Out of Schedule Vaccination Template - Child
Introduction
The Out of Schedule Vaccination - child template is a structured clinical template designed to support practice nurses in recording vaccinations for children and young people patients under 18 years of age who require re-vaccination or booster vaccinations following immunosuppressive treatment.
The template covers two distinct clinical pathways.
- Children who have undergone haematopoietic stem cell transplantation (HSCT) are treated clinically never vaccinated and require a full re-vaccination programme starting from six months post transplant.
- Children who have completed standard-dose chemotherapy without transplant require a one-off booster schedule only, starting from the three months after end of treatment.
These two pathways have different vaccine schedules and must not be confused.
The template is based on the CCLG Vaccination Guideline: For Children and Young People Treated for Cancer with Standard-Dose Chemotherapy and Haemopoietic Stem Cell Transplant (HSCT), Version 2 (May 2026),
A separate template is available for adult patients (18 years of age and over) – see Out of Schedule Vaccination – Adult.
What Does it Actually Do
The template provides a complete clinical workflow covering both paediatric vaccination pathways within a single structured template. It is structured across seven tabs and is designed so the template performs the clinical decision support, allowing the nurse to focus on confirming actions rather than consulting multiple external documents during the consultation.
Section 1: Safety Screen
The safety screen must be completed before any vaccination is recorded. It opens with a prominent advisory for CAR-T cell paediatric patients, for whom there is no fixed vaccination schedule and vaccination must be individualised in consultation with the treatment centre.
The clinician selects the treatment pathway — HSCT or standard-dose chemotherapy — and the patient's age band — under 10 years or 10 years and over — before completing any other fields. These two selections determine which vaccine reference table the nurse uses on Tab 3. They also affect vaccine choice at certain time points, particularly the diphtheria dose strength at the three-year booster.
A seven-item general safety checklist must be completed before proceeding. A separate Live Vaccine Gate must be completed on visits where MMR is being given. The paediatric Live Vaccine Gate contains five criteria, including a requirement that the patient must be confirmed in remission — a criterion that does not exist in the adult template. The IVIg-free interval for live vaccines in this template is three months, reflecting the CCLG May 2026 guidance. VZV serostatus is also checked within the Live Vaccine Gate as varicella vaccine may be offered at 24 months to VZV seronegative patients.
Section 2: Hepatitis B
This section provides a dedicated standalone Hepatitis B pathway for pediatric patients who require HepB vaccination outside the full HSCT re-vaccination schedule. The structure is equivalent to the adult template with one important difference: the standard paediatric HBVAXPRO formulation is HBVAXPRO 5mcg, not 10mcg. HBVAXPRO 5mcg is licensed for patients from birth through 15 years of age. Pre-vaccination serology assessment, mandatory post-vaccination anti-HBs serology prompt, next vaccination date field, and recall confirmation follow the same structure as the adult template.
Section 3: Other vaccinations
This section covers all other scheduled post-transplant vaccines and seasonal influenza for both pathways. In line with the CCLG May 2026 guideline, eligible children who have completed standard-dose chemotherapy may receive live attenuated influenza vaccine (LAIV) from three months after completion of treatment. A link to the dedicated Seasonal Flu template is provided to support recording influenza vaccination in accordance with local and national guidance.
The clinician is presented with a safety reminder and selects the relevant pathway - HSCT patients or standard-dose chemotherapy. Four vaccine recording rows allow multiple vaccines to be recorded at a single visit, each with its own next vaccination due drop-down.
A COVID-19 vaccination checkbox is included to allow clinicians to record vaccination where appropriate. COVID-19 vaccination recommendations are maintained separately from the core CCLG vaccination schedule and should always follow the latest national guidance.
Section 4 and 5 - HSCT Vaccine Schedule Reference
Two static reference sections provide the HSCT re-vaccination schedule reproduced from the CCLG May 2026 guideline. These pages are intended as a quick clinical reference only and represent the typical vaccination schedule. Clinicians should always follow any patient-specific vaccination plan or instructions provided by the specialist or consultant team where these differ from the standard schedule.
Section 6 - Standard-dose chemotherapy booster reference
This reference page is also intended as a guide only. Any patient-specific vaccination instructions provided by the specialist or consultant team should take precedence over the standard schedule.
How to use this template
Use the template in the following order:
1. Complete the Safety Screen first. This confirms the patient's treatment pathway and checks whether vaccination can safely proceed.
2. Navigate to the relevant vaccination page (Hepatitis B or Other Vaccinations) to record vaccines administered during the consultation.
