Official Statistics

Human papillomavirus (HPV) vaccination coverage in adolescents in England: 2023 to 2024

Updated 23 January 2025

Applies to England

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This publication is available at https://www.gov.uk/government/statistics/human-papillomavirus-hpv-vaccine-coverage-estimates-in-england-2023-to-2024/human-papillomavirus-hpv-vaccination-coverage-in-adolescents-in-england-2023-to-2024

This report presents vaccine coverage data for the routine school-aged HPV immunisation programme in England for the 2023 to 2024 academic year. These results include HPV vaccine coverage estimates for children in years 8, 9 and 10 (or the equivalent ages) measured up to 31 August 2024.

HPV vaccine coverage is presented for England at national, NHS commissioning region, and local authority level.

In September 2023, the adolescent HPV vaccination programme moved to a one-dose schedule. All coverage numbers given in this report are therefore stated as single dose figures.

Main points

The main findings of this report are that during the 2023 to 2024 academic year:

  • HPV coverage for year 8 students was 72.9% for females and 67.7% for males
  • HPV coverage for year 9 students was 74.1% for females and 68.5% for males
  • HPV coverage for year 10 students was 76.7% for females and 71.2% for males
  • HPV coverage for year 9 females was 1.6 percentage points lower than for year 9 females in the 2022 to 2023 academic year
  • HPV coverage for year 9 males was 1.2 percentage points lower than for year 9 males in the 2022 to 2023 academic year
  • HPV coverage in female year 9 students by NHS commissioning region was lowest in London (60.9%) and highest in the South East (79.7%)
  • HPV coverage in male year 9 students by NHS commissioning region was lowest in London (56.5%) and highest in the South East (74.2%)

Analysis of HPV vaccine coverage by cohort

HPV vaccine coverage is first described in terms of cohorts, where a cohort is a group of students who first became eligible for the HPV vaccine in the same academic year. For example, the 2021 to 2022 cohort (female cohort 19, male cohort 3) first became eligible in the 2021 to 2022 academic year when they were in school year 8. This cohort would then have been in school year 9 in the 2022 to 2023 academic year, and in school year 10 in the 2023 to 2024 academic year. The dates of birth and first academic year of HPV vaccine eligibility for these cohorts are described in Table 1. The trends in HPV vaccine coverage by cohort, and in which school year they were vaccinated, are shown in Figure 1 for female students and Figure 2 for male students.

Table 1. HPV vaccination cohorts

School year Dates of birth First academic year eligible
Female cohort 21 1 September 2010 to 31 August 2011 2023 to 2024
Female cohort 20 1 September 2009 to 31 August 2010 2022 to 2023
Female cohort 19 1 September 2008 to 31 August 2009 2021 to 2022
Female cohort 18 1 September 2007 to 31 August 2008 2020 to 2021
Female cohort 17 1 September 2006 to 31 August 2007 2019 to 2020
Female cohort 16 1 September 2005 to 31 August 2006 2018 to 2019
Female cohort 15 1 September 2004 to 31 August 2005 2017 to 2018
Female cohort 14 1 September 2003 to 31 August 2004 2016 to 2017
Female cohort 13 1 September 2002 to 31 August 2003 2015 to 2016
Female cohort 12 1 September 2001 to 31 August 2002 2014 to 2015
Male cohort 5 1 September 2010 to 31 August 2011 2023 to 2024
Male cohort 4 1 September 2009 to 31 August 2010 2022 to 2023
Male cohort 3 1 September 2008 to 31 August 2009 2021 to 2022
Male cohort 2 1 September 2007 to 31 August 2008 2020 to 2021
Male cohort 1 1 September 2006 to 31 August 2007 2019 to 2020

Figure 1. HPV vaccine coverage for female students by cohort and school year of vaccination between the 2014 to 2015 and the 2023 to 2024 academic years

HPV vaccine coverage for female students has consistently decreased from pre-COVID-19 pandemic levels (Figure 1). Describing HPV vaccine coverage in terms of cohorts requires some caveats, in that the most recently eligible cohort will only have been vaccinated in year 8, while the next most recently eligible cohort will only have been able to be vaccinated in school years 8 and 9. After 3 years of HPV vaccine eligibility the HPV vaccine coverage for female students in school year 10 in the 2023 to 2024 academic year (the 2021 to 2022 cohort), was 76.7%.

Figure 2. HPV vaccine coverage for male students by cohort and school year of vaccination between the 2014 to 2015 and the 2023 to 2024 academic years [Note 1]

Note 1: the shorthand ‘[z]’ is used to mark cohorts that were not eligible in the given academic year so do not have a coverage estimate.

