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

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 2009-10 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 2009-10 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

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 2009-10 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

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 4 2010. Highest proportions children given BCG by one and two years of age this quarter were seen in Newport LA and Cardiff LA 7. 14. 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 4 2010, 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: http://wales.gov.uk/topics/health/publications/health/ministerial/hpvvaccination/?lang=en Welsh Health Circular (2005) 081 MMR immunisation catch-up: http://www.wales.nhs.uk/documents/whc_2005_081.pdf Accelerated HPV catch-up for young women born between 1 September 1991 and 31 August 1995 (intranet): http://howis.wales.nhs.uk/sites3/page.cfm?orgid=474&pid=21255 Public Hea;th Wales Vaccination and Immunisation intranet site HPV pages: http://howis.wales.nhs.uk/sites3/page.cfm?orgid=474&pid=21297 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

Figure 1. Percentage uptake of childhood immunisations in Wales, quarter 4 1990 to quarter 4 2009. 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) 95 90 % uptake 85 80 75 70 65 60 1997-1 1997-2 1997-3 1997-4 1998-1 1998-2 1998-3 1998-4 1999-1 1999-2 1999-3 1999-4 2000-1 2000-2 2000-3 2000-4 2001-1 2001-2 2001-3 2001-4 2002-1 2002-2 2002-3 2002-4 2003-1 2003-2 2003-3 2003-4 2004-1 2004-2 2004-3 2004-4 2005-1 2005-2 2005-3 2005-4 2006-1 2006-2 2006-3 2006-4 2007-1 2007-2 2007-3 2007-4 2008-1 2008-2 2008-3 2008-4 2009-1 2009-2 2009-3 2009-4 Public Health Wales COVER report 4

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 95-100 (14) 90-95 (8) 0-90 (0) % uptake 95-100 (1) 90-95 (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 95-100 (0) 90-95 (2) 0-90 (20) % uptake 95-100 (1) 90-95 (12) 0-90 (9) Public Health Wales COVER report 5

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 402 390 97.0 390 97.0 360 334 92.8 338 93.9 346 96.1 372 321 86.3 338 90.9 377 348 92.3 316 83.8 291 77.2 Neath Port Talbot LA 380 363 95.5 362 95.3 362 335 92.5 324 89.5 338 93.4 402 333 82.8 353 87.8 394 373 94.7 340 86.3 306 77.7 Swansea LA 666 643 96.5 640 96.1 639 600 93.9 598 93.6 607 95.0 652 570 87.4 593 91.0 677 632 93.4 577 85.2 552 81.5 Health Board Total 1448 1396 96.4 1392 96.1 1361 1269 93.2 1260 92.6 1291 94.9 1426 1224 85.8 1284 90.0 1448 1353 93.4 1233 85.2 1149 79.4 Blaenau Gwent LA 211 207 98.1 207 98.1 168 158 94.0 153 91.1 160 95.2 177 153 86.4 160 90.4 246 228 92.7 214 87.0 13 5.3 Caerphilly LA 532 510 95.9 510 95.9 539 508 94.2 504 93.5 524 97.2 461 398 86.3 411 89.2 511 468 91.6 418 81.8 55 10.8 Monmouthshire LA 223 205 91.9 204 91.5 196 180 91.8 178 90.8 181 92.3 227 198 87.2 210 92.5 272 227 83.5 183 67.3 118 43.4 Newport LA 478 465 97.3 464 97.1 479 447 93.3 440 91.9 455 95.0 485 414 85.4 423 87.2 496 448 90.3 406 81.9 94 19.0 Torfaen LA 261 256 98.1 256 98.1 273 252 92.3 250 91.6 263 96.3 287 255 88.9 264 92.0 300 283 94.3 253 84.3 46 15.3 Health Board Total 1705 1643 96.4 1641 96.2 1655 1545 93.4 1525 92.1 1583 95.6 1637 1418 86.6 1468 89.7 1825 1654 90.6 1474 80.8 326 17.9 Betsi Cadwaladr University LHB Anglesey LA 189 184 97.4 184 97.4 196 186 94.9 186 94.9 188 95.9 160 142 88.8 150 93.8 205 193 94.1 174 84.9 138 67.3 Conwy LA 285 265 93.0 266 93.3 277 259 93.5 252 91.0 258 93.1 281 247 87.9 249 88.6 350 332 94.9 302 86.3 273 78.0 Denbighshire LA 240 226 94.2 224 93.3 283 264 93.3 255 90.1 266 94.0 246 210 85.4 218 88.6 323 304 94.1 275 85.1 253 78.3 Flintshire LA 408 386 94.6 385 94.4 433 394 91.0 387 89.4 403 93.1 442 379 85.7 392 88.7 459 442 96.3 424 92.4 321 69.9 Gwynedd LA 322 309 96.0 305 94.7 316 293 92.7 292 92.4 302 95.6 301 265 88.0 280 93.0 338 324 95.9 304 89.9 251 74.3 Wrexham LA 424 400 94.3 400 94.3 390 367 94.1 359 92.1 365 93.6 395 360 91.1 370 93.7 364 348 95.6 339 93.1 281 77.2 Health Board Total 1868 1770 94.8 1764 94.4 1895 1763 93.0 1731 91.3 1782 94.0 1825 1603 87.8 1659 90.9 2039 1943 95.3 1818 89.2 1517 74.4 Cardiff and Vale University LHB Cardiff LA 1120 1058 94.5 1054 94.1 1083 998 92.2 973 89.8 1001 92.4 989 823 83.2 855 86.5 1033 941 91.1 866 83.8 686 66.4 Vale of Glamorgan LA 359 340 94.7 338 94.2 371 352 94.9 346 93.3 354 95.4 354 311 87.9 323 91.2 429 393 91.6 362 84.4 317 73.9 Health Board Total 1479 1398 94.5 1392 94.1 1454 1350 92.8 1319 90.7 1355 93.2 1343 1134 84.4 1178 87.7 1462 1334 91.2 1228 84.0 1003 68.6 Merthyr Tydfil LA 180 172 95.6 172 95.6 194 178 91.8 180 92.8 181 93.3 187 168 89.8 174 93.0 183 171 93.4 165 90.2 152 83.1 Rhondda Cynon Taff LA 683 659 96.5 661 96.8 691 650 94.1 645 93.3 663 95.9 666 593 89.0 613 92.0 709 672 94.8 628 88.6 519 73.2 Health Board Total 863 831 96.3 833 96.5 885 828 93.6 825 93.2 844 95.4 853 761 89.2 787 92.3 892 843 94.5 793 88.9 671 75.2 Carmarthenshire LA 506 482 95.3 479 94.7 515 489 95.0 486 94.4 498 96.7 454 393 86.6 411 90.5 458 412 90.0 373 81.4 336 73.4 Ceredigion LA 128 124 96.9 122 95.3 162 147 90.7 149 92.0 151 93.2 140 128 91.4 134 95.7 191 186 97.4 172 90.1 153 80.1 Pembrokeshire LA 305 287 94.1 287 94.1 314 292 93.0 285 90.8 286 91.1 309 260 84.1 271 87.7 379 345 91.0 309 81.5 120 31.7 Health Board Total 939 893 95.1 888 94.6 991 928 93.6 920 92.8 935 94.3 903 781 86.5 816 90.4 1028 943 91.7 854 83.1 609 59.2 Powys Teaching LHB 293 280 95.6 278 94.9 302 274 90.7 271 89.7 280 92.7 321 257 80.1 283 88.2 404 364 90.1 337 83.4 305 75.5 Unknown 78 77 98.7 76 97.4 61 55 90.2 56 91.8 58 95.1 58 49 84.5 50 86.2 104 69 66.3 53 51.0 39 37.5 Wales Total 8673 8288 95.6 8264 95.3 8604 8012 93.1 7907 91.9 8128 94.5 8366 7227 86.4 7525 89.9 9202 8503 92.4 7790 84.7 5619 61.1 * 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

