Screening and Vaccinations Among Children and Young People

This topic area covers statistics and information relating to screening and vaccinations among children and young people in Hull including local strategic need and service provision. Further information relating to screening and vaccinations among adults is given under Prevention within Adults. Further information relating to the uptake rate of the COVID-19 vaccination can be found within Coronavirus (COVID-19) in Health Factors under Adults.

This page contains information from the Office for Health Improvement & Disparities’ Fingertips. Information is taken ‘live’ from the site so uses the latest available data from Fingertips and displays it on this page. As a result, some comments on this page may relate to an earlier period of time until this page is next updated (see review dates at the end of this page).

Headlines

• Almost all (99.1%) of newborn babies had their hearing screening test in Hull during 2022/23.
• It is estimated that vaccines prevent up to three million deaths worldwide every year. Since vaccines were introduced to the UK, diseases like smallpox, polio and tetanus that used to kill or disable millions of people are either gone or seen very rarely.
• The vaccine uptake rate for a number of routine vaccinations given to children at ages one, two and five vary in Hull from around 85% to 94%. and are generally higher than England. However, despite being higher than England in many cases, the uptake rate in Hull generally fall short of the national target rate of 95% and have decreased at a steady trend in the last decade. The vaccines given to the younger ages tend to have higher uptake rates relative to those vaccines given at older ages, although uptake of the flu vaccine among 2-3 year olds and primary school age children are both lower in Hull compared to England.
• Vaccination rates were higher around 2016/17 and have generally fallen since then. For many of the pre-school vaccinations, the rates have fallen in the last couple of years, and whilst this could be attributed to the COVID-19 pandemic, this might not necessarily be the case as the rates were generally falling anyway prior to this.
• Among looked after children, the rate of uptake of vaccinations was lower than England between 2018 and 2021 particularly so for 2021 when around half of looked after children had the vaccinations compared to 86% for England. However, the percentage has increased in 2023 to 80% although the rate is slightly below that for England (82%).
• Whilst rates have been consistently lower for the human papillomavirus (HPV) vaccine in Hull compared to England, very few had their vaccination during 2019/20 and 2020/21 due to the COVID-19 pandemic and lack of access into the schools from March 2020. This was further complicated as those who had not had a first dose could not have a second dose the subsequent year. A catch-up programme was set up to vaccinate the missed children, and rates have increased more recently but are still considerably lower than England, and the uptake rates are considerably lower than the rates prior to the pandemic.
• The vaccination rate for Meningococcal ACWY conjugate among 14-15 year olds is considerably lower in Hull compared to England (53% versus 63% for 2021/22), although uptake rates in Hull had been comparable to England in 2020/21 at just under 80%.
• Over one-third of 2-3 year olds (37.2%) and half of 4-11 year olds (50.0%) had their flu vaccination in Hull for 2023/24 and 2023 respectively. Compared to England, uptake rates were significantly lower in Hull among both 2-3 year olds (44.4% for England) and 4-11 year olds (55.1% for England). Overall, 4,180 2-3 year olds and 11,851 primary school age children did not have their flu vaccination in the most recent year.
• Previous analyses of uptake rates using local data revealed substantial differences across Hull.

The Population Affected – Why Is It Important?

There are a number of screening programmes in place in the UK relating to antenatal and newborn. Tests in pregnancy and in the newborn after birth are designed to help make the pregnancy safer, check and assess the development and wellbeing of the woman and her baby, and screen for particular conditions. However, data relating to uptake rates for screening of pregnant women are only available for England and for each region and not available at local authority level. Uptake rates are also not available at local authority level for the physical examination of infants after birth or the infant ‘blood spot’ screening, although information is available for the infant hearing test.

Specific vaccines are offered to children, young people, pregnant women, older people and other adults with specific long-term health conditions.  All children are offered vaccines against key diseases to prevent them getting serious diseases that can kill or cause long-term health consequences. A small number of vaccines are just offered to a selected group of children and adults who are at risk owing to their personal circumstances.

For certain vaccinations, generally only one dose or a small number of doses are required and for others the vaccination is required every year (such as for influenza). The majority of the vaccinations given in childhood require one or a small number of doses over time and last a long time or a lifetime, although boosters are sometimes given such as a tetanus vaccination following an injury which could result in an infection.

Where sufficient numbers of people have the vaccine, it can also prevent the disease spreading in the community, and sometimes even gets rid of diseases in the community entirely. This is important for the small number of people who cannot have a vaccine for other health reasons.

