Official Statistics

Quarterly vaccination coverage statistics for children aged up to 5 years in the UK (COVER programme): October to December 2022

Updated 26 September 2023

This report of the cover of vaccination evaluated rapidly (COVER) programme presents quarterly coverage data for children in the UK who reached their first, second, or fifth birthday during the evaluation quarter (October to December 2022).

The full coverage data (which is broken down by country, NHS England local team (configuration as of 1 April 2018) and NHS England region) is now contained in the separate data file accompanying this report along with data by Upper Tier Local Authority and UK Health Security Agency (UKHSA) region.

1. Main points

In comparison with the previous quarter:

• 12-month UK coverage for the ‘6-in-1’ vaccine decreased by 0.1% to 92.3%, rotavirus increased by 0.2% to 89.6%, meningitis B second dose (MenB2) decreased by 0.3% to 92.0% and pneumococcal conjugate vaccine (PCV) dose 1 decreased by 0.1% at 94.2%
• in England, ‘6-in-1’ coverage decreased by 0.2% to 91.9%, MenB decreased by 0.3% to 91.6%, rotavirus increased by 0.3% to 89.3% and PCV1 coverage decreased by 0.1% to 94.0%
• at the country-level, in Scotland at least 95% coverage was achieved for all antigens (except rotavirus) at 12 months, in Wales at least 94% coverage and in Northern Ireland coverage was at least 92%
• in the UK, 24-month coverage of the ‘6-in-1’ vaccine increased 0.1% to 93.4%, but all other antigens decreased; measles, mumps and rubella first dose vaccination (MMR1) decreased by 0.6% at 89.5%, combined dose of the haemophilus influenzae type b and meningitis C vaccines (Hib/MenC) decreased 0.6% to 89.4%, coverage for PCV decreased by 0.8% to 89.1% and MenB decreased by 0.7% to 88.4%
• at 24 months, coverage in England for the ‘6-in-1’ vaccine increased by 0.1% to 93.0%, it decreased by 0.6% to 88.9% for Hib/MenC and decreased by 0.8% to 87.8% for MenB; coverage for the PCV booster decreased by 0.9% to 88.5% and decreased by 0.7% to 89.0% for MMR1
• at the country level, coverage in Scotland exceeded 93% for all the vaccines offered from the first birthday, in Wales it exceeded 92% and in Northern Ireland, coverage exceeded 88%
• at 5 years, UK coverage for the pre-school booster (DTaP/IPV) increased by 0.6% to 85.0%, MMR2 increased by 0.3% to 85.8% and the Hib/MenC booster decreased by 0.2% to 91.5%
• this is the first report for which BCG coverage has been collected for all eligible children in England measured at 12 months, coverage in England was 78.7%

2. Scope

Children who reached their first birthday in this quarter would have been scheduled to receive their primary course (third dose) of the combined diphtheria, tetanus, acellular pertussis vaccine, inactivated poliomyelitis vaccine, haemophilus influenzae type b vaccine and hepatitis B vaccine (DTaP/IPV/Hib/HepB3 or ‘6-in-1’ vaccination) which protects against diphtheria, tetanus, pertussis (whooping cough), polio, haemophilus influenzae type b (Hib) and hepatitis B. They would have been scheduled to receive their primary course (second dose) of MenB vaccine which protects against meningococcal group B disease at the age of 16 weeks, between February 2022 and April 2022. They would have also been scheduled to receive a single dose of PCV (protecting against pneumococcal disease) and two doses of rotavirus vaccine at age 12 weeks, between January 2022 and March 2022.

With the exception of the rotavirus vaccine, which is only offered up to 6 months of age, all other vaccines are available to children in the current cohort at any time and would have been captured in this report if given by their first birthday. Children born to hepatitis B surface antigen (HBsAg) positive mothers who reached their first birthday in this quarter should also have received monovalent hepatitis B vaccine at birth and at 4 weeks of age.

Children who reached their second birthday would have been scheduled to receive their primary course (third dose) of the ‘6-in-1’ vaccination between February 2021 and April 2021 and their first MMR vaccination, a Hib/MenC booster (protecting against haemophilus influenzae type b and meningococcal group C disease), MenB booster and PCV booster at age one year between October and December 2021. Children born to HBsAg positive mothers, who reached their second birthday in this quarter (born October to December 2020), were scheduled to receive a third dose monovalent hepatitis B vaccine aged one year.

Children who reached their fifth birthday would have been scheduled to receive their primary course (third dose) of the ‘6-in-1’ vaccination between February 2018 and April 2018, their first MMR and the Hib/MenC booster between October and December 2018, their pre-school diphtheria, tetanus, acellular pertussis and polio (DTaP/IPV) booster, and second-dose MMR from February 2021 to April 2021.