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 402 390 97.0 390 97.0 390 97.0 390 97.0 390 97.0 0 0.0 390 97.0 390 97.0 27 6.7 Neath Port Talbot LA 380 363 95.5 363 95.5 363 95.5 363 95.5 363 95.5 0 0.0 362 95.3 363 95.5 22 5.8 Swansea LA 666 643 96.5 643 96.5 643 96.5 643 96.5 641 96.2 2 0.3 640 96.1 640 96.1 27 4.1 Health Board Total 1448 1396 96.4 1396 96.4 1396 96.4 1396 96.4 1394 96.3 2 0.1 1392 96.1 1393 96.2 76 5.2 Blaenau Gwent LA 211 207 98.1 207 98.1 207 98.1 207 98.1 207 98.1 0 0.0 207 98.1 207 98.1 14 6.6 Caerphilly LA 532 510 95.9 510 95.9 510 95.9 510 95.9 510 95.9 1 0.2 510 95.9 514 96.6 24 4.5 Monmouthshire LA 223 205 91.9 205 91.9 205 91.9 205 91.9 205 91.9 0 0.0 204 91.5 204 91.5 7 3.1 Newport LA 478 465 97.3 465 97.3 465 97.3 465 97.3 465 97.3 1 0.2 464 97.1 463 96.9 27 5.6 Torfaen LA 261 256 98.1 256 98.1 256 98.1 256 98.1 256 98.1 0 0.0 256 98.1 254 97.3 13 5.0 Health Board Total 1705 1643 96.4 1643 96.4 1643 96.4 1643 96.4 1643 96.4 2 0.1 1641 96.2 1642 96.3 85 5.0 Betsi Cadwaladr University LHB Anglesey LA 189 184 97.4 184 97.4 184 97.4 184 97.4 184 97.4 0 0.0 184 97.4 184 97.4 8 4.2 Conwy LA 285 265 93.0 265 93.0 265 93.0 265 93.0 265 93.0 1 0.4 266 93.3 267 93.7 15 5.3 Denbighshire LA 240 226 94.2 226 94.2 226 94.2 226 94.2 226 94.2 0 0.0 224 93.3 225 93.8 11 4.6 Flintshire LA 408 386 94.6 386 94.6 386 94.6 386 94.6 386 94.6 0 0.0 385 94.4 385 94.4 12 2.9 Gwynedd LA 322 309 96.0 309 96.0 309 96.0 310 96.3 308 95.7 4 1.2 305 94.7 308 95.7 14 4.3 Wrexham LA 424 400 94.3 400 94.3 400 94.3 400 94.3 400 94.3 2 0.5 400 94.3 400 94.3 25 5.9 Health Board Total 1868 1770 94.8 1770 94.8 1770 94.8 1771 94.8 1769 94.7 7 0.4 1764 94.4 1769 94.7 85 4.6 Cardiff and Vale University LHB Cardiff LA 1120 1058 94.5 1058 94.5 1058 94.5 1058 94.5 1058 94.5 1 0.1 1054 94.1 1049 93.7 44 3.9 Vale of Glamorgan LA 359 340 94.7 340 94.7 340 94.7 340 94.7 340 94.7 0 0.0 338 94.2 338 94.2 13 3.6 Health Board Total 1479 1398 94.5 1398 94.5 1398 94.5 1398 94.5 1398 94.5 1 0.1 1392 94.1 1387 93.8 57 3.9 Merthyr Tydfil LA 180 172 95.6 172 95.6 172 95.6 172 95.6 172 95.6 0 0.0 172 95.6 172 95.6 4 2.2 Rhondda Cynon Taff LA 683 659 96.5 659 96.5 659 96.5 659 96.5 659 96.5 1 0.1 661 96.8 662 96.9 36 5.3 Health Board Total 863 831 96.3 831 96.3 831 96.3 831 96.3 831 96.3 1 0.1 833 96.5 834 96.6 40 4.6 Carmarthenshire LA 506 482 95.3 482 95.3 482 95.3 482 95.3 482 95.3 3 0.6 479 94.7 480 94.9 27 5.3 Ceredigion LA 128 124 96.9 124 96.9 124 96.9 124 96.9 124 96.9 0 0.0 122 95.3 122 95.3 11 8.6 Pembrokeshire LA 305 287 94.1 287 94.1 287 94.1 287 94.1 287 94.1 3 1.0 287 94.1 287 94.1 24 7.9 Health Board Total 939 893 95.1 893 95.1 893 95.1 893 95.1 893 95.1 6 0.6 888 94.6 889 94.7 62 6.6 Powys Teaching LHB 293 280 95.6 280 95.6 280 95.6 279 95.2 279 95.2 1 0.3 278 94.9 278 94.9 10 3.4 Unknown 78 77 98.7 77 98.7 77 98.7 77 98.7 77 98.7 0 0.0 76 97.4 77 98.7 3 3.8 Wales Total 8673 8288 95.6 8288 95.6 8288 95.6 8288 95.6 8284 95.5 20 0.2 8264 95.3 8269 95.3 418 4.8 * Full primary 2 dose course of pneumococcal conjugate vaccine Public Health Wales COVER report 7

