Child Immunisation Declining

 
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Child Immunisation Declining

Immunisation Decline

This form should only be used when the offer of immunisation(s) are declined. Please ensure that all relevant information is provided.

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Gender: *
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8 Week Vaccinations

When your child has reached 8 weeks or more they will be due to have the following set of immunisations.

For more information, visit the NHS website

1st 6in1: Diphtheria, Tetanus, Pertussis (whooping cough), Polio, Hib & Hepatitis B :
Rotavirus vaccine:
MenB vaccine:
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12 Week Vaccinations

When your child has reached 12 weeks or 4 weeks after the first set of immunisations, they will be due to have the following set of immunisations.

For more information, visit the NHS website

2nd 6in1: Diphtheria, Tetanus, Pertussis (whooping cough), Polio, Hib & Hepatitis B:
MenB vaccine:
Rotavirus vaccine:
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16 Week Vaccinations

When your child has reached 16 weeks or 4 weeks after the last vaccinations, they will be due to have the following set of immunisations.

For more information, visit the NHS website

3rd 6in1: Diphtheria, Tetanus, Pertussis (whooping cough), Polio, Hib & Hepatitis B:
1st Pneumococcal Vaccine:
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12/13 Month Vaccinations

When your child has reached 1 year old, they will be due to have the following set of immunisations.

For more information, visit the NHS website

1st MMR (Measles, Mumps & Rubella):
2nd Pneumococcal Vaccine:
3rd Meningitis B Vaccine:
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18 Months Vaccinations

If your child is born after 1st July 2024, when your child has reached 18 months, they will be due to have the following set of immunisations. For more information visit the NHS website

4th dose 6in1: Diphtheria, Tetanus, Pertussis (whooping cough), Polio, Hib & Hepatitis B:
2nd MMR (Measles, Mumps & Rubella) Vaccine:
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3years 4months Vaccinations

When your child has reached 3 years 4 months they will be due to have the following set of immunisations. If they were born before 30th June 2024, they will also be due for their 2nd MMR vaccine.

For more information, visit the NHS website

4in1 Pre-school booster (Diphtheria, Tetanus, Pertussis & Polio vaccine:
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