Changes to the routine childhood immunisation schedule in Wales in 2026
Following the success of varicella (chickenpox) vaccination programmes in other countries, the Joint Committee on Vaccination and Immunisation (JCVI) recommended adding a universal two-dose chickenpox vaccination programme to the UK routine childhood immunisation schedule.
The NHS routine varicella vaccination programme for babies started on 1 January 2026. The vaccine used is the combined measles, mumps, rubella and varicella vaccine MMRV.
Detailed information about changes to vaccine recommendations for babies and young children, including eligibility, can be found below on this page.
Varicella (chickenpox) vaccination selective catch-up programme running November 2026 to March 2028
The NHS in Wales is offering a time-limited varicella (chickenpox) catch-up programme using the combined MMRV vaccine. This is to help protect eligible children against chickenpox infection.
Children born between 1 January 2020 and 31 August 2022 are being offered one dose of the MMRV vaccine. The programme runs between 1 November 2026 and 31 March 2028.
This follows advice from the Joint Committee on Vaccination and Immunisation (JCVI). JCVI is an expert scientific advisory committee which advises the UK government on vaccination and immunisation matters.
The MMRV selective catch-up programme is expected to help accelerate control and to further reduce transmission in the population. Children will be invited and encouraged to attend if they have not yet had chickenpox infection or two doses of a varicella vaccine.
On 1 January 2026 the measles, mumps, rubella and varicella (MMRV) vaccine replaced the measles, mumps and rubella (MMR) vaccine in the routine childhood immunisation schedule in Wales. The routine MMRV programme helps prevent severe cases and other serious varicella-related complications, which, while rare, may result in hospitalisation or lead to other serious outcomes.
Information:
To learn more about the reasons for these changes, see:
Two doses of an MMR-containing vaccine are recommended to provide the best protection against measles.
In 2025, uptake of the first dose of MMR vaccine among primary school children in Wales was 92.5%, while uptake of the second dose was 91.2%.
Among secondary school children, uptake of the first dose was 95.8%, and uptake of the second dose was 93.0%.
Over recent years, Wales has experienced sporadic measles cases linked to international travel as well as small, localised outbreaks. There were two confirmed measles cases in 2025, and five cases were reported between January and September 2026.
When to give the vaccines?
From 1 January 2026:
Routine vaccinations
The first dose of MMRV is given to babies at 12 months and the second dose at 18 months.
The 18-month visit is a new vaccination appointment. During this visit, a fourth dose of the multivalent 6-in-1 vaccine (diphtheria, tetanus, whooping cough, polio, Hib, and hepatitis B) is also given.
Chickenpox catch-up vaccinations for eligible children
There is a selective MMRV catch-up programme for older children aged over 3 years and 4 months to under 6 years old on 1 January 2026 (Date of Birth: 1 January 2020 – 31 August 2022) to help accelerate control and to further reduce transmission of chickenpox in the population. This programme will be delivered between 1 November 2026 to 31 March 2028.
For details on selective catch-up cohort (greater than 3 years 4 months to less than 6 years) see the Frequently asked questions section.
Non-routine vaccinations
The MMR vaccine is no longer available for the NHS routine childhood programme from 1 January 2026.
The MMR vaccine is still available for administration outside of the routine childhood programme for people who need it. This includes older children and adults who have not received two doses of MMR and are not eligible for MMRV.
For details on non-routine vaccinations see the Frequently asked questions section.
Information:
An eligibility tool to support healthcare professionals when implementing the routine and catch-up programmes for MMRV vaccination from 1 January 2026 is available at:
All healthcare professionals should make every contact count and take advantage of existing opportunities to check vaccination status and administer or arrange vaccinations for:
all children and young adults who have not been vaccinated
new entrants to the UK at General Practice registration consultation and immigration assessments
postnatal women through health visiting assessments and six-week maternal checks
women accessing preconception or fertility services.
MMR should be used to protect women of childbearing age and healthcare workers against rubella infection.
The diseases
Measles, mumps and rubella are notifiable diseases in Wales.
Measles
Measles is one of the most highly communicable infectious diseases. It is spread by airborne or droplet transmission. The incubation period is about ten days.