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 360 354 98.3 354 98.3 354 98.3 354 98.3 354 98.3 334 92.8 354 98.3 353 98.1 338 93.9 346 96.1 Neath Port Talbot LA 362 347 95.9 347 95.9 347 95.9 346 95.6 345 95.3 335 92.5 340 93.9 342 94.5 324 89.5 338 93.4 Swansea LA 639 622 97.3 622 97.3 622 97.3 622 97.3 620 97.0 600 93.9 611 95.6 610 95.5 598 93.6 607 95.0 Health Board Total 1361 1323 97.2 1323 97.2 1323 97.2 1322 97.1 1319 96.9 1269 93.2 1305 95.9 1305 95.9 1260 92.6 1291 94.9 Blaenau Gwent LA 168 165 98.2 165 98.2 165 98.2 165 98.2 165 98.2 158 94.0 165 98.2 165 98.2 153 91.1 160 95.2 Caerphilly LA 539 534 99.1 534 99.1 534 99.1 534 99.1 534 99.1 508 94.2 534 99.1 533 98.9 504 93.5 524 97.2 Monmouthshire LA 196 186 94.9 186 94.9 186 94.9 186 94.9 186 94.9 180 91.8 184 93.9 186 94.9 178 90.8 181 92.3 Newport LA 479 466 97.3 466 97.3 466 97.3 465 97.1 463 96.7 447 93.3 460 96.0 461 96.2 440 91.9 455 95.0 Torfaen LA 273 270 98.9 270 98.9 270 98.9 270 98.9 270 98.9 252 92.3 270 98.9 271 99.3 250 91.6 263 96.3 Health Board Total 1655 1621 97.9 1621 97.9 1621 97.9 1620 97.9 1618 97.8 1545 93.4 1613 97.5 1616 97.6 1525 92.1 1583 95.6 Betsi Cadwaladr University LHB Anglesey LA 196 191 97.4 191 97.4 191 97.4 191 97.4 191 97.4 186 94.9 191 97.4 191 97.4 186 94.9 188 95.9 Conwy LA 277 267 96.4 267 96.4 267 96.4 267 96.4 267 96.4 259 93.5 264 95.3 266 96.0 252 91.0 258 93.1 Denbighshire LA 283 276 97.5 276 97.5 276 97.5 276 97.5 276 97.5 264 93.3 274 96.8 272 96.1 255 90.1 266 94.0 Flintshire LA 433 417 96.3 417 96.3 417 96.3 417 96.3 417 96.3 394 91.0 417 96.3 416 96.1 387 89.4 403 93.1 Gwynedd LA 316 309 97.8 309 97.8 309 97.8 309 97.8 309 97.8 293 92.7 305 96.5 305 96.5 292 92.4 302 95.6 Wrexham LA 390 378 96.9 378 96.9 378 96.9 377 96.7 378 96.9 367 94.1 372 95.4 371 95.1 359 92.1 365 93.6 Health Board Total 1895 1838 97.0 1838 97.0 1838 97.0 1837 96.9 1838 97.0 1763 93.0 1823 96.2 1821 96.1 1731 91.3 1782 94.0 Cardiff and Vale University LHB Cardiff LA 1083 1054 97.3 1054 97.3 1054 97.3 1055 97.4 1053 97.2 998 92.2 1024 94.6 1028 94.9 973 89.8 1001 92.4 Vale of Glamorgan LA 371 363 97.8 363 97.8 363 97.8 362 97.6 362 97.6 352 94.9 361 97.3 360 97.0 346 93.3 354 95.4 Health Board Total 1454 1417 97.5 1417 97.5 1417 97.5 1417 97.5 1415 97.3 1350 92.8 1385 95.3 1388 95.5 1319 90.7 1355 93.2 Merthyr Tydfil LA 194 188 96.9 188 96.9 188 96.9 187 96.4 188 96.9 178 91.8 188 96.9 187 96.4 180 92.8 181 93.3 Rhondda Cynon Taff LA 691 682 98.7 682 98.7 682 98.7 682 98.7 682 98.7 650 94.1 679 98.3 678 98.1 645 93.3 663 95.9 Health Board Total 885 870 98.3 870 98.3 870 98.3 869 98.2 870 98.3 828 93.6 867 98.0 865 97.7 825 93.2 844 95.4 Carmarthenshire LA 515 509 98.8 509 98.8 509 98.8 507 98.4 507 98.4 489 95.0 506 98.3 502 97.5 486 94.4 498 96.7 Ceredigion LA 162 155 95.7 155 95.7 155 95.7 155 95.7 155 95.7 147 90.7 150 92.6 149 92.0 149 92.0 151 93.2 Pembrokeshire LA 314 301 95.9 301 95.9 301 95.9 301 95.9 301 95.9 292 93.0 298 94.9 298 94.9 285 90.8 286 91.1 Health Board Total 991 965 97.4 965 97.4 965 97.4 963 97.2 963 97.2 928 93.6 954 96.3 949 95.8 920 92.8 935 94.3 Powys Teaching LHB 302 292 96.7 292 96.7 292 96.7 292 96.7 292 96.7 274 90.7 289 95.7 290 96.0 271 89.7 280 92.7 Unknown 61 59 96.7 59 96.7 59 96.7 59 96.7 59 96.7 55 90.2 60 98.4 59 96.7 56 91.8 58 95.1 Wales Total 8604 8385 97.5 8385 97.5 8385 97.5 8379 97.4 8374 97.3 8012 93.1 8296 96.4 8293 96.4 7907 91.9 8128 94.5 * 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

