Official Statistics

Quarterly vaccination coverage statistics for children aged up to 5 years in the UK (COVER programme): July to September 2023

Updated 26 March 2024

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 (July to September 2023).

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.

Main points

In comparison with the previous quarter:

• 12-month UK coverage for the ‘6-in-1’ vaccine decreased by 0.2% to 91.7%, rotavirus decreased by 0.4% to 88.7%, meningitis B second dose (MenB2) decreased by 0.1% to 91.4% and pneumococcal conjugate vaccine (PCV) dose 1 decreased by 0.2% to 93.7%
• in England, ‘6-in-1’ coverage decreased by 0.2% to 91.3%, MenB decreased by 0.2% to 91.0%, rotavirus decreased by 0.5% to 88.2% and PCV1 decreased by 0.2% to 93.4%
• at the country-level, in Scotland at least 94%, and in Wales at least 93% coverage was achieved for all antigens (except rotavirus) at 12 months, and in Northern Ireland coverage was at least 92% (except rotavirus)
• in England excluding London, at least 92% coverage was achieved for all antigens (except rotavirus)
• in the UK, 24-month coverage for the ‘6-in-1’ vaccine increased by 0.1% to 93.3%, whereas all other antigens decreased; measles, mumps and rubella first dose vaccination (MMR1) decreased by 0.1% to 89.8%, combined dose of haemophilus influenzae type b and meningitis C vaccines (Hib/MenC) decreased by 0.2% to 89.7%, PCV decreased by 0.2% at 89.3% and MenB decreased by 0.2% to 88.5%
• at 24 months, coverage in England for the ‘6-in-1’ increased by 0.1% to 92.9%, decreased by 0.3% to 89.2% for Hib/MenC and decreased by 0.1% to 88.0% for MenB; coverage for the PCV booster decreased by 0.2% to 88.80% and decreased by 0.1% to 89.4% for MMR1
• at the country level, coverage in Scotland exceeded 93% for all antigens measured at 24 months, in Wales it exceeded 92% and in Northern Ireland, coverage exceeded 88%
• in England, excluding London, at least 90% coverage was achieved for all antigens (except MenB at 89.6%)
• at 5 years, UK coverage for the pre-school booster (DTaP/IPV) decreased by 0.1% to 83.6%, MMR2 decreased by 0.1% to 84.5% and the Hib/MenC booster decreased by 0.2% to 90.8%
• in England excluding London, at least 91% coverage was achieved for all antigens, except MMR2 and the pre-school booster (DTaP/IPV)
• this is the fourth report for which BCG coverage has been collected for all eligible children in England measured at 12 months, coverage in England was 81.9%

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, and their primary course (second dose) of MenB vaccine which protects against meningococcal group B disease at the age of 16 weeks, between November 2022 and January 2023. They would have also been scheduled to receive a single dose of PCV (protecting against pneumococcal disease) and 2 doses of rotavirus vaccine at age 12 weeks, between October 2022 and December 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 November 2021 and January 2022 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 July and September 2022. Children born to HBsAg positive mothers, who reached their second birthday in this quarter (born July to September 2022), were scheduled to receive a third dose monovalent hepatitis B vaccine at one year of age.

Children who reached their fifth birthday would have been scheduled to receive their primary course (third dose) of the ‘6-in-1’ vaccination between November 2018 and January 2019, their first MMR and the Hib/MenC booster between July and September 2019, their pre-school diphtheria, tetanus, acellular pertussis and polio (DTaP/IPV) booster, and second-dose MMR from November 2021 to January 2022.

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.

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.

Coverage at 12 months

Compared with the previous quarter, UK coverage for the ‘6-in-1’ vaccine decreased by 0.2% to 91.7%, rotavirus decreased by 0.4% to 88.7%, PCV1 coverage decreased by 0.2% to 93.7%, while MenB2 decreased by 0.1% to 91.4% (the previous quarter’s coverage is reflected in Quarterly vaccination coverage statistics for children aged up to 5 years in the UK (COVER programme): January to March 2023). Quarterly vaccination coverage statistics for children aged up to 5 years in the UK (COVER programme): April to June 2023).

In England, 12-month coverage of the ‘6-in-1’ decreased by 0.2% to 91.3%, rotavirus decreased by 0.5% to 88.2%, MenB decreased by 0.2% to 91.0% and PCV1 coverage decreased by 0.2% to 93.4%.

In England excluding London, ‘6-in-1’ coverage at 12 months was 92.4%, 1.1% higher than the overall England coverage; PCV1 coverage was 94.3%, 0.9% higher than the overall England coverage; rotavirus was 89.2%, 1.0% higher than the overall England coverage and MenB coverage was 92.1%, 2.1% higher than the overall England coverage.

With the exception of the rotavirus vaccine, in Scotland, at least 94% coverage was achieved for all antigens at 12 months, in Wales it was at least 93% coverage, 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, and at 91.3% this quarter was 3.5% lower than the peak. Rotavirus coverage this quarter was 2.7% lower than the peak of 90.9% in quarter 1 (April to June) of 2020 to 2021 while MenB coverage was 2.0% 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 2 (July to September) 2013 to 2014 and quarter 2 2023 to 2024

Notes:

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 1 of 2013 to 2014 to quarter 3 2018 to 2019 represents 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.

