Official Statistics

Quality and methodology information: older adult respiratory syncytial virus (RSV) vaccine coverage estimates in England

Published 5 March 2026

Applies to England

About this report

This Quality and Methodology Information (QMI) report outlines the approach used for the production of the official statistics on the respiratory syncytial virus (RSV) vaccine coverage in older adults, published by the UK Health Security Agency (UKHSA). This QMI report supports users in understanding the strengths and limitations of the data, methods and statistics, ensuring UKHSA is compliant with the quality standards stated in the Code of Practice for Statistics.

 The report covers:

• the strengths and limitations of the data used to produce the statistics
• the methods used to produce the statistics
• the quality of the statistical outputs

About the statistics

Respiratory syncytial virus (RSV) is a common respiratory pathogen that can cause serious illness in older adults, particularly those with underlying health conditions. RSV infections are often seasonal and can lead to complications such as bronchiolitis and pneumonia.

The national RSV vaccination programme for older adults was introduced in 2024 following recommendations from the Joint Committee on Vaccination and Immunisation (JCVI). The programme aims to protect individuals aged 75 to 79 years from RSV-related morbidity and mortality. The eligibility for the target individuals (aged 75 to 79 years) is defined by 2 cohorts:

• routine cohort – individuals turning 75 during the programme year
• catch-up cohort – individuals aged 75 to 79 at the start of the programme

This monthly report presents cumulative RSV vaccine coverage among eligible older adults in England, based on data from the Immunisation Information System (IIS). The statistics are updated monthly to monitor uptake trends and identify disparities across age, sex, deprivation, ethnicity, and geography.

Geographical coverage: England

Publication frequency: monthly

Purpose: to monitor vaccine uptake and identify equity gaps in coverage across the eligible population

Changes to this document

5 March 2026: QMI report first published

Contact

Lead consultant: Colin Campbell

Contact information: rsv@ukhsa.gov.uk

Suitable data sources

Statistics should be based on the most appropriate data to meet intended uses.

This section describes the data used to produce the statistics.

Data sources

RSV vaccine uptake statistics are derived from IIS, formerly known as the National Immunisations Management System. IIS sources data from the Data Processing Service (DPS) at NHS England (NHSE). This includes both vaccine administration records and eligible population data. The IIS structure allows for consistent, individual-level tracking using NHS number, and supports linkage to demographic and geographic indicators. This infrastructure supports the national RSV vaccination programme and enables timely, granular surveillance.

IIS is an individual-level record system that includes vaccination and eligibility data for approximately 68 million primary care registered individuals in England. Unlike similar systems such as the ImmForm collection which collect aggregated vaccination and eligible population records from participating GP practices, IIS data is updated daily. This provides various sociodemographic information such as sex, ethnicity, and regional deprivation and analysis can be conducted in near real-time or for specific period of interest.

RSV vaccine data is collected through NHS vaccination providers, including community pharmacies, general practices (GPs), and other commissioned services. Vaccination data is transmitted via automated daily feeds into IIS and subsequently transferred to UKHSA’s secure data warehouse.

The IIS structure allows for:

• consistent individual-level tracking using NHS numbers
• linkage to demographic and geographical indicators
• monitoring of vaccine uptake across cohorts and regions

Denominator data for the RSV programme is based on extracts of the eligible population, defined by age (75 to 79 years) and NHS registration status. These estimates are dynamic and updated regularly to reflect individuals ageing into or out of the eligible cohort.

This automated and centralised data flow ensures high completeness and timeliness, reduces the reporting burden on providers, and enables UKHSA to assess the impact of service delivery models on coverage with high granularity such as by Lower Super Output Area (LSOA) or NHS commissioning region.

Data quality

The data that we use to produce statistics must be fit for purpose. Poor quality data can cause errors and hinder effective decision making.

We have assessed the quality of the source data against the data quality dimensions in the Government Data Quality Framework.

This assessment covers the quality of the data that was used to produce the statistics, not the quality of the final statistical outputs. The quality summary section below assesses the quality of the final statistical outputs.

