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, the percentage of children who have, by their first birthday, completed a primary course of immunisation for diphtheria, tetanus, polio, pertussis and haemophilus influenzae b (Hib) has increased over the last twenty years from a baseline of around 91-93% (depending on the vaccination) to 94% in the first three quarters of 2015/16. There was a slight decline in uptake between the years of 1995/96 and 2005/06 but after the introduction of a combined vaccination for immunisation against all five diseases in 2006/07 this trend reversed. The availability of a single, combined vaccination could make it easier for parents and children to take the immunisations. 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 in the last four years of the data, where it follows a similar pattern to the other two vaccinations after a large increase in the percentage of children taking the vaccination in 2008/09 compared to 2007/08.

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 it was consistently above 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 2013/14, where it reached higher levels than 1997/98 of 91%. 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 coverage (2003/04), only 80% of children were vaccinated, which is well below the 92-94% required for herd immunity to measles and close to the 75-76% and 80-85% coverage needed for herd immunity for mumps and rubella, respectively. 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.

Coverage of the other vaccinations that children should receive by their second birthday, Pneumococcal disease (PCV) booster and Hib/Men C booster, have increased between 2008/09 and 2013/14, where they plateaued out at 92% coverage and subsequently continues to meet similar coverage levels in the first three quarters of 2015/16.

Vaccination coverage in children in the United Kingdom

In 2014/15, there was a high percentage of children (>92%) in the United Kingdom completing the recommended immunisations by the age of two years, with little variation between the four nations across all vaccines.

How does UK's DTP immunisation coverage compare internationally?

Since 2008, the UK has improved significantly on the DTP vaccination rate: this increased from 92 per cent in 2008 to 97 per cent in 2012, although it dropped to 96 per cent in 2013. Belgium, France and Greece – together with many other OECD countries (e.g. the Czech Republic, Hungary and Poland) – have reached even higher vaccination rates, with 99 per cent coverage.

How does UK's measles immunisation coverage compare internationally?

Following the pattern in England, UK measles vaccination rates in the early 2000s were actually declining – falling below 80 per cent for some cohorts of children. As mentioned earlier, this was because the safety of the measles, mumps and rubella (MMR) vaccine was questioned. From 2004, vaccination rates started to improve again, reaching 95 per cent in 2013, meeting the 95 per cent recommended WHO coverage target. In 2013, Greece – together with several other OECD countries (e.g. the Czech Republic, Hungary and Korea) – reached coverage of 99 per cent, followed by Portugal (98 per cent) and Sweden (97 per cent).

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 - 93.9% for the first dose and 86 - 89% 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 (the age the vaccine is given at) to be routinely offered rotavirus vaccine alongside other primary vaccines were evaluated from January 2014. Before this they may have only been offered it alongside the other vaccines ad-hoc or at a separate time. Also babies in November 2013 were the first cohort eligible by age for the vaccine.

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 three 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, and the third dose always has the lowest uptake. Over the last three years measured the uptake of all three doses in England has remained fairly static, averaging 91% for the first dose, 90% for the second dose and 87% for the third dose. There are similar patterns of vaccination coverage across all four nations of the United Kingdom, apart from the third dose which drops down to 81% in Scotland and as low as 77% in Wales.

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 (Public Health England). 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 of that age and they have the greatest risk of complications and death. 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 from birth by boosting the short-term immunity to babies by women passing on antibodies to their children intra-uterine until they can be vaccinated themselves (Department of Health).

Pertussis vaccination coverage in pregnant women is not very high but from July 2013 over half of those eligible have taken up the immunisation and since its introduction there has been an in uptake from 44% in October 2012 to its highest level of 62% in December 2014.

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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