Guidance: Hexavalent combination vaccine: programme guidance

Guidance for healthcare practitioners on the hexavalent vaccine programme, including its use in the selective neonatal hepatitis B programme.

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All babies born on or after 1 August 2017 are eligible for the hexavalent vaccine, which includes hepatitis B (HepB), for their primary immunisations. From July 2025, the routine childhood immunisation schedule changed, and children born on or after 1 July 2024 will receive an additional hexavalent vaccine at 18 months of age. The selective neonatal hepatitis B pathway for children born to women with hepatitis B was also amended.

This guidance is aimed at healthcare practitioners involved in the programme and provides information about the hexavalent vaccines ( Vaxelis® and Infanrix hexa®), including information on the changes, eligibility, scheduling and vaccine administration. Separate information for healthcare practitioner guidance, specifically covering the changes to the routine childhood schedule from 1 July 2025 and January 2026, is also available.

Appendix A: the number of hepatitis-B containing vaccine doses for children flowchart amended for clarity.

Updated to reflect that changes to the childhood programme have been in place for a year, DOB based cohorts have been updated for clarity

Updated to include new training slides for download and updates to the main guidance document to reflect the introduction of MMRV to the routine schedule for children from 1 January 2026

Updates made to the guidance for healthcare practitioners relating to the changes to the childhood schedule from 1 July 2025. Additional appendix A added.

Added new slide set which includes all the changes to the childhood vaccination programme.

Added updated guidance and training slide set.

Updated information on incomplete or uncertain vaccination histories and stability of Vaxelis.

Added updated information for healthcare practitioners and link to updated training slide set.