Measles is caused by a morbillivirus of the paramyxovirus family. The prodromal stage is characterised by the onset of fever, malaise, coryza, conjunctivitis and cough. The rash starts at the head, spreading to the trunk and limbs over three to four days.
Koplik spots (small red spots with blueish/white centres) may appear on the mucous membranes of the mouth one to two days before the rash appears.
Individuals are infectious from the beginning of the prodromal period (when the first symptom appears) to four days after the appearance of the rash.
The following features are strongly suggestive of measles:
rash for at least three days
fever for at least one day, and
at least one of the following – cough, coryza or conjunctivitis.
Mumps
Mumps is an acute viral illness caused by a paramyxovirus, characterised by parotid swelling. Symptoms like fever, headache, malaise, myalgias, and anorexia may also occur. Asymptomatic cases are common in children.
Mumps is spread through airborne or droplet transmission, with an incubation period of around 17 days. People are infectious from a few days before to after parotid swelling onset.
The mumps virus frequently affects the nervous system. Neurological complications, including meningitis and encephalitis, can occur.
Common complications include pancreatitis, oophoritis, and orchitis. Sensorineural deafness, nephritis, arthropathy, cardiac abnormalities, and rarely, death have been reported.
Rubella
Rubella is caused by a togavirus. It may begin with non-specific symptoms like low-grade fever, malaise, coryza, and mild conjunctivitis. The rash is usually transitory, and seen behind the ears, face, and neck. Clinical diagnosis can be unreliable due to the fleeting nature of the rash.
Rubella spreads via droplet transmission, with an incubation period of 14 to 21 days.
Complications include thrombocytopaenia and post-infectious encephalitis. In adults, arthritis and arthralgia may occur.
Maternal rubella infection during pregnancy can lead to foetal loss or congenital rubella syndrome (CRS), which includes cataracts, deafness, cardiac abnormalities, microcephaly, growth retardation, and inflammatory lesions. Infection in the first eight to 10 weeks of pregnancy can cause damage in up to 90% of surviving infants, often resulting in multiple defects.
Chickenpox
Varicella (chickenpox) is an acute, highly infectious disease caused by the varicella zoster virus. Varicella spreads through direct contact or droplets, with a one to three-week incubation period.
A mild fever and malaise may occur before the rash, which starts on the face and scalp, spreading to the trunk and abdomen. The rash lasts for three to four days, then dries into scabs, and may be sparse or extensive.
Varicella is more serious in very young infants, adults, pregnant women (affecting both mother and foetus), and immunosuppressed adults.
While most varicella (chickenpox) cases in children are mild and resolve without medical treatment. Some children develop complications, such as bacterial skin infections, encephalitis, pneumonitis, and stroke, potentially leading to hospitalisation or, rarely, death.
Data shows that severe varicella (chickenpox) infections often lead to complications that are both common and expensive, adding strain to healthcare services. It is likely that the actual number of hospital admissions due to varicella is underreported. Many of these hospitalisations arise from secondary complications such as invasive group A streptococcal infections or childhood strokes, which are often not recorded as being related to varicella. There may also be other secondary complications related to varicella that are not recorded or fully understood with the existing data.
Herpes zoster (shingles) results from reactivation of the varicella (chickenpox) virus. It’s more common in the elderly and immunosuppressed individuals. The UK has had a universal shingles vaccination programme in place since 2013 in older adults. For more information, visit Shingles – Information for health professionals
The vaccines
MMRV vaccine – Varicella (chickenpox) vaccination selective catch-up programme running November 2026 to March 2028
The NHS in Wales is offering a time-limited varicella (chickenpox) catch-up programme using the combined MMRV vaccine. This is to help protect eligible children against chickenpox infection.
Children born between 1 January 2020 and 31 August 2022 are being offered one dose of MMRV vaccine. These children were too old to be offered the routine chickenpox vaccination when it was introduced into the UK childhood immunisation schedule earlier this year.
If this group of children has not had chickenpox or been vaccinated against chickenpox, they are at risk of getting the infection.
The MMRV selective catch-up programme is expected to accelerate control of chickenpox infection, reduce transmission, and provide protection for eligible children who remain susceptible to chickenpox.
Notification of eligibility should be issued to parents and guardians by 31 March 2027 at the latest.
Who should be offered the MMRV selective catch-up vaccine?