HPV vaccine coverage for male students has also decreased since the COVID-19 pandemic (Figure 2), however the 2019 to 2020 academic year was the first year that males were eligible for HPV vaccination. After 3 years of HPV vaccine eligibility the HPV vaccine coverage for male students in school year 10 in the 2023 to 2024 academic year (the 2021 to 2022 cohort), was 71.2%.

Analysis of HPV vaccine coverage by school year

This section of the report presents HPV vaccine coverage for students by school year for the 2023 to 2024 academic year.

The HPV vaccine is routinely offered in year 8, with some local authorities running catch up programmes in year 9 and 10. Year 8 coverage will be impacted by both the number of students consenting and how many students were offered the vaccine. This means that year 8 coverage can be used as an indicator of initial uptake and timeliness of routine programme delivery. By year 9 and 10, catch up will be complete which means coverage in these students can be used as an indicator of the final level of protection achieved.

The majority of HPV vaccine doses are given in year 8, with some catch up required in years 9 and 10, particularly during and following the COVID-19 pandemic (Figures 1 and 2). In the 2023 to 2024 academic year, the HPV vaccine was offered routinely to children in year 8 in all 151 local authorities. Catch up activity was completed in 94 (62.3%) local authorities, not complete in 54 (35.8%) local authorities, and not required in 3 (2.0%) local authorities. Since catch up in year 10 has been very limited we have only provided additional analyses and figures for the year 8 and year 9 students in this report.

Table 2 shows HPV vaccine coverage in each academic year since the 2016 to 2017 academic year, by school year and sex. This table shows that coverage in year 8 has risen slightly compared to last year, although remains below pre-pandemic levels. However, coverage in year 9 and 10 has fallen since last year.

Table 2. HPV vaccine coverage for students in year 8, year 9 and year 10, between the 2017 to 2018 and the 2023 to 2024 academic years

School year 2017 to 2018 2018 to 2019 2019 to 2020 2020 to 2021 2021 to 2022 2022 to 2023 2023 to 2024 Change between 2022 to 2023 and 2023 to 2024 (percentage points)
Year 8 Female 86.9 88.0 59.2 76.6 69.6 71.3 72.9 1.6
Year 9 Female 89.1 88.9 88.9 82.9 82.2 75.7 74.1 -1.6
Year 10 Female [z] [z] [z] [z] 86.5 83.2 76.7 -6.5
Year 8 Male [z] [z] 54.4 71.0 62.4 65.2 67.7 2.5
Year 9 Male [z] [z] [z] 78.2 77.6 69.7 68.5 -1.2
Year 10 Male [z] [z] [z] [z] 81.5 78.6 71.2 -7.4

Note 2: the shorthand ‘[z]’ is used to mark cohorts that were not eligible in the given academic year so do not have a coverage estimate.

Year 8 HPV vaccine coverage in 2023 to 2024

Year 8 students in 2023 to 2024 are represented by female cohort 21 and male cohort 5 in Table 1, and first became eligible for the HPV vaccine in the 2023 to 2024 academic year.

The main findings for year 8 students in 2023 to 2024 are that:

  • HPV coverage for female year 8 students was 72.9%, which is 1.6 percentage points higher than female year 8 students in 2022 to 2023
  • HPV coverage for male year 8 students was 67.7%, which is 2.5 percentage points higher than male year 8 students in 2022 to 2023
  • HPV coverage for female year 8 students by NHS commissioning region was lowest in London (61.6%) and highest in the South East (78.6%)
  • HPV coverage for male year 8 students by NHS commissioning region was lowest in London (57.0%) and highest in the South East (73.3%)
  • HPV coverage for female year 8 students at local authority level ranged from 32.9% (Brent) to 89.2% (Wiltshire)
  • HPV coverage for male year 8 students at local authority level ranged from 27.4% (Westminster) to 85.2% (West Berkshire)

Figure 3. HPV vaccine coverage by NHS commissioning region and sex for year 8 students in the 2023 to 2024 academic year

In the 2023 to 2024 academic year, HPV vaccine coverage for year 8 students was lowest in London and highest in the South East (Figure 3). HPV vaccine coverage was similar for all NHS commissioning regions, apart from London where coverage was lower than the national coverage by 11.3 percentage points in females and 10.8 percentage points in males. Also, coverage in males was lower than females across all NHS commissioning regions.