Children born in areas where the TB incidence is greater than or equal to 40 per 100,000 or who are born to parents or grandparents from TB endemic areas were eligible for a BCG vaccination at 28 days. Coverage is measured at 3 months of age and 12 months of age for this selective immunisation. The full routine immunisation schedule sets out the schedule for all childhood immunisations.

3. Results

This publication is released on a quarterly basis and aligns with financial quarters. The analysis follows this pattern; any discussion of quarters aligns with the financial year whereby quarter 1 starts in April.

3.1 Coverage at 12 months

Compared with the previous quarter, UK coverage for the ‘6-in-1’ vaccine decreased by 0.1% to 92.3%, rotavirus increased by 0.2% to 89.6% while MenB2 decreased by 0.3% to 92.0% (the previous quarter coverage is reflected in Quarterly vaccination coverage statistics for children aged up to 5 years in the UK (COVER programme): July to September 2022). This is the eighth quarterly cohort to be routinely offered one PCV dose in the first year of life at 12 weeks and the UK coverage decreased by 0.1% to 94.2%.

In England, 12-month coverage of the ‘6-in-1’ decreased by 0.2% to 91.9%, rotavirus increased by 0.3% to 89.3% and MenB decreased by 0.3% to 91.6%. PCV1 coverage decreased by 0.1% to 94.0%.

With the exception of the rotavirus vaccine, in Scotland at least 95% coverage was achieved for all antigens at 12 months, at least 94% coverage in Wales, and in Northern Ireland coverage was at least 92%.

Full coverage data by country, NHS England local team (configuration as of 1 April 2018), NHS England region, Upper Tier Local Authority and UKHSA region is contained in the separate data file accompanying this report.

In England, coverage for the ‘6-in-1’ vaccine peaked at 94.7% in quarter 4 (January to March) of 2013 to 2014, at 91.9% this quarter was 2.8% lower than the peak. Rotavirus coverage this quarter was 1.6% lower than the peak of 90.9% in quarter 1 (April to June) of 2020 to 2021 while MenB coverage was 1.4% lower than the peak of 93.0% in quarter 3 (October to December) of 2017 to 2018.

Figure 1. Completed primary immunisations in England at 12 months between quarter 3 (October to December) 2012 to 2013 and quarter 3 2022 to 2023

Note: 1. The ‘5-in-1’ (DTaP/IPV/Hib3) vaccine was used prior to August 2017 when it was replaced with the ‘6-in-1’ vaccine (DTaP/IPV/Hib3/HepB). As a result, quarter 3 of 2012 to 2013 to quarter 3 2018 to 2019 represent coverage of the ‘5-in-1’ vaccine and quarter 4 of 2018 to 2019 onwards represents the ‘6-in-1’ vaccine.
2. From quarter 4 (January to March) 2020 to 2021 we started to report PCV1 rather than PCV2 to reflect the change in the PCV schedule.

3.2 Coverage at 24 months

In the UK, coverage of the ‘6-in-1’ vaccine increased 0.1% to 93.4%, MMR1 decreased by 0.6% to 89.5%, and Hib/MenC decreased 0.6% to 89.4%. Coverage for PCV decreased by 0.8% to 89.1% and MenB decreased by 0.7% to 88.4%.

Compared with the previous quarter, coverage in England for the ‘6-in-1’ vaccine increased by 0.1% to 93.0%, decreased by 0.6% to 88.9% for Hib/MenC and decreased by 0.8% to 87.8% for MenB. Coverage for the PCV booster decreased by 0.9% to 88.5%. Coverage for MMR1 decreased by 0.7% to 89.0%.

At the country level, coverage in Scotland exceeded 93% for all the vaccines offered from the first birthday, in Wales it exceeded 92% and in Northern Ireland, coverage exceeded 88%.

Full coverage data by country, NHS England local team (configuration as of 1 April 2018), NHS England region, Upper Tier Local Authority and UKHSA region is contained in the separate data file accompanying this report.

Figure 2. Completed primary immunisations in England at 24 months between quarter 3 (October to December) 2012 to 2013 and quarter 3 2022 to 2023

Note: The ‘5-in-1’ (DTaP/IPV/Hib3) vaccine was used prior to August 2017 when it was replaced with the ‘6-in-1’ vaccine (DTaP/IPV/Hib3/HepB). As a result, quarter 3 of 2012 to 2013 to quarter 3 2019 to 2020 represent coverage of the ‘5-in-1’ vaccine and quarter 4 of 2019 to 2020 onwards represents the ‘6-in-1’ vaccine.

