A report from the Royal College of Paediatrics and Child Health (RCPCH) has highlighted the significant barriers and difficulties some parents face to get their child vaccinated from serious but preventable diseases and calls on governments to act now to prevent future outbreaks.
The World Health Organization recommends a 95% vaccination rate to keep vulnerable groups such as babies, the elderly, and those who are immunosuppressed safe through herd immunity. But in the UK, not a single routine childhood vaccine has hit that target since 2021. Over the past few years measles and whooping cough (pertussis) have seen a resurgence in the UK due to declining vaccination rates and waning immunity.
Concerned by this downward trend, RCPCH set up the Commission on Immunisation Access, Uptake and Equity and, over a 12-month period, examined national data and research, and gathered first-hand experiences from parents, healthcare workers, and children to understand what’s really preventing uptake.
The Commission concluded that the core challenges lie in logistical and systemic shortcomings and that the current system is fragmented, hard to navigate, and too often fails the very families who need it most. The Commission also found that research and public health resources are sometimes misdirected by focusing too heavily on vaccine hesitancy, when in fact there are many parents who want to vaccinate but simply can’t access services that work for them.
The report highlights the critical role of the system in addressing access-related barriers, which can deter families, especially those with questions about vaccination, from seeking immunisation for their children. When asked about these obstacles parents reported:
- Difficulty booking appointments, especially ones that fit around work commitments and childcare needs.
- Transport challenges, including inconvenient clinic locations and the high cost of public transit.
- A lack of continuity in care, with many parents seeing a different GP or clinician at each visit. The absence of health visitors was especially significant, as it limited understanding of individual family circumstances that could influence vaccination decisions.
- A lack of reminders from GP offices about upcoming vaccinations, parents and carers also reported having no easy way to determine what vaccines their children have and have not had, with no set digital records available.
- A fear of being judged for raising concerns about vaccines or having beliefs in alternative medicine.
The report also underscored the growing disparity in vaccine uptake among some ethnic minority groups, socioeconomically disadvantaged families and migrant communities. These groups reported specific challenges such as limited access to information due to language difficulties, digital exclusion, challenges in navigating the NHS, and a lack of targeted outreach.
In order to reverse declining vaccination rates, the UK must prioritise investments in infrastructure, digital health records for children, staffing levels and staff training. By addressing systemic barriers to access, including those which may more frequently affect underserved communities, the delivery and access to vaccinations can be improved for all.
Read the full findings and recommendations for change in the report ‘Vaccination in the UK: access, uptake and equity.’
RCPCH Officer for Health Improvement, Dr Helen Stewart, said:
Steady declines in vaccination rates in a wealthy country such as the United Kingdom is extremely concerning. It poses a significant risk to public health, with outbreaks of preventable diseases such as measles and whooping cough already being seen. It also weakens the UK’s pandemic preparedness for the future and puts immense strain on already struggling health services.
Vaccinations are one of the most powerful tools we have in preventing ill health. Vaccines have saved millions of children’s lives, protecting them from serious illness and life changing complications. They have fundamentally transformed the world we live in. Since the measles vaccine was introduced in the UK in 1968 it has prevented an estimated 20 million cases and 4,500 deaths. However, we are now seeing resurgence of this dangerous and preventable disease.
Parents are often blamed for vaccine hesitancy, but the reality is that there are many who simply need better support and easier access to appointments. With the right guidance and access, they’d gladly protect their children with these essential vaccines. If we are ever to truly tackle low uptake, then we must first ensure that everyone who is willing to be vaccinated is able to do so quickly and easily.
Dr Julie Yates, Deputy Director, Immunisations Programmes at UKHSA, said:
This report is a reminder that parents and carers have busy lives, and for some finding time to ensure children attend appointments can be a challenge. The pandemic also caused disruption to vaccination services and impacted uptake.
We know our colleagues in general practice and other services are working exceptionally hard to deliver our immunisation programmes and through their efforts they protect millions of children each year. However, we must not become complacent and UKHSA is committed to working with the NHS and partners to improve childhood vaccine uptake.
Despite the challenges, it is also important to note that parents have high confidence in vaccinations with almost 90% agreeing vaccines are effective. The NHS England Vaccination Strategy is already working to improve the ‘front door’ to vaccination, ensuring more flexible appointment booking systems, making vaccines more widely available across locations, making access easier and ease of responding to the specific needs identified within each community.
Getting our vaccination rates up to the 95% WHO target to eliminate these diseases will take sustained effort and a long-term effort across the public health system but we are committed to working together and with families to do this.
Alison Morton, CEO of the Institute for Health Visitors, said:
Whilst most parents get their children vaccinated without hesitation, the widening inequalities and decline in vaccine uptake rates are a national cause for concern. This timely report presents a compelling case to ensure babies and children are protected against serious diseases that were once feared by families and can cause so much unnecessary harm.
The good news is that there is lots of evidence on how to reverse the current trend - captured in the practical recommendations of this report. By working together across national government and local systems, we can tackle the systemic barriers that make it harder for some families to get the vaccines their children need. This includes investing in health visitors who remain parents’ first port of call for trusted advice and, with sufficient funding, are ideally placed to deliver vaccinations to vulnerable groups.