Strengths and limitations of the RSV data

IIS receives high granularity, patient-identifiable information (PII) daily. This is a major strength of the RSV vaccine programme, as it enables near real-time monitoring of coverage trends. Decision-makers can respond quickly to emerging issues, such as low uptake in specific areas, and implement targeted catch-up campaigns. The detailed sociodemographic data also supports identification of under-vaccinated groups, allowing for tailored interventions that reduce health inequalities and improve population-level protection.

However, IIS also has limitations. It includes individuals registered only in primary care with an NHS number. This means people outside the healthcare system (who may be at higher risk of being unvaccinated) are not captured in the data.

Additionally, stratification by geography and ethnicity depends on the availability of valid postcode (sourced from the ONS National Statistics Postcode Lookup) and on ethnicity derived from recorded ethnicity code entries. The accuracy of subgroup analyses may be affected by incomplete or outdated data in these fields.

Despite these limitations, general data completeness within IIS is high, particularly for core fields such as NHS number, date of birth, and vaccination date. This supports robust and reliable coverage reporting for the RSV programme.

Accuracy

Accuracy refers to how well the data represents real-world conditions. This includes the correctness of details such as names and addresses, and whether the information is factual, current, and reliable

Accuracy of the RSV vaccine uptake data depends on several factors, including the quality of data entry (such as clinical coding), the robustness of data specifications, and the reliability of data transfer processes between NHSE and UKHSA.

RSV vaccine data flows through centralised systems managed by NHSE and is transferred to UKHSA’s data warehouse via secure and structured processes. Both NHSE and UKHSA conduct regular data checks to ensure the integrity of vaccination records and population denominators. These checks include validation of site codes, age eligibility, and consistency across reporting periods.

UKHSA operates a well-documented and routinely executed Extract, Transform, and Load (ETL) process to ingest data into its data warehouse. This process ensures that data is cleaned, standardised, and structured appropriately for statistical analysis. Peer-reviewed publications and internal audits have demonstrated the reliability and accuracy of vaccine uptake data within IIS, which underpins the RSV coverage statistics. The system’s national scope and individual-level granularity make it a robust source for monitoring vaccine uptake.

All data used in RSV vaccine coverage reports is considered provisional and subject to ongoing validation and refinement as part of UKHSA’s commitment to data quality and transparency.

Completeness

Completeness refers to the extent to which all expected records are present and essential fields are populated.

For the RSV vaccine programme, completeness is generally high due to the structured data flow from NHSE into IIS. The preprocessing performed by NHSE’s DPS ensures that key fields (such as NHS Number, and date of birth) are consistently populated , which supports linkage and cohort assignment. Missing data is however sometimes found in fields such as ethnicity and postcode of residence. This can occur if individuals choose not to disclose this information or due to data transfer or system limitations. We do not know if this is due to voluntary non-disclosure and technical data loss, meaning that incompleteness may not solely reflect data quality issues.

For the RSV programme, vaccination events are flowed to IIS via NHSE’s DPS, which receives vaccination events records from point of care applications at time of vaccination. This includes data from all NHS vaccination providers such as GPs, maternity clinics, and pharmacies. This contributes to a high level of completeness across regions. Where data fails validation checks and no sufficient explanation is provided, UKHSA may exclude records from coverage calculations to maintain data integrity.

Uniqueness

Uniqueness refers to the extent to which each record in the data set represents a distinct entity, without duplication. In the context of the RSV vaccine programme, this means that each individual is represented by a single, unique record in the eligible population data set, and the vaccine dose administered is recorded as a singular event.

The IIS eligible population data set is uniquely structured around the NHS Number, ensuring that each individual is only counted once for eligibility purposes.

To maintain uniqueness in reporting, UKHSA applies deduplication processes to ensure that only one vaccine event per individual is counted for coverage statistics. This helps prevent inflation of uptake figures and ensures accurate cohort-level analysis.

Consistency

Consistency describes the degree to which values in a data set do not contradict other values representing the same entity.

Data within IIS is strictly managed to ensure consistency and analytical flexibility. For the RSV vaccine programme, vaccine administration records and eligible population records are maintained in separate data sets, although some fields (such as NHS number and postcode of residence) may appear in both.

