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2025 theme: Vaccines

Abstract

BACKGROUND

Many countries use school-based vaccination for adolescent vaccination; it has been shown to reduce inequities in uptake compared with other delivery routes. In England, coverage for human papillomavirus (HPV), meningococcal groups A, C, W and Y (MenACWY) and tetanus, diphtheria and inactivated polio virus (Td/IPV) vaccine programmes exceeded 80% before the COVID-19 pandemic. However, recent data show declining uptake.

AIM

This study examined the relationship between socio-economic deprivation and coverage over time.

METHODS

We conducted an ecological analysis of first-dose coverage for HPV (females and males), MenACWY and TdIPV in adolescents across 150 local authorities in England from 2017 to 2024. Coverage data were linked to 2025 Index of Multiple Deprivation (IMD) scores. Associations between IMD quintile, academic year and vaccination coverage were estimated using beta regression models.

RESULTS

Between 2020 and 2024, lower coverage was consistently associated with higher deprivation, and differences in coverage between the most and least deprived IMD quintiles more than doubled. In 2024 these differences were 17.7%, 18.2%, 16∙8% and 16.9% for HPV (females), HPV (males), MenACWY and Td/IPV, respectively. The consistency of these findings suggests the effect of deprivation on coverage is not vaccine-specific.

CONCLUSION

We demonstrated a consistent and strengthening association between coverage and deprivation across multiple adolescent school-based vaccination programmes in England over time. Contributory factors may be numerous, and further research is needed to understand which factors are driving trends for different populations. Addressing these inequalities will require sustained targeted interventions to improve awareness of and access to vaccination.

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This work is licensed under a Creative Commons Attribution 4.0 International License.
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/content/10.2807/1560-7917.ES.2026.31.13.2500586
2026-04-02
2026-04-10
/content/10.2807/1560-7917.ES.2026.31.13.2500586
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Inequalities in adolescent HPV, Td/IPV and MenACWY vaccination coverage by socio-economic status: an ecological study, England, 2017 to 2024
<p class="citation"> <span>Citation style for this article:</span> <span class="meta-value authors"> <a href="/search?value1=Muhammad+Ibaad+Alvi&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Alvi Muhammad Ibaad</a>, <a href="/search?value1=Laura+Viviani&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Viviani Laura</a>, <a href="/search?value1=Susan+Hopkins&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Hopkins Susan</a>, <a href="/search?value1=Kate+Soldan&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Soldan Kate</a>, <a href="/search?value1=Sharif+Ismail&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Ismail Sharif</a></span>. Inequalities in adolescent HPV, Td/IPV and MenACWY vaccination coverage by socio-economic status: an ecological study, England, 2017 to 2024. <a href="/content/ecdc">Euro Surveill.</a> 2026;31(13):pii=2500586. <a href="https://doi.org/10.2807/1560-7917.ES.2026.31.13.2500586" title="doi link" target="_blank">https://doi.org/10.2807/1560-7917.ES.2026.31.13.2500586</a> <span class="ES_Article_citation"> <span class="generated">Received</span>: 04 Aug 2025;&nbsp;&nbsp; <span class="generated">Accepted</span>: 13 Jan 2026 </span> </p>
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