Research and analysis

Estimated annual deaths and hospitalisations prevented by routine childhood immunisation, England, 2026

Published 5 February 2026

Applies to England

Numbers in square brackets in the text and tables refer to references at the end of the report.

Background

The UK has a world-leading immunisation programme over the life course. Vaccination ranks second only to clean water as the most effective public health intervention to prevent disease [1]. Diseases that were previously common are now rare, and millions around the world each year are protected from severe illness and death. 

The UK’s universal routine childhood immunisations protect against diseases such as diphtheria, tetanus, whooping cough (pertussis), polio, Haemophilus influenzae type B (Hib), hepatitis B, measles, mumps, rubella, chickenpox (varicella), pneumococcal, meningococcal B (MenB), meningococcal group A C W-135 and Y conjugate (MenACWY) and human papillomavirus (HPV), given at specific ages from infancy through adolescence. Many of these vaccines provide a high degree of indirect protection. As well as directly protecting individuals who are vaccinated, they also reduce transmission across the whole population. This means that the impact of the programme is often greater than may be predicted prior to implementation. 

The World Health Organization (WHO) estimates that immunisation currently prevents 3.5 million to 5 million deaths every year from diseases such as diphtheria, tetanus, pertussis (whooping cough), influenza and measles [2]. Likewise, the US Centers for Disease Control and Prevention (CDC) estimate that about 4 million deaths worldwide are prevented by childhood vaccination every year [3]. 

In this publication, we set out to provide an approximate estimate for the impact of the routine vaccine programmes on deaths and hospitalisations from vaccine-preventable disease each year in England. We focus on diseases included in the routine pre-school vaccination programme and have based our estimates on the cumulative impact of the programmes to date. These figures are crude, being based on a simple comparison with the scenario without vaccines. They do not consider the long-term health impacts of these diseases or account for changes in healthcare over time and are likely to represent a conservative estimate of the impact of vaccination.

Estimates

We estimated that each year in England, at least 4,960 deaths (Table 1) and at least 228,447 hospitalisations (Table 2) have been prevented by the routine pre-school vaccination programme. 

These estimates were based on a comparison of annual deaths and hospitalisations from the pre-vaccination time period, to annual observed deaths and hospitalisations from the most recent surveillance and reporting since vaccination was introduced. This was calculated on a disease-by-disease basis. This is an estimate and should be interpreted as indicative only, rather than as a precise value.

Some diseases had vaccines introduced significantly earlier than other diseases. There have been other changes over time since vaccines were introduced, including increasing population size, differences in identification of disease and improvement in clinical approaches and outcomes. These are not accounted for in these estimates. These estimates also do not include the impact of vaccination programmes for chickenpox (varicella) or deaths from rotavirus, mumps or hepatitis B, due to the limited availability of data, or the lag on mortality following infection. On balance, taking these additional factors into account, it is likely that the actual number will exceed 5,000 deaths and 228,000 hospitalisations prevented each year in England.

Table 1. Estimated number of deaths prevented by routine childhood immunisation, England (totals may not add up due to rounding) [notes 1, 2, 3, 4]

Numbers in square brackets refer to references at the end of the report.

Disease	Year vaccine introduced	Annual deaths before vaccination introduced	Current annual deaths	Annual deaths prevented
Diphtheria	1942	2,724 [4]	0 [5]	2,724
Tetanus	1961	106 [6]	2 [7]	104
Pertussis	1957	358 [8]	2 [9]	355
Poliomyelitis	1956	352 [10]	0 [11]	352
Haemophilus influenzae type b (Hib)	1992	27 [7]	2 [8]	25
Invasive meningococcal disease	1999	224 [14]	31 [15]	193
Rotavirus	2013	[x]	[x]	[x]
Invasive pneumococcal disease	2006	1,957 [16]	843 [17]	1,114
Measles	1968	95 [18]	1 [19]	94
Mumps	1988	[x]	[x]	[x]
Total	[x]	5,842	881	4,960

Note 1: For detailed assumptions and assessment of sources, see supplementary tables.
Note 2: Haemophilus influenzae type b is limited to invasive infections only.
Note 3: Total counts for invasive meningococcal disease were used which may include counts through non‑infant programmes.
Note 4: Counts for rotavirus and mumps were excluded from the estimated number of deaths prevented, due to availability of data.

