What healthcare staff need to know
Effective from 1 January 2026
From 1 January 2026 the routine childhood immunisation programme in the UK will change: the combined measles, mumps and rubella vaccine (MMR) used in the routine programme will be replaced by a combined measles-mumps-rubella-varicella vaccine (MMRV). This adds routine protection against chickenpox (varicella) while keeping measles, mumps and rubella protection in the same two-dose schedule. Below is a concise, practice-focused briefing you can use for informing your staff or operational planning.
Summary of the changes
- What’s changing: The NHS will use a combined MMRV vaccine in place of MMR for the routine childhood programme. That means varicella protection is added to the routine schedule.
- When: Changes come into effect 1 January 2026.
- Why: JCVI recommended a universal varicella programme with a selective catch-up to reduce varicella disease, severe cases and transmission.
Routine schedule — exact DOB rules
Note: eligibility is defined primarily by date of birth rather than current age on a given clinic date; use the DOB ranges below when checking records. Sources: GOV.UK guidance and the Green Book.
- Children born on or after 1 January 2025
- Routine: 2 doses of MMRV — first dose at 12 month appointment and second dose at the new 18 month appointment
- Children born 1 July 2024 – 31 December 2024
- These children will already have been eligible for MMR at 12 months; their revised schedule is MMR at 12 months (if already received), then MMRV at 18 months and again at 3 years 4 months
- Children born 1 September 2022 – 30 June 2024
- These children should receive one dose of MMRV at 3 years 4 months (they will likely already have had MMR at 12 months).
Selective catch-up programme (older children)
- Who is eligible for the selective catch-up?
Children born 1 January 2020 to 31 August 2022 (i.e. those who were aged approximately 3 years 4 months to under 6 years on 31 December 2025) who have not had chickenpox infection or 2 doses of varicella vaccine. These children are eligible for one dose of MMRV in the selective catch-up. - When will the catch-up be delivered?
The selective catch-up campaign will run from 1 November 2026 to 31 March 2028 (or until the end date subsequently communicated by NHS England). - Notes on catch-up:
- There is no requirement to perform varicella serology before offering the catch-up; if a child/parent accepts the offer, vaccinate.
- Children born before 1 January 2020 remain outside the routine varicella offer — they should receive standard MMR if catching up for measles/mumps/rubella, unless MMRV is the only available vaccine at the time and immediate protection is required.
Practical points for vaccinators / service leads
- Vaccine products: 2 MMRV vaccines are available for the programme: ProQuad® and Priorix-Tetra® – see SPCs for preparation and storage. They are considered clinically equal and interchangeable. Both are live attenuated vaccines. Proquad contains porcine gelatine but Priorix-Tetra does not and ordering for the latter will be restricted in the same way as the Priorix MMR vaccine is. A varicella-only vaccine will not be offered by the NHS as part of the routine childhood or catch-up programme,
- Intervals: The second dose should normally be given at 18 months; if a second dose is needed earlier, it can be given ≥3 months after the first dose. If a dose is given before 12 months (e.g. for travel), it should not be counted and a further dose should be given at the routine times.
- MMR availability: From 1 January 2026 MMR will no longer be part of the NHS routine childhood programme. MMR remains the vaccine for those born before 1 January 2020 who need MMR catch-up, but MMRV may be used if required and appropriate.
Quick action checklist for practices / school immunisation teams
Update recall lists to reflect MMRV eligibility by DOB ranges above.
- Order and store appropriate MMRV stock (check local procurement routes).
- Ensure staff are trained on differences between MMR and MMRV (SPC/Green Book), contraindications and administration technique. This will be covered in our childhood immunisation updates: https://primarycarecpdtraining.co.uk/course/hcp-childhood-immunisation-update-webinar/
If staff are new to immunising remember they must attend a 2 day introductory course followed by supervised practice in the workplace and formal assessment of competency before they begin immunising:
https://primarycarecpdtraining.co.uk/course/introduction-to-immunisation-vaccination/
- Update patient information leaflets and appointment text to explain added chickenpox protection and the catch-up offer.
- Make a plan for catch-up delivery (Nov 2026–Mar 2028) for eligible children born 1 Jan 2020–31 Aug 2022.
FAQs
Q: Do we still give MMR at all?
A: MMR will not be routinely used in the childhood programme from 1 Jan 2026 — instead eligible children will receive MMRV.
MMR remains for those born before 1 January 2020 who need MMR catch-up.
Q: Do we need to check for prior chickenpox before giving catch-up?
A: No routine serology/history check is required; offer the catch-up to eligible children and vaccinate if they accept. If a child has had chickenpox, MMRV can still be given (no harm), but in the selective catch-up those who already had 2 varicella doses and/or have had chickenpox do not require the dose.
Q: Why has it taken so long for the NHS to offer Varicella vaccine?
A: There was concern that a chidren’s varicella vaccine programme could theoretically lead to an increase in older people getting Shingles (as they would have less exogenous boosting from circulating chickenpox). However real-world evidence from USA now suggests no increase in shingles despite a Varicella programme since 1995. There is also now better understanding of disease burden (complications from severe varicella are common, costly and place a burden on health services and that the true extent of hospitalisations caused by varicella is underestimated through routine data sources due to errors in coding)
Q: What do I give for travel or outbreaks?
A: Children aged 6 months to one year who are travelling to a country with a high incidence of measles or who are identified as part of a local outbreak and who require measles-containing vaccine should be given MMR rather than MMRV. However if any dose of MMR (or MMRV if given in error) administered below the age of one year should be discounted as residual maternal antibodies may reduce the response to the vaccine. Adults and children outside of the MMRV cohorts should be offered MMR not MMRV for incomplete immunisations including travel
See next month’s blog for more frequently asked questions about the programme
References and Resources
- MMRV programme: information for healthcare practitioners, https://www.gov.uk/government/publications/mmrv-patient-group-direction-pgd-template
- Childhood immunisation eligibility calculator
https://find-public-health-resources.service.gov.uk/Childhood%20immunisation%20eligibility%20calculator/CIEC1EN
- Green Book — Measles chapter (updated) — clinical dosing/intervals and rationale.
https://www.gov.uk/government/publications/measles-the-green-book-chapter-21
- Green Book — Varicella chapter (updated) — clinical dosing/intervals and rationale.
https://www.gov.uk/government/publications/varicella-the-green-book-chapter-34
- MMRV PGD template
https://www.gov.uk/government/publications/mmrv-patient-group-direction-pgd-template
- Visual guide to vaccines — January 2026 — quick reference for clinics.
https://www.gov.uk/government/publications/a-visual-guide-to-vaccines-poster
- Introduction of routine varicella/MMRV programme
- MMRV and febrile convulsions
https://www.gov.uk/government/publications/mmrv-and-febrile-convulsions
- Vaccines and porcine gelatine
https://www.gov.uk/government/publications/vaccines-and-porcine-gelatine
- The complete routine immunisation schedule
https://www.gov.uk/government/publications/the-complete-routine-immunisation-schedule
- Vaccination of individuals with uncertain or incomplete immunisation status
https://www.gov.uk/government/publications/vaccination-of-individuals-with-uncertain-or-incomplete-immunisation-status
- UKHSA national webinar – introduction of MMRV vaccine