Vaccine Uptake in Children in Wales October to December 2009 COVER 93: Wales March 2010

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1 Vaccine Uptake in Children in Wales October to December 2009 COVER 93: Wales March 2010 Key points Uptake of the 5 in 1 vaccine, MenC and pneumococcal conjugate vaccines (PCV) at one year of age all exceed the 95% uptake target this quarter. Eleven LA areas exceeded the target of 95% for all routine immunisations by one year of age. Uptake of the first dose of MMR in two year old children increased to 93.1% this quarter, ranging by LHB from 90.7% to 95.0%. One LA area (Carmarthenshire) exceeded the 95% target. Uptake of the second MMR dose by five years of age increased again this quarter to 86.4% ranging by LHB from 80.1% to 91.4% Uptake of pre-school 4 in 1 booster in five year old children increased this quarter to 89.9%, ranging by LHB from 86.5% to 95.7% Uptake of one dose of Human Papilloma Virus (HPV) vaccine in girls in the School Year 8 is 80.8 % These results are for children living in Wales in February 2010 and reaching their first, second, fifth, 15 th and 16 th birthdays during the quarter 01/10/2009 to 31/12/2009. Uptake of the HPV vaccine is reported here for girls in the School Year 8 (reaching their 13 th birthday between 01/09/2009 and 31/08/2010). HPV vaccination protects girls against cervical cancer associated with HPV types 16 and 18. The routine HPV vaccination schedule consists of three doses, usually given to girls in school Year 8 at intervals of one to two months then six months. BCG and hepatitis B immunisation uptake data are also presented here. BCG and hepatitis B immunisations are not part of the routine childhood schedule and are given selectively following risk assessment; further information on circumstances in which these immunisations should be given can be found in Immunisations Against Infectious Disease (The Green Book). Findings 1. Uptake of all three doses of the combined 5 in 1 DTaP/IPV/Hib 1, scheduled at 2, 3 and 4 months of age was 95.6% this quarter; which represents a decrease of 0.5% from the previous quarter. Uptake in the seven Health Boards ranged from 94.5% to 96.4% and by Local Authority (LA) from 91.9% (Monmouthshire) to 98.1% (Blaenau Gwent and Torfaen). Fourteen of the 22 LA areas achieved the target 95% uptake (see Figure 2 and Tables 1, 2). 2. National uptake of a completed two dose course of MenC 2 vaccine in children reaching their first birthday this quarter was 95.3% (compared to 95.9% last quarter). Uptake for the Health Boards ranged from 94.1% to 96.5% and by LA from 91.5% (Monmouthshire) to 98.1% (Blaenau Gwent and Torfaen). Eleven LA areas achieved an uptake in excess of the target 95% (see Tables 1, 2). 1 DTaP/IPV/Hib vaccine protects against Diphtheria, Tetanus, Pertussis (Whooping Cough), Polio and Hib infection. 2 Men C vaccine protects against meningitis caused by meningococcus group C infection. PCV protects against pneumococcal meningitis, bacteraemia, pneumonia and otitis media. Children reaching one year of age this quarter have been scheduled for the two dose course of pneumococcal conjugate vaccination (PCV) at two and four months of age and the two dose MenC primary course scheduled at three and four months of age. Children reaching 2 years of age this quarter should have been offered a routine dose of the Hib/ MenC at 12 months and PCV at 13 months. Public Health Wales COVER report 1

