What are the guidelines for administering vaccines to children with underlying health conditions?

Current guidelines for administering vaccines to children with underlying health conditions recommend tailored immunization schedules based on the specific medical condition to reduce the risk of serious infections.

Children with conditions such as asplenia or splenic dysfunction (including sickle cell disease and coeliac disease) should receive MenACWY, MenB, pneumococcal vaccines (PCV13 or PPV23), and annual influenza vaccination.

Children with cochlear implants should be given pneumococcal vaccines (PCV13 or PPV23).

Those with chronic respiratory or heart conditions (e.g., severe asthma, chronic pulmonary disease, heart failure) require pneumococcal vaccines and annual flu vaccination.

Children with chronic neurological conditions (such as learning disabilities) should also receive pneumococcal vaccines and annual influenza vaccine.

Diabetic children are recommended pneumococcal vaccines and annual flu vaccination.

Children with chronic kidney disease, including those on haemodialysis, should receive pneumococcal vaccines, annual flu vaccine, and hepatitis B vaccination.

Those with chronic liver conditions require pneumococcal vaccines, annual flu vaccine, and hepatitis A and B vaccines.

Children with haemophilia should be vaccinated against hepatitis A and B.

Immunosuppressed children due to disease or treatment should receive pneumococcal vaccines and annual influenza vaccination.

Children with complement disorders, including those on complement inhibitor therapy, should receive MenACWY, MenB, pneumococcal vaccines, and annual flu vaccine.

Varicella vaccination is recommended for non-immune children who are close contacts of immunocompromised individuals, with two doses spaced 4–8 weeks apart for children aged 1 year or older. The varicella and MMR vaccines should be spaced 4 weeks apart if not given simultaneously.

Consent must be obtained appropriately, with parental consent for children not competent to consent themselves, and Gillick competence assessed for older children.

Vaccination administration and scheduling should follow the Public Health England Green Book chapters relevant to each vaccine and condition.