Official Statistics

Quarterly vaccination coverage statistics for children aged up to 5 years in the UK (COVER programme): July to September 2024

Updated 19 December 2024

The UK Health Security Agency (UKHSA) is preparing to take over the production and publication of the annual cover of vaccination evaluated rapidly (COVER) programme statistics from NHS England with a plan to publish the next report in the late summer of 2025. A key benefit of this to users will be that the full suite of COVER statistics will be published more coherently in one place as part of the same statistical series. Work is underway to explore development of dashboard-style reporting for these annual statistics on GOV.UK. More details on the development plan will be made available alongside the next release of UKHSA’s quarterly statistics. 

During this development phase we encourage users to provide comments and feedback using a short feedback survey on the statistics previously published by NHS England. This survey will be open until Friday 28 February 2025 and insights gathered will help to inform the development of the annual statistical series.

UKHSA is currently engaging with the Office for Statistics Regulation to ensure that the transfer of these accredited official statistics is managed according to the Code of Practice for Statistics.

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 2024).

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 data file accompanying this report along with data by upper tier local authority (UTLA) and UK Health Security Agency (UKHSA) region.

Main points

In comparison with the previous quarter:

• coverage at 12 months in England and in the UK decreased for all antigens, decreasing by 0.3 percentage points for the 12-month ‘6-in-1’ and by 0.3 percentage points for the 12-month PCV1 vaccine
• in England, coverage decreased by 0.8 percentage points for rotavirus and by 0.3 percentage points for the MenB vaccine
• coverage in the UK decreased by 0.7 percentage points for rotavirus and by 0.2 percentage points for the MenB vaccine
• coverage of the first dose of MMR measured at 24 months (in children who first became eligible between July and September 2023) decreased by 0.4 percentage points in England and in the UK
• in England, coverage of the first dose of MMR measured at 5 years of age decreased by 0.5 percentage points, largely reflecting vaccinations delivered in July to September 2020
• UK coverage for the pre-school booster (DTaP/IPV) decreased by 0.9 percentage points and MMR2 decreased by 0.2 percentage points, reflecting vaccinations that should have been delivered between January to March 2023
• both Scotland and Wales exceeded the 95% World Health Organization (WHO) target for coverage for both the ‘6-in-1’ and MMR1 vaccines measured at 5 years
• in England, vaccination coverage varies geographically and is lowest for all antigens in London
• vaccination coverage measured this quarter remains below peaks in coverage reported in the previous ten-year period, and for a number of antigens, represents a continuation of an ongoing declining trend in coverage

Coverage at 12 months

Compared with the previous quarter, UK coverage for the ‘6-in-1’ vaccine measured at 12 months decreased by 0.3 percentage points to 91.1%, PCV1 coverage decreased by 0.3 percentage points to 93.1%, rotavirus decreased by 0.7 percentage points to 88.4% and MenB decreased by 0.2 percentage points to 91.0%. The previous quarter’s coverage is reflected in Quarterly vaccination coverage statistics for children aged up to 5 years in the UK (COVER programme): April to June 2024.

In England, 12-month coverage of the ‘6-in-1’ decreased by 0.3 percentage points to 90.7%, MenB decreased by 0.3 percentage points to 90.6%, rotavirus coverage decreased by 0.8 percentage points to 88.0%, and PCV1 coverage decreased by 0.3 percentage points to 92.8%.

Excluding London as the region with the lowest coverage, across all other English regions the ‘6-in-1’ coverage at 12 months was 92.1%, 1.4 percentage points higher than the overall England coverage. PCV1 coverage was 94.1%, 1.3 percentage points higher than the overall England coverage, rotavirus was 89.3%, 1.3 percentage points higher than the overall England coverage and MenB coverage was 92.0%, 1.4 percentage points higher than the overall England coverage.

In Scotland and Wales, coverage was above 94.0% for all antigens at 12 months except for rotavirus at 92.1% and 91.6%, respectively. In Northern Ireland, coverage was above 90.0% for all antigens except for rotavirus at 87.1%.

Coverage varies by geography and full coverage data by country, NHS England local team (configuration as of 1 April 2018), NHS England region, UTLA and UKHSA region is contained in the data file accompanying this report. Coverage for the ‘6-in-1’ vaccine for quarter 2 2024 to 2025 by UTLA measured at 12 months is presented in Figure 1.

