Why There's No 6-Month NHS Vaccination — The Direct Answer
The UK NHS immunisation schedule uses a compressed front-loaded approach: three appointments in the first 16 weeks of life complete the primary immunisation course. By 4 months, a UK baby has received three doses of the 6-in-1 (covering six diseases), two doses of MenB, two doses of rotavirus, and one dose of PCV. The primary course is done.
Other countries — most visibly the USA, Canada, and Australia — include a 6-month appointment because their schedules space the same primary course more widely. The US schedule gives the equivalent 6-in-1 doses at 2 months, 4 months, and 6 months. The UK gives them at 8 weeks, 12 weeks, and 16 weeks. Both achieve the same endpoint; the UK does it faster and with fewer appointment visits.
| Appointment | UK NHS Schedule | US CDC Schedule | Key Difference |
|---|---|---|---|
| First appointment | 8 weeks — 6-in-1, MenB, Rotavirus | 2 months — DTaP, Hib, IPV, PCV, Rotavirus, Hep B 2nd dose | UK 6-in-1 includes Hep B; US gives Hep B separately. UK includes MenB routinely; US does not |
| Second appointment | 12 weeks — 6-in-1, PCV, Rotavirus | 4 months — DTaP, Hib, IPV, PCV, Rotavirus | Near-identical vaccine coverage; timing 4 weeks apart |
| Third appointment (primary) | 16 weeks (4 months) — 6-in-1, MenB. Primary course COMPLETE | 6 months — DTaP, Hib, IPV, PCV, Rotavirus, Flu (1st dose), Hep B 3rd dose | UK primary course is complete at 4 months; US continues to 6 months. US adds flu routinely from 6 months; UK does not for healthy babies |
| At 6 months | No routine vaccination appointment | Third primary appointment — vaccination visit | This is the source of parental confusion for UK families with US connections or who have moved from the US |
| Next appointment after primary | 12–13 months (MMR, boosters) | 12–15 months (MMR, Hib booster, Varicella, Hep A, PCV booster) | UK next appointment is at 1 year. US varicella and Hep A are not part of the routine UK schedule |
What Protection Is in Place at 6 Months — The Immunity Picture
After completing the primary course at 16 weeks, your baby's immunity at 6 months looks like this:
| Disease / Pathogen | Status at 6 Months | Notes |
|---|---|---|
| Diphtheria | ✅ 3-dose primary course complete | Strong protection; pre-school booster extends it at 3 years 4 months |
| Tetanus | ✅ 3-dose primary course complete | Strong protection; pre-school booster at 3 years 4 months; adult booster at 14 |
| Whooping cough (pertussis) | ✅ 3-dose primary course complete | Good protection; some natural waning occurs over years; pre-school booster important |
| Polio | ✅ 3-dose primary course complete | Strong protection; pre-school booster at 3 years 4 months; teenage booster at 14 |
| Hib meningitis | ✅ 3-dose primary course complete | Good protection; 1-year Hib/MenC booster further consolidates |
| Hepatitis B | ✅ 3-dose primary course complete | Long-lasting protection established; no UK booster in standard schedule |
| Rotavirus | ✅ 2-dose course complete | Good protection against severe rotavirus gastroenteritis through early childhood |
| Meningococcal B (MenB) | ⚠️ 2 of 3 doses given | Substantial but incomplete protection; 3rd dose (booster) at 1 year optimises long-term immunity — baby is not unprotected but is partially protected |
| Pneumococcal (PCV) | ⚠️ 1 of 2 doses given | Partial protection; PCV booster at 1 year needed for full coverage across all strains |
| Measles | ❌ No protection yet | MMR first dose not until 1 year — baby is unvaccinated against measles, mumps, and rubella until then |
| Mumps and rubella | ❌ No protection yet | Part of MMR; given at 1 year; risk in normal childhood is low but measles remains circulating in UK |
| Meningococcal C (MenC) | ❌ Not yet given | Hib/MenC booster at 1 year; note: MenC disease has become rarer in UK due to the vaccine programme in older cohorts |
The Measles Gap
The absence of measles protection until 1 year is the most clinically significant gap in the 6-month immunity picture. Measles remains the most contagious respiratory disease known — a single case in an unvaccinated community can infect 90% of contacts. Measles outbreaks continue to occur in the UK in areas with below-threshold MMR uptake.