It is estimated that vaccines prevent up to three million deaths worldwide every year. Since vaccines were introduced to the UK, diseases like smallpox, polio and tetanus that used to kill or disable millions of people are either gone or seen very rarely. Other diseases like measles and diphtheria have been reduced by up to 99.9% since their vaccines were introduced.

Vaccination and immunisation are often used interchangeable, but are different. Vaccination is the process of introducing the vaccination and immunisation is what is achieved.

The Hull Picture

Screening

The Office for Health Improvement & Disparities’ Fingertips presents data on the percentage uptake of the infant hearing screening test. In 2022/23, almost all of newborn babies in Hull had their hearing screening test within 4-5 weeks, and the percentage is higher than England and the region.

Between 2013/14 and 2022/23, the percentage uptake in Hull has been consistently higher than England and the region. The latest uptake rate is the lowest it has been but it is still higher or the same as the highest rate for England and the region over the entire period.

Around 27 babies did not have their newborn hearing screening undertaken for 2022/23.

Vaccinations Among Looked After Children

Fingertips also presents the percentage of children in care who have received their vaccinations. Eight in ten looked after children had their immunisations in 2023 which was lower than England, and among the lowest in the region.

Between 2014 and 2017, the percentage uptake of vaccinations among children in care in Hull was comparable to England, but has since fallen substantially in Hull between 2017 and 2021 reaching a low of 51% for 2021. A decrease in 2020 and 2021 might have been expected due to the COVID-19 pandemic, but the percentages for England and the region were not affected.

The percentage in Hull increased in 2022 to a level comparable to England and the region, but the uptake decreased slightly in Hull in 2023.

A total of 474 children in care receiving their immunisations, although this does mean that around 118 children in care in Hull did not receive their immunisations in 2023.

Vaccinations At Age 1

Children aged one year are should be vaccinated for diptheria, tetanus, and pertussis (DTaP), inactivated polio vaccine (IPV) and Haemophilus influenzae type B (Hib), meningococcal group B vaccine (MenB), rotavirus, and pneumococcal vaccine (PCV). Babies should also receive the vaccination for hepatitis B (HepB) if their mothers have hepatitis B. This applies to a small number of babies so the information is not presented for all local authorities due to small numbers.

Hull’s vaccination uptake rates are generally comparable or better than the national average, although are below the national target of 95%.

In general, the uptake rates remained relatively high – above 95% – between 2010/11 to 2016/17 for diptheria, tetanus, and pertussis, inactivated polio vaccine and Haemophilus influenzae type B. However, since then the rates have fallen below the 95% threshold.

There was a relatively sharp decreased between 2020/21 and 2021/22 from 93.6% to 91.1% possibly associated with the COVID-19 pandemic, access into primary care and/or the cost of living crisis with people finding it more difficult to travel or take time off work.

The rate increased between 2021/22 and 2022/23, but is still relatively low and below the 95% target, although marginally higher than England.

Around 265 infants in Hull did not have their diptheria, tetanus, and pertussis, inactivated polio vaccine and Haemophilus influenzae type B vaccination during 2022/23.

The uptake rates for the meningococcal group B vaccine has also decreased between 2017/18 and 2022/23 although the rate did increase marginally to 93.3% for 2022/23. The uptake rates in Hull have been consistently higher than England and statistically significantly higher than England.

Around 225 infants did not have their meningococcal group B vaccine in Hull for 2022/23.

The uptakes rates have been relatively consistent in Hull at around 90% for rotavirus between 2016/17 and 2022/23. The uptake rates in Hull have also been comparable to England for these seven years, and in most cases slightly above rate for England. For three of the last seven years, the uptake rate has fallen below 90% and two of those occasions were in the last two years falling to a new low of 89.2% for 2021/22 and remaining unchanged for 2022/23.

Around 362 infants in Hull did not have their vaccination for rotavirus in 2022/23.

The uptake rates for pneumococcal vaccine in Hull were relatively consistent just over 95% between 2010/11 and 2016/17 and statistically significantly higher than England. However, since 2016/17 the uptake rates in Hull have fallen to a low of 92.6% in 2018/19, although increased the following year in 2019/20. There was no data for 2020/21, and the rate decreased in 2021/22 although was above the low rate in 2018/19. The rate increased in the last year for 2022/23 to 94.1%. So the uptake rate in Hull has been more variable in the last 4-5 years. However, the rate for 2022/23 is the highest it has been since 2016/17 when it was consistently above 95%. Even with the recent variability in Hull, the rate in Hull between 2017/18 and 2022/23 has been comparable to or higher than the rate for England.

