Td/IPV vaccine coverage for the NHS adolescent vaccination programme in England, academic year 2024 to 2025
Updated 29 January 2026
Applies to England
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Main Points
This report presents vaccine coverage data for the routine school-aged diphtheria, tetanus and inactivated poliomyelitis (Td/IPV) immunisation programme in England for the 2024 to 2025 academic year. These results include Td/IPV vaccine coverage estimates for children in years 9 and 10 (or the equivalent ages) measured up to the 31 August 2025.
Td/IPV vaccine coverage is presented for England at national, NHS commissioning region, and local authority levels.
The main findings of this report are that:
- Td/IPV coverage for year 9 students during the 2024 to 2025 academic year was 72.4%, which is 0.7 percentage points higher than the year 9 cohort in 2023 to 2024
- Td/IPV coverage for year 10 students during the 2024 to 2025 academic year was 74.7%, which is 2 percentage points higher than the year 10 cohort in 2023 to 2024
- Td/IPV coverage for year 10 students was 3 percentage points higher than in the 2023 to 2024 academic year when they were in year 9
- Td/IPV coverage for year 9 students was lowest in the North West (66.1%) and highest in the South East (77.9%)
- Td/IPV coverage for year 10 students was lowest in London (64.8%) and highest in the East of England (82.5%)
Table 1. Td/IPV vaccination cohorts in the 2024 to 2025 academic year
| School year in 2024 to 2025 | Age in 2024 to 2025 | Dates of birth |
|---|---|---|
| 9 (routine) | 13 to 14 years | 1 September 2010 to 31 August 2011 |
| 10 (routine or catch up) | 14 to 15 years | 1 September 2009 to 31 August 2010 |
Results
Summary of Td/IPV coverage by year group
Figure 1. Td/IPV coverage in adolescents in school years 9 and 10 by academic year from 2015 to 2025
Table 2. Td/IPV coverage in years 9 and 10 from 2015 to 2025 [Note 1]
| Academic year | Year 9 Td/IPV coverage (%) | Year 10 Td/IPV coverage (%) |
|---|---|---|
| 2015 to 2016 | 83.5 | 74.9 |
| 2016 to 2017 | 83.0 | 81.7 |
| 2017 to 2018 | 85.5 | 82.9 |
| 2018 to 2019 | 87.6 | 86.0 |
| 2019 to 2020 | 57.6 | 86.4 |
| 2020 to 2021 | 76.3 | 80.3 |
| 2021 to 2022 | 69.0 | 79.5 |
| 2022 to 2023 | 68.3 | 74.1 |
| 2023 to 2024 | 71.7 | 72.7 |
| 2024 to 2025 | 72.4 | 74.7 |
Figure 1 and Table 2 show the Td/IPV vaccine coverage for year 9 and year 10 students in England from 2015 to 2025.
Td/IPV coverage for year 9 students during the 2024 to 2025 academic year was 72.4%, which is 0.7 percentage points higher than the year 9 cohort in 2023 to 2024. For year 10 students, coverage was 74.7% in the 2024 to 2025 academic year, which is 2.0 percentage points higher than the year 10 cohort in the previous year.
Note 1: In 2015 to 2016, only half of the year 9 and 10 cohorts were eligible for the vaccine meaning these figures are not comparable to later years. Also, over time many local authorities have moved from routinely offering the vaccine in year 10 to offering it in year 9. During transitional years, some local authorities offered the vaccine routinely to both year 9 and 10. This transition meant that in 2018 to 2019, the year 9 data was incomplete meaning some local authorities were excluded from national coverage figures. Since almost all local authorities now offer the vaccine in year 9, the year 10 coverage figures from 2021 to 2022 onwards are the year 9 coverage plus additional catch up. These changes mean that national coverage figures are not directly comparable over time and explain why coverage in the year 10 cohort may appear to decrease when compared to previous years.
Summary of Td/IPV Coverage by Cohort
Figure 2. Td/IPV coverage in adolescents in school years 9 and 10 by cohort for those eligible from 2017 to 2025 [Note 2]
Figure 2 presents Td/IPV vaccine coverage by cohort, where a cohort is a group of students who first became eligible for the HPV vaccine in the same academic year. Most vaccinations are administered in year 9, with some additional doses given in year 10. There were high levels of year 10 catch-up in the cohort who became eligible in 2020 to 2021 due to the disruption caused by the COVID-19 pandemic. Low-level year 10 catch-up has occurred for all subsequent cohorts.
Final cumulative coverage has remained relatively stable since the 2022 to 2023 academic year and reached 74.7% among those who became eligible in the 2023 to 2024 financial year, who are now in year 10.
Note 2: Year 10 data for those first eligible in the 2019 to 2020 academic year was excluded as the data collected during the COVID-19 pandemic was incomplete, making comparison between those years invalid.