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 372 359 96.5 359 96.5 359 96.5 359 96.5 355 95.4 357 96.0 350 94.1 321 86.3 338 90.9 338 90.9 338 90.9 338 90.9 Neath Port Talbot LA 402 385 95.8 385 95.8 385 95.8 385 95.8 384 95.5 386 96.0 366 91.0 333 82.8 353 87.8 353 87.8 353 87.8 353 87.8 Swansea LA 652 633 97.1 633 97.1 634 97.2 633 97.1 634 97.2 625 95.9 610 93.6 570 87.4 594 91.1 594 91.1 593 91.0 594 91.1 Health Board Total 1426 1377 96.6 1377 96.6 1378 96.6 1377 96.6 1373 96.3 1368 95.9 1326 93.0 1224 85.8 1285 90.1 1285 90.1 1284 90.0 1285 90.1 Blaenau Gwent LA 177 171 96.6 171 96.6 171 96.6 172 97.2 171 96.6 171 96.6 171 96.6 153 86.4 160 90.4 160 90.4 160 90.4 160 90.4 Caerphilly LA 461 451 97.8 451 97.8 451 97.8 451 97.8 451 97.8 449 97.4 437 94.8 398 86.3 411 89.2 411 89.2 411 89.2 411 89.2 Monmouthshire LA 227 215 94.7 215 94.7 215 94.7 215 94.7 215 94.7 212 93.4 209 92.1 198 87.2 210 92.5 210 92.5 210 92.5 209 92.1 Newport LA 485 469 96.7 469 96.7 469 96.7 469 96.7 464 95.7 463 95.5 460 94.8 414 85.4 423 87.2 423 87.2 423 87.2 424 87.4 Torfaen LA 287 280 97.6 280 97.6 280 97.6 280 97.6 278 96.9 279 97.2 272 94.8 255 88.9 264 92.0 264 92.0 264 92.0 264 92.0 Health Board Total 1637 1586 96.9 1586 96.9 1586 96.9 1587 96.9 1579 96.5 1574 96.2 1549 94.6 1418 86.6 1468 89.7 1468 89.7 1468 89.7 1468 89.7 Betsi Cadwaladr University LHB Anglesey LA 160 157 98.1 157 98.1 157 98.1 157 98.1 157 98.1 153 95.6 150 93.8 142 88.8 150 93.8 150 93.8 150 93.8 150 93.8 Conwy LA 281 269 95.7 269 95.7 269 95.7 266 94.7 268 95.4 264 94.0 263 93.6 247 87.9 249 88.6 249 88.6 249 88.6 249 88.6 Denbighshire LA 246 239 97.2 239 97.2 239 97.2 238 96.7 239 97.2 239 97.2 227 92.3 210 85.4 219 89.0 219 89.0 218 88.6 218 88.6 Flintshire LA 442 427 96.6 427 96.6 427 96.6 425 96.2 423 95.7 422 95.5 416 94.1 379 85.7 392 88.7 392 88.7 392 88.7 392 88.7 Gwynedd LA 301 289 96.0 289 96.0 289 96.0 289 96.0 286 95.0 282 93.7 278 92.4 265 88.0 281 93.4 281 93.4 280 93.0 280 93.0 Wrexham LA 395 385 97.5 385 97.5 385 97.5 384 97.2 383 97.0 379 95.9 380 96.2 360 91.1 370 93.7 370 93.7 370 93.7 370 93.7 Health Board Total 1825 1766 96.8 1766 96.8 1766 96.8 1759 96.4 1756 96.2 1739 95.3 1714 93.9 1603 87.8 1661 91.0 1661 91.0 1659 90.9 1659 90.9 Cardiff and Vale University LHB Cardiff LA 989 942 95.2 942 95.2 942 95.2 937 94.7 931 94.1 891 90.1 914 92.4 823 83.2 855 86.5 855 86.5 855 86.5 854 86.3 Vale of Glamorgan LA 354 345 97.5 345 97.5 345 97.5 345 97.5 343 96.9 346 97.7 338 95.5 311 87.9 323 91.2 323 91.2 323 91.2 323 91.2 Health Board Total 1343 1287 95.8 1287 95.8 1287 95.8 1282 95.5 1274 94.9 1237 92.1 1252 93.2 1134 84.4 1178 87.7 1178 87.7 1178 87.7 1177 87.6 Merthyr Tydfil LA 187 183 97.9 183 97.9 183 97.9 183 97.9 183 97.9 183 97.9 180 96.3 168 89.8 174 93.0 174 93.0 174 93.0 174 93.0 Rhondda Cynon Taff LA 666 653 98.0 653 98.0 653 98.0 651 97.7 651 97.7 649 97.4 628 94.3 593 89.0 613 92.0 613 92.0 613 92.0 613 92.0 Health Board Total 853 836 98.0 836 98.0 836 98.0 834 97.8 834 97.8 832 97.5 808 94.7 761 89.2 787 92.3 787 92.3 787 92.3 787 92.3 Carmarthenshire LA 454 429 94.5 429 94.5 429 94.5 427 94.1 428 94.3 430 94.7 420 92.5 393 86.6 411 90.5 411 90.5 411 90.5 411 90.5 Ceredigion LA 140 134 95.7 134 95.7 134 95.7 134 95.7 134 95.7 132 94.3 133 95.0 128 91.4 134 95.7 134 95.7 134 95.7 134 95.7 Pembrokeshire LA 309 298 96.4 298 96.4 298 96.4 295 95.5 295 95.5 291 94.2 287 92.9 260 84.1 271 87.7 271 87.7 271 87.7 271 87.7 Health Board Total 903 861 95.3 861 95.3 861 95.3 856 94.8 857 94.9 853 94.5 840 93.0 781 86.5 816 90.4 816 90.4 816 90.4 816 90.4 Powys Teaching LHB 321 303 94.4 303 94.4 303 94.4 303 94.4 302 94.1 303 94.4 287 89.4 257 80.1 283 88.2 283 88.2 283 88.2 283 88.2 Unknown 58 53 91.4 55 94.8 55 94.8 54 93.1 52 89.7 52 89.7 51 87.9 49 84.5 50 86.2 50 86.2 50 86.2 50 86.2 Wales Total 8366 8069 96.4 8071 96.5 8072 96.5 8052 96.2 8027 95.9 7958 95.1 7827 93.6 7227 86.4 7528 90.0 7528 90.0 7525 89.9 7525 89.9 * refers to full completed courses of MenC (before the 2006 schedule change) Public Health Wales COVER report 9

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 848 741 87.4 565 66.6 * Immunisation sessions and data entry for the 1 st and 2 nd dose of Neath Port Talbot LA 817 692 84.7 542 66.3 HPV in girls in the current School Year 8 may not have been complete Swansea LA 1270 1077 84.8 796 62.7 at the time of data extraction. Updated figures for this year cohort will Health Board Total 2935 2510 85.5 1903 64.8 be provided in subsequent quarterly COVER reports. Blaenau Gwent LA 404 376 93.1 336 83.2 Caerphilly LA 1066 891 83.6 500 46.9 Monmouthshire LA 570 410 71.9 355 62.3 Newport LA 940 735 78.2 464 49.4 Torfaen LA 611 534 87.4 429 70.2 Health Board Total 3591 2946 82.0 2084 58.0 Betsi Cadwaladr University LHB Anglesey LA 404 324 80.2 305 75.5 Conwy LA 577 417 72.3 415 71.9 Denbighshire LA 577 336 58.2 324 56.2 Flintshire LA 870 736 84.6 413 47.5 Gwynedd LA 682 544 79.8 493 72.3 Wrexham LA 661 546 82.6 469 71.0 Health Board Total 3771 2903 77.0 2419 64.1 Cardiff and Vale University LHB Cardiff LA 1897 1463 77.1 1016 53.6 Vale of Glamorgan LA 846 683 80.7 408 48.2 Health Board Total 2743 2146 78.2 1424 51.9 Merthyr Tydfil LA 362 327 90.3 296 81.8 Rhondda Cynon Taff LA 1346 1204 89.5 857 63.7 Health Board Total 1708 1531 89.6 1153 67.5 Carmarthenshire LA 1013 799 78.9 763 75.3 Ceredigion LA 336 253 75.3 245 72.9 Pembrokeshire LA 671 550 82.0 525 78.2 Health Board Total 2020 1602 79.3 1533 75.9 Powys Teaching LHB 737 571 77.5 508 68.9 Unknown 181 87 48.1 66 36.5 Wales Total 17686 14296 80.8 11090 62.7 Public Health Wales COVER report 10