Figure 1. Coverage of the ‘6-in-1’ vaccine measured at 12 months of age in England for quarter 2 2024 to 2025 by UTLA

Coverage of the ‘6-in-1’ vaccine measured at 12 months varies by UTLA. The data underlying Figure 1 is available in the accompanying data file.

In England, coverage for the ‘6-in-1’ vaccine peaked at 94.1% in quarter 2 of 2014 to 2015, and at 90.7% this quarter was 3.4 percentage points lower than the peak (Figure 2a). Coverage of PCV1 in this quarter at 92.8% was 1.4 percentage points lower than the peak coverage of 94.2% in quarter 2 of 2022 to 2023 (Figure 2b). Rotavirus coverage this quarter was 2.9 percentage points lower than the peak of 90.9% in quarter 4 of 2019 to 2020 (Figure 2d), while MenB coverage was 2.3 percentage points lower than the peak of 93.0% in quarter 3 of 2017 to 2018 (Figure 2c).

Figure 2a. Coverage of the primary course of the ‘6-in-1’ vaccine in England measured at 12 months between quarter 2 2014 to 2015 and quarter 2 2024 to 2025 [note 1]

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 1 of 2013 to 2014 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.

Figure 2b. Coverage of the PCV vaccine in England measured at 12 months between quarter 2 2014 to 2015 and quarter 2 2024 to 2025 [note 2]

Note 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.

Figure 2c. Coverage of the MenB vaccine in England measured at 12 months between quarter 2 2016 to 2017 and quarter 2 2024 to 2025

Figure 2d. Coverage of the rotavirus vaccine in England measured at 12 months between quarter 1 2015 to 2016 and quarter 2 2024 to 2025

Coverage at 24 months

In the UK, compared with the previous quarter, coverage of the ‘6-in-1’ vaccine decreased by 0.4 percentage points to 92.5%, PCV coverage decreased by 0.3 percentage points to 88.7%, MMR1 coverage decreased by 0.4 percentage points to 89.3%, MenB coverage decreased by 0.4 percentage points to 88.0% and Hib/MenC booster decreased by 0.3 percentage points to 89.2%. The previous quarter’s coverage is reflected in Quarterly vaccination coverage statistics for children aged up to 5 years in the UK (COVER programme): April to June 2024.

In England, 24-month coverage of the ‘6-in-1’ decreased by 0.4 percentage points to 92.1%, MenB decreased by 0.5 percentage points to 87.3%, PCV coverage decreased by 0.4 percentage points to 88.0%, MMR1 decreased by 0.4 percentage points to 88.8%, and Hib/MenC decreased by 0.4 percentage points to 88.7%.

In England excluding London as the region with the lowest coverage, ‘6-in-1’ coverage at 24 months was 93.5%, 1.4 percentage points higher than the overall England coverage. PCV coverage was 90.2%, 2.2 percentage points higher than the overall England coverage. MMR1 was 90.7%, 1.9 percentage points higher than the overall England coverage. MenB coverage was 89.4%, 2.1 percentage points higher than the overall England coverage Hib/MenC coverage was 90.7%, 2.0 percentage points higher than the overall England coverage.

At the country level, coverage in Scotland and Wales exceeded 92.5% for all the vaccines offered from the first birthday, and in Northern Ireland, coverage exceeded 89.0%.

Coverage varies by geography and full coverage data by country, NHS England local team (configuration as of 1 April 2018), NHS England region, UTLA and UKHSA region is contained in the data file accompanying this report. Coverage for the MMR1 vaccine for quarter 2 2024 to 2025 by UTLA measured at 24 months is presented in Figure 3.

Figure 3. Coverage of MMR1 vaccine measured at 24 months of age in England for quarter 2 2024 to 2025 by UTLA

Coverage of the MMR vaccine measured at 24 months varies by UTLA. The data underlying Figure 3 is available in the accompanying data file. 

