that dangerous diseases, such as polio and measles, have disappeared in the UK. But these diseases could come back – they are still around in many countries throughout the world. That’s why it’s so important for you to protect yourself. In the UK, such diseases are kept at bay by the high immunisation rates.

How vaccines work

The vaccines we talk about in this guide contain a small part of the bacteria or virus that causes a disease, or tiny amounts of the chemicals the bacteria produce.

Vaccines work by causing the body’s immune system to make antibodies (substances to fight infections and diseases). So if you come into contact with the infection, the antibodies will recognise it and protect you.

Protecting yourself means protecting others

When enough of the population are protected from a specific disease by a vaccination, this helps prevent the spread of that infection in the community. This is called herd protection. By having a vaccine, you can help to protect your friends and family who may be vulnerable or who cannot be vaccinated and reduce the likelihood of an outbreak of disease.

Human papillomavirus (HPV)

HPV is very common and it is caught through intimate skin-to-skin and sexual contact with another person who already has it. Because it is a very common infection, more than 70% of people will get HPV in their lifetime, widespread vaccination will reduce this.

There are many different types of HPV. Most HPV infections do not cause any symptoms and get better on their own. Some types do not clear up and can lead to cancer whilst others cause genital warts.

HPV related cancers

HPV increases the risk of developing some cancers in later life including cervical cancer (cancer of the entrance to the womb), some mouth and throat cancers and some cancers of the anus and genital area. HPV causes more than 99% of all cervical cancer, the most common cancer among women under the age of 35. Most vaginal, vulval, penile and anal cancers are also caused by HPV.

Having the vaccine will reduce your chance of getting cancers caused by the HPV virus.

Impact of the HPV vaccine

The HPV vaccine protects against high risk HPV types that cause cancer including most cases (around 90%) of cervical cancer. Having this vaccine will also protect you against the 2 types of HPV that cause the majority of cases of genital warts. There is evidence from Australia, Denmark, Scotland and England that the vaccine is already having a major impact on HPV infections.

The HPV vaccine has been used in girls in the UK since 2008 and most women aged 15 to 24 years have now been given the vaccine. From September 2019, the vaccine has been offered to boys and girls aged 12 and 13 years. The vaccine protects boys against some kinds of cancer too and will stop them from passing on HPV to their future partners. It won’t protect you against any other sexually transmitted diseases such as chlamydia and it won’t stop you getting pregnant.

Over 80 million people have received the vaccine worldwide. In time it is expected that the vaccine will save hundreds of lives every year in the UK.

It has been 15 years since the start of this vaccination programme in the UK. As a result there has been a big decline in HPV infections and in the number of young people with genital warts. A study published in The Lancet in 2021 found that cervical cancer rates were 87% lower in young women who had been eligible for HPV vaccination when they were aged 12 to 13 years. This is compared with similar young women who were born a few years earlier who had not been offered the vaccination and clearly showed that this programme is preventing cervical cancer.

Having the HPV vaccination

The vaccine is given as an injection in your upper arm. Most people will need only one dose to be protected. This is usually given around the time you are in school year 8.

The HPV vaccine is offered to everyone starting in school year 8 (aged 12 to 13 years) and those offered the vaccine at school will remain eligible up to their 25th birthday.

Consent for the HPV vaccine

You will probably want to share information about the vaccine with your parents and discuss it together. If you are being offered the vaccination at school, you may be given a consent form that your parent or guardian should sign for you to have the vaccine. You may also be able to give consent yourself. The doctor or nurse will discuss the HPV vaccine with you at your appointment and will be able to answer any questions you may have.

Side effects of the HPV vaccine

Like most injections, the side effects of the HPV vaccine are quite mild. Stinging and soreness in the arm are common but wear off in a couple of days. Some people feel a bit faint after the vaccine. More serious side effects are extremely rare.