For a 6-month-old in normal daily life — at home, visiting family, at baby groups with a similar vaccination status — the practical risk is low but not zero. Being aware that measles is unvaccinated territory until 1 year is a useful piece of information — not because it should change daily plans, but because it explains why the 1-year MMR appointment should be kept without delay.
The 6-8 Month Health Visitor Review — What IS Routine Right Now
While no vaccination is due, the health visitor 6-8 month review is a meaningful routine contact that most families in England receive. Availability and format vary by area — it may be a clinic appointment, a home visit, or a phone call — but the content is consistent.
| Area Assessed | What the Health Visitor Checks | What's Normal at 6-8 Months |
|---|---|---|
| Growth | Weight, length, and head circumference plotted on the growth chart in the red book; trajectory since birth | A consistent centile or gradual movement within 2 centile spaces; abrupt drops warrant investigation; crossing upward centiles noted for feeding assessment |
| Motor development | Sitting with and without support; reaching and grasping; transferring objects between hands; rolling; weight-bearing through legs when held standing | Sitting with support expected; many babies sitting briefly unsupported; rolling at least one direction; strong grasp; passing objects hand-to-hand emerging |
| Communication | Responding to name; turning toward sounds; babbling (da, ba, ma — early consonant sounds); responding to emotional tone of voice | Should respond consistently to own name by 6–8 months; babbling present; stranger awareness often developing |
| Vision | Tracking objects; reaching accurately for items; responses to faces; any concerns from the 8-week red reflex check followed up | Accurate reaching; good eye tracking; responds to faces and movement at distance |
| Hearing | Response to voices, sounds from different directions; any concerns from the newborn hearing screening followed up | Turning toward sound sources; startling to sudden sounds; different responses to familiar vs. unfamiliar voices |
| Weaning and feeding | Whether solid food introduction has begun; feeding approach; any feeding difficulties; breastfeeding or formula feeding continuation | NHS guidance: solid foods from around 6 months; signs of readiness (sitting with support, good head control, loss of tongue-thrust reflex, showing interest in food) |
| Sleep | Parental wellbeing regarding sleep; any concerns about sleep safety; support with sleep routines if needed | Wide variation is normal at 6–8 months; night waking is developmentally normal; the 6-month sleep regression has typically passed or is resolving |
| Parental wellbeing | Postnatal depression screening (PHQ-9 or equivalent); anxiety; relationship; social support; domestic safety if concerns | The 6-8 month check is an important point for identifying postnatal depression that was missed at earlier contacts; symptoms peaking at 3–6 months are not uncommon |
The Flu Vaccine at 6 Months — Who Is Eligible and What It Involves
For healthy babies in the UK, the routine nasal spray flu vaccine begins at 2–3 years of age. However, babies aged 6 months and above who have certain health conditions are eligible for the annual flu vaccine through the at-risk programme.
Conditions That Qualify at 6 Months
| Condition | Why Flu Poses Higher Risk | Confirmation Needed |
|---|---|---|
| Chronic heart or lung conditions (including severe asthma requiring regular inhaled steroids) | Influenza significantly worsens respiratory and cardiac function; can trigger acute deterioration | GP assessment; not all asthma qualifies — severity and treatment type matter |
| Chronic kidney or liver disease | Impaired immune response and metabolic vulnerability to severe flu | GP confirmation of condition severity |
| Chronic neurological conditions (including cerebral palsy, muscular dystrophy, stroke-related conditions) | Respiratory complications from flu are more severe; swallowing difficulties increase aspiration risk | GP or specialist confirmation |
| Immunosuppression (from disease or treatment, including corticosteroid treatment at immunosuppressive doses) | Inability to mount normal immune response to influenza; higher risk of severe complications | GP confirmation; may require specialist advice on timing relative to treatment |
| Diabetes | Influenza disrupts metabolic control; increased risk of diabetic ketoacidosis and complications | GP confirmation; relevant even for well-controlled diabetes |
| Severe or morbid obesity | Higher risk of influenza-related respiratory complications | GP assessment by clinical measure rather than parental perception of weight |
What the Flu Vaccine Involves for Under-2s
The nasal flu spray (Fluenz Tetra) is a live attenuated vaccine given as a nasal spray and is the standard form for healthy children aged 2–17 years. For at-risk babies under 2 years, the flu vaccine is given as an inactivated flu injection — not the nasal spray. The injection is given once per season for the first year of vaccination, and once per season thereafter.
