{ "schema_version": "1.0.0", "as_of": "2026-10-19", "period": "2025/26", "release": "UKHSA annual COVER, published 27 August 2026, revised 13 October 2026", "units": { "percentages": "0–100; not proportions", "counts": "children", "gaps": "percentage points" }, "area_codes": { "Hounslow": "E09000018", "London": "E12000007", "England": "E92000001", "Ealing": "E09000009", "Hillingdon": "E09000017", "Richmond upon Thames": "E09000027" }, "denominators_by_cohort": { "12_months": { "England": 565208, "London": 102236, "Ealing": 4486, "Hillingdon": 3697, "Hounslow": 3381, "Richmond upon Thames": 1709 }, "24_months": { "England": 576882, "London": 101300, "Ealing": 4439, "Hillingdon": 3620, "Hounslow": 3410, "Richmond upon Thames": 1785 }, "5_years": { "England": 628371, "London": 107318, "Ealing": 4520, "Hillingdon": 3713, "Hounslow": 3656, "Richmond upon Thames": 2271 } }, "measures": [ { "id": "six_in_one_12m", "label": "6-in-1 primary course by 12 months", "cohort": "12_months", "percentages": { "England": 90.5, "London": 85.1, "Ealing": 88.8, "Hillingdon": 90.9, "Hounslow": 89, "Richmond upon Thames": 89.6 }, "vaccinated_counts": { "England": 511548, "London": 87020, "Ealing": 3984, "Hillingdon": 3360, "Hounslow": 3009, "Richmond upon Thames": 1532 }, "hounslow_minus_england_percentage_points": -1.5, "source_tables": [ "T4a_UTLA12m", "T4b_UTLA12m" ] }, { "id": "six_in_one_24m", "label": "6-in-1 primary course by 24 months", "cohort": "24_months", "percentages": { "England": 92.3, "London": 86.8, "Ealing": 88.8, "Hillingdon": 92.2, "Hounslow": 86.1, "Richmond upon Thames": 91.3 }, "vaccinated_counts": { "England": 532475, "London": 87949, "Ealing": 3944, "Hillingdon": 3338, "Hounslow": 2935, "Richmond upon Thames": 1629 }, "hounslow_minus_england_percentage_points": -6.2, "source_tables": [ "T5a_UTLA24m", "T5b_UTLA24m" ] }, { "id": "mmr1_24m", "label": "MMR first dose by 24 months", "cohort": "24_months", "percentages": { "England": 87.9, "London": 79.5, "Ealing": 82.7, "Hillingdon": 86.2, "Hounslow": 82.5, "Richmond upon Thames": 82.5 }, "vaccinated_counts": { "England": 507201, "London": 80495, "Ealing": 3673, "Hillingdon": 3122, "Hounslow": 2813, "Richmond upon Thames": 1473 }, "hounslow_minus_england_percentage_points": -5.4, "source_tables": [ "T5a_UTLA24m", "T5b_UTLA24m" ] }, { "id": "menb_booster_24m", "label": "MenB booster by 24 months", "cohort": "24_months", "percentages": { "England": 86.8, "London": 77.5, "Ealing": 79.7, "Hillingdon": 84.1, "Hounslow": 77.8, "Richmond upon Thames": 85.4 }, "vaccinated_counts": { "England": 500872, "London": 78471, "Ealing": 3537, "Hillingdon": 3043, "Hounslow": 2654, "Richmond upon Thames": 1525 }, "hounslow_minus_england_percentage_points": -9, "source_tables": [ "T5a_UTLA24m", "T5b_UTLA24m" ] }, { "id": "pcv_booster_24m", "label": "PCV booster by 24 months", "cohort": "24_months", "percentages": { "England": 87.5, "London": 78.6, "Ealing": 81.7, "Hillingdon": 85, "Hounslow": 81, "Richmond upon Thames": 83.6 }, "vaccinated_counts": { "England": 504845, "London": 79642, "Ealing": 3626, "Hillingdon": 3076, "Hounslow": 2763, "Richmond upon Thames": 1492 }, "hounslow_minus_england_percentage_points": -6.5, "source_tables": [ "T5a_UTLA24m", "T5b_UTLA24m" ] }, { "id": "mmr1_5y", "label": "MMR first dose by 5 years", "cohort": "5_years", "percentages": { "England": 92.1, "London": 85, "Ealing": 86.5, "Hillingdon": 91, "Hounslow": 86.8, "Richmond upon Thames": 90 }, "vaccinated_counts": { "England": 578749, "London": 91191, "Ealing": 3909, "Hillingdon": 3380, "Hounslow": 3173, "Richmond upon Thames": 2045 }, "hounslow_minus_england_percentage_points": -5.3, "source_tables": [ "T6a_UTLA5y", "T6b_UTLA5y" ] }, { "id": "mmr2_5y", "label": "MMR second dose by 