Table 2. Estimated number of hospital admissions prevented by routine childhood immunisation, England [notes 1, 3, and notes 5, 6, 7, 8, 9]

Numbers in square brackets refer to references at the end of the report.

Disease	Year vaccine introduced	Annual incidence before vaccination	Post-vaccination case-hospitalisation rate	Estimated annual hospitalisations without vaccination	Current annual hospitalisations	Annual hospitalisations prevented
Diphtheria	1942	52,570 [20]	0.330 [21]	17,348	4 [22]	17,344
Tetanus	1961	1,059 [23]	1.000 [24]	1,059	6 [25]	1,053
Pertussis	1957	11,562 [26]	0.920 [27]	10,637	294 [28]	10,343
Poliomyelitis	1956	7,588 [29]	1.000 [30]	7,588	0 [31]	7,588
Haemophilus influenzae type b (Hib)	1992	948 [32]	1.000 [33]	948	15 [34]	933
Invasive meningococcal disease	1999	2,573 [35]	1.000 [36]	2,573	378 [37]	2,195
Rotavirus	2013	[x]	[x]	[x]	[x]	50,427 [38]
Invasive pneumococcal disease	2006	6,019 [39]	1.000 [40]	6,019	4,598 [41]	1,421
Measles	1968	390,848 [42]	0.350 [43]	136,797	212 [44]	136,585
Mumps	1988	19,374 [45]	0.029 [46]	562	4 [47]	558
Total	[x]	492,541	[x]	[x]	[x]	228,447

Note 5: For detailed assumptions and assessment of sources, see supplementary tables.
Note 6: In terms of hospitalisations prevented by vaccination, this is assuming we were to see the pre-vaccination incidence of disease now, using the current case-hospitalisation rate.
Note 7: Pertussis is limited to infants only.
Note 8: Some reported incidence is based on notifications rather than laboratory-confirmed cases.
Note 9: Rotavirus estimate is based on published calculation of prevented hospitalisations and as such other counts are not provided.

Methods

Diseases included 

This calculation included estimates for diseases protected against in the routine childhood vaccination schedule for pre-school children in England. These are listed in the Green Book, Tables 11.1 and 11.2. 

Recommended vaccinations are:

• diphtheria
• tetanus
• pertussis (whooping cough)
• polio
• Haemophilus influenzae type B (Hib)
• hepatitis B (Hep B) [note 10]
• invasive meningococcal disease [note 11]
• Rotavirus gastroenteritis
• invasive pneumococcal disease
• measles, mumps, rubella and varicella [note 12]

Note 10: Hep B is included in the routine immunisation schedule but was not included in the estimates for prevented deaths and hospitalisations. This is because Hep B-related mortality, or other long-term outcomes, often manifest decades after infection. Therefore, a comparison of annualised deaths pre- versus post-vaccination is unsuitable for Hep B. 

Note 11: Historic mortality data for invasive meningococcal disease does not stratify by serogroup so, for consistency and comparability, total counts for invasive meningococcal disease were used which may include counts through non‑infant programmes (for example MenACWY).

Note 12: Chickenpox (varicella) was added to the routine immunisation schedule in January 2026. This is excluded from the calculation due to the recency of the introduction.

Annual deaths before vaccination introduced

Annual reported deaths by infection were taken from published reporting, prioritising reporting from the Office of Population Censuses and Surveys, and Public Health England (now UKHSA). Where data was available, a multi-year average was used. Due to the age of the data, it is likely some changes in how deaths are recorded have occurred over time. 

Where deaths were reported for England and Wales, these were adjusted to show England only, approximated using ONS 2024 mid-year population estimates. 

Data was available for the majority of infections, with the exception of rotavirus, mumps and rubella. These 3 infections were therefore excluded from the calculation of deaths prevented.

Current annual deaths

Current annual deaths were taken from published reporting, prioritising the most recently published UKHSA national surveillance, or prospective national surveillance data. These were available for all infections considered, except for rotavirus, mumps and rubella, which were excluded from the calculation of deaths prevented. 