Year 9 vaccine coverage
The main findings for the year 9 cohort were that:
- Td/IPV coverage for year 9 students in 2024 to 2025 was 72.4%, which is 0.7 percentage points higher than year 9 students in the previous year
- Td/IPV coverage for year 9 students was lowest in the North West (66.1%) and highest in the South East (77.9%)
- Td/IPV coverage for year 9 students at local authority level ranged from 9.7% (Bolton) [Note 3] to 91.0% (West Berkshire)
- out of 151 LAs, coverage in 50 (33.1%) was less than 70%, coverage in 63 (41.7%) was between 70% and 80%, coverage in 36 (23.8%) was between 80% and 90%, and coverage in 2 (1.3%) was greater than 90%
Note 3: In some local authorities, the vaccine is routinely offered in both years 9 and 10, so year 9 uptake does not represent final coverage. Consequently, these figures are not directly comparable with areas that offer the vaccine in year 9 only.
Figure 3. Year 9 Td/IPV coverage by NHS commissioning region
Td/IPV coverage in year 9 students was lowest in the North West (66.1%) and highest in the South East (77.9%)
Figure 4. Year 9 Td/IPV coverage variation by NHS commissioning region
Figure 4 shows the distribution of Td/IPV vaccine coverage in school year 9 by NHS commissioning region. The boxes indicate the inter-quartile range (IQR), the range between the first and third quartiles, among constituent local authorities in each NHS commissioning region. The median (second quartile) is indicated by the horizontal white line within each box. Vertical black lines indicate the range of coverage values among local authorities that fall within 1.5 times the IQR above the third quartile or below the first quartile. Local authorities with coverage outside this range are considered outliers and indicated by a black dot.
Within each NHS commissioning region, coverage for year 9 by local authority varied substantially. The NHS commissioning region with the most variation in coverage was the North West, where local authority level coverage varied by 74.9 percentage points, from 9.7% to 84.6%. The NHS commissioning region with the least variation in coverage was the East of England, where local authority level coverage varied by 19.4 percentage points, from 63.0% to 82.3%.
Figure 5. Map of year 9 Td/IPV coverage by local authority
Figure 5 shows the geographical distribution of Td/IPV vaccine coverage at the local authority level for year 9 students in England. Coverage within local authorities ranged from 9.7% in Bolton to 91% in West Berkshire.
Year 10 vaccine coverage
The main findings for the year 10 cohort were that:
- Td/IPV coverage for year 10 students in 2024 to 2025 was 74.7%, which is 2.0 percentage points higher than year 10 students in the previous year
- Td/IPV coverage for year 10 students was 3.0 percentage points higher than in 2023 to 2024 when they were in year 9 suggesting ongoing catch up activities in year 10
- Td/IPV coverage for year 10 students was lowest in London (64.8%) and highest in the East of England (82.5%)
- Td/IPV coverage for year 10 students at local authority level ranged from 32.6% (Brent) to 96.5% (Cumberland)
- out of 151 LAs, coverage in 44 (29.1%) was less than 70%, coverage in 58 (38.4%) was between 70% and 80%, coverage in 46 (30.5%) was between 80% and 90%, and coverage in 3 (2%) was greater than 90%
Figure 6. Year 10 Td/IPV coverage by NHS commissioning region
Td/IPV coverage in year 10 students was lowest in London (64.8%) and highest in the East of England (82.5%)
Figure 7. Year 10 Td/IPV coverage variation by NHS commissioning region
Figure 7 shows the distribution of Td/IPV vaccine coverage in school year 10 by NHS commissioning region. The boxes indicate the inter-quartile range (IQR), the range between the first and third quartiles, among constituent local authorities in each NHS commissioning region. The median (second quartile) is indicated by the horizontal white line within each box. Vertical black lines indicate the range of coverage values among local authorities that fall within 1.5 times the IQR above the third quartile or below the first quartile. Local authorities with coverage outside this range are considered outliers and indicated by a black dot.
Within each NHS commissioning region, coverage for year 10 by local authority varied substantially. The NHS commissioning region with the most variation in coverage was London, where local authority level coverage varied by 57.2 percentage points, from 32.6% to 89.8%. The NHS commissioning region with the least variation in coverage was the South West, where local authority level coverage varied by 16.8 percentage points, from 64.1% to 80.9%.
Figure 8. Map of year 10 Td/IPV coverage by local authority
Figure 8 shows the geographical distribution of Td/IPV vaccine coverage at the local authority level for year 10 students in England. Coverage within local authorities ranged from 32.6% in Brent to 96.5% in Cumberland.
Discussion
Td/IPV vaccine coverage for year 9 in 2024 to 2025 was 72.4%. This is slightly higher than coverage in 2023 to 2024 and not yet back to pre-pandemic levels. Coverage in the year 10 cohort was 74.7%, which is a small improvement on uptake recorded for this cohort in year 9 during the previous academic year, suggesting ongoing catch up activity. Coverage in year 10 was 2 percentage points higher compared to year 10 in 2023 to 2024, when it was 72.7. When coverage was calculated for each NHS commissioning region, the estimates varied considerably.