This duplication is intentional and serves distinct analytical purposes as time-sensitive fields, for example postcode of residence, may differ between data sets. In the vaccine records, the postcode reflects the individual’s location at the time of vaccination while in the eligible population data set, it reflects their current residence at the time of analysis. This distinction allows for retrospective, current, and prospective analyses of vaccine uptake and equity.

This structured approach supports robust surveillance and enables UKHSA to answer questions about vaccine uptake from multiple temporal perspectives while maintaining data integrity.

Timeliness

Timeliness refers to how accurately the data reflects the period it represents and whether the values are current and up to date.

For the RSV vaccine programme, data is added, updated, and deleted in IIS on a daily basis. There is a 24-hour lag in the data, meaning that data recorded on day 1 is typically available for reporting by the morning of day 3. This applies to both vaccination events and eligible population records.

The RSV programme began on 1 September 2024 and is delivered as a single-dose, year-round programme. Vaccination timing is influenced by individual eligibility (based on age) and local service delivery models, including general practices and community pharmacies. Data is reported to UKHSA daily via automated feeds, which reduces the reporting burden on providers and ensures timely updates.

Validity

Validity refers to the extent to which data values fall within expected ranges and formats. For example, dates of birth should not exceed the current date and must be within a plausible age range for the RSV programme (such as individuals aged 75 to 79).

Data within IIS is routinely checked for validity and consistency. This includes verification of:

• GP practice codes
• vaccination dates
• date of birth
• postcode formats
• eligibility criteria

All data is stored within a relational database management system hosted on secure UKHSA premises and accessed using standard tools such as T-SQL. To support secure and efficient access, UKHSA uses SQL views that simplify commonly requested perspectives of the data. These views may differ slightly from the raw tables but are valid for their intended analytical use.

Regular validation processes help ensure that the RSV vaccine coverage statistics are based on data that is internally consistent, logically sound, and suitable for public health reporting.

Sound methods

Statistical outputs in this report were produced using the best available methods and recognised standards, in line with UKHSA’s approach to immunisation surveillance.

Data on RSV vaccinations for older adults are sourced from IIS which receives individual-level vaccination records from NHSE via the DPS. These records include key demographic and clinical fields, enabling stratified analysis by risk group, geography, and equity indicators.

To ensure data quality, automated validation checks are applied during data ingestion. These include logic checks on fields such as valid NHS numbers, vaccination dates within programme windows and completeness assessments for key fields such as postcode and ethnicity. Where appropriate, missing values are grouped under categories such as Unknown or Not stated to ensure transparency and maintain the interpretability of stratified outputs. Routine monitoring by UKHSA analysts identifies anomalies such as duplicate records or implausible coverage rates. These are flagged for review and correction in collaboration with NHSE regional teams.

Standardised data formats and controlled vocabularies reduce variation across submitting systems, supporting consistency and comparability. The IIS data flow benefits from a centralised, automated infrastructure that supports daily updates and real-time validation. This allows for timely and accurate reporting of vaccine uptake, without reliance on manual review prompts.

Data set production

Data used in the monthly RSV vaccine coverage report comes from a single source: IIS. Coverage is calculated based on the total number of eligible individuals aged 75 to 79 who have received the RSV vaccine.

To improve reproducibility, transparency, and efficiency, the RSV coverage reports are generated using automated workflows in R and R Markdown. Automation ensures consistency across reporting periods and enables the generation of charts, tables, and supplementary spreadsheets directly from validated IIS extracts.

Quality assurance

The RSV vaccine coverage report is produced using R, with automation applied to the generation of statistics, charts, and supplementary spreadsheets. This approach reduces the risk of human error by eliminating the need for manual updates or copying and pasting between documents. Members of the UKHSA vaccine coverage team carry out quality assurance throughout the production process. Before running the automated script, the input data from IIS is reviewed to ensure accuracy and completeness. After the script is executed, the outputs are manually checked for anomalies or inconsistencies.

Figures and tables generated by the script are cross-checked against the narrative text in the report and compared with previous monthly reports to ensure consistency. If discrepancies or concerns are identified, further checks are conducted to determine whether the issue lies in the source data or the automation process.

This combination of automation and manual validation ensures that the RSV vaccine coverage statistics are reliable, reproducible, and fit for public health reporting.

