Protecting the population of Scotland from vaccine preventable diseases: Vaccination and Immunisation Report
Annual report

About this release

This release by Public Health Scotland (PHS) is the first Annual Vaccination and Immunisation Report. This report provides an overview of vaccine preventable disease (VPD) surveillance and health protection activities, uptake/coverage statistics of vaccines offered across the life course, and key achievements and challenges in delivering the vaccination and immunisation programme in Scotland in 2023.

Main points

Scotland has a very successful vaccination and immunisation programme with high uptake / coverage rates. However, action is required across several areas and below is a summary list of the key points.

• There is a pressing need to halt the current declines in childhood immunisation uptake rates across Scotland and demonstrable improvements are achieved (Figure 1).
• Uptake of teenage immunisations has recovered following the COVID-19 pandemic, but not yet to pre-pandemic rates. This must be monitored closely.
• In addition to slower uptake (around 10% difference between the most and least deprived areas regarding the timeliness of 6-in-1 vaccine at 6 months of age), there is also significant variation between the most and least deprived areas, with lower overall uptake in areas of higher deprivation. For example, in 2023, there was more than 9 percentage points difference for the 2nd dose of MMR by 5 years between the most and least deprived areas.
• Improvements in uptake in the at-risk groups, particularly for seasonal flu, pneumococcal and hepatitis B vaccinations is needed.
• Seasonal flu and COVID-19 immunisation uptake of front-line health and social care workers was low.
• The surveillance of vaccine preventable disease is a core function of PHS, and intelligence underpins public health action. Following COVID-19 restrictions, vaccine preventable disease reduced considerably from 2020 (Quarter 2), and incidence and prevalence in general remained low in 2023.
• In 2023, key incidents requiring health protection response included:
  1. Ongoing toxigenic diphtheria outbreak in asylum seekers.
  2. Identification of 'circulating' vaccine derived polio virus type 2 in London wastewater.
  3. Resurgence of measles in Europe.
• The trend across Scottish childhood immunisations is one of long-term modest declines. During the initial phases of Vaccine Transformation Programme (VTP), where the model of immunisation delivery changed from GPs to NHS Boards, national declines slowed, stabilised and reversed. By the first COVID-19 lockdown in March 2020, national uptake was increasing and continued to increase, before the more recent declines from mid-2022 (Figure 1).

A graph of quarterly trends in childhood immunisation uptake by 12 months in Scotland, March 2015 to December 2023. National trends show long term declines in uptake followed by a period of increasing uptake from the beginning of the vaccine transformation programme and through the first COVID-19 lockdown, before declining again from 2022.

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Figure 1: Quarterly trends in childhood immunisation uptake by 12 months in Scotland, March 2015 to December 2023

Background

The Scottish Vaccination and Immunisation Programme (SVIP) has responsibility for all delivery aspects of vaccinations and immunisations in Scotland. There is an emphasis on partnership working between PHS, national and territorial NHS Boards, the Scottish Government, Health and Social Care partnerships (HSCP), and third sector organisations. PHS is the lead organisation in SVIP with activities coordinated through the Vaccination and Immunisation Division (VAID) within the Clinical and Protecting Health (CPH) directorate. SVIP is currently finalising Scotland's 5-year Vaccination and Immunisation Framework and Delivery Plan which will set out the plan of action for achieving clear goals and aspirations for Scotland.

See the Annual Report reference list for links to other detailed publications, the key points from which have been summarised in this report.

Further information

The next release of this publication will be July 2025.