Official Statistics

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

Updated 28 June 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 (January to March 2024).

The full coverage data is broken down by country, NHS England local team (configuration as of 1 April 2018) and NHS England region. This data is now contained in the separate 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 in England and the UK for all vaccines measured at 12 months, with the exception of rotavirus, decreased by 0.2% to 0.3%
• Coverage in England and the UK of all antigens except measles, mumps and rubella (MMR) measured at 24 months decreased by 0.1% to 0.3%
• coverage of the first dose of the MMR vaccine measured at 24 months (in children who first became eligible between January and March 2023) increased by 0.1% in England and the UK
• in England, compared with the previous quarter, coverage of the first dose of MMR measured at aged 5 years decreased by 0.2% in England, largely reflecting vaccinations delivered in January to March 2020
• UK coverage for the pre-school booster (DTaP/IPV) increased by 0.3% to 84.5% and MMR2 increased by 0.2% to 85.2%, reflecting vaccinations that should have been delivered between May and July 2022
• 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 aged 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 10-year period and, for a number of antigens, represents a continuation of an ongoing declining trend in coverage

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Coverage at 12 months

Compared with the previous quarter, UK coverage for all vaccines measured at 12 months, with the exception of rotavirus, decreased. The ‘6-in-1’ vaccine decreased by 0.2% to 91.5%, PCV1 coverage decreased by 0.2% to 93.5%, MenB2 decreased by 0.3% to 91.2% and rotavirus increased by 0.2% to 89.5%. The previous quarter’s coverage is reflected in Quarterly vaccination coverage statistics for children aged up to 5 years in the UK (COVER programme): October to December 2023.

In England, 12-month coverage of the ‘6-in-1’ decreased by 0.2% to 91.1%, MenB decreased by 0.3% to 90.9%, PCV1 coverage decreased by 0.3% to 93.2%, while rotavirus increased by 0.3% to 89.2%.

In England excluding London, ‘6-in-1’ coverage at 12 months was 92.3%, 1.2% higher than the overall England coverage; PCV1 coverage was 94.2%, 1.0% higher than the overall England coverage; rotavirus was 90.3%, 1.1% higher than the overall England coverage and MenB coverage was 92.1%, 1.2% higher than the overall England coverage.

In Scotland, at least 93% coverage was achieved for all antigens at 12 months. With the exception of rotavirus, in Wales at least 93% coverage was achieved and in Northern Ireland coverage was at least 91%.

Coverage varies by geography and full coverage data by country, NHS England local team (configuration as of 1 April 2018), NHS England region, upper tier local authority (UTLA) and UKHSA region is contained in the separate data file accompanying this report. Coverage for the 6-in-1 vaccine for quarter 4 2023 to 2024 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 4 2023 to 2024 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 94.7% in quarter 4 (January to March) of 2013 to 2014. This quarter was 3.6% lower than the peak, at 91.1% (Figure 2a). Coverage of PCV1 was comparable to coverage of the previous 2-dose PCV programme (PCV2) in quarter 1 2020 to 2021, prior to the change to a one dose programme (Figure 2b). MenB coverage was 2.1% lower than the peak of 93.0% in quarter 3 (October to December) of 2017 to 2018 (Figure 2c). Rotavirus coverage this quarter was 1.7% lower than the peak of 90.9% in quarter 1 (April to June) of 2020 to 2021 (Figure 2d).

Figure 2a. Coverage of the primary course of the 6-in-1 vaccine1 in England measured at 12 months between quarter 4 (January to March) 2013 to 2014 and quarter 4 2023 to 2024

Figure 2b. Coverage of the PCV vaccine2 in England measured at 12 months between quarter 4 (January to March) 2013 to 2014 and quarter 4 2023 to 2024

Figure 2c. Coverage of the MenB vaccine in England measured at 12 months between quarter 4 (January to March) 2013 to 2014 and quarter 4 2023 to 2024

Figure 2d. Coverage of the rotavirus vaccine in England measured at 12 months between quarter 4 (January to March) 2013 to 2014 and quarter 4 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 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.