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 388 341 87.9 307 79.1 5 1.3 187 162 86.6 148 79.1 201 179 89.1 159 79.1 Neath Port Talbot LA 425 399 93.9 356 83.8 7 1.6 211 196 92.9 173 82.0 214 203 94.9 183 85.5 Swansea LA 627 570 90.9 482 76.9 33 5.3 309 282 91.3 233 75.4 318 288 90.6 249 78.3 Health Board Total 1440 1310 91.0 1145 79.5 45 3.1 707 640 90.5 554 78.4 733 670 91.4 591 80.6 Blaenau Gwent LA 211 201 95.3 186 88.2 3 1.4 115 111 96.5 102 88.7 96 90 93.8 84 87.5 Caerphilly LA 521 464 89.1 411 78.9 36 6.9 255 225 88.2 196 76.9 266 239 89.8 215 80.8 Monmouthshire LA 299 245 81.9 211 70.6 41 13.7 122 95 77.9 87 71.3 177 150 84.7 124 70.1 Newport LA 502 450 89.6 400 79.7 36 7.2 251 219 87.3 194 77.3 251 231 92.0 206 82.1 Torfaen LA 313 300 95.8 279 89.1 16 5.1 158 151 95.6 141 89.2 155 149 96.1 138 89.0 Health Board Total 1846 1660 89.9 1487 80.6 132 7.2 901 801 88.9 720 79.9 945 859 90.9 767 81.2 Betsi Cadwaladr University LHB Anglesey LA 223 197 88.3 175 78.5 4 1.8 96 82 85.4 74 77.1 127 115 90.6 101 79.5 Conwy LA 313 280 89.5 254 81.2 23 7.3 147 135 91.8 124 84.4 166 145 87.3 130 78.3 Denbighshire LA 270 255 94.4 222 82.2 7 2.6 124 116 93.5 97 78.2 146 139 95.2 125 85.6 Flintshire LA 432 409 94.7 351 81.3 6 1.4 218 207 95.0 172 78.9 214 202 94.4 179 83.6 Gwynedd LA 329 306 93.0 277 84.2 7 2.1 163 149 91.4 138 84.7 166 157 94.6 139 83.7 Wrexham LA 396 372 93.9 325 82.1 41 10.4 196 184 93.9 161 82.1 200 188 94.0 164 82.0 Health Board Total 1963 1819 92.7 1604 81.7 88 4.5 944 873 92.5 766 81.1 1019 946 92.8 838 82.2 Cardiff and Vale University LHB Cardiff LA 990 864 87.3 774 78.2 639 64.5 497 436 87.7 397 79.9 493 428 86.8 377 76.5 Vale of Glamorgan LA 388 348 89.7 312 80.4 275 70.9 189 165 87.3 150 79.4 199 183 92.0 162 81.4 Health Board Total 1378 1212 88.0 1086 78.8 914 66.3 686 601 87.6 547 79.7 692 611 88.3 539 77.9 Merthyr Tydfil LA 172 157 91.3 140 81.4 1 0.6 89 82 92.1 75 84.3 83 75 90.4 65 78.3 Rhondda Cynon Taff LA 667 621 93.1 555 83.2 6 0.9 310 282 91.0 259 83.5 357 339 95.0 296 82.9 Health Board Total 839 778 92.7 695 82.8 7 0.8 399 364 91.2 334 83.7 440 414 94.1 361 82.0 Carmarthenshire LA 492 438 89.0 389 79.1 199 40.4 242 222 91.7 200 82.6 250 216 86.4 189 75.6 Ceredigion LA 164 146 89.0 127 77.4 8 4.9 79 69 87.3 64 81.0 85 77 90.6 63 74.1 Pembrokeshire LA 333 291 87.4 259 77.8 56 16.8 168 144 85.7 129 76.8 165 147 89.1 130 78.8 Health Board Total 989 875 88.5 775 78.4 263 26.6 489 435 89.0 393 80.4 500 440 88.0 382 76.4 Powys Teaching LHB 363 326 89.8 282 77.7 16 4.4 166 147 88.6 122 73.5 197 179 90.9 160 81.2 Unknown 125 74 59.2 52 41.6 5 4.0 69 39 56.5 28 40.6 56 35 62.5 24 42.9 Wales Total 8943 8054 90.1 7126 79.7 1470 16.4 4361 3900 89.4 3464 79.4 4582 4154 90.7 3662 79.9 * Teenage booster dose of diphtheria, tetanus and polio (diphtheria used as proxy) Public Health Wales COVER report 11

