Immunisations: Teenagers

Data are derived from the Child Health System Programme School system (CHSP School) and Scottish Immunisation and Recall System (SIRS). They are used by all NHS Boards in Scotland.

Teenagers are offered two vaccines boosters at around 14 years of age:

• The teenage Td/IPV booster vaccine, which boosts protection against tetanus, diphtheria and polio.
• The MenACWY vaccine, which protects against meningitis and septicaemia (blood poisoning) caused by four strains of meningococcal bacteria – meningococcal (Men) groups A, C, W and Y.

In Scotland, teenage booster vaccines are routinely offered to pupils in S3, predominantly through a school-based programme. Pupils who miss the routine teenage booster immunisation sessions in S3 are offered the vaccines in S4. Teenagers who are not fully immunised may also be offered the vaccines in their fifth year and sixth year of secondary school (S5 and S6).

Teenagers are also offered a single vaccination against the human papilloma virus (HPV) ) (prior to school year 2022/23 two doses were offered). Coverage rates are reported for males and females in their first, second, third and fourth year of secondary school (S1, S2 S3 and S4) in 2022/23.

Datasets for analysts are also available on the teenager immunisations from the Public Health Scotland website Datasets - Scottish Health and Social Care Open Data (nhs.scot) and includes data by NHS Board of school and Local Authority of residence.

Information on the incidence of theses viruses/diseases are available on the infectious diseases section of the Public Health Scotland website.

Immunisations: Inequalities in uptake for teenagers

HPV vaccine

There was a 21.0% difference in single dose coverage between the most and least deprived S1 pupils by the end of the 2022/23 school year but only a 9.2% difference for S4 pupils, with pupils in the most deprived areas less likely to have received the vaccine. There was also a gap between male and female coverage in all deprivation categories, with males having lower coverage than females. The HPV Immunisation Statistics report provides further detail about inequalities in HPV immunisation uptake for teenagers. 

Teenage booster immunisations

Inequalities across deprivation also exist for both the Td/IPV and MenACWY uptake rates for teenagers. Pupils in more deprived areas were less likely to receive the Td/IPV and MenACWY vaccines in 2022/23. By the end of S4, 66.9% and 66.9% of pupils from the most deprived areas were immunised, compared with 88.0% and 88.1% from the least deprived areas (Td/IPV vaccine and MenACWY vaccines respectively). For further information refer to the Teenage Booster Immunisation report and data files. 

A range of information on immunisation uptake rates across the world is available on the UNICEF and WHO websites. These provide comparable information for countries across the world, including the UK. There are still inequalities in immunisation rates across the world, with the UK comparing favourably. 

Immunisations: Factors affecting uptake in teenagers

HPV vaccine

• A systematic review and meta-analysis into the uptake of HPV vaccination by Fisher et al (2013) found strong evidence for inequalities in HPV vaccination initiation by ethnicity and healthcare coverage, but did not find a strong association with parental education or family income variables. The majority of studies originated from the USA.
• Examination of inequalities in the uptake of the school-based HPV vaccination programme in England by Fisher et al (2014) found uptake did not vary markedly by social deprivation, although there was evidence of differences in vaccination completion by deprivation quintile. However, associations with ethnicity and substantially lower uptake in non-mainstream educational settings were observed.
• Research by Spencer et al (2014) in the north west of England similarity found that although deprivation is not associated with routine vaccination initiation it is with completion of the vaccination schedule, with girls living in more deprived areas less likely to receive all the required doses.
• UK research by Boyce and Holmes (2012) showed that delivery of the national HPV immunisation programme differed vastly across the UK. School nurses played a key role in reducing health inequalities, according to whom, young women’s social class and educational status were the most important factors in whether vaccination would be missed, rather than religious beliefs or ethnicity, which previous research had suggested.

MenC vaccine

• Immunisation has been found low among young people who are not in education (Booth and Naracott, 2000).