Around 198 infants in Hull did not have their pneumococcal vaccine in 2022/23.

The numbers of babies eligible for the hepatitis B vaccine in Hull is low and there is considerable year-on-year variability associated with the uptake rate (see Small Numbers). However, in general over the last six years, seven in ten infants have had their vaccination.

For 2022/23, five infants in Hull who were eligible for a hepatitis B vaccine did not receive it.

Vaccinations At Age 2

Children aged two years are should be vaccinated for diptheria, tetanus, and pertussis (DTaP), inactivated polio vaccine (IPV) and Haemophilus influenzae type B (Hib), pneumococcal vaccine (PCV), measles, mumps and rubella (MMR), and have boosters for Haemophilus influenzae type B (Hib) and Meningococcal C (MenC), and for meningococcal group B vaccine (MenB). Children aged two years should also receive the vaccination for hepatitis B (HepB) if their mothers have hepatitis B. This applies to a small number of children so the information is not presented for all local authorities due to small numbers.

Uptake of all these universal vaccinations among two year olds in 2022/23 in Hull was around 90% or just under, but higher than England except for diptheria, tetanus, and pertussis and for hepatitis B. Rates in Hull are therefore below the national target of 95%.

For diptheria, tetanus, and pertussis, inactivated polio vaccine and Haemophilus influenzae type B uptake rates were relatively high around 97-98% between 2010/11 and 2016/17, but decreased sharply between 2016/17 and 2017/18 to a low of 93.0% in 2018/19. Whilst uptake rates increased between 2018/19 and 2021/22, they fell sharply between 2021/22 and 2022/23 to achieve a new low in Hull of 91.8%.

For most years, the uptake rate in Hull has been statistically significantly higher than England, although that is not the case for the most recent year 2022/23. Since 2010/11, there has been one previous occasion where the rate in Hull was lower than England but this was for three years (2017/18 to 2019/20 and the first two years the rate was statistically significantly lower than England).

There were around 266 two year olds in Hull who did not have their diptheria, tetanus, and pertussis, inactivated polio vaccine and Haemophilus influenzae type B vaccine in 2022/23.

Vaccination uptake rates for the pneumococcal vaccine booster were around 94% between 2012/13 and 2016/17. Since the high of 94.8% in 2013/14, the uptake rate has steadily fallen in Hull as it has across the country. For the first time since 2010/11, the uptake rate in Hull fell below 90% to reach a new low of 89.3% for the latest year 2022/23. Despite this, the rate in Hull is marginally higher than England.

For 2022/23, there were approximately 348 two year olds who did not have their pneumococcal vaccine booster in Hull.

The uptake rates for the first dose of the measles, mumps and rubella vaccine in Hull has decreased gradually from around 95% between 2013/14 and 2015/16 to 89.7% in 2022/23. This is the first time since 2010/11 that the rate in Hull is lower than 90%, although the uptake rate in Hull is marginally higher than England.

Around 335 two year olds in Hull did not have their first dose of the measles, mumps and rubella vaccine in 2022/23.

The uptake rates for the boosters for Haemophilus influenzae type B and Meningococcal C show a similar pattern to the pneumococcal vaccine booster and the measles, mumps and rubella vaccine with a relatively high rate period to 2016/17 with a recent gradually decrease since then. The latest rate for 2022/23 in Hull is the lowest it has been at 89.4% and the first time below 90%, although again marginally higher than England.

For 2022/23, around 345 two year olds in Hull did not have their Haemophilus influenzae type B and Meningococcal C booster vaccinations.

There are fewer years of data relating to the uptake of the meningococcal group B vaccine among two year olds. For the first year in 2018/19 the rate was 91.3% although it increased for 2019/20 and 2020/21 to over 92%, the rate decreased back to 91.3% in 2021/22. The rate has further fallen in 2022/23 to reach a new low, and is currently below the 90% for the first time, although the uptake rate in Hull is statistically significantly higher than England.

Around 328 two year olds in Hull did not have their meningococcal group B vaccine booster for 2022/23.

There are relatively few two year olds in Hull who are eligible for the hepatitis B vaccination. The uptake rate in the last three years has been around 60%.

Two of the two year olds eligible for the hepatitis B vaccination did not have their vaccination for 2022/23.

Vaccinations At Age 5

Children aged five years should have a booster vaccination for diptheria, tetanus, and pertussis (DTaP) and inactivated polio vaccine (IPV), and two doses of vaccine for measles, mumps and rubella (MMR).