2 3. Uptake of a complete two dose primary course of pneumococcal conjugate vaccination (PCV2 2 ) in children at one year of age was 95.3%, ranging by LA from 91.5% (Monmouthshire) to 98.1% (Blaenau Gwent). Twelve LA areas achieved the target 95% uptake (see Table 2). 4. Uptake of the first dose of MMR 3 in children reaching their second birthday (scheduled at 13 months of age) increased to 93.1% this quarter (from 91.9% last quarter), ranging by LA from 90.7% (Ceredigion and Powys) to 95.0% (Carmarthenshire) (see Tables 1, 3). One LA (Carmarthenshire) achieved the target of 95% uptake, All LAs have uptakes above 90%. 5. Uptake of the final dose of Pneumococcal Conjugate Vaccine (PCVf, scheduled at 13 months of age) by the second birthday increased to 91.9% (from 90.4% last quarter). Uptake by LA ranged from 89.4% (Flintshire) to 94.9% (Anglesey) (see Tables 1, 3). 6. Uptake of the Hib/MenC (given at 12 months of age) in children reaching 2 years of age during this quarter increased to 94.5% (from 93.4% last quarter) ranging by LA from 91.1% (Pembrokeshire) to 97.2% (Caerphilly) (see Tables 1, 3). Nine LAs areas achieved uptakes in excess of 95%. 7. In children reaching five years of age this quarter, uptake of one dose of MMR increased to 93.6% (from 93.4% last quarter) and uptake of two doses increased to 86.4% (from 85.6% in the previous quarter). Uptake of two doses ranged by Health Board from 80.1% to 89.2 % and by LA from 80.1% (Powys) to 91.4% (Ceredigion) (Table 4). 8. Uptake of the 4 in 1 DTaP/IPV 4 pre-school booster in children reaching their fifth birthday this quarter increased to 89.9% (from 89.8% last quarter), ranging by Health Board from 88.2% to 92.3% and by LA from 88.2% (Powys) to 95.7 % (Ceredigion) (Tables 1, 4). One LA had uptakes in excess of 90%. 9. Uptake of one dose of HPV vaccine in girls in the School Year 8 (reaching their 13 th birthday between 01/09/2009 and 31/08/2010) is currently 80.8% (Table 5), ranging by LA from 58.2% (Denbighshire) to 93.1% (Blaenau Gwent) (Table 5). Uptake of two doses of HPV vaccine is currently 62.7%. Immunisation sessions and data entry may not have been complete at the time that this data was extracted. Uptake in last year s routine campaign group (girls turning 14 years of age during 01/09/09 to 31/08/10) is currently 88.9%, 88.1% and 85.2% for one, two and three doses respectively (Table 9). 10. Uptake of two doses of MMR in 16 year olds this quarter was 84.7% (Table 7), ranging by LA from 67.3% (Monmouthshire) to 93.1% (Wrexham). Uptake of one dose of MMR in 16 year olds this quarter was 92.4%, ranging by LHB from 83.5% (Monmouthshire) to 97.4% (Ceredigion). Uptake of a full course (two doses of MMR) of immunisation against rubella in 16 year old girls this quarter was 85.2% and uptake of only one dose was 92.8 %. 11. National uptake of the Td/IPV 5 teenage booster in children reaching 16 years of age was 61.1% (Table 7), ranging from by LA from 5.3% (Blaenau Gwent) to 83.1% (Merthyr Tydfil). Uptake in four LAs remains below 20%. 12. The HPV catch-up campaign for girls in current school years 10 to 13 is underway. Uptake of one dose in girls reaching their 15 th birthday (year 10) is currently 77.8% and uptake of two doses is 61.0%. Uptake of one dose in girls reaching their 16 th birthday (year 11) is currently 76.0% and uptake of two doses is 61.6%. Uptake of one dose in girls reaching their 17 th birthday (year 12) is currently 50.2% and uptake of two doses is 38.6% (see Table 8). Uptake of one dose in girls reaching their 18 th birthday (year 13) is currently 42.1% and uptake of two doses is 31.3%. Uptake in last year s catch-up campaign (for girls turning 19 years of age during 01/09/09 to 31/08/10) is currently 46.8%, 40.6% and 27.7% for one, two and three doses respectively (see Table 9). 3 MMR protects against measles, mumps and rubella infections. 4 DTaP/IPV (and dtap/ipv) vaccines boost protection against Diphtheria, Tetanus, Pertussis and Polio infection before school entry 5 Td/IPV boosts protection against Diphtheria, Tetanus and Polio infection before entering adulthood 6 BCG protects against tuberculosis infection. 7 Numbers of eligible children for BCG and hep B are not known Public Health Wales COVER report 2

