Baby Vaccinations at 8 Weeks: Which Jabs, Fever and Paracetamol

This page covers the first routine vaccination visit on the NHS childhood schedule: what is given at 8 weeks, what to expect on the day and over the next couple of days, and what comes next. It follows NHS and UKHSA advice for England. Scotland, Wales and Northern Ireland run their own health services, so follow the invitation and leaflets you are given locally.

Vaccination is your choice. The NHS says vaccines are not mandatory in the UK and cannot be given without your consent, and that it is best to have them on time, but you can usually catch up if you miss one. Your GP, health visitor or practice nurse can answer questions about your own baby.

Which vaccines are given at 8 weeks?

The NHS vaccination schedule lists three vaccines for babies aged 8 weeks, given at the same appointment:

The pneumococcal vaccine is not part of the 8-week visit. The NHS schedule gives the first dose at 16 weeks, with a booster at 1 year. Some babies are offered extra vaccines: the NHS lists BCG (tuberculosis) at around 4 weeks for babies in some groups, and hepatitis B vaccine at birth and 4 weeks for babies born to mothers who have hepatitis B. Your midwife or health visitor will tell you if this applies to your baby.

Booking and where it happens

• Your GP surgery will usually contact you when your baby is due, by letter, text, phone call or email. You do not need to wait: if you know your baby is due, you can speak to the surgery to book (NHS).
• The appointment could be at your GP surgery or a local child health clinic (NHS).
• The NHS says your baby's first vaccinations are at 8 weeks and are offered free of charge in the UK.
• It is really important that premature babies still have their vaccinations from 8 weeks old, says the NHS.
• Let the surgery know beforehand if your baby has a bleeding disorder such as haemophilia, or has had a fit (seizure) in the past without a high temperature (NHS).

Not sure when your baby's date falls? The vaccine schedule calculator turns your baby's date of birth into the dates on the UK schedule.

On the day: what to expect

• Take the red book. The NHS says to remember your personal child health record (in England usually the "red book") so the vaccines can be recorded.
• Dress for easy access. Babies under 12 months have their injections in the thigh, so the NHS suggests clothes that are easy to remove.
• Hold your baby on your knee during the injection. If you would rather not watch, the NHS says you can ask a nurse or another member of staff to hold your baby. Try to stay calm and give yourself plenty of time to get there.
• If your baby is unwell: if they have a high temperature, wait until they are feeling better (NHS). A minor illness without a temperature, such as a cold, does not stop them having the vaccines.
• The rotavirus drops: given by mouth. If your baby spits out or brings up the liquid straight away, they will be given another dose (NHS).

The person who vaccinates your baby will be trained to deal with allergic reactions and treat them immediately. The NHS says serious allergic reactions are very rare and usually happen within minutes.

After the jabs: crying, a sore leg and fever

• Your baby may cry for a little while, which UKHSA says usually settles soon with a cuddle or a feed. Most babies do not have any other reaction.
• Some babies have some swelling, redness or a small hard lump where the injection was given, which may be sore to touch. This usually lasts 2 to 3 days and does not need any treatment (UKHSA).
• Common side effects of the 6-in-1 vaccine include a high temperature, feeling tired, loss of appetite, being sick or diarrhoea, and irritability (NHS). For MenB, the NHS lists swelling or pain at the injection site, a high temperature, feeling tired or irritable, loss of appetite and diarrhoea, and says these usually get better within 1 or 2 days.
• After the rotavirus vaccine, the most common side effects are diarrhoea and being irritable, and for a few weeks your baby's poo may contain a weakened version of rotavirus, so the NHS suggests keeping up regular handwashing, especially after changing a nappy.

Fever and paracetamol after MenB

UKHSA says fever is more common when the MenB vaccine is given with the other routine vaccines at 8 and 12 weeks, and advises giving paracetamol soon after the vaccination rather than waiting for a fever to develop:

• Product: infant paracetamol suspension 120mg/5ml. UKHSA says to get it before the appointment if you do not already have it, from a pharmacy or supermarket. Junior paracetamol (6 plus, 250mg/5ml) is stronger and must not be used in babies.
• Dose: 3 doses of 2.5ml (60mg), measured with a syringe or a 2.5ml spoon. The first dose is given at the time of vaccination or as soon as possible afterwards, the second 4 to 6 hours later and the third 4 to 6 hours after that.
• Sleeping baby: if your baby is asleep when the next dose is due, UKHSA says not to wake them. Give it when they next wake, as long as there is at least 4 hours between doses.
• Still a fever after 3 doses: in the 48 hours after the vaccination, if your baby has a fever but is otherwise well, you can continue the same 2.5ml dose, always leaving at least 4 hours between doses and never giving more than 4 doses in any 24 hours.
• Premature babies: for very premature babies (born before 32 weeks), paracetamol should be prescribed by your doctor according to weight.
• 12 months: three doses are not routinely needed after the MenB booster at 12 months.

UKHSA says the 3-dose advice only applies after the MenB vaccine; at any other time of fever follow the instructions on the packaging. Keep your baby cool with not too many layers of clothes or blankets, and give them lots of fluids. If your baby is breastfed, UKHSA says breast milk is the best fluid to give. UKHSA also says not to put a feverish baby in a bath, sponge them down or put a fan on them, and says never to give medicines that contain aspirin to children under 16.

UKHSA describes a fever as a temperature over 38C. It also notes that the fever shows the baby's immune system is responding, but that the level of fever does not show how well the vaccine will protect your baby.

When to get advice after the jabs

The NHS says to ask for an urgent GP appointment or call NHS 111 if your baby:

• is under 3 months old and has a temperature of 38C or higher, or you think they have a high temperature
• is 3 to 6 months old and has a temperature of 39C or higher, or you think they have a high temperature
• still has a high temperature more than 48 hours after having the MenB vaccination
• is unwell and you are worried about them

After the rotavirus vaccine, the NHS says to get the same urgent advice if your baby keeps being sick, has blood in their poo or poo that looks like redcurrant jelly, has a swollen or painful tummy, stops feeding, has signs of dehydration such as fewer wet nappies, or has diarrhoea for more than 7 days. The NHS describes a very small risk of the bowel becoming blocked (intussusception) in the week after the vaccine. If you are worried, UKHSA says to trust your instincts and speak to your GP or call NHS 111.

What comes next

If your baby misses a dose, contact your GP surgery. The NHS says the rotavirus vaccine can be given up to 15 weeks for the 1st dose and 24 weeks for the 2nd, the MenB vaccine up to the age of 2, and the 6-in-1 vaccine up to the age of 10. For the full UK schedule, see our baby vaccine schedule guide.

If you are in the US: the 2-month visit

The US schedule is different. The CDC's child and adolescent schedule lists first doses of DTaP, Hib, pneumococcal conjugate, polio (IPV) and rotavirus vaccines at 2 months, with hepatitis B starting at birth, and the American Academy of Pediatrics lists a 2-month well-child visit. Ask your pediatrician which vaccines your baby is due for, and do not apply the UK paracetamol advice above to US schedules.

Frequently asked questions