If your baby has a qualifying condition, contact your GP surgery before the autumn flu season (typically August–October in the UK) to arrange the injection. The vaccine composition changes annually to match circulating strains — so it must be given each flu season, not just once.
RSV and Your 6-Month-Old — The Respiratory Virus That Hospitalises UK Babies
RSV (Respiratory Syncytial Virus) causes the majority of cases of bronchiolitis — a chest infection that narrows the tiny airways in young babies and is the most common reason babies under 12 months are admitted to hospital in the UK. RSV peaks November to February. Approximately 1 in 50 UK babies is hospitalised with RSV bronchiolitis in their first winter.
The Maternal RSV Vaccine Programme
Since 2024, the NHS has offered an RSV vaccine (Abrysvo) to pregnant women at 28–36 weeks gestation. The vaccine causes the mother to produce RSV antibodies that cross the placenta to the baby before birth, providing protection through the first 6 months of life — the highest-risk window.
If your baby's birth mother received the RSV vaccine in the recommended window during pregnancy, your baby has meaningful RSV protection. If the maternal vaccine was not received (either because it was not offered, was declined, or the baby was born before the programme started), there is no maternal RSV protection in place.
Nirsevimab (Beyfortus) for High-Risk Babies
Nirsevimab (branded Beyfortus) is a monoclonal antibody injection — not a traditional vaccine — that provides direct RSV protection to high-risk babies for approximately 5 months. In the UK, it is available for babies who are at highest risk of severe RSV disease:
- Babies born significantly premature (particularly below 29 weeks gestation) in their first RSV season
- Babies with congenital heart disease or chronic lung disease
- Babies with immunosuppression
If your baby was premature or has a cardiac or respiratory condition, ask the specialist team or your GP about RSV protection before the baby's first RSV season. Timing matters — it is given at the start of the RSV season, not at birth.
RSV Signs in a 6-Month-Old
Most 6-month-old babies who contract RSV will have a cold-like illness that passes at home. Signs that the RSV has progressed to bronchiolitis warrant medical assessment:
- Breathing that is faster than usual or visibly effortful — ribs visible, tummy sucking in with each breath
- Persistently high temperature not responding to paracetamol
- Significantly reduced feeding (less than half their usual volume in 24 hours)
- Fewer wet nappies than normal
- Blue or grey colour around the lips or fingertips (call 999)
- Unusually floppy, unresponsive, or difficult to rouse (call 999)
- Stopping breathing, even briefly (call 999)
Meningitis Warning Signs — What Every Parent Needs to Know at 6 Months
Your baby has received two of the three MenB (meningococcal B) vaccine doses. The third — the booster — is at 1 year. Two doses provide substantial but not complete protection against the most common cause of bacterial meningitis in the UK. This is the period during which knowing the warning signs is most important.
Bacterial meningitis can develop and worsen rapidly — hours, not days. It is rare, but the consequences of delayed recognition are severe. Parents who know the signs have repeatedly been shown to seek help earlier and improve outcomes.
- Non-blanching rash — red or purple spots or patches that do not fade when pressed firmly with a clear glass. Can start as a fine spotty rash. This is a medical emergency — call 999 now, do not wait for other symptoms
- High-pitched, unusual, or moaning cry — different in character from the baby's normal cry; often described as a continuous moan or "meningitis cry"
- Stiff neck — resistance when the head is gently moved forward toward the chest; difficult to assess in a baby but sometimes visible as reluctance to move the head
- Tense or bulging fontanelle — the soft spot on top of the head feels firm or pulsating outward; normally it is soft and slightly concave
- Extreme irritability — baby is inconsolable; may resist or cry harder when picked up rather than settling (dislike of being handled)
- Sensitivity to light — baby appears distressed by or turns away from normal light
- Fever with cold hands and feet — temperature at the core (forehead, body) is high while extremities are cold; mottled skin
- Seizures or unusual jerking movements
- Drowsiness or unresponsiveness — difficult to rouse; limp; not responding to normal stimuli
Meningitis Research Foundation (meningitis.org) provides a free app, "Meningitis Now," with the glass test and symptom guide — a useful reference to have on your phone during the gap before the 1-year MenB booster.
