Protecting the population of Scotland from vaccine preventable diseases: Vaccination and Immunisation Report
Annual report in 2024

About this release

This release by Public Health Scotland (PHS) is the second annual Vaccination and Immunisation Report. This report provides an overview of vaccine preventable disease (VPD) surveillance and health protection activities, uptake/coverage statistics of vaccines offered across the life course, and key achievements and challenges in delivering the vaccination and immunisation programme in Scotland in 2024.

Main points

Scotland has a very successful vaccination and immunisation programme with high uptake / coverage rates. However, as seen in other nations, there have been in declines in uptake over time and gaps in uptake due to inequalities.

Childhood immunisation uptake rates

• Childhood immunisation uptake was lower in 2024 compared to 2023 across most vaccines and ages, raising concern especially amidst increased measles and pertussis cases.
• Uptake of measles, mumps, and rubella (MMR)1 by 5 years of age declined to the lowest levels recorded over the last decade in the quarter ending December 2024 (95.2%), (Figure 1).
• Uptake of MMR2 by 5 years remained below 90.0%, ranging from 89.1% to 89.4%, in each of the quarters in 2024. The difference in MMR2 uptake by 5 years between those living in the least and most deprived quintiles, as measured by the Scottish Index of Multiple Deprivation (SIMD) was 10.3%.
• While Scotland-level immunisation uptake remains high, this masks inequalities. There is lower uptake in those living in, and attending school in, more deprived areas, and within certain ethnic groups. Evidence indicates that delayed immunisation and incomplete vaccination schedules are more likely among individuals living in the most deprived areas.

Teenage immunisation uptake rates

• Teenage immunisation uptake rates showed little or no improvement in 2024 and remain below pre-COVID-19 pandemic levels.
• Human Papillomavirus (HPV) vaccine coverage was 71.5% in school year 2023/24 in S1 pupils, down from 72.9% in 2022/23, and 73.5% in 2021/22. This ranged by NHS Health Board from 59.3% to 80.5%.
• For MenACWY and Td/IPV vaccines, there was a difference of almost 25 percentage points between S3 pupils attending schools in the least and most deprived areas, and over 20 percentage points for S4 pupils. This gap has widened over time, particularly since the pandemic.

Figure 1 is a graph of quarterly trends in childhood immunisation uptake by 12 months in Scotland, from March 2016 to December 2024. National trends show long term declines in uptake since March 2016 followed by a period of increasing uptake in March 2018, and through the first COVID-19 lockdown, before declining again from 2022 until more recently with declines possibly slowing with some improvements observed in quarterly data, particularly from March to September 2024.

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Figure 1: Quarterly trends in childhood immunisation uptake (%) by 5 years in Scotland, March 2016 to December 2024

Adult immunisation uptake rates

• Scotland's respiratory syncytial virus (RSV) immunisation programme was launched in August 2024. In the first year, the programme achieved good uptake with 70.6% of eligible older adults and 49.6% of pregnant women vaccinated. Early research indicates a 62% reduction in RSV-related hospitalisations among the older adult eligible age group following introduction of the vaccine.
• While there was high uptake of influenza vaccine this winter in older care home residents (83.8%) and among adults aged 75 years and older (80.6%); uptake was lower in healthcare workers (35.9%) and social care workers (17.2%).
• Coverage of shingles vaccine among the eligible population was 70.8%. Specifically, this was 49.4% for 65-years, 63.1% for 70-years, 77.9% for 71-79 years, and 56.5% for individuals with a severely weakened immune system.

Vaccine Preventable Diseases

• Scotland, as well as the rest of the UK and Europe, experienced a significant surge in pertussis with 7,051 laboratory-confirmed cases in 2024. An increase in cases was expected due to the cyclical nature of pertussis which had been delayed due to COVID-19 infection control restrictions; however, the magnitude was unprecedented.
• Amid a resurgence of measles in Europe, only 24 laboratory-confirmed measles cases were reported in Scotland in 2024. This reflects robust public health management to prevent onward transmission and the success of the MMR vaccination programme.
• In winter 2024/25, Scotland experienced a high number of influenza cases, similar to levels in 2022/23, but with no unexpected or disproportionate rise in flu-related hospitalisations or deaths, and with no evidence of increased severity compared to previous years.

Key vaccination and immunisation activities (2024)

• Scotland's 5-year Vaccination and Immunisation Framework and Delivery Plan was published in November 2024. The strategic document provides clear objectives: improving vaccine uptake, reducing inequalities, and averting illnesses. It also outlines four key priorities that will guide future work: equitable vaccine access, making every contact count, strengthening capacity and capability, and taking a system-wide approach.
• Over the year, PHS Vaccination and Immunisation Division (VAID) colleagues visited each of the 14 territorial NHS Health Boards. The visits were invaluable for meeting teams, understanding local challenges and sharing of good practice. They also provided a platform for open dialogue discussing opportunities for improvements.
• To enhance local insights relating to inequalities and support targeted action, PHS began reporting childhood and teenage immunisation data by ethnicity and urban-rural classification for the first time in 2024, complementing existing deprivation breakdowns.

Background

The Scottish Vaccination and Immunisation Programme (SVIP) has responsibility for all delivery aspects of vaccinations and immunisations in Scotland. There is an emphasis on partnership working between PHS, national and territorial NHS Boards, the Scottish Government, Health and Social Care partnerships (HSCP), and third sector organisations. PHS is the lead organisation in SVIP, with activities coordinated through the Vaccination and Immunisation Division (VAID) within the Clinical and Protecting Health (CPH) directorate.

Scotland delivers a comprehensive immunisation programme, with routine vaccines offered across all life stages and provided free of charge by the NHS. Details of the vaccines offered in 2024 are accessible via NHS Inform and the Public Health Scotland (PHS) website.

Further information

The next release of this publication will be June 2026.