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 377 348 92.3 316 83.8 291 77.2 186 169 90.9 151 81.2 191 179 93.7 165 86.4 Neath Port Talbot LA 394 373 94.7 340 86.3 306 77.7 185 182 98.4 165 89.2 209 191 91.4 175 83.7 Swansea LA 677 632 93.4 577 85.2 552 81.5 320 299 93.4 274 85.6 357 333 93.3 303 84.9 Health Board Total 1448 1353 93.4 1233 85.2 1149 79.4 691 650 94.1 590 85.4 757 703 92.9 643 84.9 Blaenau Gwent LA 246 228 92.7 214 87.0 13 5.3 127 118 92.9 112 88.2 119 110 92.4 102 85.7 Caerphilly LA 511 468 91.6 418 81.8 55 10.8 282 258 91.5 232 82.3 229 210 91.7 186 81.2 Monmouthshire LA 272 227 83.5 183 67.3 118 43.4 123 103 83.7 85 69.1 149 124 83.2 98 65.8 Newport LA 496 448 90.3 406 81.9 94 19.0 254 230 90.6 210 82.7 241 218 90.5 196 81.3 Torfaen LA 300 283 94.3 253 84.3 46 15.3 144 135 93.8 120 83.3 156 148 94.9 133 85.3 Health Board Total 1825 1654 90.6 1474 80.8 326 17.9 930 844 90.8 759 81.6 894 810 90.6 715 80.0 Betsi Cadwaladr University LHB Anglesey LA 205 193 94.1 174 84.9 138 67.3 88 83 94.3 77 87.5 117 110 94.0 97 82.9 Conwy LA 350 332 94.9 302 86.3 273 78.0 176 171 97.2 157 89.2 173 160 92.5 145 83.8 Denbighshire LA 323 304 94.1 275 85.1 253 78.3 160 152 95.0 140 87.5 163 152 93.3 135 82.8 Flintshire LA 459 442 96.3 424 92.4 321 69.9 240 227 94.6 218 90.8 219 215 98.2 206 94.1 Gwynedd LA 338 324 95.9 304 89.9 251 74.3 161 155 96.3 145 90.1 177 169 95.5 159 89.8 Wrexham LA 364 348 95.6 339 93.1 281 77.2 168 162 96.4 156 92.9 196 186 94.9 183 93.4 Health Board Total 2039 1943 95.3 1818 89.2 1517 74.4 993 950 95.7 893 89.9 1045 992 94.9 925 88.5 Cardiff and Vale University LHB Cardiff LA 1033 941 91.1 866 83.8 686 66.4 484 440 90.9 403 83.3 549 501 91.3 463 84.3 Vale of Glamorgan LA 429 393 91.6 362 84.4 317 73.9 205 185 90.2 174 84.9 224 208 92.9 188 83.9 Health Board Total 1462 1334 91.2 1228 84.0 1003 68.6 689 625 90.7 577 83.7 773 709 91.7 651 84.2 Merthyr Tydfil LA 183 171 93.4 165 90.2 152 83.1 87 81 93.1 77 88.5 96 90 93.8 88 91.7 Rhondda Cynon Taff LA 709 672 94.8 628 88.6 519 73.2 339 321 94.7 300 88.5 370 351 94.9 328 88.6 Health Board Total 892 843 94.5 793 88.9 671 75.2 426 402 94.4 377 88.5 466 441 94.6 416 89.3 Carmarthenshire LA 458 412 90.0 373 81.4 336 73.4 219 199 90.9 180 82.2 239 213 89.1 193 80.8 Ceredigion LA 191 186 97.4 172 90.1 153 80.1 91 89 97.8 81 89.0 100 97 97.0 91 91.0 Pembrokeshire LA 379 345 91.0 309 81.5 120 31.7 188 174 92.6 156 83.0 191 171 89.5 153 80.1 Health Board Total 1028 943 91.7 854 83.1 609 59.2 498 462 92.8 417 83.7 530 481 90.8 437 82.5 Powys Teaching LHB 404 364 90.1 337 83.4 305 75.5 190 179 94.2 168 88.4 214 185 86.4 169 79.0 Unknown 104 69 66.3 53 51.0 39 37.5 55 36 65.5 28 50.9 49 33 67.3 25 51.0 Wales Total 9202 8503 92.4 7790 84.7 5619 61.1 4472 4148 92.8 3809 85.2 4728 4354 92.1 3981 84.2 * Teenage booster dose of diphtheria, tetanus and polio (diphtheria used as proxy) Public Health Wales COVER report 12

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 (2009-10 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 728 604 83.0 491 67.4 795 618 77.7 512 64.4 773 513 66.4 354 45.8 809 370 45.7 209 25.8 Neath Port Talbot LA 820 690 84.1 536 65.4 764 638 83.5 514 67.3 855 556 65.0 457 53.5 842 447 53.1 351 41.7 Swansea LA 1295 1041 80.4 787 60.8 1312 1017 77.5 754 57.5 1313 793 60.4 605 46.1 1383 723 52.3 554 40.1 Health Board Total 2843 2335 82.1 1814 63.8 2871 2273 79.2 1780 62.0 2941 1862 63.3 1416 48.1 3034 1540 50.8 1114 36.7 Blaenau Gwent LA 423 391 92.4 344 81.3 448 398 88.8 342 76.3 476 154 32.4 132 27.7 485 139 28.7 120 24.7 Caerphilly LA 1050 833 79.3 427 40.7 1093 848 77.6 466 42.6 1100 386 35.1 218 19.8 1111 269 24.2 118 10.6 Monmouthshire LA 498 367 73.7 301 60.4 609 426 70.0 329 54.0 582 280 48.1 235 40.4 631 256 40.6 216 34.2 Newport LA 989 769 77.8 472 47.7 968 653 67.5 455 47.0 966 384 39.8 216 22.4 1014 344 33.9 181 17.9 Torfaen LA 603 504 83.6 403 66.8 652 547 83.9 385 59.0 637 277 43.5 189 29.7 649 229 35.3 137 21.1 Health Board Total 3563 2864 80.4 1947 54.6 3770 2872 76.2 1977 52.4 3761 1481 39.4 990 26.3 3890 1237 31.8 772 19.8 Betsi Cadwaladr ULHB Anglesey LA 366 279 76.2 247 67.5 382 278 72.8 250 65.4 389 150 38.6 104 26.7 471 154 32.7 114 24.2 Conwy LA 600 398 66.3 393 65.5 646 449 69.5 443 68.6 633 261 41.2 235 37.1 672 250 37.2 219 32.6 Denbighshire LA 579 323 55.8 316 54.6 602 363 60.3 344 57.1 622 247 39.7 202 32.5 611 219 35.8 182 29.8 Flintshire LA 900 756 84.0 712 79.1 892 727 81.5 690 77.4 880 470 53.4 396 45.0 934 494 52.9 416 44.5 Gwynedd LA 683 547 80.1 537 78.6 685 555 81.0 514 75.0 688 290 42.2 186 27.0 676 249 36.8 161 23.8 Wrexham LA 680 541 79.6 459 67.5 706 536 75.9 442 62.6 743 270 36.3 211 28.4 788 297 37.7 220 27.9 Health Board Total 3808 2844 74.7 2664 70.0 3913 2908 74.3 2683 68.6 3955 1688 42.7 1334 33.7 4152 1663 40.1 1312 31.6 Cardiff & Vale ULHB Cardiff LA 2003 1554 77.6 1064 53.1 2042 1493 73.1 1009 49.4 2061 1119 54.3 789 38.3 2196 961 43.8 624 28.4 Vale of Glamorgan LA 857 628 73.3 342 39.9 805 597 74.2 387 48.1 879 526 59.8 382 43.5 901 424 47.1 286 31.7 Health Board Total 2860 2182 76.3 1406 49.2 2847 2090 73.4 1396 49.0 2940 1645 56.0 1171 39.8 3097 1385 44.7 910 29.4 Merthyr Tydfil LA 353 293 83.0 274 77.6 366 306 83.6 286 78.1 371 243 65.5 223 60.1 375 186 49.6 170 45.3 Rhondda Cynon Taff LA 1310 1127 86.0 707 54.0 1373 1188 86.5 1065 77.6 1377 943 68.5 815 59.2 1365 741 54.3 598 43.8 Health Board Total 1663 1420 85.4 981 59.0 1739 1494 85.9 1351 77.7 1748 1186 67.8 1038 59.4 1740 927 53.3 768 44.1 Carmarthenshire LA 976 723 74.1 697 71.4 1005 743 73.9 704 70.0 1006 603 59.9 523 52.0 1013 608 60.0 514 50.7 Ceredigion LA 341 251 73.6 241 70.7 367 258 70.3 246 67.0 369 200 54.2 173 46.9 401 206 51.4 175 43.6 Pembrokeshire LA 711 513 72.2 491 69.1 766 591 77.2 564 73.6 780 436 55.9 392 50.3 853 385 45.1 338 39.6 Health Board Total 2028 1487 73.3 1429 70.5 2138 1592 74.5 1514 70.8 2155 1239 57.5 1088 50.5 2267 1199 52.9 1027 45.3 Powys Teaching LHB 720 546 75.8 469 65.1 751 542 72.2 458 61.0 734 96 13.1 36 4.9 736 81 11.0 50 6.8 Unknown 239 104 43.5 93 38.9 225 103 45.8 86 38.2 214 69 32.2 50 23.4 312 69 22.1 58 18.6 Wales Total 17724 13782 77.8 10803 61.0 18254 13874 76.0 11245 61.6 18448 9266 50.2 7123 38.6 19228 8101 42.1 6011 31.3 17 years 18 years Public Health Wales COVER report 13