5 years", "cohort": "5_years", "percentages": { "England": 83.8, "London": 70.4, "Ealing": 74.2, "Hillingdon": 79.2, "Hounslow": 71.8, "Richmond upon Thames": 70.2 }, "vaccinated_counts": { "England": 526316, "London": 75589, "Ealing": 3352, "Hillingdon": 2941, "Hounslow": 2625, "Richmond upon Thames": 1595 }, "hounslow_minus_england_percentage_points": -12, "source_tables": [ "T6a_UTLA5y", "T6b_UTLA5y" ] }, { "id": "dtap_ipv_booster_5y", "label": "Preschool dTaP/IPV booster by 5 years", "cohort": "5_years", "percentages": { "England": 81.9, "London": 66.9, "Ealing": 69.6, "Hillingdon": 75.5, "Hounslow": 68, "Richmond upon Thames": 67.5 }, "vaccinated_counts": { "England": 514868, "London": 71771, "Ealing": 3146, "Hillingdon": 2803, "Hounslow": 2487, "Richmond upon Thames": 1534 }, "hounslow_minus_england_percentage_points": -13.9, "source_tables": [ "T6a_UTLA5y", "T6b_UTLA5y" ] } ], "source": { "title": "Vaccination coverage statistics for children aged up to 5 years, England (COVER programme): April 2025 to March 2026", "landing_url": "https://www.gov.uk/government/statistics/cover-of-vaccination-evaluated-rapidly-cover-programme-april-2025-to-march-2026", "data_url": "https://assets.publishing.service.gov.uk/media/6accde83b8542d3693fd434e/cover-annual-data-tables-2025-to-2026.ods", "methodology_url": "https://www.gov.uk/government/statistics/cover-of-vaccination-evaluated-rapidly-cover-programme-april-2025-to-march-2026/vaccination-coverage-statistics-for-children-aged-up-to-5-years-england-cover-programme-report-april-2025-to-march-2026", "original_local_file": "work/vaccination_action/cover-annual-data-tables-2025-to-2026.ods", "extract_local_file": "work/vaccination_action/vaccination_2025_26_extract.json" }, "historical_headline": { "period": "2024/25", "verified_metric": "Recorded MMR two-dose coverage by fifth birthday", "hounslow_percentage": 70.8, "hounslow_vaccinated_count": 2658, "hounslow_denominator": 3752, "london_percentage": 69.6, "england_percentage": 83.7, "verification": "Direct source UKHSA tables T6a_UTLA5y and T6b_UTLA5y; same 70.8 value as Childhood Lottery dataset identified by report_audit.", "data_url": "https://assets.publishing.service.gov.uk/media/6a61dba291d54bc7d5127e4d/cover-annual-data-tables-2024-to-2025.ods", "landing_url": "https://www.gov.uk/government/statistics/cover-of-vaccination-evaluated-rapidly-cover-programme-april-2024-to-march-2025", "crosscheck_url": "https://fingertips.phe.org.uk/static-reports/public-health-outcomes-framework/at-a-glance/E09000018.html?area-name=Hounslow", "caveat": "The historical table's Note 23 says system changes in 14 London UTLAs and changes to multiple-dose calculations mean MMR2 and preschool-booster coverage is likely underestimated; reported falls in these vaccines should not be used for local performance management or alone to direct public health action. Hounslow is named.", "interpretation": "Do not call this coverage of all childhood vaccines. Report annex's MMRV label for 2024/25 is anachronistic relative to the UKHSA MMR2 source; MMRV routine introduction was January 2026." }, "caveats": [ "Annual birth-cohort coverage means children reaching ages 1, 2 or 5 during April 2025–March 2026; it is not a snapshot of every resident child.", "Different ages and successive annual releases represent different cohorts; do not infer individual dropout, causality or change in service quality from cross-sectional age gaps.", "Latest annual methodology excludes GP-unregistered children from Hounslow and 13 other London UTLAs because their denominator data are uncertain. These estimates do not cover all children needing services.", "UKHSA warns population movement can cause underestimation of coverage in highly urbanised