Figure 4. HPV vaccine coverage for female students in year 8 between the 2014 to 2015 and the 2023 to 2024 academic years

HPV vaccine coverage for female year 8 students has decreased since the 2014 to 2015 academic year, with some NHS commissioning regions showing a significant drop in 2019 to 2020 due to the COVID-19 pandemic. HPV vaccine coverage for year 8 students remains slightly below pre-pandemic levels in all NHS commissioning regions, with uptake in London having fallen the most (Figure 4). Despite this overall trend, year 8 coverage has improved slightly in 2023 to 2024 compared to the 2022 to 2023 academic year.

Figure 5. HPV vaccine coverage for male students in year 8 between the 2014 to 2015 and the 2023 to 2024 academic years

The 2019 to 2020 academic year was the first year that male students were offered the HPV vaccine. Therefore there is no pre-pandemic data to compare with current HPV vaccine coverage figures. However, there has been a general increase in HPV vaccine coverage in male year 8 students since the 2019 to 2020 academic year (Figure 5).

Figure 6. HPV vaccine coverage by local authority and sex for year 8 students in the 2023 to 2024 academic year

Figure 6 shows the distribution of HPV vaccine coverage within local authorities by NHS commissioning region and sex for year 8 students in the 2023 to 2024 academic year. The boxes indicate the range of the first to third quartiles, the inter-quartile range (IQR), among constituent local authorities in each NHS commissioning region. The median (second quartile) is indicated by the horizontal white line within each box. Vertical black lines indicate the range of coverage values among local authorities that fall within 1.5 times the IQR above the third quartile or below the first quartile. Local authorities with coverage outside this range are considered outliers and indicated by a black dot.

Within each NHS commissioning region, coverage by local authority varied substantially. The NHS commissioning region with the greatest variation in coverage was London where local authority level coverage ranged from 32.9% to 84.3% in females and 27.4% to 82.6% in males. The NHS commissioning region with the least variation in coverage was the South East for females, where local authority level coverage ranged from 62.8% to 87.7%, and the East of England for males, where local authority level coverage ranged from 54.5% to 78.2%.

Figure 7. HPV vaccine coverage by local authority for year 8 female students in the 2023 to 2024 academic year

The map in Figure 7 shows HPV vaccine coverage by local authority for female year 8 students. London was the only NHS commissioning region with over half of constituent local authorities reporting less than 70% coverage, with 23 out of 33 local authorities (69.9%).

Figure 8. HPV vaccine coverage by local authority for year 8 male students in the 2023 to 2024 academic year

The map in Figure 7 shows HPV vaccine coverage by local authority for male year 8 students. NHS commissioning regions with over half of local authorities reporting coverage less than 70% included London (26 out of 33; 78.8%), the North West (13 out of 22; 59.1%), and the Midlands (13 out of 24; 54.2%)

Year 9 HPV vaccine coverage in 2023 to 2024

Year 9 students in 2023 to 2024 are represented by female cohort 20 and male cohort 4 in Table 1, and first became eligible for the HPV vaccine in the 2022 to 2023 academic year.

The main findings for year 9 students in 2023 to 2024 are that:

  • HPV coverage for female year 9 students was 74.1%, which is 1.6 percentage points lower than female year 9 students in 2022 to 2023
  • HPV coverage for female year 9 students was 2.8 percentage points higher than in 2022 to 2023 when the same cohort was in year 8, suggesting ongoing catch up
  • HPV coverage for male year 9 students was 68.5%, which is 1.2 percentage points lower than male year 9 students in 2022 to 2023
  • HPV coverage for male year 9 students was 3.3 percentage points higher than in 2022 to 2023 when the same cohort was in year 8, suggesting ongoing catch up
  • HPV coverage for female year 9 students by NHS commissioning region was lowest in London (60.9%) and highest in the South East (79.7%)
  • HPV coverage for male year 9 students by NHS commissioning region was lowest in London (56.5%) and highest in the South East (74.2%)
  • HPV coverage for female year 9 students at local authority level ranged from 25.5% (Brent) to 94.7% (Warwickshire)
  • HPV coverage for male year 9 students at local authority level ranged from 25.8% (Kensington and Chelsea) to 88.9% (Kingston Upon Thames)

Figure 9. HPV vaccine coverage by NHS commissioning region and sex for year 9 students in the 2023 to 2024 academic year

In the 2023 to 2024 academic year, HPV vaccine coverage for year 9 students was lowest in London and highest in the South East. HPV vaccine coverage was similar for all NHS commissioning regions, apart from London where coverage was lower than the national coverage by 13.2 percentage points in females and 12.1 percentage points in males. Also, coverage in males was lower than females across all NHS commissioning regions (Figure 9).