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 18/02/2010. 14 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 743 649 87.3 644 86.7 628 84.5 848 236 27.8 173 20.4 101 11.9 Neath Port Talbot LA 783 726 92.7 716 91.4 711 90.8 868 373 43.0 340 39.2 240 27.6 Swansea LA 1266 1175 92.8 1169 92.3 1141 90.1 1438 600 41.7 532 37.0 379 26.4 Health Board Total 2792 2550 91.3 2529 90.6 2480 88.8 3154 1209 38.3 1045 33.1 720 22.8 Blaenau Gwent LA 406 392 96.6 388 95.6 373 91.9 472 120 25.4 107 22.7 66 14.0 Caerphilly LA 1037 957 92.3 945 91.1 917 88.4 1133 400 35.3 350 30.9 246 21.7 Monmouthshire LA 517 416 80.5 413 79.9 326 63.1 588 266 45.2 235 40.0 165 28.1 Newport LA 901 765 84.9 744 82.6 702 77.9 1106 463 41.9 431 39.0 254 23.0 Torfaen LA 551 520 94.4 520 94.4 510 92.6 619 333 53.8 306 49.4 186 30.0 Health Board Total 3412 3050 89.4 3010 88.2 2828 82.9 3918 1582 40.4 1429 36.5 917 23.4 Betsi Cadwaladr ULHB Anglesey LA 380 339 89.2 336 88.4 326 85.8 432 300 69.4 237 54.9 154 35.6 Conwy LA 590 515 87.3 513 86.9 499 84.6 650 316 48.6 287 44.2 193 29.7 Denbighshire LA 505 452 89.5 448 88.7 431 85.3 656 394 60.1 357 54.4 263 40.1 Flintshire LA 882 821 93.1 816 92.5 802 90.9 1014 607 59.9 526 51.9 396 39.1 Gwynedd LA 634 546 86.1 541 85.3 527 83.1 726 422 58.1 367 50.6 314 43.3 Wrexham LA 736 657 89.3 650 88.3 638 86.7 820 454 55.4 388 47.3 262 32.0 Health Board Total 3727 3330 89.3 3304 88.7 3223 86.5 4298 2493 58.0 2162 50.3 1582 36.8 Cardiff & Vale ULHB Cardiff LA 1944 1641 84.4 1610 82.8 1536 79.0 2129 838 39.4 717 33.7 453 21.3 Vale of Glamorgan LA 777 695 89.4 689 88.7 654 84.2 857 364 42.5 218 25.4 138 16.1 Health Board Total 2721 2336 85.9 2299 84.5 2190 80.5 2986 1202 40.3 935 31.3 591 19.8 Merthyr Tydfil LA 364 345 94.8 344 94.5 337 92.6 312 90 28.8 77 24.7 32 10.3 Rhondda Cynon Taff LA 1294 1196 92.4 1188 91.8 1178 91.0 1570 706 45.0 600 38.2 320 20.4 Health Board Total 1658 1541 92.9 1532 92.4 1515 91.4 1882 796 42.3 677 36.0 352 18.7 Carmarthenshire LA 997 895 89.8 892 89.5 865 86.8 909 695 76.5 633 69.6 512 56.3 Ceredigion LA 317 265 83.6 264 83.3 258 81.4 417 214 51.3 187 44.8 119 28.5 Pembrokeshire LA 679 587 86.5 582 85.7 570 83.9 819 360 44.0 315 38.5 195 23.8 Health Board Total 1993 1747 87.7 1738 87.2 1693 84.9 2145 1269 59.2 1135 52.9 826 38.5 Powys Teaching LHB 683 599 87.7 594 87.0 585 85.7 802 502 62.6 467 58.2 369 46.0 Unknown 166 101 60.8 100 60.2 97 58.4 373 91 24.4 84 22.5 56 15.0 Wales Total 17152 15254 88.9 15106 88.1 14611 85.2 19558 9144 46.8 7934 40.6 5413 27.7 Public Health Wales COVER report 14