Coverage at 24 months

In the UK, compared with the previous quarter, coverage of the ‘6-in-1’ vaccine decreased by 0.3 to 92.9%, PCV decreased by 0.2% to 88.6% and MenB decreased by 0.1% to 87.9%. Coverage of Hib/MenC remained at 89.2%, while MMR1 coverage increased by 0.1% to 89.2%

Compared with the previous quarter, coverage in England for the ‘6-in-1’ vaccine decreased by 0.1% to 92.5% and by 0.1% to 88.1% for the PCV booster. Coverage of the Hib/MenC booster remained at 88.7 and the MenB booster remained at 87.3%. MMR1 coverage increased by 0.1% to 88.7%.

At the country level, coverage in Scotland and Wales exceeded 92% for all the vaccines offered from the first birthday, and in Northern Ireland coverage exceeded 88%.

Coverage measured at 24-months of age in England excluding London exceeded 89% for all antigens. Coverage in England excluding London for the ‘6-in-1’ was 93.6%, 1.1% higher than the overall England coverage. PCV booster was 89.8%, 1.7% higher than the overall England coverage. Hib/MenC was 90.3%, 1.6% higher than the overall England coverage. MenB coverage was at 89.0%, 1.7% higher than the overall England coverage.

Excluding London, MMR1 coverage was 90.3%, 1.6% higher than the overall England coverage. Compared with the previous quarter, MMR1 coverage increased in the South East by 2.1%, in the North East and Yorkshire region by 0.3% and in London by 0.1%. In the Midlands, East of England and North West regions, coverage decreased by between 0.2% and 0.8%.

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 separate data file accompanying this report. Coverage for the first dose of MMR vaccine for quarter 4 2023 to 2024 by UTLA measured at 12 months is presented in Figure 3.

Figure 3. Coverage of MMR1 vaccine measured at 24 months of age in England for quarter 4 2023 to 2024 by UTLA

Coverage of the MMR1 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 2013 to 2014 (January to March 2014) (figures 4a, 4b, 4c and 4d). This quarter, coverage of the ‘6-in-1’ was 3.8% lower than the peak, PCV booster coverage was 4.7% lower, Hib/MenC coverage was 4.2% lower and MMR1 coverage was 3.9% lower. MenB coverage was 2.2% lower than the peak of 89.5% in quarter 2 (July to September) of 2020 to 2021 (Figure 2e).

Figure 4a. Coverage of the primary course of the 6-in-1 vaccine in England measured at 24 months between quarter 4 (January to March) 2013 to 2014 and quarter 4 2023 to 2024

Figure 4b. Coverage of the PCV booster in England measured at 24 months between quarter 4 (January to March) 2013 to 2014 and quarter 4 2023 to 2024

Figure 4c. Coverage of the Hib/MenC booster in England measured at 24 months between quarter 4 (January to March) 2013 to 2014 and quarter 4 2023 to 2024

Figure 4d. Coverage of the MMR1 in England measured at 24 months between quarter 4 (January to March) 2013 to 2014 and quarter 4 2023 to 2024

Figure 4e. Coverage of the MenB booster in England measured at 24 months between quarter 4 (January to March) 2013 to 2014 and quarter 4 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 represent coverage of the ‘5-in-1’ vaccine and quarter 4 of 2019 to 2020 onwards represents the ‘6-in-1’ vaccine.

Coverage at 5 years

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.

For the ‘6-in-1’ vaccine, coverage in England, and in the UK as a whole, remained unchanged compared with the previous quarter, at 93.0% and 93.4%, respectively. Coverage of MMR1 vaccine decreased by 0.5% in the UK to 92.5% this quarter. 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 2022 and July 2022.

Compared with the previous quarter, UK coverage for the pre-school booster (DTaP/IPV) increased by 0.3% to 84.5% and MMR2 increased by 0.2% to 85.2%, while the Hib/MenC booster decreased by 0.5% to 90.2%.

In England, MMR1 decreased by 0.2% to 92.1%, MMR2 increased by 0.4% to 84.7% and the pre-school booster increased by 0.4% to 83.6%. Pre-school booster and MMR2 coverage exceeded 89% in Scotland and Wales.

