Immunisation for Your Newborn Baby

Immunisation is one of the most effective ways to protect your baby from serious infectious diseases. Vaccines help your baby’s immune system produce antibodies, which can recognise and fight particular infections in the future.

In Ireland, routine childhood vaccines are provided free of charge. Your baby will receive their first routine vaccinations at 2 months old, followed by further vaccines at 4, 6, 12 and 13 months. It is important to attend every appointment and complete the full vaccination schedule, as one dose may not provide enough long-term protection.

Does My Baby Receive Vaccines at Birth?

Most babies do not routinely receive a vaccine immediately after birth. The routine childhood vaccination programme generally begins when your baby is 2 months old.

However, some newborn babies may be offered additional protection shortly after birth because of their individual circumstances.

Hepatitis B

Hepatitis B vaccination is included in the routine 6-in-1 vaccine given from 2 months of age.

However, if you tested positive for hepatitis B during pregnancy, your baby will be offered the hepatitis B vaccine shortly after birth. Your baby may also receive an injection containing antibodies to provide additional protection and will need follow-up testing later in infancy.

BCG Vaccine

The BCG vaccine protects against tuberculosis, also known as TB. It is no longer routinely given to every baby in Ireland because TB is uncommon.

Your baby may be offered the BCG vaccine if they are considered at increased risk of TB. This may include babies who:

* Live with someone who was born in a country with high rates of TB.
* Were born in or lived for more than 3 months in a country with high rates of TB.
* Have a parent with TB.
* Are regularly in close contact with someone who has TB.

Speak to your GP, public health nurse or hospital team if you think your baby may need the BCG vaccine.

RSV Immunisation

The HSE may offer newborn babies seasonal immunisation against respiratory syncytial virus, known as RSV. RSV can cause serious breathing problems, particularly in very young or premature babies.

RSV immunisation uses an antibody called nirsevimab. It is not a vaccine, as it provides protective antibodies directly rather than stimulating the baby’s immune system to produce them. Eligibility and programme dates may change each winter, so parents should check the latest HSE guidance or ask their maternity hospital.

Vitamin K After Birth

All newborn babies are offered vitamin K shortly after birth. Although vitamin K is not a vaccine, it is an important part of newborn care.

Babies are born with low levels of vitamin K, which is needed for normal blood clotting. A vitamin K injection is usually given into your baby’s thigh within 6 hours of birth to protect against a rare but serious bleeding disorder called vitamin K deficiency bleeding.

Your Baby’s Vaccination Schedule

The current schedule below applies to babies born on or after 1 October 2024.

At 2 Months

Your baby will be offered:

* 6-in-1 vaccine.
* Pneumococcal conjugate vaccine, known as PCV.
* Meningococcal B vaccine, known as MenB.
* Rotavirus oral vaccine.

At 4 Months

Your baby will be offered:

* 6-in-1 vaccine.
* MenB vaccine.
* Rotavirus oral vaccine.

At 6 Months

Your baby will be offered:

* 6-in-1 vaccine.
* PCV.

At 12 Months

Your baby will be offered:

* MMR vaccine against measles, mumps and rubella.
* MenB vaccine.
* Chickenpox, or varicella, vaccine.

At 13 Months

Your baby will be offered:

* A fourth dose of the 6-in-1 vaccine.
* Meningococcal C vaccine, known as MenC.
* PCV.

The schedule is different for children born before 1 October 2024. Parents should check their baby’s vaccination record or speak to their GP or public health nurse if they are unsure which schedule applies.

What Does the 6-in-1 Vaccine Protect Against?

The 6-in-1 vaccine protects your baby against six serious infections:

* Diphtheria.
* Tetanus.
* Haemophilus influenzae type b, known as Hib.
* Pertussis, or whooping cough.
* Polio.
* Hepatitis B.

Your baby needs every recommended dose to build effective and lasting protection.

Where Will My Baby Receive Their Vaccines?

Your baby’s routine vaccinations are given by your GP or GP practice nurse.

You may receive a letter with information about the vaccination schedule, but you should contact your GP surgery if you have not received one or if your baby is approaching 2 months of age and does not yet have an appointment.

Your baby should receive their first vaccines at 2 months of age, even if they have not yet received a PPS number.

Bring your baby’s vaccination record or passport to each appointment so that every vaccine can be recorded.

Preparing for the Vaccination Appointment

Before your baby receives a vaccine, tell the GP or practice nurse if your baby:

* Has a temperature of 38°C or higher.
* Is currently unwell.
* Has had a serious reaction to a previous vaccine.
* Has a medical condition affecting their immune system.
* Is taking medication.
* Has a bleeding disorder.
* Was born prematurely or is very small for their age.

