A statistical report from UKHSA and NHS England in September 2024 reveals a drop in childhood vaccination coverage in England in 2023-2024. The report uses data from the COVER (cover of vaccination evaluated rapidly) programme, which collates information for children aged 1, 2, and 5 by financial year. The UK routine childhood immunisation programme includes WHO Europe’s recommendations as well as others advised by the Joint Committee on Vaccination and Immunisation (JCVI) and defined by UKHSA.
Coverage details
6-in1
For the 6-in-1 vaccine (previously 5-in-1), which protects against diphtheria, pertussis, tetanus, polio, disease caused by Haemophilus influenzae type b, and hepatitis B, vaccination is scheduled at ages 8, 12, and 16 weeks.
Coverage at 12 months in England has remained below the WHO Europe target of at least 95% of children immunised; for 2023-2024, 91.2% of children were reported to have completed their primary course of 3 doses at 12 months. This is a decrease from the previous year, which was 91.8%, and a continued “downward trend” since a peak of 94.7% in 2012-2013. In the 2023-2024 period, 8 out of 9 regions exceeded 90%, with 1 region (North East) exceeding the national target of 95%, reaching 95.2%. London had the lowest coverage of 86.2%.
Coverage at 24 months was 92.4%, lower than the previous year, which reached 92.6%, and continuing the “downward trend” since the peak at 96.3% in 2012-2013. This has not exceeded the target since 2018-2019. For regional coverage at 24 months, 8 out of 9 regions reached 90% coverage and 1 region met the national target of 95%. Again, London had the lowest regional coverage (87.7%).
At the 5-year coverage assessment, coverage was 92.6%, lower than the 93.2% coverage reported for the 5-in-1 vaccine in 2022-2023. This is the lowest since 2009-2009. However, at regional level, coverage exceeded 90% in 8 of 9 regions with the South West exceeding the 95% target. Once more, London had the lowest coverage (86.9%).
MMR
The MMR vaccine protects against measles, mumps, and rubella; doses are scheduled at 12 months (MMR1) and 3 years and 4 months (MMR2). Coverage is measured at 24 months (MMR1) and 5 years (both doses).
MMR1 coverage at 24 months reached 88.9% in 2023-2024; this is a decrease from 89.3% in the previous year and is the third consecutive year that coverage has been below 90%. For the 10 years between 2011-2012 and 2020-2021, coverage exceeded 90%. Regionally, 6 out of 9 regions reached 90% coverage, but no region met the national target of 95%. London had the lowest coverage (81.8%). At 5 years, MMR1 coverage was 91.9%, a decrease from 92.5% the previous year. 95% was achieved for the first and only time in 2016-2017; coverage has “consistently decreased” since then. The North East was the only region to meet the target of 95%.
MMR2 coverage at 5 years reached 83.9%, a decrease from 84.5% the previous year. Coverage decreased in all regions; no regions exceeded 90% coverage. The lowest coverage was in London (73.3%).
Rotavirus
The rotavirus vaccine is administered at 12 weeks and coverage is measured at 12 months; unlike other vaccines in the primary schedule, the rotavirus vaccine cannot be given beyond 6 months. This means that coverage at 12 months is “likely to be lower” than other vaccines.
National coverage at 12 months was 88.5%, a decrease from 88.7% in the previous year. This means that rotavirus vaccine coverage is “now at its lowest level since data became available” in 2016-2017. In 4 regions, coverage exceeded 90%, but none achieved 95%. London was the region with the lowest coverage at 83.6%.
PCV
The pneumococcal conjugate vaccine (PCV) protects against pneumococcal disease. The primary course is scheduled at 12 weeks and the booster dose at 12 months; coverage is measured at 12 months and 24 months.
The primary course coverage at 12 months was 93.2%, a decrease of 0.5% from 2022-2023. The booster coverage reached 88.2%, a decrease from 88.5% the previous year and a continuation of the downward trend since it peaks in 92.5% in 2012-2013. 5 out of 9 regions reached 90% coverage for the booster, but no regions exceeded the national target of 95%. London had “consistently lower coverage” between 2021-2024 and achieved 80.4% in 2023-2024.
Hib/MenC
The Hib/MenC vaccine protects against Haemophilus influenzae type b (Hib) and meningococcal disease group C (MenC). The combined vaccine is administered at 12 months, with coverage measured at 24 months and 5 years. It includes a booster for Hib, which is offered within the DTaP/IPV/Hib/HepB primary course.
At 24 months, coverage in England remained below 90% for the third year; it has declined consistently since a peak of 92.7% in 2012-2013. 88.6% of children were reported as having received the Hib/MenC vaccine. 6 out of 9 regions reached 90% coverage and no region achieved 95%. The lowest coverage was 81.2% in London. At 5 years, coverage was 89.4%, a decrease from 90.4% the previous year. This takes coverage to its lowest point since 2011-2012. 7 out of 9 regions reached 90% but no regions met 95%. London had the lowest coverage at 82.5%.
MenB vaccine and booster
The MenB vaccine and booster protects against meningococcal disease (group b). It is a combined vaccine scheduled at 8 weeks with a booster at 12 months, and coverage is measured at 12 months and 24 months.
At 12 months, 90.6% received 2 doses; this is a decrease from 91.0% the previous year. London had the lowest coverage at 85.5%. At 24 months, coverage was 87.3%, a decrease from 87.6% the previous year. Again, London had the lowest coverage (79.3%).
Parents encouraged to seek vaccines
Responding the report, Minister for Public Health and Prevention Andrew Gwynne urged parents to “take up vaccinations to keep children safe”, particularly as they return to school or nursery this Autumn.
“Vaccines are our best form of protection against serious illness.”
Steve Russell, NHS National Director for Vaccinations and Screening is concerned that “too many children are still not fully vaccinated” against vaccine-preventable diseases that can cause “serious illness”.
“Vaccinations have been protecting children for decades and are offered free as part of the NHS routine immunisation programme, saving thousands of lives and preventing tens of thousands of hospital admissions every year.”
UKHSA Consultant Epidemiologist Dr Vanessa Saliba emphasised the importance of the drive to increase vaccine uptake so that “no child is left at risk of serious illness or life-long complications”.
“These vaccines offer the best protection as children start their journey into nursery and mixing more widely. Many who missed out on their vaccinations have already been caught up, but more needs to be done to ensure all those eligible are vaccinated.”
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