In England, coverage for the ‘6-in-1’, PCV booster, Hib/MenC booster and MMR1 over the past ten years peaked in quarter 4 of 2014 to 2015 (January to March 2015) (Figure 4a, 4b, 4c, 4d).   This quarter, coverage of the ‘6-in-1’ was 3.8 percentage points lower than the peak, PCV booster coverage was 4.4 percentage points lower, Hib/MenC coverage was 3.6 percentage points lower and MMR1 coverage was 3.6% lower. MenB coverage was 2.2 percentage points lower than the peak of 89.5% in quarter 2 (July to September) of 2020 to 2021 (Figure 4e).

Figure 4a. Coverage of the primary course of the ‘6-in-1’ vaccine in England measured at 24 months between quarter 2 2014 to 2015 and quarter 2 2024 to 2025 [note 1]

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 2 of 2014 to 2015 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.

Figure 4b. Coverage of the PCV booster in England measured at 24 months between quarter 2 2014 to 2015 and quarter 1 (April to June) 2024 to 2025 and quarter 2 2024 to 2025

Figure 4c. Coverage of the Hib/MenC booster in England measured at 24 months between quarter 2 2014 to 2015 and quarter 2 2024 to 2025

Figure 4d. Coverage of the MMR1 in England measured at 24 months between quarter 2 2014 to 2015 and quarter 2 2024 to 2025

Figure 4e. Coverage of the MenB booster in England measured at 24 months between quarter 3 2017 to 2018 and quarter 2 2024 to 2025

Coverage at 5 years

For the ‘6-in-1’ vaccine, coverage in UK decreased by 0.2 percentage points to 93.1% and MMR1 decreased by 0.4 percentage points to 91.8%. Coverage at 5 years for these vaccines primarily reflects vaccinations delivered 4 years ago.

MMR2 and the preschool booster (DTaP/IPV) are given from age 3 years and 4 months and reflect vaccinations that should have been delivered between January to March 2023.

MMR2 coverage decreased by 0.2 percentage points to 84.1% and DTaP/IPV booster decreased by 0.9 percentage points to 81.9%. Hib/MenC decreased by 0.3 percentage points to 89.5%.

In England, coverage at 5 years of the ‘6-in-1’ decreased by 0.2 percentage points to 92.6%, MMR1 coverage decreased by 0.5 percentage points to 91.2%, MMR2 coverage decreased by 0.2 percentage points to 83.4%, Hib/MenC decreased by 0.4 percentage points to 88.7%, and DTaP/IPV decreased by 1.0 percentage points to 80.8%.

In England excluding London as the region with the lowest coverage, ‘6-in-1’ coverage at 5 years was 94.3%, 1.7 percentage points higher than the overall England coverage. MMR1 was 93.3%, 2.1 percentage points higher than the overall England coverage. MMR2 coverage was 86.4%, 3.0 percentage points higher than the overall England coverage.DTaP/IPV coverage was 84.7%, 3.9 percentage points higher than the overall England coverage and Hib/MenC coverage was 90.9%, 2.2 percentage points higher than the overall England coverage.

Both Scotland and Wales exceeded the 95% WHO target for coverage for both the ‘6-in-1’ and MMR1 vaccines measured at 5 years, while coverage in Northern Ireland was above 94.0%.

Compared to the previous quarter, MMR1 coverage decreased in the East Midlands (0.1 percentage points), the East of England (0.1 percentage points), London (2.4 percentage points), and Yorkshire and the Humber (1.0 percentage point). There was an increase in MMR1 coverage in the North East (0.2 percentage points), the South East (0.4 percentage points), the South West (0.4 percentage points), and the West Midlands (0.1 percentage points).

Coverage of MMR2 also decreased in the East of England (0.2 percentage points), London (2.3 percentage points), the North East (0.1 percentage points), and the North West (0.1 percentage points). Coverage of MMR2 increased in the East Midlands (0.5 percentage points), the South East (0.7 percentage points), the South West (0.7 percentage points), the West Midlands (0.2 percentage points), and Yorkshire and the Humber (0.5 percentage points).

Coverage varies by geography and full coverage data by country, NHS England local team (configuration as of 1 April 2018), NHS England region, UTLA and UKHSA region is contained in the data file accompanying this report. Coverage for theMMR2 vaccine for quarter 2 2024 to 2025 by UTLA measured at 5 years is presented in Figure 5.

