The aim of vaccination is immunisation of the child against diseases to prevent mortality and morbidity from specific infections. Adequate immunization coverage is the prerequisite for creating herd immunity. The maintenance of these levels of population immunity requires continuous vigilance and changes to immunisation schedule in response to changing circumstances. Changes have been made over the years to optimise the immunisation of poliomyelitis, measles, mumps, rubella, and varicella. The introduction of hemophilus influenza type B pneumococcal have reduced the incidence of these infections. Vaccination against human papillomavirus infection is being expanded to protect against cervical neoplasia in females and also anal intraepithelial neoplasia in both genders. Childhood exanthems due to viral and bacterial infections, as well as immunological causes continue to important and the ability to recognise them is necessary.