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 18/02/2010. 1 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 402 11 2.7 360 7 1.9 372 8 2.2 377 2 0.5 Neath Port Talbot LA 380 10 2.6 362 5 1.4 402 10 2.5 394 7 1.8 Swansea LA 666 65 9.8 639 63 9.9 652 51 7.8 677 8 1.2 Health Board Total 1448 86 5.9 1361 75 5.5 1426 69 4.8 1448 17 1.2 Aneurin Bevan Blaenau Gwent LA 211 5 2.4 168 6 3.6 177 1 0.6 21 0 0.0 Caerphilly LA 532 6 1.1 539 9 1.7 461 6 1.3 511 4 0.8 Monmouthshire LA 223 5 2.2 196 12 6.1 227 8 3.5 272 3 1.1 Newport LA 478 78 16.3 479 73 15.2 485 62 12.8 496 21 4.2 Torfaen LA 261 1 0.4 273 2 0.7 287 5 1.7 300 0 0.0 Health Board Total 1705 95 5.6 1655 102 6.2 1637 82 5.0 1600 28 1.8 Betsi Cadwalladr University Anglesey LA 189 6 3.2 196 3 1.5 160 4 2.5 205 3 1.5 Conwy LA 285 9 3.2 277 12 4.3 281 5 1.8 350 9 2.6 Denbighshire LA 240 12 5.0 283 20 7.1 246 11 4.5 323 9 2.8 Flintshire LA 408 12 2.9 433 8 1.8 442 11 2.5 459 36 7.8 Gwynedd LA 322 16 5.0 316 11 3.5 301 10 3.3 338 2 0.6 Wrexham LA 424 33 7.8 390 20 5.1 395 17 4.3 364 11 3.0 Health Board Total 1868 88 4.7 1895 74 3.9 1825 58 3.2 2039 70 3.4 Cardiff and Vale University Cardiff LA 1120 196 17.5 1083 202 18.7 989 188 19.0 1033 123 11.9 Vale of Glamorgan LA 359 15 4.2 371 15 4.0 354 18 5.1 429 8 1.9 Health Board Total 1479 211 14.3 1454 217 14.9 1343 206 15.3 1462 131 9.0 Cwm Taf Merthyr Tydfil LA 180 8 4.4 194 5 2.6 187 1 0.5 183 3 1.6 Rhondda Cynon Taff LA 683 23 3.4 691 19 2.7 666 7 1.1 709 5 0.7 Health Board Total 863 31 3.6 885 24 2.7 853 8 0.9 892 8 0.9 Hywel Dda Carmarthenshire LA 506 15 3.0 515 16 3.1 454 3 0.7 458 6 1.3 Ceredigion LA 128 5 3.9 162 9 5.6 140 8 5.7 191 6 3.1 Pembrokeshire LA 305 8 2.6 314 10 3.2 309 3 1.0 379 3 0.8 Health Board Total 939 28 3.0 991 35 3.5 903 14 1.6 1028 15 1.5 Powys Teaching Health Board 293 9 3.1 302 7 2.3 321 4 1.2 404 4 1.0 Unknown 78 6 7.7 61 0 0.0 58 0 0.0 104 3 2.9 Wales Total 8673 554 6.4 8604 534 6.2 8366 441 5.3 8977 276 3.1 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

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 402 2 2 1 50.0 360 0 0 0 0.0 372 5 5 4 0.0 377 0 0 0 0.0 Neath Port Talbot LA 380 1 1 1 100.0 362 3 3 2 66.7 402 3 2 2 66.7 394 0 0 0 0.0 Swansea LA 666 13 11 9 69.2 639 23 15 13 56.5 652 16 13 12 75.0 677 10 7 6 60.0 Health Board Total 1448 16 14 11 68.8 1361 26 18 15 57.7 1426 24 20 18 75.0 1448 10 7 6 60.0 Aneurin Bevan Blaenau Gwent LA 211 2 2 2 100.0 168 3 3 3 100.0 177 3 2 1 33.3 246 0 0 0 0.0 Caerphilly LA 532 4 2 2 50.0 539 4 3 1 25.0 461 4 4 4 100.0 511 3 1 0 0.0 Monmouthshire LA 223 2 2 1 50.0 196 3 3 2 66.7 227 3 2 2 66.7 272 2 1 0 0.0 Newport LA 478 8 7 5 62.5 479 10 7 5 50.0 485 10 9 7 70.0 496 3 2 2 66.7 Torfaen LA 261 0 0 0 0.0 273 0 0 0 0.0 287 3 3 3 0.0 300 1 1 0 0.0 Health Board Total 1705 16 13 10 62.5 1655 20 16 11 55.0 1637 23 20 17 73.9 1825 9 5 2 22.2 Betsi Cadwalladr University Anglesey LA 189 0 0 0 0.0 196 0 0 0 0.0 160 1 1 1 0.0 205 2 1 0 0.0 Conwy LA 285 0 0 0 0.0 277 2 2 1 50.0 281 4 4 3 75.0 350 3 2 1 33.3 Denbighshire LA 240 3 2 1 33.3 283 1 1 1 100.0 246 3 2 2 66.7 323 1 1 0 0.0 Flintshire LA 408 5 3 2 40.0 433 1 0 0 0.0 442 6 4 4 66.7 459 2 1 0 0.0 Gwynedd LA 322 7 6 3 42.9 316 6 4 3 50.0 301 6 3 0 0.0 338 2 2 2 100.0 Wrexham LA 424 7 5 5 71.4 390 3 3 1 33.3 395 6 6 5 83.3 364 1 1 1 100.0 Health Board Total 1868 22 16 11 50.0 1895 13 10 6 46.2 1825 26 20 15 57.7 2039 11 8 4 36.4 Cardiff and Vale University Cardiff LA 1120 38 32 23 60.5 1083 32 29 19 59.4 989 61 54 43 70.5 1033 23 15 11 47.8 Vale of Glamorgan LA 359 2 2 2 100.0 371 5 4 3 60.0 354 5 3 2 40.0 429 8 4 3 37.5 Health Board Total 1479 40 34 25 62.5 1454 37 33 22 59.5 1343 66 57 45 68.2 1462 31 19 14 45.2 Cwm Taf Merthyr Tydfil LA 180 1 1 0 0.0 194 1 1 0 0.0 187 1 1 1 100.0 183 2 2 2 100.0 Rhondda Cynon Taff LA 683 2 2 1 50.0 691 7 5 4 57.1 666 6 6 5 83.3 709 3 1 1 33.3 Health Board Total 863 3 3 1 33.3 885 8 6 4 50.0 853 7 7 6 85.7 892 5 3 3 60.0 Hywel Dda Carmarthenshire LA 506 7 3 3 42.9 515 7 7 2 28.6 454 2 1 1 50.0 458 2 1 1 50.0 Ceredigion LA 128 2 1 1 50.0 162 2 2 1 50.0 140 2 2 1 50.0 191 0 0 0 0.0 Pembrokeshire LA 305 3 3 1 33.3 314 5 5 5 100.0 309 3 3 3 100.0 379 0 0 0 0.0 Health Board Total 939 12 7 5 41.7 991 14 14 8 57.1 903 7 6 5 71.4 1028 2 1 1 50.0 Powys Teaching Health Board 293 4 4 2 50.0 302 2 1 1 50.0 321 2 1 1 50.0 404 1 1 1 100.0 Unknown 78 3 3 2 66.7 61 0 0 0 0.0 58 2 2 0 0.0 104 1 1 0 0.0 Wales Total 8673 116 94 67 57.8 8604 120 98 67 55.8 8366 157 133 107 68.2 9202 70 45 31 44.3 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