Protecting the population of Scotland from vaccine preventable diseases: Vaccination and Immunisation Report
Annual report in 2025

About this release

This release by Public Health Scotland (PHS) is the third 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 2025.

Main points

Scotland has a very successful vaccination and immunisation programme. However, as seen in other nations, there have been declines in uptake over time, and gaps in uptake due to inequalities. Ongoing efforts to improve uptake, reduce inequalities, and reduce disease burden remain the priority, as outlined in Scotland's 5-year Vaccination and Immunisation Framework and Delivery Plan.

Childhood immunisation

• While Scotland maintains high uptake across childhood immunisations, there have been long-term declines, with concerning trends in the period immediately following the COVID-19 pandemic. These declining trends were seen across the four UK nations. More recently, annual childhood immunisation uptake by 12 months of age was stable between 2024 and 2025. In contrast, decreases were observed for all vaccines by 24 months, while uptake increased for all vaccines by five years of age between 2024 and 2025 (Figure 1).
• Notably, when comparing annual uptake between 2024 and 2025, uptake of the second dose of measles, mumps and rubella (MMR2) by 5 years improved by 1.0 percentage point. In 2025, the gap in MMR2 uptake by 5 years between those living in the most and least deprived areas decreased to 8.9 percentage points compared with a gap of 10.3 percentage points in 2024.
• There continues to be inequalities in uptake by urban-rurality, ethnicity, and deprivation. Children living in the most deprived areas have lower overall uptake, tend to receive their immunisations later / take up offers later, and are less likely to complete courses (receive all doses). National-level figures can mask local variation.

Line graph showing vaccination uptake percentages from March 2016 to December 2025 for four vaccines: Four-in-one, Hib/MenC, MMR1, and MMR2, with a marked milestone at the first COVID-19 lockdown in March 2020. The graph highlights a general decline in uptake for all vaccines after the lockdown, with MMR1 consistently having the highest uptake around 96-98% and Four-in-one showing the lowest uptake, dropping below 92% by 2025. Uptake increased for all vaccines by five years of age between 2024 and 2025

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Figure 1: Quarterly trends in childhood immunisation uptake (%) by 5 years in Scotland, March 2016 to December 2025

Teenage immunisation

• Human papillomavirus (HPV) vaccine coverage has declined over the past 10 years with lower rates following the COVID-19 pandemic. In 2024/25, there were increases in HPV coverage for S1 pupils overall (72.6% compared with 71.5% in 2023/24); for S3 pupils 3-in-1 teenage booster (Td/IPV) vaccine was 70.1% (68.9% in 2023/24), and MenACWY was 70.2% (68.9% in 2023/24).
• Coverage is lower in males than in females, with a 6.0 percentage point difference for HPV in S1, and a 3.3 percentage point difference for MenACWY in S4.
• For S1 pupils living in the most and least deprived quintiles, HPV coverage was 62.0% and 83.4%, respectively (21.4 percentage points difference). The deprivation gap in S3 coverage was 25.9 and 26.1 percentage points for Td/IPV and MenACWY, respectively.
• Teenage immunisation coverage varied by urban rural category. For HPV in S1, coverage was highest in accessible rural areas (75.9%) and lowest in remote small towns (59.5%), a difference of 16.4 percentage points. Please note, these data are not adjusted for other factors such as deprivation and ethnicity which vary across rural and urban areas.

Adult immunisation

• Scotland's respiratory syncytial virus (RSV) immunisation programme was launched in August 2024. For those turning 75 years between 01 August 2025 and 31 July 2026, 36,043 doses of RSV vaccine were administered with uptake of 68.8%. This is a slight decrease of 1.2 percentage points compared to the previous year where uptake was 70.0%.
• Over 1.8 million doses of influenza vaccine were administered in Scotland during winter 2025/26. Uptake was highest among older care home residents (82.6%), and among adults aged 75 years and older (81.0%).
• As of 31 August 2025, shingles vaccine coverage among the eligible population was 69.4%.
• As of 31 March 2026, coverage of the pneumococcal vaccine among the eligible adult and at-risk population was 73.1%. This increased compared to last year for both those aged 65 years and older (77.4% to 79.5%) and among those aged 2 to 64 years at-risk (55.5% to 56.8%).

Selective and non-routine immunisation

• For those aged 2 to 64 years and at higher risk of developing complications from pneumococcal infection, coverage of the pneumococcal vaccine was 56.8%.
• For those with a severely weakened immune system, shingles vaccine coverage was 60.1%.
• Influenza vaccine uptake in the 6 months to 2 years at-risk cohort was 40.1% in winter 2025/26. Although the uptake figures are low, notable increases in influenza uptake during winter 2025/26 were achieved in the 18-64 at-risk group (34.6% to 38.9%), those with a weakened immune system (61.0% to 64.5%), and in healthcare workers (35.9% to 42.0%).
• Uptake of influenza vaccine among adults under prison care in winter 2025/26 was low with 17.5% vaccinated by early January 2026.
• From 1 August 2025, 4CMenB (Bexsero®) vaccine has been offered to those at greatest risk of gonorrhoea. Coverage of first dose of MenB up to 30 April 2026 was 46.4%, coverage of both doses was 26.2%. From 1 August 2025 to 30 April 2026, 5,589 first doses and 3,093 second doses of the 4CMenB vaccine were administered.

Vaccines in pregnancy

• In 2025, 24,848 doses of RSV vaccine were administered in pregnancy, with an uptake of 56.3%. The highest monthly uptake of 63.9% was in December 2025.
• During winter 2025/26, influenza vaccine uptake in pregnancy was 37.9% in November 2025, 49.5% in December 2025, 57.6% in January 2026, and 62.0% in February 2026.
• From 1 April 2021 to 28 February 2026, monthly uptake of pertussis vaccine in pregnancy ranged from 77.4% in November 2024 to 87.6% in January 2025.

Vaccine Preventable Diseases

• Following a resurgence of measles globally since 2023, with recent large outbreaks occurring in England, 28 laboratory-confirmed measles cases were reported in Scotland in 2025.
• Scotland experienced an earlier influenza season in winter 2025/26, driven by influenza A. The season peaked in early December with relative increase in hospital admissions, but overall impact was lower than the previous season.
• There was an increase in laboratory-confirmed rotavirus cases from March 2025, which rapidly peaked and then followed a downward trend, returning to typical seasonal post-pandemic levels later in the year.
• Following a large increase in laboratory-confirmed pertussis cases in 2024, incidence of pertussis returned to low levels in 2025.

Other activities

• The inaugural Scottish Vaccination and Immunisation Programme (SVIP) National Conference was held in Edinburgh in June 2025, bringing together delegates from all 14 NHS Boards to share progress, strengthen collaboration and discuss current challenges. The next conference is scheduled for 11 June 2026.
• In 2025, there were several changes to immunisation programmes. These included:
  • A two-stage rollout of changes to the childhood immunisation schedule.
  • The introduction of 4‑component meningococcal B vaccine (4CMenB) for gonorrhoea prevention.
  • A change of vaccine in the adult and at-risk pneumococcal programme.
  • An extension of RSV immunisation was agreed with rollout in 2026.
  • Changes to COVID-19 immunisation eligibility.

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.

Scotland delivers a comprehensive immunisation programme, with routine vaccines offered across all life stages and provided free of charge by the NHS. Details of the vaccines offered are accessible via NHS Inform and the Public Health Scotland (PHS) website.

Further information

The next release of this publication will be June 2027.