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Vaccinations
Introduction
Immunisation is a global health and development success story, saving millions of lives every year. Vaccines reduce risks of getting a disease by working with your body’s natural defences to build protection. When you get a vaccine, your immune system responds. We now have vaccines to prevent more than 20 life-threatening diseases, helping people of all ages live longer, healthier lives. Immunization currently prevents 3.5-5 million deaths every year from diseases like diphtheria, tetanus, pertussis, influenza and measles. Immunization is a key component of primary health care and an indisputable human right. It’s also one of the best health investments money can buy. Vaccines are also critical to the prevention and control of infectious disease outbreaks. They underpin global health security and will be a vital tool in the battle against antimicrobial resistance [1].In the UK, the childhood vaccination schedule is as follows:
8 weeks
6-in-1 vaccine (diptheria, hepatitis B, Hib, polio, tetanus & whooping cough)
Rotavirus vaccine
MenB vaccine
12 weeks
6-in-1 (second dose)
Pneumococcal vaccine
Rotavirus vaccine (2nd dose)
16 weeks
6-in-1 vaccine (3rd dose)
MenB vaccine (2nd dose)
1 year
Hib/MenC vaccine (1st dose)
MMR vaccine (1st dose)
Pneumococcal vaccine (2nd dose)
MenB vaccine (3rd dose)
2 to 15 years
Children's flu vaccine yearly
3 years and 4 months
MMR vaccine (2nd dose)
4-in-1 pre-school booster vaccine (diptheria, tetanus, whooping cough, polio)
12 to 13 years
HPV vaccine
14 years
3-in-1 teenage booster vaccine (tetanus, diptheria, polio)
MenACWY vaccine
Vaccination coverage is the best indicator of the level of protection a population will have against vaccine preventable communicable diseases. Coverage is closely correlated with levels of disease. Monitoring coverage identifies possible drops in immunity before levels of disease rise.
Data Overview
Hepatitis B
Infants born to hepatitis B virus (HBV) infected mothers are at high risk of acquiring HBV infection themselves. Babies born to infected mothers are given a dose of the hepatitis B vaccine after they are born. This is followed by another two doses (with a month in between each) and a booster dose 12 months later. Around 20% of people with chronic hepatitis B will go on to develop scarring of the liver (cirrhosis), which can take 20 years to develop, and around 1 in 10 people with cirrhosis will develop liver cancer. Since April 2000 it has been recommended that all pregnant women in England and Wales should be offered testing for hepatitis B through screening for HBsAg, and that all babies of HBsAg seropositive women should be immunised (HSC 1998 127). A dose of paediatric hepatitis B vaccine is recommended for all infants born to an HBV infected mother as soon as possible after birth, then at 1 and 2, and 12 months of age.1 year relates to children at 12 months old that have received the complete course (3 doses) of hepatitis B vaccine.
2 years relates to children at 24 months old that have received the complete course (4 doses) of hepatitis B vaccine.
Oldham's latest year's coverage for Hepatitis B at 1 year was 77.8%. Coverage at 2 years was much lower, at 46.2%. Similar drop offs in rate are seen regionally and nationally. Due to small numbers, the rate fluctuates significantly year on year.
Figure 1: Population vaccination coverage: Hepatitis B (1 year old) trend
Source: Cover of vaccination evaluated rapidly (COVER) data collected by UK Health Security Agency (UKHSA) Dtap IPV Hib
The combined DTaP IPV Hib is the first in a course of vaccines offered to babies to protect them against diphtheria, pertussis (whooping cough), tetanus, Haemophilus influenzae type b (an important cause of childhood meningitis and pneumonia) and polio (IPV is inactivated polio vaccine).Between 2010/11 and 2021/22, vaccination coverage for 1 year olds has decreased across Oldham, the North West and England. Oldham has seen a steeper decline (-7.1%) when compared regionally (-3.8%) and nationally (-2.5%), largely driven by a significant decrease following the Covid-19 pandemic. This sudden and significant decrease is not reflected regionally or nationally (figure 2). Across Greater Manchester, Oldham has the 3rd lowest rate. With the exception of Manchester and Salford, all other Greater Manchester authorities achieve rates equivalent to or above the national average (figure 4).
