Early childhood infections: Advice and guidance

Useful information and resources for those living or working with early years children
What vaccinations does your child need?

It is important that vaccines are given on time for the best protection, but if you or your child missed a vaccine, contact your GP to catch up.

Please see the NHS website for the vaccination schedule: 

NHS vaccinations and when to have them - NHS (www.nhs.uk)

Parents and carers in the City of London are being asked to check their children's MMR records as London vaccination levels fall 11 per cent behind those for England.

The free measles, mumps, and rubella (MMR) vaccine is a safe and effective way of protecting against severe forms of the diseases which can result in serious hospitalisation in up to 40 percent of cases. Two doses of the MMR give lifelong protection for 99% of people vaccinated.

If you are unsure about your child’s vaccination status, you can contact your GP practice to check and book an appointment.

Why are we doing this?
Measles cases are rising in London. There is no cure and vaccination is the only protection against becoming seriously unwell.

Measles is a contagious virus illness. Initial symptoms include high fever, sore, red, watery eyes, coughing, aching, and feeling generally unwell. A blotchy red brown rash typically appears a few days later. It can lead to complications such as ear infections, pneumonia and in rare cases can lead to long term disability or death.

Those most at risk are babies under one year old, pregnant women and those with a weakened immune system.

Anyone with symptoms that could be measles is advised to stay at home and phone their GP or NHS 111 for advice, rather than visiting the surgery or A&E to avoid spreading it any further. For more information visit: Measles - NHS (www.nhs.uk) and MMR (measles, mumps and rubella) vaccine - NHS (www.nhs.uk).

Polio can also lead to serious complications including paralysis and in some cases, even death. There is no cure for polio, vaccination is the only protection. In 2022, polio virus was found in sewage samples in London, suggesting that the virus has been spreading between people.

How do I get a catch-up dose for my child?Your GP can quickly arrange for you to catch up with vaccinations. If your child had first vaccinations abroad it is important you still have routine vaccinations here, and your GP can help arrange that. If you’re not registered with a GP, you can register online (anyone can register and you don’t need ID or proof of address).

Parents of children aged 4 to 11, whose vaccination record says they are behind on polio and measles, mumps and rubella (MMR) vaccinations will also be contacted by an organisation called Vaccination UK, who have been employed by the NHS, to arrange catch up doses at a local clinic or at school.

You can book one directly by calling 0208 017 4292;

or visit Vaccination UK to find a catch up clinic in your area: School Vaccinations UK

Staff working with children in childcare settings have a ‘duty of care’ to provide a safe environment for children.

Infection prevention and control in childcare settings involves carrying out risk assessments and putting measures in place to manage any risks identified these should be reviewed and updated regularly. For more information on risk assessments, visit www.hse.gov.uk/pubns/raindex.htm.

The Health & Safety at Work Act 1974 legislates that employers must provide adequate protection against the risks associated with the task undertaken (for example, Personal Protective Equipment (PPE) must be provided for dealing with blood or bodily fluids). For details of this visit www.hse.gov.uk/


Infection Risk

Infection risk in the childcare setting can be reduced by;

  • Training all staff in Standard Infection Control Precautions (SICPs)
  • Supervising children when exposed to pets. Pets must be clean and healthy. Exotic (non-domestic and unusual) animals, such as reptiles should not be kept as nursery pets due to high risk of salmonella which they carry. Rodents are also not recommended (if in a childminding setting, they should be excluded from the area children are cared for). Pet living quarters must be kept clean and away from food areas.
  • Planning ahead when arranging special days out or activities
  • Ensuring Staff and/or children with symptoms of an infectious disease do not attend the childcare setting.
  • Seeking advice from your local Health Prevention Team on infection prevention and control issues e.g. exclusion criteria if an outbreak of infection is suspected.

Excluding a child from a childcare setting when not necessary can be a burden on parents or guardians. However, failing to exclude a child (with signs or symptoms of infection) could lead to an outbreak of infection in the childcare setting

What is infection prevention and control?

  • Preventing and controlling infection in an early years setting
  • The importance of hand washing before and after regular activities
  • Good practice for hand washing and a range of other ways of preventing the spread of germs in an early years setting
  • Understanding effective procedures for cleaning toys, equipment and the environment:

It is important that staff understand and follow:

  • Guidance for managing illness and infections
  • Exclusion times

How do germs spread?


