NI Audit Office Media Release - Pre-School Vaccinations in Northern Ireland

Northern Ireland’s Comptroller & Auditor General (C&AG) has today (Friday 5 May 2023) published a report on Pre-School Vaccinations in Northern Ireland.

Dorinnia Carville’s report considers outcomes of vaccination against 14 infectious diseases among pre-school children, and the benchmarking of vaccination coverage against the World Health Organisation’s (WHO) target of 95 per cent, recommended to ensure population immunity.

The report finds overall vaccination coverage has steadily been declining for almost all diseases and increasing numbers of children have not received all the vaccinations available to maximise protection against harmful diseases.  Across Northern Ireland, there are 15,000 children who have not been fully immunised against Measles, Mumps and Rubella (MMR) over the last seven years. In addition, a total of 10,200 children have not received all the recommended doses of the Pneumococcal Conjugate Vaccine (PCV) since 2015.

While this downward trend in coverage is reflected in other parts of the UK, the report notes that data reveals regional variation in the uptake of vaccinations, with particularly low levels in Belfast. Within the Belfast Health and Social Care Trust area, 1 in 3 children have not been fully immunised against pneumococcal disease since 2015, and 1 in 7 have missed ‘6-in-1’[1] vaccine doses which protect against multiple diseases, over the last seven years.

More positively the report notes that vaccination rates in three of Northern Ireland’s five health trusts were close to or above the WHO target.

Commenting on the report’s findings, the C&AG said:

“Vaccination against infectious disease remains one of the most successful and cost-effective ways to help manage the health of a population.  However, as many vaccine-preventable diseases require a series of immunisations to be administered to infants and small children at pre-determined intervals, overall effectiveness is heavily reliant on consistently high levels of participation.

“Whilst there is no single reason for the declining rates of vaccination coverage shown, workforce shortages and delivery capacity within GP practices in Northern Ireland are likely to have contributed to the overall trend.  It is hugely important that there is a comprehensive plan of action to reverse the decline.”


Notes for Editors


  1. The Comptroller and Auditor General (C&AG) is Head of the Northern Ireland Audit Office (the Audit Office). She and the NIAO are totally independent of Government. The C&AG certifies the accounts of Government Departments and a range of other public sector bodies. She has statutory authority to report to the Assembly on the economy, efficiency and effectiveness with which departments and public bodies use their resources. Her reports are published as Assembly papers.


  1. The report is available on the Audit Office website at The report is embargoed until 00.01 hrs on Friday 5 May 2023.


  1. Background briefing can be obtained from the Northern Ireland Audit Office by contacting Roger McCance (028 9025 4312).

[1] ‘6-in-1’ vaccines protect against diphtheria; tetanus; pertussis; polio; Haemophilus influenza type b (Hib) and hepatitis B.