Whooping Cough at 6 Months — What Protection the Primary Course Provides
Whooping cough (pertussis) was the most urgent driver of the maternal vaccination programme (given in pregnancy at 16–32 weeks) and of the 8-week start to the infant schedule. The disease is most dangerous — potentially fatal — in the first 3 months of life. By 6 months, a baby who has completed the primary course has meaningful protection.
The primary course protection is not permanent — pertussis immunity wanes over years, which is why the pre-school booster at 3 years 4 months exists. But at 6 months, the primary course immunity is relatively fresh and provides good protection against serious disease.
Signs of whooping cough to know: prolonged coughing fits (lasting more than 3 weeks) with a distinctive "whooping" sound as the baby gasps for breath after coughing; vomiting after coughing bouts; coughing to the point of turning red or blue. Vaccinated babies who contract whooping cough typically have milder illness — but vaccinated does not mean immune in all cases. If a prolonged or atypical cough develops, contact your GP.
If Vaccines Were Missed — What Can Still Be Caught Up at 6 Months
If the primary course appointments at 8, 12, or 16 weeks were delayed, missed, or only partially completed, the catch-up situation at 6 months is as follows:
| Vaccine | Can It Be Caught Up at 6 Months? | What to Do |
|---|---|---|
| 6-in-1 (any missed dose) | ✅ Yes — no age limit for catch-up | Contact surgery; missed dose(s) can be given now; the course continues from where it left off, not from the beginning |
| MenB (missed 1st or 2nd dose) | ✅ Yes — can be given at any age | Contact surgery; catch-up schedule may differ from the primary schedule — your GP will advise on timing and dosing interval |
| PCV (missed 12-week dose) | ✅ Yes — can be given now | Contact surgery; given as a single catch-up dose; the 1-year booster still needed regardless |
| Rotavirus 1st dose (missed before 15 weeks) | ❌ Cannot be given — deadline passed | The first dose must be given before 15 weeks; the second before 25 weeks. Both deadlines have passed by 6 months. The rotavirus course cannot be started or completed after these ages. Contact surgery for documentation only |
| Rotavirus 2nd dose only (if 1st given but 2nd missed) | ❌ Likely cannot be given — depends on exact age | The 2nd dose must be given before 25 weeks. If the baby is under 25 weeks, contact surgery urgently. If over 25 weeks, the deadline has passed |
Situations Parents Face at 6 Months
"My friend in America says her 6-month-old just had vaccines — why didn't mine?"
Your friend's baby is receiving their third primary-course appointment — the equivalent of what your baby received at 16 weeks. The US spaces the same primary vaccines across 2, 4, and 6 months; the UK covers the same diseases at 8, 12, and 16 weeks. The outcome in terms of protection is similar; the UK achieves it two months earlier. Additionally, the US routinely gives flu and hepatitis A vaccines that are not in the standard UK schedule. Your baby is not behind the US schedule — they are ahead of it on primary course completion.
"I'm worried about meningitis — my baby only has 2 of the 3 MenB doses"
Two doses of MenB provide meaningful protection — this is not a binary state of protected vs. unprotected. The 1-year third dose is a booster that deepens and extends long-term immunity rather than being the first dose that provides protection. The risk of MenB meningitis, while serious, is rare at population level. The most useful thing to do with this concern is to memorise the meningitis warning signs — particularly the non-blanching rash and the glass test. Knowing what to look for and acting quickly is the most effective mitigation available.
"It's winter and everyone keeps talking about RSV — how do I know if my baby has bronchiolitis?"
The progression from a cold to bronchiolitis typically happens over 2–3 days. Day 1–2: runny nose, mild cough, possibly mild fever — looks like a normal cold. Day 3–5: the cough worsens; breathing may become faster or more effortful; feeding reduces. The key signs that distinguish bronchiolitis from a cold are: breathing that is visibly faster or harder than usual; ribs visible with each breath (recession); reduced feeding significantly (less than half the usual volume); fewer wet nappies. These signs warrant a same-day GP call or NHS 111 contact. Blue colour around the lips or breathing that stops, even briefly, is a 999 emergency.
"We missed the 12-week appointment due to illness — what do we do now?"