Compared to England, Hull’s vaccination uptake rates in 2022/23 for five year olds were better than England for the diptheria, tetanus, and pertussis and inactivated polio vaccine booster, and for the second dose of the measles, mumps and rubella vaccinations, but lower for the first dose of the measles, mumps and rubella vaccination.

The uptake rates were lower than the target uptake rate of 95%.

Vaccination uptake rates for diptheria, tetanus, and pertussis and inactivated polio vaccine in Hull among five year olds has steadily decreased from a high of 91.2% in 2015/16 to low of 85.3% in 2022/23. The decrease in the last year was 2.7 percentage points which was relatively high. Despite the decreases in Hull, the uptake rate in Hull is statistically significantly higher than England.

During 2022/23, 528 five year olds did not have their diptheria, tetanus, and pertussis and inactivated polio vaccine in Hull.

The uptake rate for the first dose for the measles, mumps and rubella vaccination gradually increased in Hull from 94.4% in 2010/11 to a high of 97.1% in 2015/16. However, the rate fell sharply by five percentage points between 2016/17 to 2017/18, and whilst the rate increased between 2018/19 and 2019/20, the rate did not recover to the same statistically significantly rate above England.

However, since 2020/21, there has been a relatively sharp decline in the percentage uptake in Hull. The uptake rate is now statistically significantly lower than England reaching a new low of 90.6% for Hull.

Around 517 five year olds in Hull did not have their second dose of the measles, mumps and rubella vaccine in 2022/23.

The percentage of five year olds having two doses of the measles, mumps and rubella vaccination followed a similar pattern to uptake rates for the first dose, but the fall between 2016/17 and 2017/18 was not as dramatic, and the recent falls in the last three years have been of a smaller magnitude. Furthermore, the uptake rate for the second dose has generally been significantly higher in Hull compared to England, and is only comparable to England for the latest year 2022/23. The uptake rate in 2022/23 is 85.6%, which is the lowest it has been in Hull since 2010/11, although it is marginally higher than England.

Vaccinations At Ages 12-15

Young people aged 12-13 years (Year 8 in school) and aged 13-14 years should be vaccinated for human papillomavirus (HPV) in two doses. The vaccination programme has recently been extended from females to both females and males. This extension commenced September 2019.

Young people aged 14-15 years are also offered the Meningococcal ACWY conjugate vaccine (for groups A, C, W and Y).

In contrast to vaccinations undertaken among the under fives, vaccination uptake rates among teenagers are generally lower in Hull compared to England.

The uptake of HPV and the Meningococcal ACWY conjugate vaccine are all statistically significantly lower in Hull for 2022/23 compared to England, and among the lowest across the region.

No young person aged 12-13 years and relatively few aged 13-14 year received their HPV vaccine during 2019/20. IntraHealth who were commissioned to undertake the vaccinations were also commissioned to undertake the flu vaccinations among all primary school children in Hull. They completed this over winter 2019/20, and the intention was then for them undertake the HPV vaccination programme in schools. However, with the first lockdown for COVID-19 at the end of March 2020 and schools being closed to most pupils until September 2020, they could not start this programme. A catch-up programme was put in place for these children.

The 2019/20 school year was the first year, males were supposed to be vaccinated against HPV, and rates have been just over 50% in the three years since 2019/20. Among girls, the programme had been in place for a number of years prior to COVID-19 pandemic with between 79% and 92% vaccinated each year between 2013/14 and 2018/19. However, following the pandemic, the uptake rate has been considerably lower among girls although the rate has increased from 63.3% in 2020/21 to 66.0% for 2022/23. There is some way to go before the uptake rates in Hull go back to their pre-COVID levels, and for the uptake rates for HPV among males to improve. Furthermore, in the couple of years the rates have only improved marginally in Hull.

For virtually the entire period (from 2019/20 for boys and from 2013/14 for girls), the uptake rate for the first dose of the HPV vaccination has been statistically significantly lower than England.

For 2022/23, around 813 boys and around 544 girls aged 12-13 years did not have their first dose of their HPV vaccine.

As none of the young people aged 12-13 years had the first dose of their HPV vaccination during the 2019/20 school year, it was not possible for any of them to have their second dose during 2020/21 when they were aged 13-14 years so the uptake rates are zero for 2020/21.

The pattern of uptake rates for the second dose are similar to those for the first dose, and are also dependent on the young people having their first dose.

Uptake rates for the second dose are around 10 percentage points lower than for the first dose.

For 2022/23, around 975 boys and around 754 girls aged 13-14 years did not have their second dose.

