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 (99.6%) of newborn babies had their hearing screening test in Hull during 2020/21.
• 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 90% to 95%. and are generally higher than England. However, despite being statistically significantly higher than England in many cases, the uptake rate in Hull generally fall short of the national target rate of 95%. The vaccines given to the younger ages tend to have higher uptake rates relative to those vaccines given at older ages. Uptake of the flu vaccine is also 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 2022 and is now at 87% in Hull which is slightly higher than England (85%).
• 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 during 2021/22 but are still considerably lower than England.
• The vaccination rate for Meningococcal ACWY conjugate among 14-15 year olds is considerably lower in Hull compared to England (64% versus 80% for 2021/22).
• 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 2021/22, almost all of newborn babies in Hull had their hearing screening test, which is among the highest percentage across the region and higher than England.

Between 2013/14 and 2021/22, the percentage uptake in Hull has been consistently higher than England and the region. The lowest rate in Hull at 99.4% is higher than the highest rate across England and the region (both at 99.2% for 2018/19).

The rate across England and the region fell in 2019/20 and 2020/21 but increased in 2021/22, but the rate in Hull has remained consistently high over this three year period.

Vaccinations Among Looked After Children

Fingertips also presents the percentage of children in care who have received their vaccinations. Just under nine in ten looked after children had their immunisations in 2022 which was slightly higher than England.

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 only decreased slightly in 2021.

The percentage in Hull increased in 2022 and is now slightly higher than England with a total of 576 children in care receiving their immunisations, although this does mean that 86 children in care in Hull did not receive their immunisations in 2022.

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 with uptake rates of 92.6% in 2018/19. The rates increased to 94.0% for 2019/20, but then decreased slightly to 93.6% for 2020/21 and further falling to 91.1% in 2021/22. Since the high of 96.9% in 2014/15, the rates have been falling and the trajectory for 2021/22 is similar to the continuing fall in uptake rates since then. However, it is also possible that the recent fall could be associated with the COVID-19 pandemic, access into primary care and/or the cost of living crisis.

The latest uptake rate in 2021/22 is the lowest it has been since 2020/11.

However, the uptake rates in Hull between 2010/11 and 2021/22 have been consistently better or similar to England.

The uptake rates for the meningococcal group B vaccine has also decreased in the last two years and is the lowest it has been at 92.9% since 2017/18. The uptake rates in Hull have been consistently significantly higher than England.

The uptakes rates have been relatively consistent in Hull at around 90% for rotavirus between 2016/17 and 2021/22. The uptake rates in Hull have also been comparable to England for these six years. Nevertheless, the uptake rate in 2021/22 is the lowest it has been at 89.2% since 2016/17.

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 the rate increased for the latest year 2019/20 to 94.2%. The latest rate in Hull is statistically significantly higher than England.

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). The rate in Hull has been 100% for two of the last three years.

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 2021/22 in Hull was higher than 90% and statistically significantly higher than England, but lower than the target of 95% (with the exception of diptheria, tetanus, and pertussis, inactivated polio vaccine and Haemophilus influenzae type B).

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. Uptake rates have increased since then, and the latest rates for 2021/22 in Hull are statistically significantly higher than England and above the 95% target.

Vaccination uptake rates for the pneumococcal vaccine booster were around 94% between 2012/13 and 2016/17, but have decreased to around 91% for the latest year 2021/22. Despite the recent decreases in Hull, the uptake rate in Hull is statistically significantly higher than England.

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 90.6% in 2021/22. The rate in Hull is statistically significantly higher than the rate in England for 2021/22.

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 2021/22 in Hull is below the 95% target at 91.0% but the rate is statistically significantly higher than England.

There are fewer years of data relating to the uptake of the meningococcal group B vaccine among two year olds, and the rate has ranged increased from 91.3% in 2018/19 to 92.6% in 2020/21, before decreasing back to 91.3% for 2021/22. Despite the decrease in the last year, the rate in Hull is statistically significantly higher than England.

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

Vaccinations At Age 5

Children aged five years are 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).

Hull’s vaccination uptake rates in 2021/22 were better than England for the diptheria, tetanus, and pertussis and inactivated polio vaccine booster, and the second dose of the measles, mumps and rubella vaccinations, and comparable to England 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 88.0% in 2021/22. Despite the decreases in Hull, the uptake rate in Hull is statistically significantly higher than England.

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. Thus the rate is now only comparable to England. The rate also also fallen for the last two years, and with the exception of 2017/18 and 2018/19, the rate in Hull is among the lowest it has been.

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 two years have been of a smaller magnitude. The uptake rates in Hull are lower than the target of 95%, but are statistically significantly 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.

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 2021/22 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 is available for these children so they will have been vaccinated during the 2020/21 school year. However, this has meant that those children (who were aged 13-14 years) were not able to have their second dose during 2020/21 so the uptake rate among 13-14 year olds in 2020/21 is zero.

Uptake rates for HPV among females have improved for 2021/22 although 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.