Confidentiality and disclosure control

Personal and confidential data is collected, processed, and used in accordance with the UKHSA Privacy Notice. All UKHSA staff with access to personal or confidential information must complete mandatory information governance training, which must be refreshed every year. Information is stored on computer systems that are kept up-to-date and regularly tested to make sure they are secure and protected from viruses and hacking. UKHSA staff do not store data on their own laptops or computers, as data is stored centrally on UKHSA servers.

Specific disclosure control methods are used to ensure that no personally identifiable information is included in published data. Consistent with the reporting approach of the vaccination programme, figures are reported cumulatively from the start of the vaccination programme. Given the large number of eligible individual across cohorts and high volume of doses administered, stratification by geography or ethnicity does not result in denominator or numerator count falling below 5. Standard techniques such as cell aggregation, and use of broad category groupings are applied to prevent outputs from being disaggregated or cross-tabulated in ways that could identify individuals. This ensures that tables cannot be combined to reveal sufficient information about individuals to pose a meaningful risk of secondary disclosure.

Geography

UKHSA produces the statistics at 3 geographical levels:

• England
• NHS commissioning region
• NHS integrated care board

These geographic breakdowns are published in the supplementary data tables.

Quality summary

The Code of Practice for Statistics states that quality means that statistics:

• fit their intended uses
• are based on appropriate data and methods
• are not materially misleading

Producing high-quality statistics requires expert judgment throughout the process of collecting, preparing, analysing, and publishing data, ensuring that outputs are fit for purpose and meet the needs of users.

This section assesses the statistics against the European Statistical System dimensions of quality.

Relevance

Relevance is the degree to which the statistics meet user needs in both coverage and content.

These RSV coverage statistics provide essential evidence to support the monitoring and evaluation of the national vaccination programme for older adults in England. The statistics have been developed to reflect the structure and delivery of the programme, including the distinction between catch-up and routine cohorts, and the use of cumulative monthly coverage.

Regular monitoring of RSV vaccine coverage is critical for assessing the impact of the programme, identifying disparities in uptake, and informing targeted interventions. The monthly publication schedule ensures timely insights for decision makers in clinical care, public health and policy.

To meet evolving user needs and the requirements for official statistics, we have continued seek feedback through our user survey and to make changes to the publication to meet user needs. We publish 3 products as part of the statistical release:

• the main statistics report
• supplementary data tables
• this QMI report, published in March 2026

By providing this range of different outputs, we can better cater to the needs of different users from a range of backgrounds, in line with the Office for National Statistics user personas.

Accuracy and reliability

Accuracy refers to the closeness of a statistical estimate to the true, but unknown, value. Reliability reflects the consistency of early estimates with subsequent data releases.

For the older adult RSV vaccine programme, data is sourced from IIS. IIS receives daily updates from NHSE’s DPS, ensuring that coverage figures are both timely and reliable.

Vaccination records are linked to individual NHS numbers, and the eligible population denominator is derived from primary care registration data. This ensures that both numerator and denominator values are accurate and reflect the population eligible for vaccination at the time of analysis. In rare cases where updated eligibility data is unavailable, provisional estimates may be used, with appropriate caveats. Any changes to historic figures will be reflected in the most recent publication.

To support data accuracy and reliability:

• automated validation checks are applied during data ingestion, including logic checks for valid NHS numbers, vaccination dates, and GP practice codes
• routine monitoring by UKHSA analysts identifies anomalies such as sudden changes in coverage or implausible uptake patterns, which are flagged for review
• consistency checks are performed across vaccine and population data sets to ensure alignment of key fields such as date of birth and postcode
• IIS data is processed using a well-established ETL pipeline, and stored in a relational database accessed via standard tools such as T-SQL

IIS provides a centralised, automated infrastructure that supports real-time validation and high granularity analysis. This enhances both the accuracy and reliability of the coverage statistics presented in this report.

Timeliness and punctuality

Timeliness refers to the time gap between the end of the reference period and the publication of the statistics. Punctuality refers to the gap between the planned and actual publication dates.

This report aims to provide up-to-date monthly figures on the cumulative RSV vaccine coverage in older adults to inform programme monitoring and public health decision-making in England. The statistics are published on the last Thursday of the month following the reporting month. For example, the data for February 2026 will be published 2 April 2026. This schedule allows sufficient time for the ingestion, processing, validation and quality assurance of the IIS data before publication in the reports.