3 13. Uptake of BCG 6 immunisation is presented in Table 10. This data is based on notifications of BCG immunisations recorded in the National Community Child Health Database (NCCHD). BCG immunisation has been received by 6.4 %, 6.2%, 5.3% and 3.1% of children reaching their first, second, fifth and 16 th birthdays (respectively) during quarter Highest proportions children given BCG by one and two years of age this quarter were seen in Newport LA and Cardiff LA Uptake of hepatitis B immunisation is presented in Table 11. This data is based on reports of hep B immunisations recorded in the National Community Child Health database. 116, 120, 157 and 70 children reaching their 1 st, 2 nd, 5 th and 16 th birthdays during quarter , respectively, had started hepatitis B immunisation courses. Of these children 57.8%, 55.8%, 68.2% and 44.3% (respectively) were recorded as having completed three doses of the hepatitis B schedule by those birthdays. Comment Uptake of all immunisations in babies reaching one year of age exceeded the 95% target once again this quarter. Uptake of the first dose of MMR in infants reaching two years of age continues to increase and is at it highest level since 1997 and uptake of both doses in children at five years of age is higher than it has ever been. Offering MMR to children on entry to primary and secondary school, and when the teenage booster is offered, who have missed doses, in line with the guidance given in 2005 in Welsh Health Circular (2005) 081, continues to be important to ensure that future outbreaks can be averted. Uptake of HPV vaccination in girls in both the routine and catch-up campaigns is encouraging, although uptake for girls reaching their 17 th and 18 th birthday during the current school year is noticeably lower than uptake for younger girls in the catch-up cohort. Many girls reaching their 17 th and 18 th birthday during the current school year will have left full time education and it is important that they are offered HPV immunisation through primary care. Further details on the routine and catch-up HPV campaigns can be found on the Public Health Wales Vaccination and Immunisation intranet site (NHS Wales Users only) and the Welsh Assembly Government internet site (links below). Links HPV catch-up for young women born between 1 September 1990 and 31 August 1991: Welsh Health Circular (2005) 081 MMR immunisation catch-up: Accelerated HPV catch-up for young women born between 1 September 1991 and 31 August 1995 (intranet): Public Hea;th Wales Vaccination and Immunisation intranet site HPV pages: Report prepared by Public Health Wales Vaccine Preventable Disease Programme and Communicable Disease Surveillance Centre. Data for this report was provided by Health Solutions Wales from the National Community Child Health Database (NCCHD). The data was sourced from Community Child Health databases maintained by local Child Health Office staff in Trusts throughout Wales based on regular returns from doctors and nurses who immunise or advise on immunisation. Uptake data presented throughout are for LHB resident population, not for LHB GP practice populations. The maps, graphs and Table 1 are best viewed in colour. Public Health Wales COVER report 3

4 Figure 1. Percentage uptake of childhood immunisations in Wales, quarter to quarter Data are for: children reaching 1 year of age each quarter for diphtheria, pertussis, Hib, MenC and pneumococcal conjugate vaccine (PCV2), children reaching 2 years of age for MMR1 (first dose) and the Hib MenC booster, and 5 years of age for MMR2 (second dose). 100 Diphtheria Hib MMR1 (2yrs) PCV2 Pertussis MenC MMR2 (5yrs) Hib MenC booster (2yrs) % uptake Public Health Wales COVER report 4

5 Figure 2. (a) Uptake of 5 in 1 vaccine in Welsh Local Authority areas in children reaching their 1 st birthday between 01/010/09 and 31/12/09. (b) Uptake of at least 1 dose of MMR immunisation in Welsh Local Authority areas in children reaching their 2 nd birthday between 01/010/09 and 31/12/09. (a) (b) % uptake (14) (8) 0-90 (0) % uptake (1) (21) 0-90 (0) Figure 3. (a) Uptake of two doses of MMR vaccine in Welsh Local Authority areas in children reaching their 5 th birthday between 01/010/09 and 31/12/09. (b) Uptake of 4 in 1 vaccine in Welsh Local Authority areas in children reaching their 5 th birthday between 01/010/09 and 31/12/09. (a) (b) % uptake (0) (2) 0-90 (20) % uptake (1) (12) 0-90 (9) Public Health Wales COVER report 5

6 Table1. Summary table with uptake of selected immunisations in resident children reaching their 1st, 2nd, 5th and 16th birthday between 01/10/09 and 31/12/09 and resident on 18/02/2010. Age 1 year Age 2 years Age 5 years Age 16 years Hib/MenC 3 in 1 Teenage children 5 in 1* MenC children MMR1 PCVf booster children MMR2 4 in 1 * children MMR1 MMR2 booster** Abertawe Bro Morgannwg University LHB (n) (n) (%) (n) (%) (n) (n) (%) (n) (%) (n) (%) (n) (n) (%) (n) (%) (n) (n) (%) (n) (%) (n) (%) Bridgend LA Neath Port Talbot LA Swansea LA Health Board Total Blaenau Gwent LA Caerphilly LA Monmouthshire LA Newport LA Torfaen LA Health Board Total Betsi Cadwaladr University LHB Anglesey LA Conwy LA Denbighshire LA Flintshire LA Gwynedd LA Wrexham LA Health Board Total Cardiff and Vale University LHB Cardiff LA Vale of Glamorgan LA Health Board Total Merthyr Tydfil LA Rhondda Cynon Taff LA Health Board Total Carmarthenshire LA Ceredigion LA Pembrokeshire LA Health Board Total Powys Teaching LHB Unknown Wales Total * Uptake of pertussis used as proxy ** Uptake of diphtheria (reinforcing booster dose) used as proxy Children receiving the final dose of PCV Public Health Wales COVER report 6

