Vaccination coverage is the best indicator of the level of protection a population will have against vaccine-preventable communicable diseases. Coverage is closely related to levels of disease; monitoring coverage identifies possible drops in immunity before levels of disease rise.
In England, vaccinations for diphtheria, tetanus, polio, pertussis and Haemophilus influenza b (Hib) were offered separately between 1994-95 and 2005-06, and uptake declined slightly over this period. From 2006-07 onwards a combined vaccination against all five diseases was introduced, and uptake subsequently improved. The availability of a single, combined vaccination may have simplified the childhood vaccination schedule for children and parents. However, between 2006-07 and 2010-11 similar improvements in uptake were observed for the pneumococcal (PCV) vaccination and the Hib/Meningococcal group C (MenC) vaccination, suggesting an overall increase in vaccination coverage, irrespective of the new delivery method.
Between 1994-95 and 1996-97, there was a relatively steady rate of measles, mumps and rubella (MMR) vaccinations for children in England, of around 91%. In 1998, a now discredited article appeared in the Lancet which linked the MMR vaccination to autism. Uptake decreased significantly, and by 2003/04 only 80% of children were vaccinated, which is well below the 92-94% required for herd immunity for mumps and rubella. In 2004, the Lancet partially retracted the paper and fully retracted it in 2010 and coverage consequently improved, reaching 93% in 2013-14. There have been outbreaks of measles in England in recent years, particularly in 2008 and 2012, when there were over a thousand confirmed cases.
Coverage for all of the childhood vaccinations plateaued between 2011-12 and 2013-14, and has since declined. The European Region of the World Health Organisation (WHO) recommends that on a national basis at least 95% of children are immunised against vaccine-preventable diseases and targeted for elimination or control. There is an expectation that UK coverage for all routine childhood immunisations that are evaluated up to five years of age achieves the 95% coverage in line with the WHO target. Currently, only the DTaP/IPV/Hib vaccination measured at a child's second birthday is meeting this target.
In 2017-18, childhood vaccination coverage for DTaP/IPV/Hib, PCV and MMR was over 90% for all UK countries. In general, there was little variation between the four nations, although England's coverage was around 3% lower than the other three nations.
The UK's DTP vaccination coverage has improved over time, from 91% in 2000 to 94% in 2016. Belgium, Denmark, Greece, Portugal and Spain have very high DTP vaccination rates, all showing over 98% coverage in 2017. Canada's DTP coverage was 91% in 2016, which was the lowest of the OECD countries compared here.
Between 2000 and 2004, the UK's vaccination coverage for measles fell from 88% to 81%. This was in response to the safety concerns surrounding the measles, mumps and rubella (MMR) vaccine. Since 2004 the coverage rate has recovered, reaching 92% in 2016. In 2017, Portugal had the highest measles vaccination coverage (98%) whilst France had the lowest (90%).
All girls aged 12 to 13 are offered the HPV (human papilloma virus) vaccination as part of the NHS childhood vaccination programme, and given a series of injections within a 12-month period. The vaccine protects against a group of viruses which have been linked to the development of cervical cancer. Not all cervical cancers are caused by HPV and so the vaccine does not result in immunity to cervical cancer, only to one of its potential causes.
There has been a consistently higher uptake of the first dose of the vaccine than subsequent doses, over time in England. Uptake for the HPV vaccination remained fairly static between 2011/12 and 2013/14, with an average uptake of 91% for the first dose and 89% for two doses. By 2017/18, uptake had declined slightly, with an uptake of 89% for the first dose and 84% for two doses.
It is important to note that the vaccine coverage data collected from 2014/15 onwards are not directly comparable to previous years due to changes to the HPV schedule from three doses to two in September 2014.
Despite high vaccine coverage since the early 1990s, in the five years prior to 2012 there were nearly 800 confirmed cases of whooping cough, where on average there were 270 babies admitted to hospital per year and four died. Babies under three months of age are too young to have completed a primary course of the pertussis vaccine, but the incidence of the disease is highest in infants of this age and they have the greatest risk of complications and death (Public Health England). In response to a national outbreak, the Department of Health announced that pertussis immunisation would be offered to pregnant women from 1 October 2012 to protect infants by boosting the short-term immunity of babies until they can be vaccinated themselves (Department of Health).
As shown in the chart, pertussis vaccination coverage for pregnant women in England is not especially high, reaching 70.8% in March 2018. Since its introduction in October 2012 there has been an increase in uptake from 43.7% to a peak of 76.2% in December 2016.
About this data
For the schedule of vaccinations please see the NHS website.
For all vaccinations some caution should be exercised when comparing coverage figures over time due to data quality issues reported by some data providers. Apparent trends could reflect changes in the quality of data reported as well as real changes in vaccination coverage. Please see individual data collections for any additional information associated with these data.
Definitions and comparability for the international indicators are taken directly from the OECD Health at a Glance 2017: OECD indicators. Detailed information about the definitions and the source and methods for each country can be found here.