Rapid communication Open Access
Like 0


Using electronic health records, we assessed the early impact of coronavirus disease (COVID-19) on routine childhood vaccination in England by 26 April 2020. Measles-mumps-rubella vaccination counts fell from February 2020, and in the 3 weeks after introduction of physical distancing measures were 19.8% lower (95% confidence interval: −20.7 to −18.9) than the same period in 2019, before improving in mid-April. A gradual decline in hexavalent vaccination counts throughout 2020 was not accentuated by physical distancing.


Article metrics loading...

Loading full text...

Full text loading...



  1. Office for National Statistics and Public Health England. Childhood vaccination coverage statistics - England 2018-192019. Leeds: NHS Digital; 26 Sep 2019. Available from: https://digital.nhs.uk/data-and-information/publications/statistical/nhs-immunisation-statistics/england-2018-19
  2. Public Health England (PHE). Cover of vaccination evaluated rapidly (COVER) programme 2019 to 2020: quarterly data. London: PHE; [Accessed: 13 May 2020]. Available from: https://www.gov.uk/government/statistics/cover-of-vaccination-evaluated-rapidly-cover-programme-2019-to-2020-quarterly-data
  3. Public Health England (PHE). Immunisation against infectious disease (the Green Book). Chapter 11: UK immunisation schedule. PHE publications gateway number 2019219. London: PHE; [Accessed: 10 May 2020]. Available from: https://www.gov.uk/government/publications/immunisation-schedule-the-green-book-chapter-11
  4. The Phoenix Partnership (TPP). What is SystmOne? Leeds: TPP. [Accessed: 12 May 2020]. Available from: https://www.tpp-uk.com/products/systmone/
  5. Public Health England (PHE). Coronavirus (COVID-19): What is social distancing? London: PHE. [Updated: 23 March 2020]. Available from: https://publichealthmatters.blog.gov.uk/2020/03/04/coronavirus-covid-19-what-is-social-distancing/
  6. Public Health England (PHE). [Withdrawn] Guidance on social distancing for everyone in the UK. London: PHE. (23 March 2020 update) 2020. Available from: https://www.gov.uk/government/publications/covid-19-guidance-on-social-distancing-and-for-vulnerable-people/guidance-on-social-distancing-for-everyone-in-the-uk-and-protecting-older-people-and-vulnerable-adults
  7. Kim HJ, Fay MP, Feuer EJ, Midthune DN. Permutation tests for joinpoint regression with applications to cancer rates. Stat Med. 2000;19(3):335-51.  https://doi.org/10.1002/(SICI)1097-0258(20000215)19:3<335::AID-SIM336>3.0.CO;2-Z  PMID: 10649300 
  8. Public Health England (PHE). Independent report. Statement from JCVI on immunisation prioritisation. London: PHE; 17 Apr 2020. Available from: https://www.gov.uk/government/publications/jcvi-statement-on-immunisation-prioritisation/statement-from-jcvi-on-immunisation-prioritisation
  9. Times of Israel Staff. Vaccinations drop amid COVID-19 fears, raising specter of fresh measles outbreak. Times of Israel. 24 Apr 2020. Available from: https://www.timesofisrael.com/vaccinations-drop-amid-virus-fears-raising-specter-of-fresh-measles-outbreak/
  10. Hart C. Confessions of a pediatric practice management consultant. The Effect of COVID-19 On Immunization Rates. 6 Apr 2020. Available from: https://chipsblog.pcc.com/the-effect-of-covid-19-on-immunization-rates
  11. Santoli JM, Lindley MC, DeSilva MB, Kharbanda EO, Daley MF, Galloway L, et al. Effects of the COVID-19 Pandemic on Routine Pediatric Vaccine Ordering and Administration — United States, 2020. MMWR Morb Mortal Wkly Rep. 2020;69(19).  https://doi.org/10.15585/mmwr.mm6919e2 
  12. Kontopantelis E, Stevens RJ, Helms PJ, Edwards D, Doran T, Ashcroft DM. Spatial distribution of clinical computer systems in primary care in England in 2016 and implications for primary care electronic medical record databases: a cross-sectional population study. BMJ Open. 2018;8(2):e020738.  https://doi.org/10.1136/bmjopen-2017-020738  PMID: 29490968 
  13. Office for National Statistics (ONS). Births in England and Wales: 2018. Newport: ONS. 1 Aug 2019. Available from: https://www.ons.gov.uk/peoplepopulationandcommunity/birthsdeathsandmarriages/livebirths/bulletins/birthsummarytablesenglandandwales/2018
  14. Funk S, Knapp JK, Lebo E, Reef SE, Dabbagh AJ, Kretsinger K, et al. Combining serological and contact data to derive target immunity levels for achieving and maintaining measles elimination. BMC Med. 2019;17(1):180.  https://doi.org/10.1186/s12916-019-1413-7  PMID: 31551070 
  15. World Health Organization Regional Office for Europe (WHO/Europe). Guidance on routine immunization services during COVID-19 pandemic in the WHO European Region. Copenhagen: WHO/Europe. 20 Mar 2020. Available from: http://www.euro.who.int/__data/assets/pdf_file/0004/433813/Guidance-routine-immunization-services-COVID-19-pandemic.pdf?ua=1

Data & Media loading...

Comment has been disabled for this content
Submit comment
Comment moderation successfully completed
This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error