Contact your surgery as soon as possible. The 6-in-1 second dose and PCV first dose that were due at 12 weeks can still be given at 6 months — no deadline has passed for these. The rotavirus second dose deadline at 25 weeks is the critical one: if the baby is currently under 25 weeks and the second rotavirus dose was missed at 12 weeks, contact the surgery urgently to give it before the deadline. If the baby is over 25 weeks, that dose can no longer be given — but all other missed vaccines can still be caught up. Raise the missed appointment when you call; the surgery may have a catch-up protocol that allows a combined appointment.
What's Coming — The 1-Year Booster and Beyond
The next routine vaccination appointment is at 12–13 months. This is one of the most consequential appointments in the schedule — it adds protection against measles (the MMR), completes the MenB course, and boosts several vaccines from the primary series.
| Vaccine | What It Covers | Why It Matters |
|---|---|---|
| MMR (1st dose) | Measles, mumps, rubella — all three in one injection | The only measles protection in the schedule — urgently important given measles is highly contagious and is still circulating in the UK. This appointment should not be delayed |
| MenB booster (3rd dose) | Meningococcal B — the 3rd and final dose in the schedule | Optimises long-term MenB immunity; the paracetamol guidance applies again at this appointment |
| Hib/MenC (booster) | Haemophilus influenzae type b and meningococcal C combined | MenC is given for the first time in the standard schedule here; Hib immunity from the primary course is boosted |
| PCV booster | Pneumococcal conjugate vaccine — the 2nd and final dose | Extends and deepens pneumococcal protection; the 1-dose primary at 12 weeks provides partial protection; this completes the picture |
6-Month Health Checklist
- Confirm the 6-8 month health visitor review is booked ☐
- Bring the red book to the health visitor review ☐
- If your baby has a qualifying health condition — contact your GP about the annual flu vaccine ☐
- If your baby was born premature or has a heart or lung condition — ask your specialist or GP about RSV protection (nirsevimab) before the first RSV season ☐
- If any primary course vaccines were missed — contact your surgery to arrange catch-up ☐
- Confirm whether the 12-week rotavirus dose was given — if missed and baby is under 25 weeks, contact surgery urgently ☐
- The glass test for meningitis rash — press a clear glass firmly on any rash. Does it fade? Not fading = non-blanching = 999 immediately ☐
- Know the RSV bronchiolitis warning signs before winter (breathing effort, reduced feeding, fewer wet nappies) ☐
- Know what "usual cry" sounds like for your baby — a high-pitched or moaning cry that is different from normal is one of the earliest meningitis signs ☐
- The 1-year booster appointment (12–13 months) is the next vaccination — confirm it's on the radar ☐
- The 1-year MMR is the first and only measles protection — do not delay it ☐
- Log all vaccines already given in the red book and in your tracking app ☐
Frequently Asked Questions — 6 Month Vaccines UK
The UK NHS primary immunisation course is completed earlier — at 8, 12, and 16 weeks — using a front-loaded approach. By 4 months, a UK baby has received the equivalent of what a US baby receives across 2, 4, and 6 months. The UK simply completes the primary course sooner, which means protection against the most dangerous diseases (whooping cough, Hib meningitis, MenB) is established earlier. No vaccine is missing from the schedule — it is designed this way. The next routine appointment is at 12–13 months.
The 6-8 month health visitor review is the routine contact at this age — covering growth (weight, length, head circumference on the growth chart), motor development, communication, hearing and vision, and the introduction of solid foods (NHS guidance: around 6 months). The health visitor also screens for postnatal depression and parental wellbeing at this contact. Bring the red book. Availability and format vary by area — some areas offer a home visit; others a clinic appointment. Contact your health visitor team if you have not heard about a review appointment.
After the primary course: strong protection against diphtheria, tetanus, whooping cough, polio, Hib, hepatitis B, and rotavirus. Substantial but partial MenB protection (2 of 3 doses; 3rd at 1 year). Partial pneumococcal protection (1 of 2 doses; booster at 1 year). No measles, mumps, or rubella protection — MMR not until 1 year. The gap is designed to be manageable for most healthy babies in normal UK life. The critical actions: keep the 1-year MMR appointment on time and know the meningitis warning signs.
Babies aged 6 months and above with specific health conditions qualify: chronic heart or lung conditions (including severe asthma needing regular inhaled steroids); chronic kidney or liver disease; neurological conditions; immunosuppression; diabetes; and severe obesity. The vaccine for under-2s is a flu injection, not the nasal spray (which is for healthy children aged 2-17). The vaccine must be given annually — flu vaccine composition changes each season. Contact your GP surgery if your baby has any of these conditions. Healthy babies without at-risk conditions do not qualify until age 2-3 years.
