Protection against infection is a key aim of any care programme for patients with sickle cell disorders, and is one of the stated objectives of the UK national neonatal screening programme. An audit of the immunisation status of the 58 sickle cell patients living in Coventry was carried out against UK national guidance (2006). Among 25 children (aged < or =16 years), 14 (56%) had complete immunisation against pneumococcus, Haemophilus influenzae type b (Hib) and meningococcus group C (MenC), with eight (32%) having some coverage, and three (12%) having none at all. Among 33 adults, only four patients (12%) had complete coverage, with up-to-date coverage against pneumococcus 21%, Hib 18% and MenC 15%. Current (ie, within the last year) immunisation against viral influenza was found in only 12% of adults and 8% of children. These rates are similar to those found in other UK studies. If the potential benefits of neonatal screening are to be realised, an effective immunisation programme is essential. There are key roles for haemoglobinopathy nurse specialists, and the proposed national haemoglobinopathy database, in improving the rates of immunisation coverage.