Immunisation

Statistical Publication Notice

Embargoed to 25 March 2008

Childhood immunisation uptake rates, quarter and year ending 31 December 2007

INTRODUCTION

Children in Scotland are protected through immunisation against many serious infectious diseases. Vaccination programmes aim both to protect the individual and to prevent the spread of these illnesses within the population. As a public health measure, immunisations have been hugely effective in reducing the burden of disease. It is of public health concern when immunisation rates fall, as this increases the possibility of disease transmission, and hence complications arising from outbreaks of infectious diseases.

The target of the national immunisation programme is for 95% of children to complete courses of the following childhood immunisations by 24 months of age:  diphtheria, tetanus, pertussis (whooping cough), polio, haemophilus influenzae type b (hib), MenC, Pneumococcal Conjugate Vaccine (PCV) and measles, mumps and rubella (MMR). An additional national target of 95% uptake of one dose of MMR vaccine (MMR1) by 5 years old was introduced in 2006 to focus efforts to reduce the number of susceptible children entering primary school.  This is in line with the World Health Organisation target for MMR.

Childhood immunisation uptake rates for Scotland are monitored and published quarterly.  This release includes data to 31 December 2007 and annual uptake rates by deprivation (SIMD category).

KEY POINTS

In Scotland as a whole, annual and quarterly uptake rates show that the 95% target for immunisation of 2 year olds is being met and exceeded for all primary immunisations apart from the first dose of MMR (MMR1) where the uptake rates are 92.1% for the calendar year and 91.8% for the latest quarter.

Uptake rates of the Hib/MenC and PCV booster vaccinations by 24 months are reported for the first time this quarter and are 74.5% and 91.0% respectively.  In September 2006 there were substantial changes to the childhood immunisation programme: a new PCV immunisation was introduced; a change was made to the schedule given in the first 4 months of life; and there was the addition of an appointment at around 12 months to deliver the Hib/Men C booster.  At the same time, a catch-up exercise was undertaken to deliver PCV immunisation to older children up to 24 months of age, and there was a continued emphasis on improving and maintaining MMR coverage.   The uptake figures for the Hib/MenC booster are modest in comparison with other immunisations, but it is too early to draw any firm conclusions from this.

For the October-December quarter of 2007 and the calendar year of 2007, the uptake of the first dose of MMR (MMR1) by 5 years old is 94.4%, just below the World Health Organisation (WHO) target of 95%.

INTERPRETATION

In Scotland uptake rates for the childhood booster vaccines (diphtheria, tetanus, pertussis and polio, and the second dose of MMR (MMR2)), have historically been reported by 6 years of age.  In line with figures for the rest of the UK, from quarter ending December 2006, uptake rates for these vaccines are now reported by 5 years.  For trend purposes, reporting by 6 years of age will continue to be presented.

For details of Scotland's routine childhood immunisation timetable see Immunisation Schedule.

DETAILED FINDINGS

For the quarter ending 31 December 2007, at Scotland level:

• Uptake rates by 12 months of age for primary courses of diphtheria, tetanus, pertussis, polio, Hib, MenC and PCV remain above 95%. 
• Uptake rates by 24 months of age for primary courses of diphtheria, tetanus, pertussis, polio, Hib and MenC have remained relatively stable at around 98%.
• The combined Hib/MenC booster (normally given at around 12 months of age) was introduced in September 2006.  This required the inclusion of an additional immunisation appointment in the childhood schedule.  Uptake for this vaccine by 24 months of age is 74.5% and is reported for the first time this quarter.  The uptake figures for the Hib/MenC booster are modest in comparison with other immunisations, but it is too early to draw any firm conclusions from this.
• A booster dose of PCV was also introduced in September 2006 (normally given at the same appointment as MMR1 at around 13 months of age).  Uptake for this vaccine by 24 months of age is 91.0% and is reported for the first time this quarter.
• Uptake of one dose of MMR (MMR1) by 24 months for children born in the 4th quarter of 2005 is 91.8%.  This is an increase of 0.1 percentage points on the previous quarter when the rate was 91.7% (children born 3rd quarter of 2005).  From the 4th quarter of 2006 there has been fall of 1.0 percentage points in MMR1 uptake by 24 months from 92.8% to 91.8%.  This followed a general trend of rises in uptake from 85.8% in the 2nd quarter of 2003 to 92.8% in the 4th quarter of 2006.  The recent fall may be due to a short-term lack of availability of vaccine appointments due to demand generated by the pneumococcal catch up programme.
• Quarterly uptake of one dose of MMR (MMR1) by 5 years old is 94.4%, just below the World Health Organisation (WHO) target of 95%.  Five NHS Boards met or exceeded the WHO target.  By 24 months the reported uptake for this cohort of children was 88.0% showing that a significant number of children are immunised beyond the standard age.
• Uptake of the second dose of MMR (MMR2) by 5 years old for children born in the 4th quarter of 2002 is 87.1%.  This is an increase of 1.4 percentage points from the previous quarter when the rate was 85.7% (children born 3rd quarter of 2002).  Other pre-school booster vaccines experienced a similar rise (from 89.4% to 91.0%).  This may be due, in part, to reducing the age of first invitation for MMR2 and pre-school booster vaccines in some boards and may partly be a rebound from the dip in quarterly uptake rates seen in the first half of 2007 which were more affected by the lack of availability of vaccine appointments.

For the year ending 31 December 2007, at Scotland level:

• Uptake of one dose of MMR (MMR1) by 24 months for children born in the calendar year of 2005 is 92.1%.  This is the same as the previous reporting calendar year (children born in 2004).
• Uptake of one dose of MMR (MMR1) by 5 years old for children born in the calendar year of 2002 is 94.4%.  This is an increase of 0.6 percentage points from the previous year (born 2001) when the rate was 93.8%.  Five NHS Boards met or exceeded the WHO target of 95.0%.  By 24 months the reported uptake for this cohort of children was 88.3% showing that a significant number of children are immunised beyond the standard age.
• Deprivation has some effect on uptake rates: uptake of the primary immunisations by 12 months of age among children in the most deprived areas is around 2 percentage points lower than uptake in the least deprived areas.  However, even in the most deprived areas, primary immunisation uptake rates by 12 months old are high, at around 95%.

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MAIN CONTACTS:

Judith Tait
Child Health Information Team Leader
Tel: 0131 275 6833
Judith.Tait@isd.csa.scot.nhs.uk

Dr Jim Chalmers (Consultant in Public Health Medicine)
Head of Programme
Women & Children's Health Information Programme
Tel: 0131 275 6136
Jim.Chalmers@isd.csa.scot.nhs.uk

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GLOSSARY:

MMR - Measles, Mumps, Rubella
Pertussis - Whooping cough
Hib - Haemophilus influenzae type b
MenC - Meningitis C
PCV - Pneumococcal Conjugate Vaccine

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PRE-RELEASE ACCESS TO THIS PUBLICATION WAS GIVEN TO:

Scottish Government Health Directorates
Health Protection Scotland
NHS Board Immunisation Co-ordinators and admin/IT staff for quality assurance purposes
Chairs of the Child Health Surveillance Programme National User Groups
NHS Board Chief Executives

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HISTORY OF THIS PUBLICATION:

Last Published: 18/12/2007
Next Due: 24/06/2008
Data Avaliable Since: March 1995

Main contact: Judith Tait

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