The vaccine meets the rigorous safety standards required for it to be used in the UK and has an excellent safety profile. Millions of doses of the vaccine have already been given to young people in the UK and around the world. As with all vaccines, any reports of side effects are closely monitored and reviewed.

More information about vaccinations and side effects is available on NHS.UK.

HPV vaccine and cervical or cancer screenings

All women aged 25 and over in England are offered cervical screening tests. The vaccines will prevent up to 90% of cervical cancer cases, but women should still attend for cervical screening when invited to do so.

Screening for HPV-related cancers is limited, but your dentist will look for oral cancers during routine appointments so it is important to attend them when offered. However, if you are worried about any symptoms you should speak to your GP.

Missed vaccination

If you missed your vaccination, for whatever reason, you should speak to your school nurse or GP surgery about making another appointment. It’s best to make your appointment as soon as possible after your original one. Most young people offered the vaccine are only eligible to receive the HPV vaccine up to their 25th birthday.

It is best to have your vaccinations at the right time so you are protected. If you miss any of your teenage jabs and you have left school, contact your GP practice and get up to date.

Being sexually active and having the vaccination

If you’ve had sex, and are in the relevant age group, you should still have the vaccine.

Contents of the HPV vaccine

A complete list of ingredients for the Gardasil 9 vaccine is available in the patient information leaflets (PIL)s.

Further information is available in the Summary of Product Characteristics (SPC).

Tetanus, diphtheria, polio (Td/IPV) and MenACWY

Tetanus

Tetanus is a painful disease affecting the nervous system which can lead to muscle spasms, cause breathing problems and can kill. It is caused when germs found in the soil and manure get into the body through open cuts or burns. Tetanus cannot be passed from person to person.

Diphtheria

Diphtheria is a serious disease that usually begins with a sore throat and can quickly cause breathing problems. It can damage the heart and nervous system, and in severe cases, it can kill.

Polio

Polio is a virus that attacks the nervous system which can cause permanent paralysis of muscles. If it affects the chest muscles or the brain, polio can kill. The teenage booster vaccine is called Revaxis, you can read the patient information leaflet for more information.

Previously immunised as a child

If you were immunised against tetanus, diphtheria and polio as a child you will still need a booster.

Number of doses needed

You need a total of 5 doses of tetanus, diphtheria and polio vaccines to build up and keep your immunity.

You should have had:

• the first 3 doses as a baby
• the fourth dose when you were between 3 and 5 years old, before you started school
• the fifth dose which is due in year 9 (aged 13 to 14)

Meningitis, septicaemia and sepsis

Meningitis is dangerous swelling of the lining around the brain and spinal cord. It can be the result of infection with bacteria or a virus or as a result of injury. Septicaemia is when bacteria enter the bloodstream and cause blood poisoning. Both of these conditions can trigger sepsis. Sepsis is an overwhelming and life-threatening immune response to any infection and can lead to tissue damage, organ failure and death.

Meningococcal disease

Meningococcal disease can cause both meningitis and septicaemia.

There are 5 main groups of meningococcal bacteria that cause disease:

• meningococcal group A (MenA)
• meningococcal group B (MenB)
• meningococcal group C (MenC)
• meningococcal group W (MenW)
• meningococcal group Y (MenY)

Meningococcal disease is rare but very serious and requires urgent hospital treatment. It can lead to life-changing disabilities such as amputations, hearing loss, brain damage and scars.

There is more information in the  Knowing about meningitis and septicaemia section.

MenACWY vaccines

You will be offered one of 3 MenACWY vaccines, which all offer good protection. They are called MenQuadfi, Menveo and Nimenrix.

Further information is available in the patient information leaflets:

• MenQuadfi
• Nimenrix
• Menveo

Immunisations as a child

The MenACWY vaccine will increase your protection against MenC disease and help to protect you against 3 other meningococcal groups (A, W and Y).

For protection against 4 groups (A, C, W and Y) of meningococcal infection, it is important to have one dose of MenACWY as a teenager.

