Official Statistics

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

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 (January to March 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.

1. Main points

In comparison with the previous quarter:

• 12-month UK coverage for the ‘6-in-1’ vaccine decreased by 0.3% to 92.0%, rotavirus decreased by 0.2% to 89.4%, meningitis B second dose (MenB2) decreased by 0.4% to 91.6% and pneumococcal conjugate vaccine (PCV) dose 1 decreased by 0.3% at 93.9%
• in England, ‘6-in-1’ coverage decreased by 0.3% to 91.6%, MenB decreased by 0.4% to 91.2%, rotavirus decreased by 0.3% to 89.0% and PCV1 coverage decreased by 0.4% from 94.0% to 93.6%
• at the country-level, in Scotland and Wales at least 94% coverage was achieved for all antigens (except rotavirus) at 12 months, and in Northern Ireland coverage was at least 92%
• in the UK, 24-month coverage of the ‘6-in-1’ vaccine remained at 93.4%, but all other antigens increased; measles, mumps and rubella first dose vaccination (MMR1) increased by 0.4% at 89.9%, combined dose of the haemophilus influenzae type b and meningitis C vaccines (Hib/MenC) increased 0.3% to 89.7%, coverage for PCV increased by 0.7% to 89.8% and MenB increased by 0.5% to 88.9%
• at 24 months, coverage in England for the ‘6-in-1’ remained at 93.0%, increased by 0.3% to 89.2% for Hib/MenC and increased by 0.6% to 88.4% for MenB; coverage for the PCV booster increased by 0.8% to 89.3% and increased by 0.5% to 89.5% 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 89%
• at 5 years, UK coverage for the pre-school booster (DTaP/IPV) decreased by 0.3% to 84.7%, MMR2 decreased by 0.2% to 85.6% and the Hib/MenC booster decreased by 0.3% to 91.2%
• this is the second report for which BCG coverage has been collected for all eligible children in England measured at 12 months, coverage in England was 79.1%

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 May 2022 and July 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 April 2022 and June 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 May 2021 and July 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 January and March 2022. Children born to HBsAg positive mothers, who reached their second birthday in this quarter (born January to March 2021), 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 May 2018 and July 2018, their first MMR and the Hib/MenC booster between January and March 2019, their pre-school diphtheria, tetanus, acellular pertussis and polio (DTaP/IPV) booster, and second-dose MMR from May 2021 to July 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 0.3% to 92.0%, rotavirus decreased by 0.2% to 89.4% while MenB2 decreased by 0.4% to 91.6% (the previous quarter coverage is reflected in Quarterly vaccination coverage statistics for children aged up to 5 years in the UK (COVER programme): October to December 2022). UK coverage of PCV1 decreased by 0.3% to 93.9%.

In England, 12-month coverage of the ‘6-in-1’ decreased by 0.3% to 91.6%, rotavirus decreased by 0.3% to 89.0% and MenB decreased by 0.4% to 91.2%. PCV1 coverage decreased by 0.4% to 93.6%.

With the exception of the rotavirus vaccine, in Scotland and Wales at least 94% coverage was achieved for all antigens at 12 months, 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 91.6% this quarter was 3.1% lower than the peak. Rotavirus coverage this quarter was 1.9% lower than the peak of 90.9% in quarter 1 (April to June) of 2020 to 2021 while MenB coverage was 1.8% 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 4 (January to March) 2012 to 2013 and quarter 4 2022 to 2023

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 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 remained at 93.4%, MMR1 increased by 0.4% to 89.9%, and Hib/MenC increased 0.3% to 89.7%. Coverage for PCV increased by 0.7% to 89.8% and MenB increased by 0.5% to 88.9%.

Compared with the previous quarter, coverage in England for the ‘6-in-1’ vaccine remained at 93.0%, increased by 0.3% to 89.2% for Hib/MenC and increased by 0.6% to 88.4% for MenB. Coverage for the PCV booster increased by 0.8% to 89.3%. Coverage for MMR1 increased by 0.5% to 89.5%.

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 89%.

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 4 (January to March) 2012 to 2013 and quarter 4 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 3.5% lower this quarter than the peak of 92.8% in quarter 4 of 2012 to 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 3.4% lower than the peak of 92.9% in quarter 3 (October to December) of 2013 to 2014. MenB coverage was 1.1% 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 decreased by 0.2% to 93.2% while coverage for the UK as a whole decreased by 0.2% to 93.6%. This target was also achieved for MMR1 in Scotland and Wales. In England, MMR1 coverage decreased by 0.2% to 92.7%. 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 May and July 2021.

Compared with the previous quarter, UK coverage for the pre-school booster (DTaP/IPV) decreased by 0.3% to 84.7%, MMR2 decreased by 0.2% to 85.6% and the Hib/MenC booster decreased by 0.3% to 91.2%.

In England, coverage for MMR2 decreased by 0.2% to 85.0% and the pre-school booster decreased by 0.4% to 84.0%. Pre-school booster and MMR2 coverage exceeded 89% 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 2.7% lower this quarter than the peak of 95.9% in quarter 4 (January to March) of 2012 to 2013. MMR1 was down by 2.9% from a peak of 95.6% in quarter 1 (April to June) of 2017 to 2018. MMR2 was down by 3.6% 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 2.7% 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 4 (January to March) 2012 to 2013 and quarter 4 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 increased 4.7% from 88% to 92.7% 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 January and March 2021) increased by 11.2% to 88.2% compared with the last quarter (77%) (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 fourth 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 October to 31 December 2022 and at age 12 months for children born 1 January 2022 to 31 March 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 70.4% and measured at 12 months, it was 79.1%.

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 and the associated general practices.

All English data were 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.

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