Research and analysis

Appendix 3. Detail on indicator programmes

Published 5 March 2026

Applies to England

Hexavalent (6-in-1)

The hexavalent combination vaccine (6-in-1) vaccine protects against diphtheria, tetanus, pertussis, polio, Haemophilus influenzae type b, and hepatitis B (DTaP/IPV/Hib/HepB). All babies are eligible for this vaccine as part of the routine childhood immunisation schedule, replacing the previous pentavalent (5-in-1) vaccine (1). The primary course involves 3 doses given at 8, 12, and 16 weeks of age; the statistics presented below are for 3-dose coverage. From 1 January 26, children born on or after 1 July 24 will receive a 4th dose at 18 months replacing the Hib/MenC vaccine previously given at 12 months (2).

In addition to the routine immunisation schedule covering hepatitis B virus infection via the hexavalent combination vaccine, the selective hepatitis B immunisation programmes target people at increased risk of infection with hepatitis B virus. The selective neonatal programme provides infants born to women with hepatitis B infection, identified through antenatal screening, to prevent perinatal transmission at or around the time of birth and consists of 3 doses of hepatitis B vaccine delivered at birth, at 4 weeks, and at 12 months (in addition to the 3 doses of 6-in-1).

Immunisation also includes the use of hepatitis B immunoglobulin for babies born to mothers considered at high risk of passing on hepatitis B to their child, to be administered within 24 hours of birth. There are range of a further population groups eligible for selective hepatitis B vaccination including people who inject drugs (PWID), people resident in prisons and places of detention, and GBMSM (3).

Measles, mumps and rubella (MMR)

The measles, mumps and rubella (MMR) vaccine is recommended for all children as part of the routine childhood immunisation programme and delivered as a 2-dose schedule at ages 12 months and 3 years and 4 months. From 1 January 26, the second dose will move to a new 18-month appointment for those born on or after 1 July 2024 (2).

HPV

The human papillomavirus (HPV) vaccine protects against infection with the human papillomavirus, recognised as a necessary cause of cervical cancer in women, and a cause of anogenital cancers and genital warts in both men and women (4).

The HPV immunisation programme was introduced in September 2008 for all female students in school year 8 in England (aged 12 to 13 years). From September 2019, the existing HPV immunisation programme for female students was extended to male students. It is a school-based programme with alternative arrangements made for those who are not in mainstream schools. Males and females in cohorts eligible for vaccination remain so until their 25th birthday (4). Initially a 3-dose course, the programme moved to a 2-dose course in April 2022 and to a one-dose course in September 2023 (5).

In April 2018, a targeted HPV vaccination strategy was implemented across England GBMSM up to and including the age of 45 years. As for the adolescent programme, this is now a one-dose course, albeit with eligible GBMSM aged 25 to 45 remaining on a 2-dose course (5).

Prenatal pertussis

The pertussis vaccine was first offered to pregnant women in October 2012 following increased pertussis activity in all age groups and the declaration of a national outbreak in April 2012, later becoming a routine programme, offered from gestational week 16, in 2019 (6). The aim is to minimise morbidity and mortality in young infants, through intra-uterine transfer of maternal antibodies, until they can be actively protected by the routine infant programme (7).

Influenza

The purpose of the seasonal influenza immunisation programme in England is to offer protection to those who are most at risk of serious illness or death should they develop influenza.

Eligibility is based on recommendations from JCVI and outlined in an annual letter jointly issued to the NHS by UKHSA, the Department of health and Social Care and NHS England (NHSE) (8).For 2024/25, eligible groups included those aged 65 years and over (65+), those aged 6 months to under 65 years with certain underlying medical conditions (clinical risk groups) defined in the Green Book, pregnant women, and a number of other smaller cohorts (8), (9).

In 2024/25, adults (excluding pregnant women) were eligible from 3rd October, rather than 1st September as in previous years, and comparisons to previous years should be interpreted with caution. In addition, the universal childhood influenza programme, with the live attenuated influenza vaccine, was introduced in 2013/14 and progressively expanded across year groups in a phased implementation (10). Its aim is to both directly protect children and indirectly protect the rest of the population through reduce influenza transmission.

References

1. UK Health Security Agency (UKHSA). Hexavalent DTaP/IPV/Hib/HepB combination vaccine: information for healthcare practitioners updated 2 June 2025 (accessed 8 August 2025)

2. UKHSA. Childhood schedule changes from 1 July 2025: information for healthcare practitioners updated 4 June 2025 (accessed 8 August 2025)

3. UKHSA. Hepatitis B: the green book, chapter 18 updated 3 June 2025 (accessed 15 August 2025)

4. UKHSA. Human papillomavirus (HPV): the green book, chapter 18a updated 20 June 2023 (accessed 8 August 2025)

5. UKHSA. HPV vaccination programme moves to single dose from September 2023 (accessed 10 August 2025)

6.UKHSA. Prenatal pertussis vaccination coverage in England from January to March 2025, and annual coverage for 2024 to 2025 updated 26 June 2025 (accessed 12 August 2025)

7. Amirthalingam G, Andrews N, Campbell H, and others. ‘Effectiveness of maternal pertussis vaccination in England: an observational study’ The Lancet 2014: volume 384, issue 9,953, pages 1,521 to 1,528

8.UKHSA, NHS England, Department of Health and Social Care (DHSC). National flu immunisation programme 2024 to 2025 letter updated 18 June 2024 (accessed 12 August 2025)

9. UKHSA. Influenza: the green book, chapter 19 updated 29 May 2025 (accessed 12 August 2025)

10. DHSC. JCVI statement on the routine annual influenza vaccination programme updated 23 July 2013 (accessed 12 August 2025)