Advice for general practice nurses on the MMRV vaccination campaign

GP practices have been offering the chickenpox (varicella) vaccine as part of the expanded routine childhood immunisation schedule since January. Speaking to Nursing in Practice’s Madeleine Anderson, consultant midwife, immunisation programmes division at the UK Health Security Agency (UKHSA), Greta Hayward, outlines the role of general practice nurses (GPNs) in the measles, mumps, rubella, varicella (MMRV) vaccine roll out and advises nurses on how best to engage patients who are hesitant to get their child vaccinated.

Why is the role of practice nurses so important when it comes to childhood vaccination?

We know that parents across the UK continue to have a high level of confidence in childhood vaccinations and maintaining that confidence is extremely important to us at UKHSA. That is why we commission regular parental attitudinal surveys to understand what parents think and feel about vaccines for their children.

Our latest survey, published in August last year, showed around 87% of parents agree that vaccines work, 85% believe they are safe, and 84% say they trust them. Another consistent finding is that NHS healthcare professionals, particularly nurses, remain the most trusted source of vaccine information for parents of children aged four and under.

This tells us something very important. What we say as nurses, and how we say it, genuinely matters.

How should nurses approach conversations with parents who have questions or concerns about the MMRV vaccine?

It is completely normal for parents to have questions. Whenever someone sees a healthcare professional, whether that is a nurse or a doctor, it is natural to want to understand more about a treatment or intervention.

Often, a short and simple conversation is enough to address concerns and help parents make an informed decision, which we hope will lead to vaccination. For parents who seem a little more hesitant, it is important to take time to listen and to understand exactly what they feel uncertain about. Once you do that, it becomes much easier to respond to the real issue.

Sometimes hesitancy is not the barrier at all. Parents may be worried about side effects or concerned about something they have heard from a friend or relative. There is a great deal of information available, and not all of it is reliable.

By listening and acknowledging concerns in a non-judgemental way, nurses can open the door to an honest and supportive conversation. It can be tempting to jump straight in with statistics, but too many facts at once can feel overwhelming or even confrontational. Asking open questions, validating feelings and keeping messages simple is often far more effective.

What key messages should nurses share about the MMRV vaccine?

Simple messages are often the most effective. The MMRV vaccine is not new. It has been used safely for many years and is already part of routine childhood vaccination programmes in several countries worldwide. It is well researched and has a strong safety record.

Every vaccine used in the UK must go through extensive safety and efficacy trials, and the MMRV vaccine is no exception. A UK study published in 2023 found that most parents supported adding varicella vaccination to the childhood programme, and most preferred a combined MMRV vaccine rather than an additional separate injection.

Will introducing MMRV affect workload in general practice?

When any new vaccine is introduced into the childhood schedule, vaccination appointments may take a little longer at first. Nurses are adjusting to a new schedule and parents may naturally have more questions.

However, these changes usually settle quickly into routine practice. We have seen several updates to the UK immunisation schedule in recent years, and each time nurses have been excellent at adapting. Their skill, flexibility and reassurance make a real difference to families and to the success of vaccination programmes and the control of infectious diseases.

It is also important to note that the MMRV vaccine directly replaces the MMR vaccine rather than adding an extra appointment.

Why is protection against chickenpox important?

For many children, chickenpox is mild, but a proportion will develop complications. These include bacterial infections of skin lesions, which account for around 11% of complications in children admitted to hospital with varicella.

There can also be neurological complications, such as acute cerebellar ataxia, and in rare cases more serious outcomes include encephalitis, pneumonitis and stroke. These complications can result in hospitalisation and, very rarely, death.

Are there wider benefits to the MMRV programme beyond clinical protection?

Yes. The benefits are not just clinical. Chickenpox has a significant social and economic impact. Research suggests around £24m a year is lost in income and productivity due to parents taking time off work and children missing school or nursery.

Children are usually off school for at least five days with chickenpox, and often longer. This creates childcare challenges, sick leave pressures and disruption for families. By vaccinating children with the MMRV vaccine, we expect far fewer cases of chickenpox, fewer missed days of education and less time parents need to take off work.

Overall, the programme is expected to reduce chickenpox cases, prevent complications and lessen the wider impact on families. It is a simple intervention that brings clear benefits across the population.

What advice should nurses give to parents who have missed vaccination appointments?

The most important message is that it is never too late for a child to be vaccinated. If a child has missed an appointment, parents should be encouraged to come forward as soon as possible.

UKHSA provides a catch-up algorithm for children who are behind with their vaccination schedule. This supports nurses in identifying which vaccines are outstanding and what steps to take next. Once gaps are identified, parents should be encouraged to bring their children in promptly so they can be protected against potentially serious infections.

The UK immunisation schedule is carefully planned so children receive protection before they reach the age at which they are most at risk. If something is missed, arranging a catch-up appointment is the best course of action. While we recommend following the routine schedule where possible, it is never too late for an eligible child to receive the MMRV vaccine and gain protection against measles, mumps, rubella and varicella.

I recognise that the schedule can feel busy or complex, which is exactly why the catch-up algorithm exists.

What is the key message for nurses in general practice?

Your guidance, reassurance and clear communication are central. Advising parents when the next vaccine is due, how to book appointments and what to expect makes a real difference.

Nurses are key to helping families catch up on missed vaccinations and ensuring children remain fully protected.

At the end of last year, the government issued guidance for parents and carers of children to help them understand the introduction of the new combined MMRV vaccine.

Meanwhile, key information on the implementation of a new chickenpox vaccination programme – including eligibility, funding and vaccine supply – was released by the government in November 2025.

The conversation comes as a recent episode of the Nursing in Practice Podcast examines latest changes to the MMRV and RSV vaccination programmes.