A minor illness without a high temperature does not always mean vaccination must be delayed. Your GP or practice nurse will advise you.

Dress your baby in clothing that can be removed easily, as most infant vaccines are given by injection into the thigh. The rotavirus vaccine is given as liquid into your baby’s mouth.

You may find it helpful to feed, cuddle or comfort your baby during and after the appointment.

What to Expect After Vaccination

Most babies have no serious problems after vaccination. Mild side effects are common and usually settle within a short time.

Your baby may experience:

* Soreness, redness or swelling where the injection was given.
* Irritability or unsettled behaviour.
* Sleepiness.
* A reduced appetite.
* A high temperature.
* Mild diarrhoea.

A high temperature is particularly common after the MenB vaccines given at 2 and 4 months.

Paracetamol After the MenB Vaccine

The HSE advises giving liquid infant paracetamol after your baby’s MenB vaccinations at 2 and 4 months to reduce the risk of a high temperature.

Your baby will usually need three doses over 24 hours, with at least 4 to 6 hours between doses. The correct amount depends on your baby’s age and weight.

Give the first dose as soon as possible after vaccination and follow the instructions provided by your GP or practice nurse. If your baby was premature or is small for their age, ask your GP about the correct dose.

Do not give your young baby any medicine unless it is suitable for their age and you know the correct dose.

Caring for Your Baby After Vaccination

After the appointment:

* Offer breastfeeds or formula feeds as usual.
* Give your baby plenty of cuddles and reassurance.
* Keep your baby comfortably dressed and avoid overheating.
* Check your baby regularly.
* Follow the advice given about infant paracetamol.
* Allow your baby to rest if they are sleepier than usual.

A small amount of redness, swelling or tenderness around the injection site is usually normal. Do not rub the area or apply creams unless advised by a healthcare professional.

When to Seek Medical Advice

Contact your GP, GP out-of-hours service or practice nurse if:

* Your baby seems unwell and you are worried.
* Side effects are getting worse rather than improving.
* Your baby is feeding much less than usual.
* Your baby has fewer wet nappies.
* Your baby is unusually sleepy or difficult to settle.
* Redness or swelling around the injection site is spreading.
* Your baby develops a temperature and you are unsure what to do.

There may be another reason for your baby’s symptoms, even if they recently received vaccines.

When to Seek Urgent Help

A temperature of 38°C or higher in a baby under 3 months requires urgent medical assessment.

Call 112 or 999 or go to the nearest emergency department if your baby:

* Has difficulty breathing.
* Has blue lips or tongue.
* Is floppy, unresponsive or difficult to wake.
* Has a seizure.
* Develops swelling of the face, mouth or throat.
* Has a rash that does not fade when pressed.
* Appears seriously unwell.

Serious allergic reactions following vaccination are very rare, but they require immediate medical treatment.

If Your Baby Misses a Vaccination

Vaccines work best when they are given at the recommended ages. This helps protect your baby during the period when they may be most vulnerable to serious infections.

If your baby misses an appointment, contact your GP surgery as soon as possible. Most vaccines can be given later as part of a catch-up schedule, and the vaccination course usually does not need to be started again.

Keep Your Baby’s Vaccination Record Safe

Keep your baby’s vaccination passport or record in a safe place and bring it to every vaccination appointment.

This record may be needed when your child:

* Starts childcare or school.
* Receives future vaccines.
* Travels abroad.
* Changes GP.
* Needs a catch-up vaccination.

If you lose the record or are unsure which vaccines your baby has received, contact your GP or local HSE immunisation office.

Key Points to Remember

* Routine infant vaccinations begin at 2 months of age.
* Vaccines are provided free of charge through the HSE childhood immunisation programme.
* Attend all five GP vaccination visits at 2, 4, 6, 12 and 13 months.
* Babies born on or after 1 October 2024 follow the updated schedule, which includes chickenpox vaccination.
* Give infant paracetamol as advised after the 2- and 4-month MenB vaccinations.
* Contact your GP if your baby misses an appointment.
* Seek urgent medical help for a temperature of 38°C or higher in a baby under 3 months or whenever your baby appears seriously unwell.

This information is based on current HSE childhood immunisation guidance and the HSE My Child resources. Vaccination programmes may be updated. Parents should follow the schedule and advice provided by their GP, practice nurse, public health nurse or hospital team.