Most infections in this analysis use a single year of annual death data, reflecting the most recent level of vaccination control. For pertussis and measles, however, a multi‑year average was used because these diseases follow cyclical patterns, with incidence fluctuating in multi-year cycles, so a single‑year figure would not capture typical disease burden. 

Annual deaths prevented 

Annual deaths prevented were calculated as annual deaths pre-vaccination minus the current annual deaths:

Annual deaths prevented = Deaths_{pre-vaccination}  − Deaths_current

Annual incidence before vaccination introduced

Annual case counts pre-vaccination were taken from published historical national surveillance reports, prioritising reporting from the Office of Population Censuses and Surveys, and Public Health England (now UKHSA). Where data was available, a multi-year average was used. Due to the age of the data, it is likely some changes in how notifications are recorded have occurred over time. Notifications are not as consistent as laboratory-confirmed cases. 

Where deaths were reported for England and Wales, these were adjusted to show England only, approximated using ONS 2024 mid-year population estimates. 

For diseases with incomplete historic case notifications, such as tetanus, historic case counts were estimated using historic mortality reports and plausible historic case fatality rates (CFRs).  

Current case-hospitalisation rate

Current case-hospitalisation rates were taken from UKHSA surveillance or peer-reviewed publications. Where published rates were not available or reliable, reasonable assumptions were made based on the nature of the disease, following discussion with subject-matter experts and review of guidance for practitioners. For invasive meningococcal disease, guidance for practitioners on standard treatment recommends hospitalisation, so a case-hospitalisation rate of 100% was used as a reasonable assumption. For polio, Hib and invasive pneumococcal disease, based on discussions with subject-matter experts, the severity of disease and in the absence of reliable current case-hospitalisation rates, a case-hospitalisation rate of 100% was used as a reasonable assumption. 

Using the current case-hospitalisation rate will underestimate expected hospitalisations because this will be affected by the introduction of vaccination. However, using a pre-vaccination case-hospitalisation rate would likely have overestimated expected hospitalisations because it would not account for improvement in healthcare. Therefore, we have used the more conservative estimate, using current case-hospitalisation rates.  

Estimated annual hospitalisations without vaccination

To estimate what current hospitalisation numbers would be if vaccination were not in place, estimates were calculated using the value given for annual incidence before vaccination introduction multiplied by the value given for the current case-hospitalisation rate:

Hospitalisations_no-vaccine  = Incidence_{pre-vaccination} × CHR_current

Current annual hospitalisations

Current annual hospitalisations were taken from the most recent UKHSA surveillance available, the Green Book or peer-reviewed publication. Most infections in this analysis use a single year of annual hospitalisation data, reflecting the most recent level of vaccination control. For pertussis and measles, however, a multi‑year average was used because these diseases follow cyclical patterns, with incidence fluctuating in multi-year cycles, so a single‑year figure would not capture typical disease burden.  

Annual hospitalisations prevented

Annual hospitalisations prevented were calculated as estimated annual hospitalisations without vaccination minus current annual hospitalisations: 

Annual hospitalisations prevented = Hospitalisations_no-vaccine – Hospitalisations_current

Detailed sources, assessment of sources and all metrics used are included in the supplementary tables.  

Key caveats 

This calculation approximates deaths and hospitalisations prevented only and should not be taken as a precise estimate. Wherever possible, we have been conservative in our selection of metrics from published reporting, to avoid overestimating deaths and hospitalisations prevented. 

Changes over time in factors affecting deaths 

These estimates assume that annual case counts pre-vaccination, population structure, and case ascertainment are directly applicable to the present day. Due to the age of data, the nature of the recording, identification or coding of deaths, notifications, cases and admissions may have changed over time.  

These estimates also do not adjust for improvements in healthcare over time. Absolute case numbers rather than incidence per population were used, so these do not adjust for changes in population size over time. As a result, these estimates may underestimate the expected disease burden in the absence of vaccination. 