For 2 year olds, rates have decreased over the same time period by a similar amount across Oldham (-3.6%), North West (-3.2%) and England (-3.1%). The steep reduction observed for 1 year olds did not occur for 2 year olds. Oldham consistently performs better than regional and national averages on this measure, with the exception of a slight dip in rate in 2013/14 (figure 3). Across Greater Manchester, Oldham has the 4th lowest rate. As with the 1 year old rate, all Greater Manchester authorities apart from Manchester and Salford outperform England (figure 5).
Figures 2 & 3: Population vaccination coverage: Dtap IPV Hib (1 year old and 2 years old) trends
Source: Cover of Vaccination Evaluated Rapidly (COVER) data collected by UK Health Security Agency (UKHSA) Figures 4 & 5: Population vaccination coverage: Dtap IPV Hib (1 year old and 2 years old) across Greater Manchester
Source: Cover of Vaccination Evaluated Rapidly (COVER) data collected by UK Health Security Agency (UKHSA) PCV
The PCV vaccine protects against pneumococcal infections that can cause pneumonia, septicaemia or meningitis. The PCV vaccine is given to all children under two years old as part of the childhood vaccination programme.Oldham's PCV vaccination coverage is consistently above regional and national averages. Although there have been year on year fluctuations, the rate has remained fairly similar over time for Oldham, with an overage percentage point difference of 0.5 (figure 6). Oldham's rate for 2019/20 is 2nd highest across Greater Manchester, behind Trafford (figure 8). Data isn't yet available post-pandemic and so we may see changes to the rate once this data becomes available.
Oldham's PCV Booster rate has decreased significantly post-pandemic. Previous to this, Oldham outperformed regional and national averages and now sits below both (figure 7). Oldham's rate is 3rd lowest across Greater Manchester. Oldham, Salford and Manchester all sit below the national rate, whilst the rest of Greater Manchester perform better when compared to the England rate (figure 9).
Figures 6 & 7: Population vaccination coverage: PCV and PCV Booster trend
Source: Cover of Vaccination Evaluated Rapidly (COVER) data collected by UKHSA Figures 8 & 9: Population vaccination coverage: PCV across Greater Manchester
Source: Cover of Vaccination Evaluated Rapidly (COVER) data collected by UK Health Security Agency (UKHSA) Hib & MenC Booster
The Hib and MenC booster increases the protection a child gets from the first course of Hib vaccine when they are 8, 12 and 16 weeks old, and the MenC vaccine when they are 12 and 16 weeks. This boosted immunity lasts into adulthood.Oldham has consistently outperformed regional and national averages for vaccination coverage by 2 years old up until the most recent data year (2021/22), when Oldham's rate decreased significantly to below the North West rate and only marginally above the national average (figure 10). Oldham's rate is 3rd lowest across Greater Manchester (figure 13). Data is available up until 2017/18 for vaccination coverage by 5 years old. Oldham's most recent rate is above regional and national averages (figure 12), however ranks 3rd lowest across Greater Manchester (figure 14).
Figures 10 & 11: Population vaccination coverage: Hib and MenC Booster (2 years old and 5 years old) trend
Source: Cover of Vaccination Evaluated Rapidly (COVER) data collected by UK Health Security Agency (UKHSA)Figure 12 & 13: Population vaccination coverage: Hib and MenC Booster (2 years old and 5 years old) across Greater Manchester
Source: Cover of Vaccination Evaluated Rapidly (COVER) data collected by UK Health Security Agency (UKHSA)MMR
MMR is the combined vaccine that protects against measles, mumps and rubella. Measles, mumps and rubella are highly infectious, common conditions that can have serious complications, including meningitis, swelling of the brain (encephalitis) and deafness. They can also lead to complications in pregnancy that affect the unborn baby and can lead to miscarriage.Oldham has historically performed better than regional and national averages across all MMR measures. However, following the Covid-19 pandemic, Oldham's performance has dipped over and above the reductions seen across other areas. Performance still exceeds national average on all measures, but the gap is much smaller than it has been previously (figures 14, 15 & 16). Following the recent decline in performance, Oldham now sits at 3rd lowest for one dose of MMR at 2, 5th lowest for one dose of MMR at 5 and 4th lowest for two doses of MMR at 5 across Greater Manchester (figures 17, 18 & 19).