Background information
Tetanus, diphtheria and polio vaccines are offered to all babies with the other primary immunisations at 8 weeks, 12 weeks and 16 weeks. A pre-school booster is then offered to children at 3 years and 4 months of age, and a school leaver booster (Td/IPV) is offered to adolescents aged 14 years. The school leaver booster is therefore the fifth dose of a tetanus, diphtheria and polio containing vaccine in the routine immunisation schedule and completes the course, providing long-term protection against all 3 infections.
Any missed doses of diphtheria, tetanus and polio vaccines can be caught up at any age observing the appropriate intervals between doses as detailed in the Green Book. NHS England (NHSE) commissions general practices and/or school aged immunisation providers to deliver the routine childhood immunisation programmes in England.
The NHS adolescent immunisation programmes in England are primarily school based and are delivered routinely by NHSE commissioned school aged vaccination providers. Adolescents who are home schooled, those who attend a small minority of schools that do not offer the routine vaccination programmes, and those eligible, but not in education should be offered their vaccinations in alternative settings, such as community clinics. Data on whether children were vaccinated in school or at alternative settings is not universally included in the school vaccination figures submitted by data providers.
In 2021 to 2022, the routine offer of Td/IPV vaccine to the year 9 cohort was implemented alongside catch up for the year 10 cohort in most local authorities. Only a small number of NHSE commissioned school-aged immunisation providers, covering 4 local authorities continue to offer the Td/IPV programme to year 10 students routinely.
Since March 2020, the COVID-19 pandemic has led to some disruption of school-based immunisation programme delivery and the impact has varied by region and local authority. The biggest impact was observed in the 2019 to 2020 academic year when all schools were closed in the first national lockdown. Throughout the 2020 to 2021 academic year, school attendance rates in England were lower than normal. In January 2021, schools were closed to all, except children of key workers and vulnerable children, with a phased reopening of secondary schools from March 2021. Staff absences in both schools and school age immunisation services also added to the disruption.
Vaccine coverage in 2020 to 2021 improved significantly but was still not back up to pre-pandemic levels. In the 2021 to 2022 academic year, school attendance rates in England remained lower than normal until the ‘Living with COVID-19’ guidance was implemented from February 2022 and all restrictions were lifted. In September 2021, the offer of COVID-19 vaccination was extended to all children aged 12 to 15 years and was delivered in secondary schools and other settings. In addition, the influenza immunisation programme was extended to all children in secondary schools. School-aged immunisation services were instrumental in supporting the delivery of all of these programmes under very challenging circumstances. It is likely that all of these factors combined impacted on the delivery of the routine adolescent immunisation programmes including the Td/IPV programme.
Methods
NHSE commissioned school age immunisation providers collect school-level vaccine coverage data, which is then aggregated up to local authority and submitted to UK Health Security Agency (UKHSA) either directly by the providers or by NHSE Regional Public Health Commissioning Teams via the ImmForm website. Where possible, regional teams also include additional data for adolescents resident in the local authority but not linked to any school. Data providers may also submit data on vaccinations delivered through community clinics or GP practices and this can then be added to the school vaccination figures.
The numerator is defined by the number of adolescents in each cohort who had received a dose of the Td/IPV vaccine by 31 August 2025. Providers must use updated data sources to identify all eligible children in the locality for the academic year. This can be calculated from school student records for all types of schools or units, plus children schooled at home, or Child Health Information Systems.
The denominator is defined by the total number of eligible adolescents in each cohort regardless of programme delivery.
Local authority level Td/IPV vaccine coverage data up to 31 August 2025 was manually uploaded by data providers to the ImmForm website retrospectively, from 1 September 2025 to 1 October 2025. The target population for the programme is defined by school age cohorts born between 1 September 2009 and 31 August 2011 (Table 1). This means that it includes those adolescents in school years 9 and 10 in the 2024 to 2025 academic year. Coverage for the year 10 cohort was intended to capture both vaccines delivered during the 2023 to 2024 academic year (when the students were in year 9) and routine or catch up vaccines delivered in 2024 to 2025.
For this report, the Isles of Scilly local authority is merged with Cornwall local authority due to small numbers.
Full details of the data collection process and definitions can be found in the user guide.
Programme delivery
The JCVI recommends that the Td/IPV vaccine is offered to students in year 9 or 10, however, the routine delivery schedule varies by local authority depending on local requirements and resources. In the 2024 to 2025 academic year, Td/IPV was routinely offered to year 9 in 109 local authorities, both years 9 and 10 in 28 local authorities and an alternative schedule was used in 14 local authorities. Out of the 151 local authorities, 2 were unable to offer the vaccine to all eligible students in 10.
Feedback and contact information
To provide feedback and for all queries relating to this document, contact Adolescent@ukhsa.gov.uk