areas, including London.", "Counts of children without recorded vaccination are not proven counts of children never vaccinated; overseas records, record transfer and moves require reconciliation.", "Do not assign GP practice coverage to the ward containing the surgery. Ward uptake requires child-residence-based anonymised CHIS data with safe aggregation and suppression.", "No available ward vaccination figures or linked individual analysis establish housing type, overcrowding, HMO residence, ethnicity, religion or culture as causes of low Hounslow coverage.", "An ecological association between ward composition and uptake could reflect confounding by deprivation, mobility, household age structure, language or service access; 22 wards are too few for a credible model with many correlated predictors.", "Census 2021 housing and population composition are dated and all-household exposures should not be treated as conditions of households with children. Raw HMO rows mix boundary labels and expired licences and do not measure poor conditions or illegality.", "National schedule changed in July 2025 and January 2026. Use vaccine/dose and birth-cohort definitions consistently; later MMRV indicators must not be silently joined to historical MMR indicators.", "The 2024/25 and 2025/26 official source-table national MMR2 values are 83.7 and 83.8 respectively. Preserve the Childhood Lottery workbook's own comparator separately if different, rather than overwriting the published report.", "Proposed 90-day owners and milestones are recommendations, not verified existing service commitments; avoid attributing negligence from coverage alone." ], "accountability": [ { "role": "NHS England London regional public health commissioner", "current_responsibility": "Section 7A vaccination commissioning in 2026/27; contract oversight and assurance should be requested alongside local improvement activity.", "evidence_url": "https://www.england.nhs.uk/long-read/medium-term-planning-framework-revenue-finance-and-contracting-guidance/", "evidence_section": "6.1, paragraphs 67–68" }, { "role": "NHS West and North London Integrated Care Board", "current_responsibility": "Current ICB covering Hounslow; strategic health commissioning and local primary-care/service improvement. Coordinate with NHSE commissioner, council and providers.", "evidence_url": "https://www.westandnorthlondon.icb.nhs.uk/how-we-are-run", "additional_url": "https://www.westandnorthlondon.icb.nhs.uk/" }, { "role": "NHS England / future ICB vaccination commissioning transition", "current_responsibility": "Earlier April 2026 delegation proposal was superseded. Transfer expected from April 2027 subject to legislation; do not claim it already happened.", "evidence_url": "https://www.england.nhs.uk/long-read/accountability-report-24-25/", "evidence_section": "Vaccinations and screening – governance and the Section 7A agreement" }, { "role": "Each GP practice's named vaccination lead", "current_responsibility": "Named lead, invitations/recall, convenient sufficient appointments, accurate records including overseas arrivals, CHIS data sharing and catch-up participation.", "evidence_url": "https://www.england.nhs.uk/long-read/general-practice-vaccination-and-immunisation-services-standards-and-core-contractual-requirements-2/", "evidence_version": "5, updated 8 September 2026", "measurable_requirements": "Initial invitation plus at least two recalls where required; third contact by healthcare professional; convenient appointments including evenings/weekends; timely follow-up and flags." }, { "role": "Council public health and Health and Wellbeing Board, with NHS partners", "current_responsibility": "Coordinate and scrutinise delivery of existing local childhood