The uptake rate for the Meningococcal ACWY conjugate vaccine (for groups A, C, W and Y) has been statistically significantly lower in Hull than England between 2016/17 and 2019/20. However, the rate increased between 2019/20 and 2020/21 and the rate in Hull was comparable to rate in England for 2020/21. However, the rate fell sharply in 2021/22 to reach a new low of 63.7% for Hull, and is again statistically significantly lower than England.

For 2022/23, around 1,167 young people aged 14-15 years did not have their Meningococcal ACWY conjugate vaccine (for groups A, C, W and Y).

Flu Vaccinations Among Children

Fingertips also presents the uptake for the flu vaccination for 2-3 year olds and all primary school children aged 4-11 years. There are also broader programmes in place for influenza (flu) vaccinations which include pregnant women and all children, adults aged from 6 months to 65 years who have underlying medical conditions, and all adults aged 65+ years although there have been slight changes to the age groups and medical conditions following the COVID-19 pandemic. Further information is available within Vaccinations in Prevention under Adults.

Whilst it has been shown above that Hull performs reasonably well in comparison to England on childhood vaccinations, this is generally not the case for the flu vaccinations with lower rates among Hull children.

Vaccination uptake for the flu among children in Hull is lower than England among 2-3 year olds for 2023/24 (37.2% versus 44.4%) and among all primary school age children for 2023 (50.0% versus 55.1%).

The uptake rate in Hull has consistently been lower than England, although in the case of 2-3 year olds the uptake rate increased significantly in Hull between 2019/20 and 2020/21 to over half of children receiving their flu vaccination in 2020/21 due to the increased emphasis on vaccination due to the COVID-19 pandemic. However, there has been a relatively sharp decline from the high of 53.8% in 2020/21 to 37.2% for 2023/24. Despite this recently decline, the rate in Hull is currently higher than pre-pandemic levels which were around 35%.

For 2023/24, around 4,180 children aged 2-3 years did not have their flu vaccination.

In contrast, the vaccination uptake among all primary school aged children fell from a high of 59.9% for 2019 to a low of 49.4% in 2020 which represents a substantial decrease of more than 10 percentage points over the two year period. The rate has improved for 2022 reaching a rate of 56.6% but subsequently fell to 50.0% for the latest year 2023.

Around 11,851 primary school aged children did not have their flu vaccination during 2023/24.

Strategic Need and Service Provision

It is important that there are high uptake rates of screening in antenatal care and among newborns to enable babies to develop healthily and that newborns can received appropriate healthcare and treatment for any problems that are found. Generally, the later health problems are detected, the worse the prognosis so that it is important that any problems are detected as early as possible.

It is necessary to have a relatively high uptake rate for vaccinations to ensure that the highest proportion of the population are immunised. This is particularly the case for contagious diseases that are easily passed from one person to another, particularly for children who socialise much more closely and are more likely to pass the disease to another child, parent or grandparent. Where sufficient numbers of people have the vaccine, it can also prevent the disease spreading in the community, and sometimes even gets rid of diseases in the community entirely. This is important for the small number of people who cannot have a vaccine for other health reasons.

Those who work with parents of children such as health visitors, Doulas, midwifery, staff at Children’s Centres and other staff who have contact with and support families should work together to ensure they promote and increase uptake of routine vaccinations within their day-to-day and routine contacts with families and parents.

Whilst vaccination rates have historical been relatively high for children in Hull, they have fallen recently although rates have improved slightly in the last year. There are also relatively large variations in uptake rates within primary care practices, perhaps associated with the characteristics of the patients within those practices. It may be useful to work with practices with relatively low uptake rates to improve their rates, and undertake some local work to improve the uptake rates.

Due to lockdown with COVID-19, it is likely that more children have not had their scheduled vaccinations, and this needs to be addressed by checking records and chasing up parents of children who have not had their vaccinations. This is particularly the case for young people aged 12-13 years who were eligible for their first HPV vaccinati0n during 2019/20, and second HPV vaccination during 2020/21. However, there is a catch-up programme in place for these young people who missed their HPV vaccination.

Resources

NHS. NHS vaccinations and when to have them. https://www.nhs.uk/conditions/vaccinations/nhs-vaccinations-and-when-to-have-them/

Office for Health Improvement & Disparities’ Fingertips: https://fingertips.phe.org.uk/

NHS Digital. Childhood Vaccination Coverage Statistics – England – 2022-23. https://www.gov.uk/government/statistics/childhood-vaccination-coverage-statistics-england-2022-23

Updates

This page was last updated / checked on 7 October 2024.

This page is due to be updated / checked in February 2025.