Figures 14, 15 & 16: Population vaccination coverage: MMR trends
Source: Cover of Vaccination Evaluated Rapidly (COVER) data collected by UK Health Security Agency (UKHSA)
Figures 17, 18 & 19: Population vaccination coverage: MMR across Greater Manchester
Source: Cover of Vaccination Evaluated Rapidly (COVER) data collected by UK Health Security Agency (UKHSA)HPV
On the advice of the Joint Committee on Vaccination and Immunisation (JCVI), a HPV national vaccination programme was introduced in 2008, to protect adolescent females against cervical cancer. At that time, a 3 dose schedule was offered routinely to secondary school year 8 females (aged 12 to 13) alongside a catch up programme targeting females aged 13 to 18. In September 2014 the programme changed to a 2 dose schedule based on evidence that showed that antibody response to 2 doses of HPV vaccine in adolescent females was as good as 3 doses. From September 2019, 12 to 13 year old males became eligible for HPV immunisation alongside females, based on JCVI advice.Oldham's vaccination coverage for HPV has previously been in line with regional and national averages, with the exception of the most recent data year (2021/22), where Oldham's rate (58.3%) is much lower than rates for the North West (71.6%) and England (69.6%) (figure 20). Oldham's rate is 2nd lowest across Greater Manchester (figure 21).
Figure 20: Population vaccination coverage: HPV one dose for 12 to 13 year olds trend
Source: Cover of Vaccination Evaluated Rapidly (COVER) data collected by UK Health Security Agency (UKHSA)Figure 21: Population vaccination coverage: HPV one dose for 12 to 13 year olds across Greater Manchester
Source: Cover of Vaccination Evaluated Rapidly (COVER) data collected by UK Health Security Agency (UKHSA)Further Information & Resources
WHO Immunisation Agenda 2030: A global Strategy to leave no one behindA2030 sets an ambitious, overarching global vision and strategy for vaccines and immunization for the decade 2021–2030. It was co-created with thousands of contributions from countries and organizations around the world. It draws on lessons from the past decade and acknowledges continuing and new challenges posed by infectious diseases (e.g. Ebola, COVID-19). The strategy has been designed to respond to the interests of every country and intends to inspire and align the activities of community, national, regional and global stakeholders towards achieving a world where everyone, everywhere fully benefits from vaccines for good health and well-being. IA2030 is operationalized through regional and national strategies and a mechanism to ensure ownership and accountability and a monitoring and evaluation framework to guide country implementation.
NHS Vaccination Schedule
Information on the vaccination schedule for children and young people
NICE Guideline: Vaccine uptake in the general population
This guideline aims to increase the uptake of all vaccines provided on the NHS routine UK immunisation schedule by everyone who is eligible. It supports the aims of the NHS Long Term Plan, which includes actions to improve immunisation coverage by GPs (including the changes to vaccinations and immunisations detailed in the 2021/2022 and 2022/23 GP contracts) and support a narrowing of health inequalities.
NHS Digital Childhood Vaccination Coverage Statistics- England, 2021-22
This statistical report, co-authored with the UK Health Security Agency (UKSHA), reports childhood vaccination coverage statistics for England in 2021-22. Data relates to the routine vaccinations offered to all children up to the age of 5 years, derived from the Cover of Vaccination Evaluated Rapidly (COVER). Additional information on children aged 2 and 3 vaccinated against seasonal flu are collected from GPs through UKHSA's ImmForm system.
OHID's Child & Maternal Health Data Profile
Provides additional data and information relating to childhood vaccinations