7 Table 2. Vaccine uptake in children reaching their 1st birthday between 01/10/09 and 31/12/09 and resident on 18/02/2010. D3 T3 P3 Po3 Hib3 MMR1 MenC PCV2* children HibMenCb Abertawe Bro Morgannwg University LHB (n) (n) (%) (n) (%) (n) (%) (n) (%) (n) (%) (n) (%) (n) (%) (n) (%) (n) (%) Bridgend LA Neath Port Talbot LA Swansea LA Health Board Total Blaenau Gwent LA Caerphilly LA Monmouthshire LA Newport LA Torfaen LA Health Board Total Betsi Cadwaladr University LHB Anglesey LA Conwy LA Denbighshire LA Flintshire LA Gwynedd LA Wrexham LA Health Board Total Cardiff and Vale University LHB Cardiff LA Vale of Glamorgan LA Health Board Total Merthyr Tydfil LA Rhondda Cynon Taff LA Health Board Total Carmarthenshire LA Ceredigion LA Pembrokeshire LA Health Board Total Powys Teaching LHB Unknown Wales Total * Full primary 2 dose course of pneumococcal conjugate vaccine Public Health Wales COVER report 7

8 Table 3. Vaccine uptake in children reaching their 2nd birthday between 01/10/09 and 31/12/09 and resident on 18/02/2010. D3 T3 P3 Po3 Hib3 MMR1 MenC* PCV2** children Abertawe Bro Morgannwg University LHB (n) (n) (%) (n) (%) (n) (%) (n) (%) (n) (%) (n) (%) (n) (%) (n) (%) (n) (%) (n) (%) Bridgend LA Neath Port Talbot LA Swansea LA Health Board Total Blaenau Gwent LA Caerphilly LA Monmouthshire LA Newport LA Torfaen LA Health Board Total Betsi Cadwaladr University LHB Anglesey LA Conwy LA Denbighshire LA Flintshire LA Gwynedd LA Wrexham LA Health Board Total Cardiff and Vale University LHB Cardiff LA Vale of Glamorgan LA Health Board Total Merthyr Tydfil LA Rhondda Cynon Taff LA Health Board Total Carmarthenshire LA Ceredigion LA Pembrokeshire LA Health Board Total Powys Teaching LHB Unknown Wales Total * Reflects uptake of the completed primary course in this age group ** Full primary 2 dose course of pneumococcal conjugate vaccine *** Final (booster) dose of pneumococcal conjugate vaccine PCVf*** HibMenCb Public Health Wales COVER report 8

9 Table 4. Vaccine uptake in children reaching their 5th birthday between 01/10/09 and 31/12/09 and resident on 18/02/2010. children D3 T3 P3 Po3 Hib3 MenC* MMR1 MMR2 D4 T4 ap Po4 Abertawe Bro Morgannwg University LHB (n) (n) (%) (n) (%) (n) (%) (n) (%) (n) (%) (n) (n) (n) (%) (n) (%) (n) (%) (n) (%) (n) (%) (n) (%) Bridgend LA Neath Port Talbot LA Swansea LA Health Board Total Blaenau Gwent LA Caerphilly LA Monmouthshire LA Newport LA Torfaen LA Health Board Total Betsi Cadwaladr University LHB Anglesey LA Conwy LA Denbighshire LA Flintshire LA Gwynedd LA Wrexham LA Health Board Total Cardiff and Vale University LHB Cardiff LA Vale of Glamorgan LA Health Board Total Merthyr Tydfil LA Rhondda Cynon Taff LA Health Board Total Carmarthenshire LA Ceredigion LA Pembrokeshire LA Health Board Total Powys Teaching LHB Unknown Wales Total * refers to full completed courses of MenC (before the 2006 schedule change) Public Health Wales COVER report 9