RSV (Respiratory Syncytial Virus) causes bronchiolitis — the most common reason babies under 12 months are hospitalised in the UK, peaking in winter. Since 2024, the NHS gives the RSV vaccine Abrysvo to pregnant women at 28-36 weeks gestation, passing antibodies to the baby before birth. Babies whose birth mothers received this vaccine have RSV protection through approximately the first 6 months. For high-risk babies (significantly premature, congenital heart disease, chronic lung disease), nirsevimab (Beyfortus) — a monoclonal antibody injection — may be offered before their first RSV season. Ask your GP or neonatal specialist if your baby has any of these conditions.
Key signs in babies: a non-blanching rash (does not fade when pressed with a clear glass — call 999 immediately); high-pitched or unusual cry; extreme irritability or inconsolability; tense or bulging fontanelle; fever with cold hands and feet; mottled or pale skin; light sensitivity; seizures; and unusual drowsiness or floppiness. A non-blanching rash is a 999 emergency — do not wait for other signs. Two of the three MenB doses have been given; the baby has meaningful but not complete protection. Knowing these signs and acting fast is the most effective available response to this risk during the gap.
Most missed vaccines can still be caught up at 6 months — 6-in-1 doses, MenB doses, and PCV can all be given late. Contact your surgery to arrange catch-up appointments. The exception is rotavirus: the first dose must be given before 15 weeks and the second before 25 weeks. If the baby is over 25 weeks old, the rotavirus course cannot be given. For all other missed vaccines, contact your surgery as soon as possible rather than waiting for the 1-year appointment.
Bring all vaccination records to your UK GP surgery. The team will compare the vaccines given against the UK NHS schedule and identify what is equivalent, what is missing, and what catch-up is needed. Key gaps that commonly arise for babies vaccinated abroad: MenB (not routinely given in many countries); specific UK combination vaccines. Extra vaccines given abroad (e.g. hepatitis A, varicella) are not harmful but not required to be repeated on the UK schedule. The catch-up programme accommodates all scenarios including partial vaccination histories and records in different languages.
The UK completes the primary course at 4 months (16 weeks); the US gives the equivalent primary course across 2, 4, and 6 months, so the US 6-month appointment equals the UK 16-week appointment in terms of primary course progress. The UK achieves earlier protection against whooping cough, Hib, and MenB. The US additionally gives flu routinely from 6 months and hepatitis A from 12 months — neither in the standard UK schedule. Australia and Canada have similar schedules to the US with a 6-month appointment. None of this means UK babies are under-vaccinated; the coverage diseases are the same with minor exceptions, at slightly different ages.
The 1-year appointment (12-13 months) is crucial: the MMR first dose (first and only measles, mumps, and rubella protection — unvaccinated territory until this point); the MenB 3rd dose/booster (the paracetamol guidance applies again); the Hib/MenC booster (MenC is introduced here for the first time); and the PCV booster. The MMR is the most urgent component — measles is highly contagious and circulates in the UK. The 1-year appointment should be kept on time and not delayed. If it is missed, it should be rescheduled as a priority, not caught up at the next routine contact.
The Gap Is Not Empty — What This Period Actually Is
The months between 16 weeks and 1 year are not a pause in your baby's health story. They are the period during which the primary course immunity is building, during which your baby is growing at the fastest rate they will ever experience, and during which you are moving from newborn survival mode into something that begins to feel like a sustainable rhythm.
The absence of a vaccination appointment at 6 months is not something that has been overlooked. It is the NHS schedule working exactly as designed — a front-loaded primary series that delivers maximum early protection and then steps back to let that protection do its work.
What remains is: the 6-8 month health visitor review (book it if you haven't already), the meningitis warning signs committed to memory, and the 1-year appointment on the calendar. Everything in between is yours.
No vaccines today — but there's plenty to track at 6 months.
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Lunara helps you record solid food introductions as they happen, track developmental milestones, log sleep and feeding patterns, and keep the vaccination history in one place ready for the 1-year appointment. When the health visitor asks about first foods at 6 months, or the GP asks when the last vaccines were given, the answer is there in seconds. Free to start.