3. Use the Reference pages for guidance only. They reproduce the typical vaccination schedules from the CCLG guideline. If the patient has a personalised vaccination plan from their specialist or consultant team, this should always take precedence over the standard schedule.
What does it look like
Screenshots below are vaccine reference 
Where to find it
Clinician can search for this template using the search bar at the bottom left of SystmOne screen or the F12 and search for 'Out of Schedule..'. or access the link from the main vaccination template
System Dependencies
The template does not require additional SystmOne modules or permissions. It is important that users are aware that the template exists.
Fitting your practice
There is no system-level dependencies that require configuration before us e.
Clinical governance responsibility rests with the GP practice. Practices should ensure that all clinical staff who may use this template are familiar with the out of schedule vaccination pathway, pre-vaccination safety screen and know how to retrieve the template using F12 search. Staff should confirm that written authorisation from the specialist team is present on the patient record before proceeding with any vaccination.
A separate template is available for adult patients aged 18 years and over - See Out of Schedule Vaccination - Adult (insert URL)
What Does it Actually Do
The template provides a complete clinical workflow covering both paediatric vaccination pathways within a single structured template. It is structured across seven tabs and is designed so the template performs the clinical decision support, allowing the nurse to focus on confirming actions rather than consulting multiple external documents during the consultation.
Section 1: Safety Screen
The safety screen must be completed before any vaccination is recorded. It opens with a prominent advisory for CAR-T cell paediatric patients, for whom there is no fixed vaccination schedule and vaccination must be individualised in consultation with the treatment centre.
The clinician selects the treatment pathway — HSCT or standard-dose chemotherapy — and the patient's age band — under 10 years or 10 years and over — before completing any other fields. These two selections determine which vaccine reference table the nurse uses on Tab 3. They also affect vaccine choice at certain time points, particularly the diphtheria dose strength at the three-year booster.
A seven-item general safety checklist must be completed before proceeding. A separate Live Vaccine Gate must be completed on visits where MMR is being given. The paediatric Live Vaccine Gate contains five criteria, including a requirement that the patient must be confirmed in remission — a criterion that does not exist in the adult template. The IVIg-free interval for live vaccines in this template is three months, reflecting the CCLG July 2025 paediatric protocol. VZV serostatus is also checked within the Live Vaccine Gate as varicella vaccine may be offered at 24 months to VZV seronegative patients.
Section 2: Hepatitis B
This section provides a dedicated standalone Hepatitis B pathway for paediatric patients who require HepB vaccination outside the full HSCT re-vaccination schedule. The structure is equivalent to the adult template with one important difference: the standard paediatric HBVAXPRO formulation is HBVAXPRO 5mcg, not 10mcg. HBVAXPRO 5mcg is licensed for patients from birth through 15 years of age. Pre-vaccination serology assessment, mandatory post-vaccination anti-HBs serology prompt, next vaccination date field, and recall confirmation follow the same structure as the adult template.
Section 3: Other vaccinations
This section covers all other scheduled post transplant vaccines and seasonal influenza for both pathways. The clinician will be presented with safety reminder and select the relevant pathway - HSCT patients or standard-dose chemotherapy. Four vaccine recording rows allow multiple vaccines to be recorded at a single visit, each with its own next vaccination due drop-down. A COVID-19 vaccination checkbox is included on this tab as CCLG July 2025 explicitly includes COVID-19 in the paediatric HSCT schedule from six months post-transplant.
Section 4 and 5 - HSCT Vaccine Schedule Reference
Two static reference sections provide the HSCT vaccine schedule sourced directly from CCLG July 2025 Appendix 2. Section 4 covers 'Less than 10 months post - HSCT. Section 5 covers greater than 10 months post-HSCT. Section 5 covers vaccine schedule 'More than 10 months post-HSCT'.
Section 6 - Standard-dose chemotherapy booster reference
What does it look like
Screenshots below are vaccine reference
Where to find it
Clinicians can search for this template using the search bar at the bottom left of SystmOne screen or the F12 and search for 'Out of Schedule..'. or access the link from the main vaccination template
System Dependencies
The template does not require additional SystmOne modules or permissions. It is important that users are aware that the template exists.
Fitting your practice
There is no system-level dependencies that require configuration before us e.
Clinical governance responsibility rests with the GP practice. Practices should ensure that all clinical staff who may use this template are familiar with the out of schedule vaccination pathway, pre-vaccination safety screen and know how to retrieve the template using F12 search. Staff should confirm that written authorisation from the specialist team is present on the patient record before proceeding with any vaccination.
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