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J Public Health (Oxf). 2012 Dec;34(4):498-504. doi: 10.1093/pubmed/fds047. Epub 2012 Jun 18.

Teenage booster vaccine: factors affecting uptake.

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Vaccine Preventable Disease Programme, Public Health Wales, Temple of Peace and Health, Cathays Park, Cardiff, Wales CF10 3NW, UK.



The teenage booster of tetanus/diphtheria/polio vaccine is the final dose in the routine UK childhood schedule. It has the lowest uptake of all childhood vaccines in Wales and no Health Board (HB) has achieved 95% uptake. We examined the services used to deliver this vaccine across Wales in order to determine how to improve the national uptake rate.


A cross-sectional survey of the systems used to deliver the vaccine in the 7 HBs in Wales and their 22 constituent local authorities. Routinely published quarterly and annual COVER report uptake data for each HB were used to compare system effectiveness.


The vaccine was either offered in school, in general practice or in both settings. Higher uptake rates were achieved with greater consistency in schools (76-81%) compared with general practice (5-74%), and when coordinated by the HB. When an option was available, most parents chose for their child to be vaccinated in school.


Higher uptake rates of the teenage booster were observed when it was given in school compared with general practice. The findings suggest that offering the teenage booster in schools in all areas of Wales may improve vaccine uptake.

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