Limitations in reporting 

Due to some of these vaccines having been used successfully for many decades, the pre-vaccine data may not be directly comparable with the post-vaccine data due to changes in clinical management and reporting. Where possible, pre-vaccine data sources have been chosen that are expected to have a high positive predictive value, that is they are highly likely to have been genuine cases. In addition, the completeness of reporting may have improved over time, as a disease became much less common. Some specific known limitations are discussed below. 

For some diseases or metrics, reliable national reporting was not available. For example, complete pre-vaccination data was missing for tetanus. Pre-vaccination cases were therefore calculated based on reported deaths and plausible CFRs, or taken from published studies. 

For some infections, case definitions have changed between pre- and post-vaccination estimates. For example, for invasive bacterial infections and pneumococcal disease, the availability and sensitivity of microbiological assays have improved over time. Therefore, it is possible that some of the deaths estimated pre-vaccination would not fit with current case definitions. However, it is known that the burden of infections, such as pneumococcal pneumonia, were underestimated in general. Therefore, it is unlikely that pneumococcal deaths averted are substantially overestimated.

For a minority of metrics, reporting is based on a subset of cases or restricted by age group. For example, pertussis hospitalisations are based on infants only – this is kept consistent for pre- and post-vaccination data on hospitalisations. Pertussis current deaths are also only for infants. Pertussis pre-vaccination reported deaths were also likely to be in infants and children, as pertussis infection was unlikely to be considered as a cause of deaths in adults in the pre-vaccine era so the figures used can be considered directly comparable.

Total polio notifications before vaccination were primarily paralytic because non-paralytic cases were less completely reported. Non-paralytic cases are not included in the estimates. Therefore, cases reported here do not necessarily represent total disease burden for all infections. 

References

1. Oxford Vaccine Group. ‘The global value of vaccination’ Clinical Vaccine Research and Immunization Education 2019 (viewed 20 January 2026)

2. World Health Organization. Vaccines and immunization (viewed 20 January 2026)

3. US Centers for Disease Control and Prevention. Fast Facts on Global Immunization 2025 (viewed 20 January 2026)

4. Ten-year average of deaths from diphtheria cases and deaths, England and Wales from Public Health England reports (now UKHSA). Death data is based on data from Office and Population Censuses and Surveys (OPCS, now Office for National Statistics (ONS)) where diphtheria is listed as cause of death. Adjusted for England only using ONS Census mid-year population estimate, 2024 Vaccine Knowledge Project, Oxford Vaccine Group. ‘Diphtheria cases and deaths, England and Wales, 1914-2013 – Graph’ Updated 2023 (viewed 19 January 2026)

5. UK Health Security Agency (UKHSA). Diphtheria in England: 2024 Updated April 2025 (viewed 19 January 2026)

6. Ten-year average of deaths assigned to tetanus, England and Wales. The annual numbers of certified deaths assigned to tetanus were obtained from published reports of the Office of Population Censuses and Surveys. Adjusted for England only using ONS Census mid-year population estimate, 2024. Galbraith NS and others. ‘National surveillance of tetanus in England and Wales 1930-79’ Journal of Infection 1981 (viewed 19 January 2026)

7. UKHSA. Tetanus in England: 2024 Updated December 2025 (viewed 19 January 2026)

8. Ten-year average of deaths based on historic pertussis deaths, England and Wales published UKHSA reports. Death data is based on data from OPCS (now ONS) where pertussis recorded as an underlying cause. Adjusted for England only using ONS Census mid-year population estimate, 2024. UKHSA. Pertussis: laboratory confirmed cases reported in England 2024 November 2025 (viewed 20 January 2016)

9. Ten-year average deaths in infants aged under one year, England based on UKHSA report of pertussis, England. UKHSA. Pertussis: laboratory confirmed cases reported in England 2024 2025 (viewed 20 January 2026)

10. Ten-year average of deaths for acute poliomyelitis, England and Wales from former Health Protection Agency report. Deaths from 1950 and earlier also include late effects. Death data is based on data from OPCS (now ONS). Adjusted for England only using ONS Census mid-year population estimate, 2024. Health Protection Agency (now UKHSA). [ARCHIVED CONTENT] HPA – Acute Poliomyelitis: Annual Corrected Notifications Deaths, England Wales 1912-2007 Reviewed 2011 (viewed 19 January 2016)

