Immunisation: DTaP (8 months)
Indicator
The percentage of babies who reached 8 months old in the preceding 12 months, who have received at least 3 doses of a diphtheria, tetanus and pertussis containing vaccine before the age of 8 months.
Indicator type
General practice indicator suitable for use in the Quality and Outcomes Framework.
This document does not represent formal NICE guidance. For a full list of NICE indicators, see our menu of indicators.
To find out how to use indicators and how we develop them, see our NICE indicator process guide.
Rationale
Diphtheria, tetanus and pertussis (whooping cough) are acute infectious diseases that can have severe complications. The routine immunisation schedule states that the hexavalent (6-in-1) vaccine is due at 8, 12 and 16 weeks old for immunisation to diphtheria, tetanus and pertussis (DTaP) as well as poliomyelitis (IPV), haemophilus influenzae type B (Hib) and hepatitis B (see the UK Health Security Agency's Complete routine immunisation schedule 2024).
The indicator supports early vaccination with the hexavalent vaccine according to the routine immunisation schedule. Measurement by 8 months old allows for vaccination deferral due to febrile illness but aims to achieve immunisation against the named acute infectious diseases as early as possible.
Source guidance
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Vaccine uptake in the general population. NICE guideline NG218 (2022), recommendations 1.2.3, 1.2.9, 1.2.21, 1.3.7, 1.3.8 and 1.3.14 to 1.3.16
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Immunizations – childhood. NICE clinical knowledge summary (updated 2024)
Specification
Numerator: The number in the denominator who have received 3 doses of a diphtheria, tetanus and pertussis containing vaccine before they reached 8 months old.
Denominator: The number of babies who reached 8 months old in the preceding 12 months.
Calculation: Numerator divided by denominator, multiplied by 100.
Exclusions: Babies with a confirmed anaphylactic reaction to a previous dose of the vaccine or any component of the vaccine.
Personalised care adjustments or exception reporting should be considered to account for situations where the patient declines, does not attend or if the immunisation is not appropriate.
Expected population size: Quality and Outcomes Framework data for 2022 to 2023 (indicator VI001) shows that 1.0% of people in England reached 8 months old in the preceding 12 months: 95 patients for an average practice with 10,000 patients. To be suitable for use in QOF, there should be more than 20 patients eligible for inclusion in the denominator, per average practice with 10,000 patients, prior to application of personalised care adjustments.