The routine dose of MenACWY is given in year 9 or 10 (around 14 years).

If you missed your teenage dose of MenACWY vaccine

It is best to get your vaccine when it is offered. If you do miss your teenage MenACWY vaccine, you can still have the vaccine up to your 25th birthday. If you are older and starting university for the first time, make sure you have had your vaccine before you enrol.

If you are still at school then speak to your school provider, otherwise you will need to make an appointment with your GP practice. If you have any questions about MenACWY talk to your school nurse or doctor.

MenACWY vaccine does not protect against MenB

MenB is caused by different group of the bug which commonly affects young infants. A different vaccine, which protects against MenB, is given to very young babies. Some adults and older children considered at risk may be eligible on the NHS. You can find out more about how to get the MenB vaccine through the charity websites.

Boosters in the future

You will probably not need further boosters of MenACWY vaccine. However, you may need extra doses of some vaccines if you are visiting certain countries. Check with your practice nurse at your GP surgery. If you have an injury, you may need another tetanus injection.

How you will be given the Td/IPV and MenACWY boosters

You will have 2 injections – 1 in each upper arm, or 2.5cm apart in the same arm. Nobody likes injections, but it is very quick. The needles used are small and you should feel only a tiny pinprick. If you are a bit nervous about having the injection, tell the nurse or doctor before you have it. Relaxing your arm should help.

Other immunisations

When you are having your HPV, TdIPV and MenACWY vaccines, it’s a good idea to check with the nurse or doctor that all your other vaccines are up to date including MMR.

It’s particularly important to check that your MMR vaccine is up to date because some teenagers have not had 2 doses of MMR. If you have never had the MMR vaccine, you should have one dose now and another one month later, to give you the best protection.

Potential reasons why you should not be immunised

There are very few teenagers who may not have the HPV, Td/IPV, and MenACWY vaccines.

You should talk to your doctor or school nurse if you have a weakened immune system because you are having treatment for a serious condition such as a transplant or cancer, if you have a condition or are taking a medication that weakens your immune system. The doctor or nurse will get specialist advice on whether you should have the MMR vaccine and whether you need additional doses of the HPV vaccine.

In the UK we use 2 slightly different MMR vaccines. Both vaccines work very well, one contains porcine gelatine and the other doesn’t. If you want to have the porcine gelatine free vaccine, talk to your nurse or GP practice when you make your appointment.

Illness on the day of the appointment

If you have a minor illness without a fever, such as a cold, you should still have the immunisations.

If you are ill with a fever, put the immunisations off until you have recovered. This is to avoid the fever being associated with the vaccines and the vaccines increasing the fever you already have.

You should speak to your doctor or nurse before having the immunisation if you have:

• had a bleeding disorder
• had convulsions (fits) not associated with fever

Side effects of the MenACWY vaccine

It is common to get some swelling, redness or tenderness where you have the injection. Sometimes a small painless lump develops, but this usually disappears in a few weeks. More serious effects are rare but include fever, headache, dizziness, feeling sick and swollen glands.

Speak to your school nurse or doctor if you are at all concerned.

If you feel unwell after the immunisation, take paracetamol. Read the instructions on the bottle or packet carefully and take the correct dose for your age. If necessary, take a second dose 4 to 6 hours later. If your temperature is still high after the second dose, speak to your GP or call the free NHS helpline 111.

It is not generally recommended that these medicines are routinely given before or after vaccination in anticipation of a fever.

Do not take medicines that contain aspirin if you are under 16.

Never give medicines that contain aspirin to children or young people under 16.

Reporting side effects

Please report any suspected side effects:

• online at Yellow Card Scheme
• downloading and using the Yellow Card app:
  • Apple
  • Android
• calling the Yellow Card scheme on 0800 731 6789 ( 9am to 5pm, Monday to Friday)

Make sure you know the signs and symptoms of meningitis and septicaemia

Meningitis is an infection of the brain. The same germ that causes meningitis can cause septicaemia (blood poisoning). Meningitis and septicaemia are both very serious – they can cause permanent disability and death and the signs can come on quickly – so you must get treatment straight away.