At 5 years, coverage in England excluding London for the pre-school booster (DTaP/IPV) was 85.8%, 2.2% higher than the overall England coverage. MMR1 was 93.6%, 1.5% higher than the overall England coverage, MMR2 was 87.1%, 2.4% higher than the overall England coverage and Hib/MenC was 91.1%, 1.6% higher than the overall England coverage (89.5%).

Compared with the previous quarter, MMR1 coverage decreased in all regions in England between 0.1% (Midlands, and East of England regions) and 0.7% (North West), while MMR2 coverage remained the same (North West and London) or increased between 0.2% (South West) to 1.3% (South East).

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 separate data file accompanying this report. Coverage for the second dose of MMR vaccine for quarter 4 2023 to 2024 by UTLA measured at 5 years of age is presented in Figure 5.

Figure 5. Coverage of MMR2 vaccine measured at 5 years of age in England for quarter 4 2023 to 2024 by UTLA

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

In England, coverage of the ‘6-in-1’ vaccine was 3.0% 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 (Figure 6a).

Also in England, MMR1 was down by 3.5% from a peak of 95.6% in quarter 1 (April to June) of 2017 to 2018. MMR2 was down by 3.9% when compared with the 88.6% seen in quarter 1 of 2014 to 2015 (figures 6b and 6c). The pre-school booster was 5.6% lower than at its peak of 89.2% in quarter 4 (January to March) of 2013 to 2014 and Hib/MenC was 3.6% lower than the peak of 93.1% in quarter 2 of 2017 to 2018 (Figure 6d).

Figure 6a. Coverage of the primary course of the 6-in-1 vaccine in England measured at 5 years between quarter 4 (January to March) 2013 to 2014 and quarter 4 2023 to 2024

Figure 6b. Coverage of MMR1 in England measured at 5 years between quarter 4 (January to March) 2013 to 2014 and quarter 4 2023 to 2024

Figure 6c. Coverage of MMR2 in England measured at 5 years between quarter 4 (January to March) 2013 to 2014 and quarter 4 2023 to 2024

Figure 6d. Coverage of pre-school booster (DTaP/IPV) in England measured at 5 years between quarter 4 (January to March) 2013 to 2014 and quarter 4 2023 to 2024

Figure 6e. Coverage of the Hib/MenC booster in England measured at 5 years between quarter 4 (January to March) 2013 to 2014 and quarter 4 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 represent 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 increased 4.9% from 89.7% to 94.6% 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 January and March 2022) decreased by 0.8% to 88.0% compared with the last quarter (88.80%) (see the 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

The data captures BCG coverage at the age of 3 months for children born 1 October to 31 December 2023 and at the age of 12 months for children born 1 January 2023 to 31 March 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 75.3% and measured at 12 months, it was 82.9%.

Data sources and methodology

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 lower than 5.

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 at the age of 16 weeks, between May 2023 and July 2023. They also would have received their primary course (second dose) of meningococcal group B (MenB) vaccine, which protects against meningococcal group B disease, at the same time (aged 16 weeks, between May 2023 and July 2023). They would have also been scheduled to receive a single dose of pneumococcal conjugate vaccine (PCV) and two doses of rotavirus vaccine at the age of 12 weeks, between April 2023 and June 2023.

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 2022 and July 2022. They would have received 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 aged one year, between October and December 2022. Children born to HBsAg positive mothers, who reached their second birthday in this quarter (born January to March 2023), were scheduled to receive a third dose monovalent hepatitis B vaccine at aged one year.

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 2019 and July 2020. Their first MMR and the Hib/MenC booster between January and March 2020, their pre-school diphtheria, tetanus, acellular pertussis and polio (DTaP/IPV) booster, and second-dose MMR from May 2022 to July 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.

Further information

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. You are welcome to contact us directly by emailing [email protected] with any comments about how we meet these standards. Alternatively, you can contact OSR by emailing [email protected] or via the OSR website.

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.

Country-specific data

Country-specific links to data are available:

• 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.

Feedback

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