Figure 10. HPV vaccine coverage for female students in year 9 between the 2014 to 2015 and the 2023 to 2024 academic years

HPV vaccine coverage for female year 9 students has gradually decreased since the 2015 to 2016 academic year, although this decrease has accelerated since the COVID-19 pandemic. This decrease in year 9 HPV vaccine coverage is greatest in London, with female year 9 coverage in the 2023 to 2024 academic year 21.6 percentage points lower than in the 2018 to 2019 academic year. However, HPV vaccine coverage for year 9 students increased slightly in the North West, East of England and South West in 2023 to 2024 compared to the 2022 to 2023 academic year (Figure 10).

Figure 11. HPV vaccine coverage for male students in year 9 between the 2014 to 2015 and the 2023 to 2024 academic years

Male students were first offered the HPV vaccine in year 9 during the 2020 to 2021 academic year, however there is a general decline in HPV vaccine coverage for male year 9 students since then.

Figure 12. HPV vaccine coverage by local authority and sex for year 9 students in the 2023 to 2024 academic year

Figure 12 shows the distribution of HPV vaccine coverage within local authorities by NHS commissioning region and sex for year 9 students in the 2023 to 2024 academic year. The boxes indicate the range of the first to third quartiles, the inter-quartile range (IQR), among constituent local authorities in each NHS commissioning region. The median (second quartile) is indicated by the horizontal white line within each box. Vertical black lines indicate the range of coverage values among local authorities that fall within 1.5 times the IQR above the third quartile or below the first quartile. Local authorities with coverage outside this range are considered outliers and indicated by a black dot.

Within each NHS commissioning region, HPV coverage for year 9 students varied substantially by local authority. The NHS commissioning region with the greatest variation in coverage was London where local authority level coverage varied from 25.5% to 93.3% in females and 25.8% to 88.9% in males. The NHS commissioning region with the least variation in coverage was the South West, where local authority level coverage varied from 70.1% to 86.2% in females and 62.6% to 81.5% in males.

Figure 13. HPV vaccine coverage by local authority for year 9 female students in the 2023 to 2024 academic year

The map in Figure 13 shows HPV vaccine coverage by local authority for female year 9 students. London was the only NHS commissioning region with over half of local authorities reporting coverage less than 70%, with 20 out of 33 local authorities (60.6%).

Figure 14. HPV vaccine coverage by local authority for year 9 male students in the 2023 to 2024 academic year

The map in Figure 14 shows HPV vaccine coverage by local authority for male year 9 students. NHS commissioning regions with over half of local authorities reporting coverage less than 70% included London (26 out of 33; 78.8%), the East of England (8 out of 12; 66.7%), and the Midlands (12 out of 24; 50.0%).

Year 10 HPV vaccine coverage in 2023 to 2024

Year 10 students in 2023 to 2024 are represented by female cohort 19 and male cohort 3 in Table 1, and first became eligible for the HPV vaccine in the 2021 to 2022 academic year.

The main findings for year 10 students in 2023 to 2024 are that:

  • HPV coverage for female year 10 students was 76.7%, which is 6.5 percentage points lower than female year 10 students in 2022 to 2023
  • HPV coverage for female year 10 students was 1.0 percentage point higher than in 2022 to 2023 when the same cohort was in year 9, suggesting ongoing catch up
  • HPV coverage for male year 10 students was 71.2%, which is 7.4 percentage points lower than male year 10 students in 2022 to 2023
  • HPV coverage for male year 10 students was 1.5 percentage points higher than in 2022 to 2023 when the same cohort was in year 9, suggesting ongoing catch up
  • HPV coverage for female year 10 students by NHS commissioning region was lowest in London (64.9%) and highest in the South East (82.7%)
  • HPV coverage for male year 10 students by NHS commissioning region was lowest in London (58.9%) and highest in the South East (77.3%)
  • HPV coverage for female year 10 students at local authority level ranged from 38.7% (Lambeth) to 97.6% (Northumberland)
  • HPV coverage for male year 10 students at local authority level ranged from 28.2% (Lambeth) to 92.2% (West Berkshire)

Factors affecting HPV vaccine coverage estimates

HPV vaccine coverage by cohort has been steadily declining, although in the 2023 to 2024 academic year this decline appears to be stabilising. Final levels of coverage measured in year 10 continue to lag behind pre-pandemic levels. However, initial uptake measured in year 8 has been gradually increasing since the 2021 to 2022 academic year, which suggests that timeliness of vaccination is improving.