11. As per the Green Book chapter on polio which confirms the UK has been declared polio free by WHO since 2003. UKHSA. Green Book Chapter 26 Poliomyelitis Immunisation against infectious disease. Updated June 2025 (viewed 20 January 2026)

12. Three-year average of fatal infections due to Hib in 6 regions of England and Wales. The population covered by the survey was approximately 35% of the total population of England and Wales, so this value of 30 deaths over 3 years has been adjusted to an annual value for the whole population. Adjusted for England only using ONS Census mid-year population estimate, 2024. Anderson EC and others. Epidemiology of invasive Haemophilus influenzae infections in England and Wales in the pre-vaccination era (1990-2) Epidemiology and Infection 1995

13. Based on laboratory reports of Haemophilus influenzae by age group and serotype, England report for 2024. UKHSA. Laboratory reports of Haemophilus influenzae by age group and serotype, England: annual 2024 (and 2023) Updated June 2025 (viewed 20 January 2026)

14. Deaths in confirmed cases of invasive meningococcal disease in England in epidemiological year 1998 to 1999. Death data in this report includes deaths from the ONS coded to meningitis or meningococcal infection as a cause of death and linked to a laboratory-confirmed case, and additionally all cases that died within 28 days of the sample date.  UKHSA. Meningococcal disease: laboratory-confirmed cases in England 2024 to 2025 March 2025 (viewed 19 January 2026)

15. This is based on the invasive meningococcal disease, England report from UKHSA which used ONS death registrations for July 2024 to June 2025. UKHSA. Invasive meningococcal disease in England: annual laboratory-confirmed reports for epidemiological year 2024 to 2025 Updated November 2025 (viewed 20 January 2026)

16. Five-year average of epidemiological years from April 1995 to 2000 based on estimates of deaths from lobar pneumonia and IPD extracted from ONS data, in England and Wales. Adjusted for England only using ONS Census mid-year population estimate, 2024. Melegaro and others. The current burden of pneumococcal disease in England and Wales Journal of Infection 2006 (viewed 19 January 2026)

17. This is based on prospective national surveillance data, including serotyping and whole-genome sequencing of invasive isolates, in England, in the financial year 2022 to 2023. Bertran and others. Invasive pneumococcal disease 3 years after introduction of a reduced 1 + 1 infant 13-valent pneumococcal conjugate vaccine immunisation schedule in England: a prospective national observational surveillance study The Lancet Infectious Diseases 2024 (viewed 20 January 2026)

18. Average deaths from the pre-vaccination era as per the Green Book, measles chapter in England and Wales. Green Book deaths are based on data from OPCS (now ONS). Adjusted for England only using ONS Census mid-year population estimate, 2024. UKHSA. The Green Book, Chapter 21 Measles Immunisation against infectious disease

19. Between 2000 and 2025 there were 10 deaths due to measles in children or adults in England and Wales that could have been prevented by the UK national immunisation programme, that is, the infection was acquired in England or Wales after the introduction of a measles-containing vaccine into the UK routine childhood immunisation programme. UKHSA. Measles: Historic confirmed cases, notifications and deaths Updated January 2026 (viewed 20 January 2026)

20. Ten-year average of notifications from diphtheria cases and deaths, England and Wales from Public Health England (now UKHSA). Cases recorded prior to 1985 are notifications, not laboratory confirmed cases. Adjusted for England only using ONS Census mid-year population estimate, 2024. Vaccine Knowledge Project, Oxford Vaccine group. Diphtheria cases and deaths, England and Wales, 1914-2013 – Graph Updated 2023 (viewed 19 January 2026)

21. In 2024, there were 12 cases identified, 4 of which were hospitalised. In terms of hospitalisations averted by vaccination, if we were to see the pre-vaccination incidence of diphtheria now, we would expect to see 33% of cases requiring hospitalisation. UKHSA. Diphtheria in England: 2024 Updated April 2025 (viewed 20 January 2026)

