The 18-month appointment was added to the NHS schedule recently, so many parents have never heard of it. Your child has two injections: a fourth dose of the 6-in-1 vaccine and a dose of MMRV.
Who gets what depends on date of birth. Children born on or after 1 July 2024 have the 4th 6-in-1 dose here. For MMRV: children born on or after 1 January 2025 get their second dose, and children born between 1 July and 31 December 2024 get their first.
From the official NHS schedule, last checked 16 September 2026. Reflects the schedule for a baby born in 2026. Children born earlier may follow slightly different dates during the 2024-2026 transition to the 4-dose 6-in-1, the 18-month appointment and MMRV (which now includes chickenpox) - your GP or Red Book has the exact plan.
A booster dose introduced to the UK schedule in 2025. It keeps protection strong through the toddler years and replaces the separate Hib/MenC booster that used to be given at 1 year.
The second MMRV dose. Two doses give around 99% protection against measles and strong protection against chickenpox.
Why a fourth 6-in-1 dose
The extra 6-in-1 dose boosts protection against diphtheria, tetanus, whooping cough, polio, Hib and hepatitis B as your child gets older. Previously children had a separate Hib/MenC booster at 1 year; the 6-in-1 at 18 months replaces that.
A toddler, not a baby
At 18 months your child knows what is happening and may be more upset by the injections than they were as a baby. A favourite toy, a snack straight afterwards or sitting on your lap facing you can all help. It is quick, and most toddlers settle within minutes.
The jabs may be given in the thigh or upper arm.
Delayed reactions from MMRV
As with the first MMRV dose, a measles-like rash with a temperature can appear about 6 to 10 days later, and a few chickenpox-like spots near the injection site about 3 to 4 weeks later. Keep any spots covered; your child can still go to nursery.
What is normal afterwards
- Swelling or pain where the injections were given.
- A high temperature, tiredness or loss of appetite for a day or two.
- Delayed MMRV rashes as described above.
When to get help
Ask for an urgent GP appointment or call NHS 111 if your child:
- has a seizure (fit)
- is unwell and you are worried about them
Call 999 if your child has difficulty breathing, is floppy or unresponsive, or has a fit for the first time.
This page is general information, not medical advice. Your GP, practice nurse, health visitor or pharmacist can advise on your own child.
2 years to school Year 11 (annually): Children's flu vaccine.
Enter your child's date of birth on our United Kingdom schedule page to see when each appointment is due, and add reminders to your phone calendar.
It may be. Children born before 1 July 2024 follow the older timetable and do not have the 18-month 6-in-1 dose. If you are not sure, ask your GP surgery - they can check your child's record.
Yes, that completes the 6-in-1 course. The next routine vaccine is the 4-in-1 pre-school booster at 3 years 4 months, and the yearly nasal flu vaccine from age 2.
Yes. Children can have several vaccines at the same appointment. The nurse will tell you what is due.
- United Kingdom schedule - NHS / UK Health Security Agency (UKHSA)
- NHS - Vaccinations and when to have them
- NHS - 6-in-1 vaccine
- NHS - MMRV vaccine
Checked against these NHS pages on 1 November 2026. How we research and check: our editorial policy.
Other United Kingdom appointments
8-week jabs · 12-week jabs · 16-week jabs · 1-year jabs · Pre-school booster