Vaccination coverage for children and mothers

Vaccination coverage is the best indicator of the level of protection a population will have against vaccine-preventable communicable diseases. Coverage is closely related to levels of disease; monitoring coverage can therefore identify possible drops in immunity before levels of disease rise.

Vaccination coverage in children by their first birthday - England

In England, immunisations for diphtheria, tetanus, polio, pertussis and haemophilus influenza b (hib) were offered separately between 1994/95 and 2005/06. From 2006/07 onwards data for diphtheria, tetanus, polio, pertussis and hib immunisation was merged into one indicator as a combined immunisation against all five diseases was introduced.

There was a slight decline in uptake between the years of 1995/96 and 2005/06 but after the introduction of the combined vaccination in 2006/07 this trend reversed. The availability of a single, combined vaccination may make it easier for parents and children to take the vaccinations. However, a similar pattern is also seen in meningococcal group C immunisation (MenC) over the time period where MenC information is collected, which may suggest an overall increase in vaccination coverage across the board, irrespective of the new delivery method. This is also reflected in the pneumococcal disease (PCV) vaccination uptake, where it follows a similar pattern to the other two vaccinations after a large increase in the percentage of children taking the vaccination between 2007/08 and 2008/09.

Updated March 2017.

Vaccination coverage in children by their second birthday - England

Between 1994/95 and 1996/97, there was a relatively steady rate of MMR (measles, mumps and rubella) immunisations in children by their second birthday in England, and was consistently over 90%. However, this began to decrease from 1997/98 to 2003/04. After this time, the uptake started to increase again, improving nearly every year until 2014/15, where it reached 95%. Since Q1 2014/15 uptake of the MMR immunisation by 2 years of age has remained above 90%.

This pattern of vaccination rates is linked to a now discredited article that appeared in The Lancet in 1998, which linked the combined MMR vaccination to autism. In 2004, The Lancet partially retracted the paper and fully retracted it in 2010. Around the same time, there are specific increases in the coverage rate of the combined MMR vaccination. However, at the lowest level of uptake in 2003/04, only 80% of children were vaccinated, which is well below the 92-94% required for herd immunity to measles and less than the upper limit of the 80-85% coverage needed for herd immunity for mumps and rubella. Subsequently there have been outbreaks of these diseases in England in recent years, particularly in 2008 and 2012, where there were over a thousand confirmed cases (source:
Public Health England)

Coverage of the other vaccinations that children should receive by their second birthday, Pneumococcal disease (PCV) booster and Hib/Men C booster, increased between 2008/09 and 2012/13, after which they plateaued out at around 92% uptake.

Updated March 2017.

Vaccination coverage in children in the United Kingdom

In July to September 2015/16, by their 1st birthday, more than 93% of children in the UK had received the DTap/IPV/Hib and PCV vaccine. A high percentage of children (>91%) in the UK also completed the recommended immunisations by the age of two years.

In general there is little variation between the four nations across all vaccines, though England has marginally lower levels of vaccination compared to the other three nations.

Updated March 2017.

How does UK's DTP immunisation coverage compare internationally?

Since 2008, the UK has improved upon the DTP vaccination rate: this increased from 91% in 2000 to 95% in 2014. Belgium, France and Greece had very high vaccination rates, with 99 per cent coverage in 2014. In 2014, Australia had the lowest coverage (92%) of the OECD countries compared here. As of 2006 most countries maintained a relatively steady level of coverage.

Updated March 2017.

How does UK's measles immunisation coverage compare internationally?

Between 2000 and 2004 the UK measles vaccination rate declined – falling from 88% to 81% over this period. From 2004 to 2014 the rate increased to 93%. The decline between 2000 and 2004 was likely due to safety concerns relating to measles, mumps and rubella (MMR) vaccine. In 2014, Portugal had the highest measles immunisations coverage (98%) whilst Italy had the lowest (86%). Immunisation coverage levels increased between 2000 and 2014 in the majority of countries.

Updated March 2017.

Rotavirus vaccination coverage in babies

Rotavirus gastroenteritis is a mild to severe disease characterised by nausea, vomiting, watery diarrhoea, and low-grade fever. Nearly every child in the world has been infected with rotavirus at least once by the age of five. Those that develop severe gastroenteritis become dehydrated, and require hospitalisation for rehydration. The national rotavirus vaccination programme started in July 2013 and is expected to prevent a significant number of young infants from developing this infection, thus preventing a significant number of admissions and rare deaths, as well as improving the herd immunity.

Since February 2014 the proportion of babies receiving the vaccine has been quite high - between 91.5-94.6% for the first dose and 86-90.5% for the second dose. Prior to this there was a much lower coverage but this is mainly due to how the programme was rolled out. Despite the programme starting in July 2013 the first cohort of children aged 25 weeks to be routinely offered rotavirus vaccine alongside other primary vaccines were evaluated from January 2014. Before this they may have only been offered at a separate time. Also, babies in November 2013 were the first cohort eligible by age for the vaccine.

Updated March 2017.

Human Papilloma Virus (HPV) vaccination coverage

All girls aged 12 to 13 are offered HPV (human papilloma virus) vaccination as part of the NHS childhood vaccination programme and are given it as a series of injections within a 12-month period. The vaccine protects against a group of viruses that have been linked to the development of cervical cancer in later life and hence it can help reduce the incidence of cervical cancer (note that not all cervical cancers are caused by HPV and so the vaccine does not result in immunity to cervical cancer, only to one of the potential causes).

There is consistently higher uptake of the first dose than subsequent doses in the England. Uptake of the doses of the HPV vaccination in England has remained fairly static since 2010/11. Between 2008/09 and 2015/16 average uptake of the first dose was 91% and 90% for the second dose.

In 2015/16 uptake of the first dose was similar across all nations of the UK. There was slightly more variation in terms of the uptake of the two doses, for example Northern Ireland is the only nation with coverage above 90%, versus the UK average of 85%.

It is important to note that the vaccine coverage data collected from 2014/15 onwards are not directly comparable to previous years due to changes to the HPV schedule from three doses to two in September 2014.

Updated March 2017.

Pertussis vaccine coverage for pregnant women

Despite high vaccine coverage since the early 1990s in the five years prior to 2012 there were nearly 800 confirmed cases of whooping cough, where on average per year there were 270 babies admitted to hospital and four died. Babies under the age of three months are too young to have completed a primary course of pertussis vaccine but the incidence of the disease is the highest in infants that age and they have the greatest risk of complications and death(Public Health England). In response to a national outbreak the Department of Health announced that pertussis immunisation would be offered to pregnant women from 1 October 2012 to protect infants by boosting the short-term immunity of babies until they can be vaccinated themselves (Department of Health) .

As can be seen in the chart, pertussis vaccination coverage in pregnant women is not especially high but has been above 70% since July 2016. Since its introduction in October 2012 there has been an increase in uptake from 44% to a high of 76% as of December 2016.

Updated March 2017.

About this data

For the schedule of vaccinations please see the NHS choices website. For all vaccinations some caution should be exercised when comparing coverage figures over time due to data quality issues reported by some data providers; apparent trends could reflect changes in the quality of data reported as well as real changes in vaccination coverage. Please see individual data collections for any additional information associated with this data.

International comparisons:

Definitions and comparability for all the indicators discussed in this report are taken directly from the OECD report Health at a Glance 2013: OECD indicators. Detailed information about the definitions and the source and methods for each country can be found here.

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