Overall, HPV vaccine coverage remains lower than pre-pandemic levels. This decline follows trends seen across many other routine vaccination programmes. One reason given by School Age Immunisation Services (SAIS) providers for the gradual decline in HPV coverage since the COVID-19 pandemic was an increase in the number of non-returned and declined consent forms. It is possible that this drop in engagement is linked to vaccine hesitancy and fatigue following the pandemic. Additional reasons given for the lower coverage included staffing issues which made it more challenging to follow up non-consenting students. In some cases, these staffing issues were caused by the additional resources required to support other vaccination programmes. There was also significant disruption to HPV programme delivery during the COVID-19 pandemic, which is still impacting coverage in some cohorts in year 10.

In summary, HPV vaccine coverage by cohort has been steadily declining, in common with trends seen across many other routine vaccination programmes, although there is evidence of some recovery in the proportion of adolescents vaccinated in year 8 since 2021 to 2022. SAIS providers continue to focus on HPV programme recovery post-pandemic and have robust catch-up plans in place for HPV based on population need.

Data sources and methodology

The data used for this report is submitted annually by Screening and Immunisation Teams (SITs) at local authority level, although the data sources used vary by local authority. In the 2023 to 2024 academic year, 62 local authorities provided data from Child Health Immunisation Services (CHIS), 79 local authorities provided data from SAIS, 4 local authorities provided data from GP databases, and 87 local authorities provided data from an alternative data source. The types of children included in the denominator also varied, with 145 local authorities including children from pupil referral units, 59 local authorities including children in secure units, 79 local authorities including children from residential units, 142 local authorities including children who were home schooled, and 107 local authorities including children resident in the local authority but not linked to a school. Also, 3 local authorities were unable to include vaccinations given in alternative settings such as GPS and maternity settings. For some local authorities it was not possible to get updated figures, accounting for movement of students in and out of the local authorities . For these local authorities provisional figures submitted for the cohort when they were measured in the 2022 to 2023 academic year have been used.

Full details of the submission process for data providers can be found in the HPV vaccine coverage user guide.

HPV vaccine coverage was calculated as the number of students vaccinated at any time in each birth and sex cohort divided by the number of students eligible for the vaccine in each cohort.

Full details of the methodology, data sources and validations used to produce this report can be found in the Quality and Methodology Information (QMI) report.

Background information

The national HPV vaccination programme was introduced in 2008 on the advice of the Joint Committee on Vaccination and Immunisation (JCVI). The aim of the programme is to protect adolescents from HPV-related cancers. In 2008, a 3-dose schedule was offered routinely to secondary school year 8 females (aged 12 to 13 years) alongside a catch up programme targeting females aged 13 to 18 years. In September 2014 the programme changed to a 2-dose schedule based on evidence that showed antibody response to 2 doses of HPV vaccine in adolescent females was as good as 3 doses.

From September 2019, males aged 12 to 13 years became eligible for HPV immunisation alongside females, based on JCVI advice. This is the fourth year that males in year 9 have been offered the HPV vaccine. In order to evaluate the roll-out of the HPV vaccine to males the vaccine coverage collection was changed to monitor coverage in males and females separately.

From September 2023, the programme changed to a one dose only schedule. This is because the JCVI advised that a one dose HPV vaccine schedule was shown to be just as effective as 2 doses at providing protection from HPV infection.

HPV vaccine programme delivery

The adolescent HPV immunisation programme is a school-based programme, with alternative provision in place for children who are not in mainstream schools. The vaccine is routinely offered in year 8 in all local authorities, with some local authorities offering catch up vaccination activity in years 9 and 10 depending on local needs. Those eligible for vaccination under the adolescent programme remain so until the age of 25, with catch up opportunities available through schools and GP surgeries.

In the 2023 to 2024 academic year, the HPV vaccine was offered routinely to children in year 8 in all 151 local authorities. Catch up activity was completed in 94 (62.3%) local authorities, not complete in 54 (35.8%) local authorities, and not required in 3 (2.0%) local authorities.

Previous reports were published by Public Health England (PHE).

Further information and contact details

Feedback and contact information

To provide feedback and for all queries relating to this document, please contact adolescent@ukhsa.gov.uk.

Official statistics

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You are welcome to contact us directly by emailing adolescent@ukhsa.gov.uk with any comments about how we meet these standards. Alternatively, you can contact OSR by emailing regulation@statistics.gov.uk or via the OSR website.

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