Onedose of MMRV vaccine should be offered to children DOB between 1 January 2020 and 31 August 2022 (those aged between 3 years 4 months to under 6 years on the 1 January 2026). Their eligibility is defined by their date of birth, not their age.
The vaccine should be offered to children who:
have no reported history of chickenpox infection and/or
have not previously received two doses of varicella vaccine.
GP surgeries do not need to check whether a child has had chickenpox infection or two doses of varicella vaccine before sending invitations. Eligibility can be confirmed if the child responds to the offer. There is no requirement for GP surgeries to check the history of chickenpox infection by undertaking serology testing.
If there is uncertainty as to whether the child has had chickenpox infection before, parents can be advised that it is safe and better for their child to have the MMRV selective catch-up vaccine.
The child should have had two previous MMR vaccinations. There are no safety concerns with having three MMR-containing vaccines.
There are no safety concerns with giving the vaccine to a child who has already had chickenpox infection or previous varicella vaccination.
January 2026: Changes to the routine childhood immunisation schedule
The NHS routine varicella vaccination programme for babies started on 1 January 2026. The vaccine used is the combined measles, mumps, rubella and varicella vaccine MMRV.
The MMRV vaccine contains live attenuated measles, mumps, rubella and varicella viruses.
MMRV has been used in other countries including the USA, Canada, Australia, and Germany for many years. Countries that have implemented varicella vaccination programmes have reported a significant decline in varicella cases and associated hospitalisations.
The first dose of MMRV is given to babies at 12 months and the second dose at 18 months.
For policy and guidance covering introduction of the MMRV vaccination programme, see:
Guidance in the Green Book supersedes the summary of product characteristics (SmPC).
The vaccines are considered clinically equivalent and interchangeable, although Priorix Tetra® may be preferred for children who do not accept pork gelatine.
A ‘varicella-only’ vaccine is not offered in the NHS routine or selective programmes.
MMR vaccine – non-routine vaccinations
The MMR vaccine is a live preparation of freeze-dried live attenuated measles, mumps and rubella.
The MMR vaccine, which helps protect against measles, mumps and rubella, is highly effective and has an excellent safety record.Since it was introduced in 1988, measles, mumps and rubella have become rare in the UK. But sometimes outbreaks happen, especially of measles, when not enough people get vaccinated.
The MMR vaccine is no longer available through the NHS routine childhood immunisation programme.
The MMR vaccine is still available for administration outside of the routine childhood programme for people who need it. This includes older children and adults whohave not received two doses of MMR and are not eligible for MMRV.
Guidance in the Green Book supersedes the summary of product characteristics (SmPC).
More information about the MMR-containing vaccines can be found in theGreen Book chapters for each disease. See Clinical resources and informationsection.
Reporting side effects of MMR-containing vaccines
Reporting suspected adversereactions after authorisation of the medicinal product is important. It allows continued monitoring of the benefit/risk balance of the medicinal product. You should report suspected adverse reactions of vaccines and medicines online atYellow Card (external site), by downloading the Yellow Card app, or by calling0800 731 6789(Monday to Friday, 9am to 5pm).
New medicines and vaccines that are underadditionalmonitoring have an inverted black triangle symbol (▼) displayed in their package leaflet andSmPC, with a short sentence explaining what the triangle means.You should report all suspected adverse reactions for these products.
Guidance
For details about changes to the routine childhood immunisation schedule please see:
Policy and guidance can also be found on the Public Health Wales Policy, letters and Welsh Government SharePoint page (access for NHS healthcare staff)
An eligibility tool to support healthcare professionals when implementing the routine and catch-up programmes for MMRV vaccination from 1 January 2026 is available at:
Can MMR-containing vaccines be given before 12 months of age?
MMR-containing vaccines should be given routinely according to the childhood immunisation schedule.
MMR-containing vaccines are not usually given to babies less than 12 months of age. This is because the immunity (protection) they get from their mother can make the vaccine less effective.
Sometimes an MMR-containing vaccine may be offered to younger children. For example, before travel to areas where measles is common or during an outbreak.
Any child who is given an MMR-containing vaccine before the age of 12 months should still receive two more doses at the recommended ages for the best protection.
If you are travelling to a measles-endemic country or area, or have any questions on eligibility, please contact your GP surgery for advice.