10 Table 5. Uptake of HPV doses 1 and 2 in girls in the 2009/10 School Year 8 and resident in Wales on 18/02/2010*. girls HPV 1 dose HPV 2 doses Abertawe Bro Morgannwg University LHB (n) (%) (n) (%) Bridgend LA * Immunisation sessions and data entry for the 1 st and 2 nd dose of Neath Port Talbot LA HPV in girls in the current School Year 8 may not have been complete Swansea LA at the time of data extraction. Updated figures for this year cohort will Health Board Total be provided in subsequent quarterly COVER reports. Blaenau Gwent LA Caerphilly LA Monmouthshire LA Newport LA Torfaen LA Health Board Total Betsi Cadwaladr University LHB Anglesey LA Conwy LA Denbighshire LA Flintshire LA Gwynedd LA Wrexham LA Health Board Total Cardiff and Vale University LHB Cardiff LA Vale of Glamorgan LA Health Board Total Merthyr Tydfil LA Rhondda Cynon Taff LA Health Board Total Carmarthenshire LA Ceredigion LA Pembrokeshire LA Health Board Total Powys Teaching LHB Unknown Wales Total Public Health Wales COVER report 10

11 Table 6. Vaccine uptake in children reaching their 15th birthday between 01/10/09 and 31/12/09 and resident on 18/02/2010 (with breakdown of MMR1 and MMR2 coverage by sex). Teenage 3 in 1 MMR1 MMR2 MMR1 MMR2 children MMR1 MMR2 booster* girls (girls) (girls) boys (boys) (boys) Abertawe Bro Morgannwg University LHB (n) (n) (%) (n) (%) (n) (%) (n) (n) (%) (n) (%) (n) (n) (%) (n) (%) Bridgend LA Neath Port Talbot LA Swansea LA Health Board Total Blaenau Gwent LA Caerphilly LA Monmouthshire LA Newport LA Torfaen LA Health Board Total Betsi Cadwaladr University LHB Anglesey LA Conwy LA Denbighshire LA Flintshire LA Gwynedd LA Wrexham LA Health Board Total Cardiff and Vale University LHB Cardiff LA Vale of Glamorgan LA Health Board Total Merthyr Tydfil LA Rhondda Cynon Taff LA Health Board Total Carmarthenshire LA Ceredigion LA Pembrokeshire LA Health Board Total Powys Teaching LHB Unknown Wales Total * Teenage booster dose of diphtheria, tetanus and polio (diphtheria used as proxy) Public Health Wales COVER report 11

12 Table 7. Vaccine uptake in children reaching their 16th birthday between 01/10/09 and 31/12/09 and resident on 18/02/2010 (with breakdown of MMR1 and MMR2 coverage by sex). Teenage 3 in MMR1 MMR2 MMR1 MMR2 children MMR1 MMR2 1 booster* girls (girls) (girls) boys (boys) (boys) Abertawe Bro Morgannwg University LHB (n) (n) (%) (n) (%) (n) (%) (n) (n) (%) (n) (%) (n) (n) (%) (n) (%) Bridgend LA Neath Port Talbot LA Swansea LA Health Board Total Blaenau Gwent LA Caerphilly LA Monmouthshire LA Newport LA Torfaen LA Health Board Total Betsi Cadwaladr University LHB Anglesey LA Conwy LA Denbighshire LA Flintshire LA Gwynedd LA Wrexham LA Health Board Total Cardiff and Vale University LHB Cardiff LA Vale of Glamorgan LA Health Board Total Merthyr Tydfil LA Rhondda Cynon Taff LA Health Board Total Carmarthenshire LA Ceredigion LA Pembrokeshire LA Health Board Total Powys Teaching LHB Unknown Wales Total * Teenage booster dose of diphtheria, tetanus and polio (diphtheria used as proxy) Public Health Wales COVER report 12

13 Table 8. Uptake of HPV in girls reaching appropriate birthdays between 01/09/09 and 31/08/10 and resident in Wales on 18/02/2010 ( accelerated catch-up campaigns). 15 years 16 years 1 dose 2 doses 1 dose 2 doses 1 dose 2 doses girls girls girls girls 1 dose 2 doses ABM ULHB (n) (%) (n) (%) (n) (%) (n) (%) (n) (%) (n) (%) (n) (%) (n) (%) Bridgend LA Neath Port Talbot LA Swansea LA Health Board Total Blaenau Gwent LA Caerphilly LA Monmouthshire LA Newport LA Torfaen LA Health Board Total Betsi Cadwaladr ULHB Anglesey LA Conwy LA Denbighshire LA Flintshire LA Gwynedd LA Wrexham LA Health Board Total Cardiff & Vale ULHB Cardiff LA Vale of Glamorgan LA Health Board Total Merthyr Tydfil LA Rhondda Cynon Taff LA Health Board Total Carmarthenshire LA Ceredigion LA Pembrokeshire LA Health Board Total Powys Teaching LHB Unknown Wales Total years 18 years Public Health Wales COVER report 13