MenACWY vaccine does not protect against all causes of meningitis and septicaemia, so you still need to know the signs and symptoms.

Signs and symptoms

Many of the early signs – diarrhoea, vomiting, fever, aches, general tiredness and headaches – are also signs of less serious illnesses like colds and flu.

Someone with meningitis and septicaemia will usually become seriously ill in a matters of hours. This is why it is important to keep checking on someone who is ill so you spot if they are getting rapidly worse. It’s also important to look for cold hands and feet.

Symptoms such as a rash that doesn’t fade (do the glass test, being confused or delirious, or too sleepy to wake occur later and are very serious – seek help immediately.

For meningitis, the most important signs to look out for are:

• fever
• a very bad headache (this alone is not a reason to get medical help)
• vomiting
• stiff neck
• dislike of bright lights
• rash
• confusion, delirium
• severe sleepiness, losing consciousness
• seizures

For septicaemia, the most important signs to look out for are:

• fever and shivering
• severe pains and aches in limbs and joints
• vomiting
• very cold hands and feet
• pale or mottled skin
• rapid breathing
• diarrhoea and stomach cramps
• red or purple ‘bruised’ or blotchy rash on skin that do not fade under pressure — on dark skin, check the eyelids or the roof of the mouth where spots may be more visible — do the glass test
• difficulty walking or standing
• severe sleepiness, losing consciousness

What you should do

Not all of these symptoms will develop and they can appear in any order and be mixed between the 2 illnesses. Meningococcal disease can be hard to identify at first because it can be like a bad case of flu.

However, anyone affected with meningococcal disease will usually become seriously ill within a few hours. You should contact your GP (family doctor) or NHS 111 for advice if you have any concerns about your own or a friend’s health.

If you become worried about yourself or a friend, particularly if symptoms are getting worse, seek medical help urgently at the closest A&E Department or by dialling 999. Early treatment can be life-saving.

The ‘glass test’

Press the side of a clear drinking glass firmly against the rash so you can see if the rash fades and loses colour under pressure. If it doesn’t change colour, contact your doctor immediately.

On dark skin, check inside the eyelids or roof of the mouth where the spots maybe more visible.

Immunisation schedules

1. The routine immunisation schedule
2. Selective immunisation programmes
3. Additional vaccines for individuals with underlying medical conditions

Vaccine Damage Payment Scheme

Current immunisations are extremely safe but, very rarely, an individual may suffer from a problem after vaccination.

The Vaccine Damage Payment Scheme is designed to ease the present and future burdens of the person who, on that very rare occasion, may be affected by the vaccination.

There are several conditions that need to be met before a payment can be made. For more information, visit Vaccine Damage Payment on GOV.UK.

Vaccine Damage Payments Unit
Department for Work and Pensions
Palatine House, Lancaster Road
Preston
PR1 1HB

You can contact them by phone on 01772 899944, or by email at CAU-VDPU@dwp.gsi.gov.uk

If you want advice on immunisation, speak to your doctor, practice nurse, health visitor or pharmacist, or call the NHS helpline 111.

More information on vaccinations  is available on NHS.UK.

Further information

For non-urgent advice, call the free NHS helpline 111.

From NHS.UK, you will find information on:

• teenage vaccinations
• cervical cancer
• cervical screening
• measles, mumps and rubella and the MMR vaccine

For meningitis, the following charities provide information, advice and support:

• Meningitis Research Foundation, free helpline 080 8800 3344, Monday to Friday, 9am to 5pm
• Meningitis Now, free helpline 0808 80 10 388 - Monday to Thursday 9am to 4pm and Fridays 9am to 1pm

Order or download print copies

Paper copies of this guide are available free to order, or download a copy to print.