immunisation action plan; publish owners, budget and outcomes.", "evidence_url": "https://democraticservices.hounslow.gov.uk/documents/s203263/HWB%20Strategy%20Progress%20Report%20Q1%20October%2015th%202025%20meeting.pdf", "additional_url": "https://democraticservices.hounslow.gov.uk/documents/g13725/Public%20reports%20pack%20Tuesday%2013-Jan-2026%2017.30%20Hounslow%20Health%20and%20Wellbeing%20Board.pdf?T=10", "evidence": "October 2025 reports agreed local action plan; January 2026 reports delivery begun and childhood immunisation amber." } ], "causal_evidence_sources": [ { "title": "Hounslow PNA 2025", "url": "https://www.hounslow.gov.uk/downloads/file/10598/pharmaceutical-needs-assessment-2025", "finding": "Reasons for low local coverage incompletely understood; population turnover may contribute." }, { "title": "UKHSA National Immunisation Programme Health Equity Audit 2025, published March 2026", "url": "https://www.gov.uk/government/publications/national-immunisation-programme-health-equity-audit-2025/national-immunisation-programme-health-equity-audit-2025", "finding": "Deprivation and ethnic inequalities warrant analysis, but some Asian groups have comparable or greater uptake than White British populations. Data quality and linkage gaps limit targeting." }, { "title": "UKHSA determinants review", "url": "https://www.gov.uk/government/publications/national-immunisation-programme-health-equity-audit-2025/appendix-4-narrative-review-of-the-determinants-of-vaccination-uptake", "finding": "Measure appointment availability, booking failures, interpreting, navigation, overseas vaccination-record translation, travel/time costs and confidence separately; cultural background alone is not an explanatory measure." } ], "proposed_90_day_actions": [ { "days": "1–30", "action": "Publish existing immunisation plan, senior owners, budget and milestones.", "owners": [ "Council Director of Public Health", "NHSE London", "West and North London ICB" ], "measure": "Dated public action plan with named role owners and reporting date." }, { "days": "1–30", "action": "Reconcile GP/CHIS records and produce resident ward/LSOA aggregates, keeping unknown/unregistered groups visible.", "owners": [ "CHIS provider", "GP leads", "ICB analytics", "Council public health" ], "measure": "Coverage numerators/denominators, unmatched records and unknown status; no patient-level public data." }, { "days": "15–60", "action": "Audit practices against current invitation, recall, appointment and recording standards.", "owners": [ "GP vaccination leads", "ICB primary care team", "NHSE commissioner" ], "measure": "Successful contacts, overdue cohort counts, appointment waits, evening/weekend access and follow-up completion." }, { "days": "30–75", "action": "Pilot supported catch-up where local residence data identify greatest need; include temporary accommodation if supported by evidence.", "owners": [ "NHS provider/commissioner", "Housing team", "Health visitors", "Family Hubs" ], "measure": "Additional completions, attendance, interpreter provision, unresolved access needs and cost." }, { "days": "30–75", "action": "Interview overdue families across housing, language and ethnic groups, including families who accept but cannot attend.", "owners": [ "Healthwatch/community partners", "Public health" ], "measure": "Separately documented access, information, confidence, refusal, mobility and record-transfer barriers." }, { "days": "90", "action": "Publish outcome and data-quality review and decide which pilots to sustain.", "owners": [ "Health and Wellbeing Board", "NHS partners" ], "measure": "Coverage, overdue counts, inequality gap, missed opportunities and corrected records; distinguish data fixes from new vaccinations." } ] }