In England, coverage for the ‘6-in-1’ vaccine peaked at 97.7% in quarter 4 (January to March) of 2012 to 2013 and this quarter was 4.7% lower than that peak at 93.0%. PCV booster coverage was 4.3% lower this quarter than the peak of 92.8% in quarter 4 of 2012 to 2013. Hib/MenC coverage was 1.0% lower than the peak of 92.9% in quarter 4 of 2013 to 2014, while MMR1 coverage was 3.9% lower than the peak of 92.9% in quarter 3 (October to December) of 2013 to 2014. MenB coverage was 1.7% lower than the peak of 89.5% in quarter 2 (July to September) of 2020 to 2021.

3.3 Coverage at 5 years

Both Scotland and Wales achieved the 95% World Health Organization (WHO) target for the ‘6-in-1’ vaccine at 5 years. In England coverage this quarter remained at 93.5% while coverage for the UK as a whole decreased by 0.1% to 93.8%. This target was also achieved for MMR1 in Scotland and Wales. In England, MMR1 coverage remained at 92.9%. Coverage at 5 years for these vaccines primarily reflects vaccinations delivered 4 years ago.

MMR2 and the preschool booster are given from age 3 years and 4 months and reflect vaccinations that should have been delivered between February and April 2021.

Compared with the previous quarter, UK coverage for the pre-school booster (DTaP/IPV) increased by 0.6% to 85.0%, MMR2 increased by 0.3% to 85.8% and the Hib/MenC booster decreased by 0.2% to 91.5%.

In England, coverage for MMR2 increased by 0.5% to 85.2% and the pre-school booster increased by 0.6% to 84.40. Pre-school booster and MMR2 coverage exceeded 90% in Scotland and Wales.

Full coverage data by country, NHS England local team (configuration as of 1 April 2018), NHS England region, Upper Tier Local Authority and UKHSA region is contained in the separate data file accompanying this report.

In England, coverage of the ‘6-in-1’ vaccine was 2.5% lower this quarter than the peak of 96.0% in quarter 2 (July to September) of 2012 to 2013. MMR1 was down by 2.7% from a peak of 95.6% in quarter 1 (April to June) of 2017 to 2018. MMR2 was down by 3.4% when compared with the 88.6% seen in quarter 1 of 2014 to 2015. The pre-school booster was 5.2% lower than at its peak of 89.2% in quarter 4 (January to March) of 2013 to 2014 and Hib/MenC was 3.1% lower than the peak of 93.1% in quarter 2 of 2017 to 2018.

Figure 3. Completed primary immunisations in England at 5 years between quarter 3 (October to December) 2012 to 2013 and quarter 3 2022 to 2023

Note: The ‘5-in-1’ (DTaP/IPV/Hib3) vaccine was used prior to August 2017 when it was replaced with the ‘6-in-1’ vaccine (DTaP/IPV/Hib3/HepB). As a result, quarter 3 of 2012 to 2013 to quarter 3 of 2021 to 2022 represent coverage of the ‘5-in-1’ vaccine and quarter 4 of 2021 to 2022 onwards represents the ‘6-in-1’ vaccine.

3.4 Neonatal hepatitis B vaccine coverage: England

National coverage at 12 months for 5 doses of a HepB-containing vaccine decreased from 89% to 88% compared with the previous quarter (as seen in the previous edition of this report). Coverage of 6 doses of a HepB-containing vaccine reported for children who reached 2 years of age in the quarter (those born between October and December 2020) decreased by 6% to 77% compared with the last quarter (83%) (see separate data file accompanying this report).

The quality of neonatal HepB vaccine data is variable and coverage by former local teams can be based on small numbers. As such, data should be interpreted with caution. Where an area reported no vaccinated children, a check was made to ensure that this was zero reporting rather than absence of available data.

3.5 Neonatal BCG vaccine coverage: England

This is the third report for which BCG coverage has been collected for all eligible children in England measured at 3 months and the first report where coverage was measured at 12 months. The data captures BCG coverage at age 3 months for children born 1 July to 30 September 2022 and at age 12 months for children born 1 October 2021 to 31 December 2021; it was provided for 151 of 152 Local Authorities in England and published in the data tables associated with this report. Measured at 3 months, coverage in England was 68.8% and measured at 12 months, it was 78.7%.

4. Participation and data quality

Data was received from all health boards in Scotland, Northern Ireland, and Wales. In England, local teams and Child Health Record Departments provided data for all upper tier local authorities (LAs) and the associated general practices (GP).

All English data were collected through NHS Digital’s Strategic Data Collection Service. Individual LA and GP data including numerators, denominators, coverage and relevant caveats where applicable are available in the data tables associated with this report. GP level data was censored when individual values were less than 5.

5. Links for country-specific data

• Quarterly data for England
• Annual data for England
• Data for Northern Ireland
• Data for Scotland
• Data for Wales

The submission and publication dates for this report series is available as is additional information for immunisation practitioners and other health professionals.