The 6-in-1 vaccine is the first routine vaccine offered to babies in Wales. It protects against six serious infectious diseases:
The vaccine is given to your child because these diseases can cause severe illness, permanent disability, or death, particularly during infancy and early childhood.
The 6-in-1 vaccine used in the UK is supplied as:
The vaccine provide protection against the same six diseases. Click the links to find out more about vaccine ingredients
In Wales, babies are routinely offered the vaccine at:
All doses are recommended for the best possible protection.
For babies born on or after 1 July 2024, the 18-month 6 in 1 booster replaces the previous Hib/MenC vaccination and strengthens long-term protection against Hib and against all six diseases.
The vaccine is given as an injection in your child's thigh muscle or upper arm depending on their age and size.
During pregnancy, protective antibodies pass from mother to baby through the placenta. These antibodies provide temporary protection after birth.
This natural protection gradually decreases during the first weeks of life. At the same time, babies come in contact with various viruses and bacteria in their environment.
The 6 in 1 vaccine is given for the first time at 8 weeks to help your baby's immune system learn how to fight these diseases before they are most at risk
Premature babies are at an even greater risk of severe infection because their immune systems are less developed. They should receive vaccinations according to their actual date of birth, not their expected due date.
What is diphtheria?
Diphtheria is a serious bacterial infection.
The bacteria infect the nose and throat and produce a powerful toxin that damages cells throughout the body. It can quickly lead to breathing problems and may damage the heart and nerves. In severe cases, it may cause death
Before the diphtheria vaccine was introduced to the UK, there were up to 70,000 cases of diphtheria and up to 5,000 deaths a year.
Because of vaccines, diphtheria is rare in the UK, but cases continue to occur worldwide.
How does diphtheria spread?
Diphtheria spreads through:
The infection spreads rapidly where vaccination rates are low.
Symptoms may include:
In places with poor hygiene, infection of the skin (cutaneous diphtheria) is more common.
If it's cutaneous diphtheria, it can cause:
pus-filled blisters on your legs, feet and hands
large ulcers surrounded by red, sore-looking skin
Complications
Serious complications include:
What is tetanus?
Tetanus is a disease that affects the body’s nerves, causing muscle spasms and breathing problems. It is a severe disease that can lead to serious health problems if not treated quickly
The bacteria is common in our environment and found in soil, dust and animal manure.
It can enter the body through a wound, cut, burn, animal bites, or scratches. Tetanus cannot spread from person to person.
Symptoms
Symptoms can be severe and extremely painful.
Complications
Even with modern medical treatment, tetanus remains a serious condition.
What is whooping cough?
Pertussis, more commonly known as whooping cough, is an infection that affects the lungs and airways. Whooping cough is very infectious, which means it passes easily from one person to another
Although older children and adults often recover, it is particularly dangerous for young babies, especially before they have completed their vaccination. Which is why whooping cough vaccinations are given in pregnancy as well.
How does whooping cough spread?
The infection spreads when infected people:
Symptoms
Early symptoms resemble a common cold:
After one to two weeks, severe coughing attacks develop.
Symptoms may include:
Young babies may not cough but instead stop breathing temporarily (apnoea).
Complications
Complications can include:
Babies younger than six months are at greatest risk.
What is polio?
Polio is a virus that can affect your nerves. It can cause permanent muscle weakness, usually in the legs. If polio affects the chest muscles or the brain, it can lead to very serious health problems.
Before the polio vaccine was introduced, there were as many as 8,000 cases of polio in the UK. Thanks to the polio vaccination’s ongoing success, the UK hasn’t seen a natural polio infection in over 40 years. The last case was reported in 1984. This is why it is important to vaccinate to stop diseases such as polio from coming back
How does polio spread?
Symptoms
Many infected people have no symptoms.
Those who become ill may develop:
Rarely, polio can lead to more serious symptoms that affect the brain and nerves, such as weakness in your muscles (paralysis), usually in the legs.
Complications
Polio can cause:
Paralysis caused by polio is permanent.
What is Hib?
Hib is a bacterial infection that can cause severe invasive disease in young children.
Before vaccination, Hib was one of the leading causes of bacterial meningitis in young children in the UK.
How does Hib spread?
Hib spreads through:
Hib can cause:
Complications
Possible complications include:
What is hepatitis B?
Hepatitis B is an infection of the liver caused by the hepatitis B virus. In children it often continues for years (without symptoms) and may eventually cause serious liver damage
How does hepatitis B spread?
The virus spreads through:
Symptoms
Many infected children have no symptoms.
Complications
Long-term complications include:
Can six vaccines overload a baby's immune system?
No.
Babies encounter thousands of bacteria, viruses, and other substances every day through breathing, feeding, and contact with their environment.
Vaccines represent only a tiny fraction of the challenges routinely handled by the immune system.
Evidence shows combination vaccines are both safe and effective.
What to do in case of allergic reactions
Vaccinations are given by trained healthcare professionals who are equipped to recognise and treat severe allergic reactions such as anaphylaxis immediately if it occurs.
Very rare side effects from the vaccine include allergic reactions, such as swelling of the face, lips, tongue or throat, hives (a raised, itchy rash), difficulty breathing or swallowing, and feeling dizzy.
These symptoms may be a sign of a serious allergic reaction and usually happen within 15 minutes of being vaccinated. Call 999 straight away if your child has had the vaccine and has any of these symptoms.
You can find reports of all side effects in the patient information leaflet for the vaccine. For more information, go to:
If your child’s symptoms get worse or if you are concerned, contact NHS 111 Wales by calling 111 or your GP surgery. Calls to NHS 111 Wales are free from landlines and mobile phones.
You should report suspected side effects of vaccines and medicines online at Yellow Card, by downloading the Yellow Card app, or by calling 0800 731 6789 (Monday to Friday, 9am to 5pm).
Mild redness, swelling, soreness, or a small lump at the injection site are common after vaccination and are not signs of a severe allergic reaction.
What are the common side effects?
Like many medications, vaccinations also have common side effects such as:
Most side effects are mild and resolve within a few days.
Are there any other reasons why the vaccine should not be given?
There are very few reasons why children cannot be vaccinated.
One reason would be a serious, life-threatening reaction to the previous dose of the vaccine or any ingredient in the vaccine.
Most children with allergies can have the vaccine with no problems.
Speak to the person giving your baby the vaccine if your baby has had a serious allergic reaction to the vaccine or ingredients in the past.
Speak to your doctor, practice nurse or health visitor before having the vaccine if your child:
Why are booster doses needed?
Babies need more than one dose of some vaccines to build strong, long-lasting protection. The 6-in-1 vaccine is one of these, and it's recommended to receive 4 doses over an extended period.
Each dose helps the immune system strengthen its response to the diseases covered by the vaccine.
The first dose starts teaching the immune system how to recognise these diseases.
The second dose helps build stronger protection.
The third dose strengthens and extends that protection.
Having all recommended doses helps provide the best possible protection against all six diseases.
Why is another dose given at 18 months?
As children begin nursery or other social activities, they encounter a greater number of infectious diseases.
The 18-month booster dose was introduced into the Welsh childhood immunisation programme to strengthen protection during the toddler years.
What happens at the appointment?
The practice nurse or GP will explain about the vaccinations and answer your questions. With babies, the vaccine is given by injection in the thigh. In children over the age of 12 months, injections are usually given in the upper arm.
Write down any questions you have and ask the health professional at the vaccination appointment.