Coverage at 24 months

In the UK, compared with the previous quarter, coverage of the ‘6-in-1’ vaccine increased by 0.1 to 93.3%. MMR1 coverage decreased by 0.1% to 89.8%, Hib/MenC decreased 0.2% to 89.7%, PCV decreased by 0.2% to 89.3% and MenB decreased by 0.2% to 88.5%.

Compared with the previous quarter, coverage in England for the ‘6-in-1’ vaccine increased by 0.1% to 92.9%, decreased by 0.3% to 89.2% for Hib/MenC and decreased by 0.1% to 88.0% for MenB. Coverage for the PCV booster decreased by 0.2% to 88.8%, while coverage for MMR1 decreased by 0.1% to 89.4%.

Coverage measured at 24-months of age in England excluding London, with the exception of MenB, exceeded 90% for all antigens. Coverage in England excluding London for the ‘6-in-1’ was 93.8%, 0.9% higher than the overall England coverage. PCV booster was 90.3%, 1.5% higher than the overall England coverage. Hib/MenC was 90.7%, 1.5% higher than the overall England coverage. MMR1 coverage was 90.8%, 1.4% higher than the overall England coverage and, MenB coverage was at 89.6%, 1.6% higher than the overall England coverage.

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 2 (July to September) 2013 to 2014 and quarter 2 2023 to 2024

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 1 of 2013 to 2014 to quarter 3 2019 to 2020 represents 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 96.3% in quarters 2, 3 and 4 of 2013 to 2014 (July 2013 to March 2014) and this quarter was 3.5 % lower than these peaks at 92.8%. PCV booster coverage was 3.7% lower this quarter than the peak of 92.8% in quarters 2 and 3 of 2013 to 2014 (July 2013 to December 2013). Hib/MenC coverage was 3.7% lower than the peak of 92.9% in quarter 4 of 2013 to 2014, while MMR1 coverage was 3.5% lower than the peak of 92.9% in quarter 3 (October to December) of 2013 to 2014. MenB coverage was 1.5% lower than the peak of 89.5% in quarter 2 (July to September) of 2020 to 2021.

Coverage at 5 years

Both Scotland and Wales achieved the 95% World Health Organization (WHO) target for both the ‘6-in-1’ and MMR1 vaccines at 5 years. In England, compared with the previous quarter, coverage of the 6-in-1 this quarter decreased by 0.3% to 92.8% while coverage for the UK as a whole decreased by 0.2% to 93.3%. In England, MMR1 coverage decreased by 0.2% to 92.3%. 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 November 2021 and January 2022.

Compared with the previous quarter, UK coverage for the pre-school booster (DTaP/IPV) decreased by 0.1% to 83.6%, MMR2 decreased by 0.1% to 84.5% and the Hib/MenC booster decreased by 0.2% to 90.8%.

In England, coverage for MMR2 decreased by 0.1% to 83.8% and the pre-school booster decreased by 0.1% to 82.7%. Pre-school booster and MMR2 coverage exceeded 88% in Scotland and Wales.

At 5 years, coverage in England excluding London for the pre-school booster (DTaP/IPV) was 84.9%, 2.2% higher than the overall England coverage. MMR2 was 86.2%, 2.4% higher than the overall England coverage and Hib/MenC was 91.6%, 1.4% higher than the overall England coverage.

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 3.2% lower this quarter than the peaks of 96.0% in quarter 4 (January to March) of 2013 to 2014, quarter 1 (April to June) of 2016 to 2017, quarter 1 (April to June) of 2017 to 2018 and quarter 2 (July to September) of 2017 to 2018.

Also in England, MMR1 was down by 3.3% from a peak of 95.6% in quarter 1 (April to June) of 2017 to 2018. MMR2 was down by 4.8% when compared with the 88.6% seen in quarter 1 of 2014 to 2015. The pre-school booster was 6.5% lower than at its peak of 89.2% in quarter 4 (January to March) of 2013 to 2014 and Hib/MenC was 2.9% 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 2 (July to September) 2013 to 2014 and quarter 2 2023 to 2024

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 1 of 2013 to 2014 to quarter 3 of 2021 to 2022 represents coverage of the 5-in-1 vaccine and quarter 4 of 2021 to 2022 onwards represents the 6-in-1 vaccine.

Neonatal hepatitis B vaccine coverage: England

National coverage at 12 months for 5 doses of a HepB-containing vaccine decreased 0.2% from 90.7% to 90.5% compared with the previous quarter (as seen in the previous quarterly 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 July and September 2021) increased  by 0.6% to 88.4% compared with the last quarter (87.8%) (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.

Neonatal BCG vaccine coverage: England

This is the sixth report for which BCG coverage has been collected for all eligible children in England measured at 3 months and the fourth report where coverage was measured at 12 months. The data captures BCG coverage at age 3 months for children born 1 April to 30 June 2023 and at age 12 months for children born 1 July 2022 to 30 September 2022; it was provided for all local authorities in England and is published in the data tables associated with this report. Measured at 3 months, coverage in England was 75.9%, an increase of 6.2% from the last quarter (69.7%) and measured at 12 months, it was 81.9%, an increase of 1.9% compared with the previous quarter (80.0%).

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 and the associated general practices (GP).

All English data was collected through NHS Digital’s Strategic Data Collection Service. Individual local authority 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.

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 are available, as is additional information for immunisation practitioners and other health professionals.

Contact

Email: cover@ukhsa.gov.uk