  • Blood and body fluids: Blood and body fluids such as urine, faeces (bowel movements), vomit or diarrhoea can all cause infection. You should only handle them when wearing personal protective equipment (PPE) (for example, disposable gloves).
  • Chain of infection: A series of steps that describes how infection spreads.
  • Vulnerable children: Some medical conditions make children more vulnerable to infections that to infection would not usually be serious in most children. Children vulnerable to infection include those being treated for leukaemia or other cancers, on high doses of steroids by mouth, and with conditions which seriously reduce their immunity.
  • Communicable disease: A disease that can be spread from one person to another.
  • COSHH Regulations: Using chemicals or other hazardous substances at work can put people’s health at risk. By law, employers must have controls in place to prevent their staff from becoming exposed to hazardous substances, including infectious agents. (for example, germs). See www.hse.gov.uk/coshh.
  • Diarrhoea: Three or more loose or liquid bowel movements in 24 hours or more often than is normal for the individual (usually at least three times in a 24-hour period).
  • Disinfectant: A chemical that will reduce the numbers of germs to a level at which they are not harmful.
  • Exclusion period: The period of time that a person with an infectious disease must be excluded from, for example childcare settings, to limit the risk of the infection being passed on to other people.
  • Food handler: Someone who directly touches food or surfaces that will come into direct contact with food.
  • Hand hygiene: The process of cleaning your hands by washing them thoroughly with liquid soap and warm water and then drying them thoroughly or using alcohol based hand-rub solutions.
  • Outbreak: When there are two or more linked cases of the same illness or when there are more cases than the number expected. Outbreaks can happen anywhere, including in nurseries, in hospitals, on cruise ships and so on.
  • Personal Protective Equipment: Equipment a person wears to protect themselves against one or more risks (PPE) to their health or safety, including exposure to infections. In a nursery setting this would include single-use disposable gloves and disposable aprons.
  • Respiratory droplets: Small particles of fluids expelled during coughing, talking, sneezing etc. Germs for example flu, can be transferred from one person to another by droplets travelling small distances and landing on the mouth, nose or eyes of others or in their environment.

The population now has much stronger protection against Covid-19 than at any point in the pandemic.

Whilst there is still a risk of Covid-19 infection, which should be treated seriously, the population generally now has much stronger protections against the virus. This means it can be managed like other respiratory infections.

What to do if your child has Coronavirus symptoms
Attending education is hugely important for children and young people’s health and their future. Children and young people with mild symptoms such as a runny nose, sore throat, or slight cough, who are otherwise well, can continue to attend their setting.

If you suspect you or your child has Covid-19, please follow the guidance set out in the government guidance, People with symptoms of a respiratory infection including Covid-19 or a positive test result. For more information on symptoms, see the latest list of NHS Covid-19 symptoms in adults and symptoms in children.

Children and young people who are unwell and have a high temperature should stay at home and avoid contact with other people, where they can. They can go back to school, college or childcare, and resume normal activities when they no longer have a high temperature and they are well enough to attend.

It is not recommended that children and young people are tested for COVID-19 unless directed to by a health professional. If, however, your child (18 years of age or under) has a positive Covid-19 test result, they should stay at home and avoid contact with other people for 3 days after the day they took the test. After 3 days, if they feel well and do not have a high temperature, the risk of passing the infection on to others is much lower. This is because children and young people tend to be infectious to other people for less time than adults.

Adults who have tested positive for Covid-19 are advised to stay at home and avoid contact with other people for 5 days.

Covid-19 vaccinations for children and young people
Vaccination is a really important way to increase protection against Covid-19 and reduce the spread of the virus, and it is the main way to continue to ensure that children, young people, and any vulnerable family members are protected from Covid-19.

Vaccination also minimises the need for children and young people to have time off from school or college, and helps them to continue to carry out hobbies, attend social events, travel abroad during the holiday period, and live their lives to the full.

See Hackney’s website for more information about vaccination: who can get vaccinated, where to go and some frequently asked questions.

Please note that parental consent is required for children aged 5 to 15. Young people aged over 16 years old can provide consent for vaccinations themselves.

As well as Hackney Council’s vaccination webpage, listed below are some reliable sources of information on vaccination.

Information and support

Reaching Families "social animation" designed as a tool to help parents talk to their children about coronavirus and the "new normal" we are all trying to adapt to.