This report is classified as official statistics and is pre-announced at least 4 weeks in advance, in accordance with the Code of Practice for Statistics.

Accessibility and clarity

Accessibility is the ease with which users can access the data, also reflecting the format in which the data is available and the availability of supporting information. Clarity refers to the quality and sufficiency of the metadata, illustrations and accompanying advice.

In the 3 statistical products, we strive to ensure compliance with the public sector body accessibility regulations and the Government Analysis Function accessibility guidance.

This report is published as HTML to ensure easy access to the report across different devices through accessibility features mentioned in the GOV.UK accessibility statement.

The publication includes visualisations that help explain the data. These are designed to be colour-blind friendly as each element has a different luminance value. This means that there is always enough contrast between elements to tell them apart.

We have simplified the commentary in the publication, focusing on plain English, and shortened the publication overall. We also include the main messages in the publication to help users understand the statistics.

The supplementary data tables are published in ODS format and follow the Government Analysis Function’s spreadsheet accessibility guidance. For example, each worksheet contains only one table. We also do not include nested tables with merged cells, as these do not work well with screen readers. We avoid using empty cells for the same reason. Each worksheet has a descriptive heading such as “RSV vaccine coverage data by integrated care board (ICB), England, September 2025 to January 2026”.

Coherence and comparability

Coherence is the degree to which data that is derived from different sources or methods, but refers to the same topic, is similar. Comparability is the degree to which data can be compared over time and domain.

The RSV cumulative coverage has consistently been published using IIS data using standardised methodologies aligned with other UKHSA immunisation programmes, ensuring methodological coherence across monthly reports.

The RSV programme is currently in its second year of implementation. In the first year, the coverage data was published only for the catch-up cohort, defined by a fixed birth range. This cohort remains consistent over time, allowing for stable cumulative reporting. In contrast, the routine cohort is dynamic, with individuals becoming eligible when they turn 75 years old. As a result, the denominator for the routine cohort increases monthly, which affects comparability over time.

In addition, while IIS supports high granularity analysis (for example, by age, sex, ethnicity, deprivation, and geography), comparisons with legacy systems such as ImmForm may be limited due to differences in data structure, update frequency, and validation processes.

As the RSV programme matures, year-on-year comparisons will become increasingly feasible and UKHSA will continue to refine the reporting framework and ensure that backing tables and statistical outputs remain coherent and comparable across reporting periods.

Uses and users

Users of statistics and data should be at the centre of statistical production, and statistics should meet user needs.

This section explains how the statistics are used, and how we understand user needs.

Appropriate use of the statistics

The statistics present RSV vaccine coverage in the England and can be used to monitor the cumulative vaccine uptake pattern and trend.

Known users and uses

We are aware that the statistics have been used by UKHSA, Department of Health and Social Care, NHS, Cabinet Office, Prime Minister’s Office, clinical professionals, the public, academia, researchers, industry professionals and media in several different ways, including:

• monitoring uptake across different regions and cohorts
• informing strategy and resource allocation
• supporting awareness campaigns
• guiding clinical decision-making
• contributing to research and evaluation
• informing national vaccine policy and programme development

User engagement

We conducted a user engagement survey in 2025 prior to the designation of these statistics as official statistics. The findings from this survey were instrumental in shaping the design and presentation of the current RSV vaccine coverage reports.

Further engagement is planned to identify additional users and understand how the statistics can be improved to better meet their needs. Insights from this future survey will inform enhancements to the April 2026 report and beyond, ensuring the statistics remain relevant, accessible, and useful to a broad range of stakeholders.

Related statistics

Most health protection functions in the UK are devolved to the other UK nations’ public health agencies.

The NHS England vaccination statistics report on the number of RSV vaccinations that have been administered in England. It includes RSV vaccinations by NHS region, RSV vaccinations by cohort and RSV vaccinations by vaccination week.

Public Health Wales publishes RSV vaccination surveillance reports.

Public Health Scotland publishes the respiratory syncytial virus (RSV) older adult vaccination in Scotland reports.