[additonal header templates/controls go here]
Home > Starting Well > 0-4 Years of Age > Childhood Immunisations (0-4 years)

Childhood Immunisations (0-4 years)

Last Modified 02/06/2021 15:57:38 Share this page

Introduction

After clean water, vaccination is the most effective public health intervention in the world for saving lives and promoting good health. Immunisation is the most essential way of protecting people and communities from serious infectious diseases: as well as the individual being protected themselves, vaccinated people are also less likely to be a source of infection to others.

Many vaccine preventable childhood diseases are now so rare that it is easy to underestimate the importance of children's vaccinations. However, whooping cough and diphtheria are still a threat. The diseases are rare now, but if children are not vaccinated, they can return with a vengeance.

Currently the European Region of the World Health Organization (WHO) recommends that on a national basis at least 95% of children are immunised against diseases preventable by immunisation and targeted for elimination or control (specifically, diphtheria, tetanus, pertussis, polio, Hib, measles, mumps and rubella)1The routine childhood immunisation programme for the UK includes these immunisations recommended by WHO as well as a number of others as defined by Public Health England (PHE) and the complete routine immunisation schedule  for health professionals and immunisation practitioners is published annually by PHE.

There are also selective childhood immunisation programmes that target children at particular risk of certain diseases, such as tuberculosis (TB).

Childhood immunisations (5 years and over) and adult vaccinations provide information on older children and adults. Health Protection provides further information on infectious diseases and other noncommunicable health threats.

Facts, figures and trends

In addition to PHE Profiles, vaccination coverage data can be accessed via two experimental interactive dashboards:

Blackpool has achieved vaccination coverage of over 90% for all the routine childhood vaccinations recommended in the first two years of life.

2019/20 data published by NHS Digital shows that in Blackpool:

    • The number of children who had received the 6-in-1 diphtheria, tetanus and pertussis (DtaP)/polio (IPV), haemophilus influenzae type b (Hib) and Hepatitis B vaccine at the age of 12 months was 1,609 (93.5%).
    • The Men B vaccine, introduced in 2015, is offered at eight and sixteen weeks of age, with a booster on or after the first birthday. Men B coverage at 12 months in Blackpool was 1,611 (93.6%) children.
    • The number of children who had received the PCV vaccine which protects against pneumococcal infections that can cause pneumonia, septicaemia or meningitis at age 12 months was 1,619 (94.1%).
    • The Rotavirus vaccine is offered at eight and twelve weeks of age, protecting against this highly infectious stomach virus. Rotavirus coverage at 12 months in Blackpool was 1,551 (90.1%).
    • The number of children who had received the diphtheria, tetanus and pertussis (DtaP)/polio (IPV) and haemophilus influenzae type b (Hib) vaccine at the age 2 years was 1,674 (94.5%).
    • The number of children who had received the Hib/meningitis C (MenC) booster by 2 years of age was 1,638 (92.5%).
    • The number of children who had received the pneumococcal (PCV) booster vaccine by 2 years of age was 1,637 (92.4%).
    • The number of children who had received the first dose of the measles, mumps and rubella (MMR) vaccine by 2 years of age was 1,630 (92.0%).
    • The number of children who had received their Menigitis B (Men B) booster by 2 year of age was 1,646 (92.9%).

For infomation on older children see: Immunisations of children at age 5 years and over.

 Figure 1: Percent of children immunised by their 1st birthday: 2019/20

Source: PHE, Public Health Outcomes Framework

Figure 2: Percent of children immunised by their 2nd birthday: 2019/20

Source: PHE, Public Health Outcomes Framework

Across Blackpool, immunisation uptake at the age of 1 year is slightly above or level with national averages. However, it is now below the 95% uptake recommended by the World Health Organization (WHO) (Figure 1), having been above this level in 2014/15. Similarly, though rates of immunsation in 2 year old children are above national averages (Figure 2), the trend in coverage has fallen slightly since 2017/18 (Figure 3).

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 and monitoring coverage identifies possible drops in immunity before levels of disease rise.

Figure 3: Trend in vaccination coverage, children aged 2 years (%)

Source: PHE, Public Health Outcomes Framework

Figure 4: Trend in uptake of MMR vaccine, children aged 2 years (%)

Source: PHE, Public Health Outcomes Framework

Despite maintaining a rate above the national average since 2017 (Figure 4), MMR coverage in Blackpool and across England remains below the WHO target of 'at least 95%' coverage. The spike in coverage in 2009/10 was due to a 'catch up' campaign. Figure 5 shows Blackpool compared with other local authorities in the country. With a 2019/20 coverage rate of 92.0%, Blackpool is ranked 75/148 of upper tier local authorities and is in the third (middle) quintile.

Figure 5: Population vaccination coverage - MMR for one dose (2 years old), upper tier local authorities, 2019/20

Source: PHE, Public Health Outcomes Framework

At a local level, there is variation in the proportion of children immunised in each of Blackpool's GP practices. Figure 6 shows immunisations due at age 1 year and at age 2 years and the proportion of children immunised by each practice in 2018/19. Elizabeth Street and South King Street practices both recorded 12 month vaccination rates significantly lower than the Blackpool average, whilst Elizabeth Street recorded a 24 month DtaP/IPV/Hib vaccination rate significantly lower than the Blackpool average. Figure 7 shows proportions immunised by the age of 2 years for selected diseases. 

Figure 6: Child Immunisations by GP Practice in Blackpool, 2018/19

Source: NHS England, Child Immunisation at Practice level

Figure 7: Proportion immunised for Dtap/IPV/Hib, MMR, Hib B / Men C booster and PCV booster by the age of 2 years in Blackpool by GP practice, 2018/19

Source: NHS England, Child Immunisation at Practice level
 

Risks

There are many reasons why people choose not to immunise themselves or their children. Studies have looked into how parents make decisions on whether to vaccinate their children or not and found that this is related to gaps in their knowledge of vaccine preventable diseases, concerns over vaccine safety and their attitudes towards immunisations, health professionals and health organisations.

Blackpool recognises that there is a need to target both overall improvement of immunisation coverage and specifically to improve the low levels of coverage amongst certain groups and in certain places.

Evidence has shown that the groups of children and young people who are most at risk of not being fully immunised are2:

• those who have missed previous vaccinations (as a result of parental choice or otherwise)
• looked after children
• those with physical or learning disabilities
• children of teenage or lone parents
• those not registered with a GP
• younger children from large families
• children who are hospitalised or have a chronic illness
• those from some minority ethnic groups
• those from non-English speaking families
• vulnerable children, such as those whose families are Gypsy Travellers, asylum seekers or are homeless.

National and local strategies

 


[1] Source: WHO, Health21 The health for all policy framework for the WHO European Region

[2] NICE. Reducing differences in the uptake of immunisations (including targeted vaccines) among children and young people aged under 19 years. London: National Institute for Health and Clinical Excellence; 2009