14 Table 9. Uptake of HPV in girls reaching their 14 th (last year s routine campaign group) or 19th (last year s catch-up campaign group) birthday between 01/09/09 and 31/08/10 and resident in Wales on 18/02/ years 19 years girls 1 dose 2 doses 3 doses girls 1 dose 2 doses 3 doses ABM ULHB (n) (%) (n) (%) (n) (%) (n) (%) (n) (%) (n) (%) Bridgend LA Neath Port Talbot LA Swansea LA Health Board Total Blaenau Gwent LA Caerphilly LA Monmouthshire LA Newport LA Torfaen LA Health Board Total Betsi Cadwaladr ULHB Anglesey LA Conwy LA Denbighshire LA Flintshire LA Gwynedd LA Wrexham LA Health Board Total Cardiff & Vale ULHB Cardiff LA Vale of Glamorgan LA Health Board Total Merthyr Tydfil LA Rhondda Cynon Taff LA Health Board Total Carmarthenshire LA Ceredigion LA Pembrokeshire LA Health Board Total Powys Teaching LHB Unknown Wales Total Public Health Wales COVER report 14

15 Table 10. Uptake of BCG immunisation in children reaching their 1 st, 2 nd, 5 th and 16 th birthdays between 01/10/09 and 31/12/09 and resident on 18/02/ yr 2 yrs 5 yrs 16 yrs BCG Immunised BCG Immunised BCG Immunised BCG Immunised Abertawe Bro Morgannwg University children (n) (n) (%) children (n) (n) (%) children (n) (n) (%) children (n) (n) (%) Bridgend LA Neath Port Talbot LA Swansea LA Health Board Total Aneurin Bevan Blaenau Gwent LA Caerphilly LA Monmouthshire LA Newport LA Torfaen LA Health Board Total Betsi Cadwalladr University Anglesey LA Conwy LA Denbighshire LA Flintshire LA Gwynedd LA Wrexham LA Health Board Total Cardiff and Vale University Cardiff LA Vale of Glamorgan LA Health Board Total Cwm Taf Merthyr Tydfil LA Rhondda Cynon Taff LA Health Board Total Hywel Dda Carmarthenshire LA Ceredigion LA Pembrokeshire LA Health Board Total Powys Teaching Health Board Unknown Wales Total Data reflects immunisations given and recorded on the NCCHD (following notifications to local Child Health Administration Offices), may be subject to under-reporting. BCG is not a routinely scheduled immunuisation. Public Health Wales COVER report 15

16 Table 11. Uptake of hepatitis B immunisation in children reaching their 1 st, 2 nd, 5 th and 16 th birthdays during 01/010/09 and 31/12/09 and resident on 18/02/2010, and percentage who are recorded as completing doses 1 to 3. children dose 1 1yr 2yrs 5yrs dose 2 dose 3 Completed 3 doses children dose 1 dose 2 Abertawe Bro Morgannwg University (n) (n) (n) (n) (%) (n) (n) (n) (n) (%) (n) (n) (n) (n) (%) (n) (n) (n) (n) (%) Bridgend LA Neath Port Talbot LA Swansea LA Health Board Total Aneurin Bevan Blaenau Gwent LA Caerphilly LA Monmouthshire LA Newport LA Torfaen LA Health Board Total Betsi Cadwalladr University Anglesey LA Conwy LA Denbighshire LA Flintshire LA Gwynedd LA Wrexham LA Health Board Total Cardiff and Vale University Cardiff LA Vale of Glamorgan LA Health Board Total Cwm Taf Merthyr Tydfil LA Rhondda Cynon Taff LA Health Board Total Hywel Dda Carmarthenshire LA Ceredigion LA Pembrokeshire LA Health Board Total Powys Teaching Health Board Unknown Wales Total Data reflects immunisations given and recorded on the NCCHD (following notifications to local Child Health Administration Offices), may be subject to under-reporting. Hepatitis B is not a routinely scheduled immunuisation. dose 3 Completed 3 doses children dose 1 dose 2 dose 3 Completed 3 doses children dose 1 16yrs dose 2 dose 3 Completed 3 doses Public Health Wales COVER report 16

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