22. UKHSA. Diphtheria in England: 2024 Updated April 2025 (viewed 20 January 2026)

23. Based on historical estimates of around 112 deaths per year 1930 to 1939 in England and Wales (see annual deaths) and a conservative historical CFR of around 10%, then we estimate 1,117 cases per year. Adjusted for England only using ONS Census mid-year population estimate, 2024. The CFR of 10% is based on the University of Oxford vaccine knowledge key disease facts stating “at least 1 in 10 of those who develop tetanus die, even in countries like the UK” and reporting from the CDC which states 1 in 10 for the US. Galbraith and others. National surveillance of tetanus in England and Wales 1930-79 Journal of Infection 1981 (viewed 20 January 2026) Vaccine Knowledge Project, Oxford Vaccine Group. Tetanus Updated 2018 (viewed 20 January 2026) CDC. Clinical Overview of Tetanus Updated June 2025 (viewed 20 January 2026)

24. Assumption of around 100% of cases are admitted to hospital as this condition is severe and almost universally requires inpatient management. All cases reported in 2023 and 2024 required hospitalisation. UKHSA. Tetanus in England: 2024 Updated December 2025 (viewed 20 January 2026)

25. UKHSA. Tetanus in England: 2024 Updated December 2025 (viewed 20 January 2026)

26. Ten-year average of all-age incidence from historic pertussis notifications and deaths, England and Wales was 121,906​. Between 1982 and 1985, infants were, on average, 10% of total pertussis cases as per pertussis notifications by age group, England: 1982 to 2024. Assuming the same proportion, 10% of the historical incidence is estimated to occur in infants. Adjusted for England only using ONS Census mid-year population estimate, 2024. UKHSA. Laboratory confirmed cases of pertussis in England: annual report for 2024 supplementary data tables Updated December 2025 (viewed 20 January 2026)

27. Ninety-two percent of confirmed infant cases hospitalised. Source: “90% of all infants and 93% aged <3M, with pertussis were hospitalised”. Campbell and others. Accelerating Control of Pertussis in England and Wales CDC Emerging Infectious Diseases 2012: volume 18, number 1 (viewed 20 January 2026)

28. Infant only – 10-year average, 2010 to 2019, in England. Amirthalingam and others. Optimization of Timing of Maternal Pertussis Immunization From 6 Years of Postimplementation Surveillance Data in England Clinical Infectious Diseases 2022 (viewed 20 January 2026)

29. Based on reported notifications of paralytic polio from Green Book chapter on polio in England and Wales. Total polio notifications before vaccination were primarily paralytic because non-paralytic cases were seldom reported. Adjusted for England only using ONS Census mid-year population estimate, 2024. UKHSA. Green Book Chapter 26, Poliomyelitis Immunisation against infectious disease. Updated 2 June 2025 (viewed 20 January 2026)

30. Assumption of around 100% of cases are admitted to hospital as nature of paralytic polio is especially severe and requires inpatient treatment.

31. As per the Green Book chapter on polio which confirms the UK has been declared polio free by WHO since 2003. UKHSA. Green Book Chapter 26, Poliomyelitis Immunisation against infectious disease. Updated 2 June 2025 (viewed 20 January 2026)

32. This UKHSA report states that “in the pre-vaccine era, Hib was responsible for almost a thousand cases of invasive infections per year in England and Wales”. Adjusted for England only using ONS Census mid-year population estimate, 2024. UKHSA. Haemophilus influenzae type b (Hib): revised recommendations for the prevention of secondary cases Updated September 2024 (viewed 20 January 2026)

33. Assumption of around 100% of cases are admitted to hospital as nature of invasive disease is severe enough to require inpatient treatment.

34. Assumption of around 100% of cases are admitted to hospital as nature of invasive disease is severe enough to require inpatient treatment.