Figure 5. Coverage of MMR2 vaccine measured at 5 years of age in England for quarter 2 2024 to 2025 by UTLA

Coverage of the MMR2 vaccine measured at 5 years varies by UTLA. The data underlying Figure 5 is available in the accompanying data file.

In England, coverage of the ‘6-in-1’ vaccine was 3.4 percentage points lower this quarter than the peak of 96.0% in quarter 2 of 2017 to 2018 (Figure 6a). MMR1 was down by 4.4 percentage points from a peak of 95.6% in quarter 1 of 2017 to 2018. MMR2 was down by 5.1 percentage points when compared with the 88.5% seen in quarter 4 of 2014 to 2015 (figures 6b and 6c). The pre-school booster was 7.8 percentage points lower than at its peak of 88.6% in quarter 4 of 2014 to 2015 and Hib/MenC was 4.6 percentage points lower than the peak of 93.3% in quarter 3 of 2015 to 2016 (figures 6d and 6e).

Figure 6a. Coverage of the primary course of the 6-in-1 vaccine in England measured at 5 years between quarter 2 2014 to 2015 and quarter 2 2024 to 2025 [note 1]

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 1 of 2013 to 2014 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.

Figure 6b. Coverage of MMR1 in England measured at 5 years between quarter 2 2014 to 2015 and quarter 2 2024 to 2025

Figure 6c. Coverage of MMR2 in England measured at 5 years between quarter 2 2014 to 2015 and quarter 2 2024 to 2025

Figure 6d. Coverage of pre-school booster (DTaP/IPV) in England measured at 5 years between quarter 2 2014 to 2015 and quarter 2 2024 to 2025

Figure 6e. Coverage of the Hib/MenC booster in England measured at 5 years between quarter 2 2014 to 2015 and quarter 2 2024 to 2025

Neonatal hepatitis B vaccine coverage: England

National coverage at 12 months for 5 doses of a HepB-containing vaccine increased by 0.4 percentage points from 92.1% to 92.5% 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 July to September 2022) decreased by 0.8 percentage points to 88.8% compared with the last quarter (89.6%) (see the 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

The data captures BCG coverage at age 3 months for children born April to June 2024 and at age 12 months for children born July to September 2023; 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 78.9% and measured at 12 months, it was 83.6%.

Data sources and methodology

Data was received from all health boards in Wales, Scotland and Northern Ireland. In England, local teams and Child Health Record Departments provided data for all UTLAs 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, is available in the data tables associated with this report. GP level data was censored when individual values were less than 5.

As part of ongoing data quality assurance in Wales, an improvement in the algorithm used to produce the dataset that the Vaccine Preventable Disease Programme routinely use for COVER reports has been made by Digital Health and Care Wales. This has led to increased completeness of vaccination data and uptake figures in Wales; primarily in children aged 4 years and older.

Background information

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.

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, November 2023 to January 2024. 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, October 2023 to December 2023.

Except for 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 November 2022 to January 2023 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 July 2023 to September 2023. 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 November 2019 to January 2020, their first MMR and the Hib/MenC booster July 2020 to September 2020, their pre-school diphtheria, tetanus, acellular pertussis and polio (DTaP/IPV) booster, and second-dose MMR from November 2022 to January 2023.

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.

Further information and contact details

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

Country-specific data

Country-specific links to data are available:

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

Official statistics

Our statistical practice is regulated by the Office for Statistics Regulation (OSR). OSR sets the standards of trustworthiness, quality and value in the Code of Practice for Statistics that all producers of official statistics should adhere to.

UKHSA is committed to ensuring that these statistics comply with the Code of Practice for Statistics. This means users can have confidence in the people who produce UKHSA statistics because our statistics are robust, reliable and accurate. Our statistics are regularly reviewed to ensure they support the needs of society for information.

UKHSA has conducted a formal review of these statistics. Following this review, an implementation plan has been developed to continue to improve the trustworthiness, quality, and value of these statistics. Key continuous improvements made will be highlighted within future releases of these statistics for transparency.

Feedback and contact information

For any questions or comments regarding this report, please email cover@ukhsa.gov.uk

Alternatively, you can contact OSR with any comments about how we meet these standards by emailing regulation@statistics.gov.uk or via the OSR website.