The DTaP/IPV/Hib/HepB vaccine protects against diphtheria, tetanus, pertussis, also known as whooping cough, polio, haemophilus influenzae type b, and hepatitis B. The number and percentage of general practices (GPs) in England with a vaccination rate of less than 90%, 90 to 93%, 94 to 95%, or more than 96% for diptheria, tetanus, and polio, for babies under eight months of age, is as follows:

• 1,830 GPs, or 29.2%, at less than 90%;
• 1,600 GPs, or 25.6%, at 90 to 93%;
• 1,102 GPs, or 17.6%, at 94 to 95%; and
• 1,727 GPs, or 27.6%, at 96% and above.

The above data is drawn from the latest published annual GP vaccine coverage data for April 2023 to March 2024 for the DTaP/IPV/Hib/HepB vaccine, measured at 12 months of age. GPs that submitted zero data for this indicator and GPs with fewer than five patients, whose data was suppressed to protect patient identifiable information, were excluded from the above response. Further information regarding the coverage data is available in the tables attached.

The UK Health Security Agency (UKHSA) publish quarterly and annual vaccine coverage data to track the performance of all national immunisation programmes including protection against tetanus, polio, diphtheria and meningococcal disease. Vaccine coverage data shows national as well as regional levels and is available at the following link:

https://www.gov.uk/government/collections/vaccine-uptake#cover-of-vaccination-evaluated-rapidly-programme

NHS England, the Department and UKHSA are committed to increase coverage across all immunisation programmes with efforts including national news coverage raising awareness of continued availability of routine immunisations, and the importance of taking up vaccination offers.

It is vitally important that everyone takes up the vaccinations to which they are entitled; for themselves, their families, and wider society. Anyone unsure about their eligibility or vaccination status should contact their general practitioner for advice.

The combined tetanus, diphtheria and polio vaccine coverage in year nine cohorts in 2020 to 2021 was 76.4%, compared to 57.6% in 2019 to 2020 and 87.6% in 2018 to 2019. In addition, updated data for the year 10 cohort in the 2020 to 2021 academic year estimated coverage at 80.3%. This is a 22.7 % increase for the same cohort when in year nine in 2019 to 2020. No specific assessment has been made of COVID-19 vaccine uptake as it is not solely delivered in a school-based setting.

To achieve high coverage, vaccinations programmes are co-ordinated nationally, using highly trained staff with improved access to vaccine information. A out-of-school offer is in place to enable eligible children and young people to receive their COVID-19 vaccination at the nearest available vaccination centre. All providers continue to work with NHS England and NHS Improvement, with clinical advice from the UK Health Security Agency, to deliver all missed school-aged vaccinations.  National Health Service school-aged immunisation providers are now resuming educational activities, such as school assemblies, to educate students of the benefits of routine NHS immunisation programmes.

COVID-19 lockdown measures have disrupted routine immunisation services in the poorest countries with the weakest health systems, reducing access to vaccines for vulnerable children. The World Health Organisation estimates that coverage of the third dose of diphtheria, tetanus, and pertussis may have declined by 25-50% in May 2020 in Gavi-supported countries as compared to baseline levels.

Routine immunisation is the strongest shield against outbreaks of vaccine preventable diseases. The UK is Gavi, the Vaccine Alliance's largest donor. Through UK support, Gavi, UNICEF and the World Health Organisation are working closely with countries to maintain and restore coverage levels, through catch up immunisation campaigns and strengthened routine immunisation programmes.

Through our support to Gavi and DFID’s bilateral health programmes, we are advocating for the importance of immunisation within countries’ COVID-19 primary health care recovery plans, with an unrelenting focus on equity at the sub-national level and reaching zero-dose children. The $8.8 billion raised by the UK at the Global Vaccine Summit on 4^th June, will enable Gavi to immunise 300 million more children and save up to 8 million lives.

We are able to provide the following information:

BCG and reinforcing dose of tetanus

Figures on the numbers of persons who received the BCG vaccination and the number of reinforcing doses of diphtheria, tetanus and polio (Td/IPV) given in the last five years (2007-08, 2008-09, 2009-10, 2010-11 and 2011-12) are collected through the KC50 return and shown in Table 1, as follows¹:¹ The Health and Social Care Information Centre (HSCIC) has been advised by Tower Hamlets Primary Care Trust that the figures they reported on the number of children aged one year and over who had received BCG vaccinations were over reported for 2008-09, 2009-10 and 2010-11. This has an impact on regional and national BCG vaccination figures for those years. In light of this, the HSCIC is undertaking a general review of BCG and Td/IPV figures from the KC50 data collection for 2008-09 to 2010-11. It is likely that revised figures will be published for BCG and it may also be necessary to publish revised figures for Td/IPV. While this work is in progress the HSCIC recommends that some caution should be exercised when using the Td/IPV figures and that the BCG figures are likely to be substantially over reported and should be used with extreme caution.

Tetanus (primary immunisation course)

Information on childhood vaccination coverage is collected through the UK COVER collection. Figures on the numbers of children who had completed a primary immunisation course against diphtheria, tetanus, pertussis, polio and Haemophilus influenza type b vaccine (DTaP/IPV/Hib) at 12 months are shown in Table 2 along with coverage (the number of persons immunised as a proportion of the eligible population). Table 2 also shows the number of children who had received the diphtheria, tetanus, pertussis and polio booster (DTaP/IPV) at five years of age.

The tetanus vaccine is not given on its own. Children should receive a primary course of three doses of diphtheria, tetanus, pertussis, polio and Haemophilus influenzae type b vaccine (DTaP/IPV/Hib 5 in 1) at two, three and four months and then a booster dose of DTaP/IPV vaccine three years after completion of the primary course. Coverage of the primary course of tetanus is measured at 12 months and coverage of the booster dose is measured at five years. A reinforcing dose of tetanus is given to school leavers as part of the Td/IPV vaccination.

The UK BCG immunisation programme aims to immunise those at increased risk of developing severe disease and/or of exposure to tuberculosis infection.

Most of the figures in Tables 1 and 2 are available from the HSCIC's annual publication, NHS Immunisation Statistics. These publications are available on the HSCIC website:

www.ic.nhs.uk/