35. Laboratory-confirmed cases of invasive meningococcal disease reported to the enhanced meningococcal surveillance programme in England, for epidemiological year 1998 to 1999. UKHSA. Meningococcal disease: laboratory-confirmed cases in England 2024 to 2025 Updated November 2025 (viewed 20 January 2026)

36. Assumption of around 100% of cases are admitted to hospital as nature of invasive disease is severe enough to require inpatient treatment. Recommendation for treatment of invasive meningococcal disease is hospitalisation. UKHSA. Guidance for public health management of meningococcal disease in the UK Updated December 2025 (viewed 20 January 2026)

37. This is based on the number of cases reported for the 2024 to 2025 epidemiological year in England, and assuming a 100% case-hospitalisation rate. UKHSA. Invasive meningococcal disease in England: annual laboratory-confirmed reports for epidemiological year 2024 to 2025 Updated November 2025 (viewed 20 January 2026)

38. Atchison and others. Rapid Declines in Age Group-Specific Rotavirus Infection and Acute Gastroenteritis Among Vaccinated and Unvaccinated Individuals Within 1 Year of Rotavirus Vaccine Introduction in England and Wales Journal of Infectious Diseases: volume 213, issue 2, pages 243 to 249 (viewed 20 January 2026)

39. This is based on the Green Book which states “prior to routine pneumococcal conjugate vaccination, there were 6,346 IPD cases in England and Wales”, based on a prospective national observational cohort study. UKHSA. Green Book Chapter 25 – pneumococcal Immunisation against infection disease (viewed 20 January 2026)

40. Assumption of around 100% of cases are admitted to hospital as nature of invasive disease is severe enough to require inpatient treatment.​

41. This is based on 4,598 laboratory-confirmed IPD cases in 2022 to 2023 in England, as based on previous research, and assuming a 100% case-hospitalisation rate. Bertran and others. Invasive pneumococcal disease 3 years after introduction of a reduced 1 + 1 infant 13-valent pneumococcal conjugate vaccine immunisation schedule in England: a prospective national observational surveillance study Lancet Infectious Diseases 2024 (viewed 20 January 2026)

42. Ten-year average based on notifications of measles in England and Wales as reported by UKHSA. Adjusted for England only using ONS Census mid-year population estimate, 2024. UKHSA. Measles: Historic confirmed cases, notifications and deaths Updated January 2026 (viewed 20 January 2026)

43. As reported in the most recent laboratory-confirmed cases of measles, rubella and mumps in England, around 35% of measles cases are hospitalised posing a significant burden on the NHS during outbreaks. ​ UKHSA. Laboratory confirmed cases of measles, rubella and mumps in England: April to June 2025 Updated September 2025 (viewed 20 January 2026)

44. In 2023, a resurgence of measles was observed in the UK driven mainly by cases in unvaccinated children under the age of 10 years. This resurgence is due to the year-on-year decline in the uptake of the childhood vaccination programme since 2013 which was exacerbated by the COVID-19 pandemic. In 2024 just under 3,000 cases were confirmed in England – the highest number of cases reported in decades. Average over 10 years: 606, assuming a 35% hospitalisation rate. UKHSA. Measles: Historic confirmed cases, notifications and deaths Updated January 2026 (viewed 20 January 2026)

45. As mumps was not a notifiable disease until 1988, this is the number of notifications in 1989 (the first year that the vaccine had been introduced) in England. HPA. [ARCHIVED CONTENT] Mumps Notifications by Region 1989-2012 Notifications of Infectious Diseases, last reviewed August 2013 (viewed 20 January 2026)

46. Surveillance from 2002 to 2006, which included the largest UK mumps outbreak in 2004 to 2005, showed that 2.9% of mumps patients were hospitalised. Yung and others. Mumps Complications and Effects of Mumps Vaccination, England and Wales, 2002-2006 Emerging Infectious Diseases 2011 (viewed 20 January 2026)

47. A total of 137 cases of mumps were identified across the 4 quarters of 2024 in England. Annual hospitalisations were estimated by multiplying 137 by the case-hospitalisation rate of 2.9%. UKHSA. Measles, mumps and rubella: lab-confirmed cases in England 2024 Updated May 2025 (viewed 20 January 2026)

Acknowledgements

We are grateful to colleagues from UKHSA Immunisations and Vaccine Preventable Diseases and Immunisation Programmes Divisions, and to NHS England, for provision of the data used in this report. 

Contributing teams

Public Health Analysis, UKHSA Analysis and Intelligence Assessment

UKHSA Immunisations and Vaccine Preventable Diseases 

UKHSA Immunisation Programmes