RCPCH has established a multidisciplinary commission to review what can be done to increase and sustain immunisation rates of children to the level that is needed. We are focusing on the UK, but hope our learning can be applied globally.
Background to this work
After clean water, vaccines are considered the greatest public health measure in history.1 No single intervention has averted more child deaths – in the decade to 2020 saving over 23 million lives worldwide.2
Yet uptake of vaccines, in the UK and around the world, has started to stall – with rates of uptake for many vaccines showing a decline each year.3 In 2020, one in five children worldwide was not fully vaccinated, with 1.5 million deaths annually from preventable disease.4 This trend began before COVID-19 with global vaccine uptake stagnating over the last decade at around 86%.5
In the UK, no childhood vaccination has met the 95% World Health Organisation target since 2020-21.6
Read the full findings and recommendations for change in the report 'Vaccination in the UK: access, uptake and equity'.
The response
Understanding fully what has led to this decline in vaccination rates is critical to ensuring appropriate and effective public health communication and vaccine delivery services.
Much current material and strategic approach in information, education and communication relies on a somewhat conventional model of public understanding, with limited impact on popular awareness and positive vaccine attitude in particular in communities most frequently underserved.
The Royal College of Paediatrics and Child Health (RCPCH) is undertaking a programme to convene a ‘Commission on Immunisation Access, Uptake and Equity’, incorporating participation from RCPCH members and other Medical Royal Colleges, child health practitioners, academic and research communities, parents, carers, children and young people’s representatives and public health agencies.
The Commission is now established and is scheduled to meet four times over a 12-month period to engage around a key question: 'What can be done to increase and sustain immunisation rates of children to the level that is needed?’
The Commission on Immunisation Access, Uptake and Equity will explore this key question by:
- drawing together current analysis and evidence relating to the interaction between immunisation delivery strategies and public vaccines uptake
- using this intelligence to create a set of recommendations on how to strengthen, widen and improve equity in vaccines and immunisation delivery and access in the UK - with potential for wider dissemination in low-to-middle-income country settings.
At the end of the initial programme period, a report on the programme findings and the strategic implications, for the UK and globally, will be shared with all relevant stakeholders and published on this website.
Why the RCPCH?
We are the leading mandated independent voice for child health in the UK. We offer a nationwide network of paediatric clinicians from community health workers to specialised consultant and research staff, with significant expertise in working with an extensive network of clinicians, academics, industry and charitable organisations, children and family groups and other stakeholder organisations to influence policy and practice.
Undertaking this programme to advance the understanding of access as a key feature of enhancing vaccine uptake, aligns particularly well with the RCPCH’s commitment to continue to inform and shape policy around health inequalities to drive better outcomes in children and young people’s health.
Outcomes from the Commission
The main output from the Commission is the Vaccination in the UK: Access, uptake and equity report, published July 2025.
This report assesses how and why vaccine uptake has stalled or declined. It outlines the evidence and our recommendations to increase uptake of routine childhood vaccinations across three broad themes: access to services, improved data systems and strengthening public information, education and communication.
The other outputs will be a series of tailored recommendations for key groups involved in vaccine delivery, as well as a toolkit offering practical ways for healthcare professionals to put these recommendations into practice.
Membership and funding
The Commission has expert advisors from the following organisations:
- Royal College of Paediatrics and Child Health
- School and Public Health Nurses Association
- Institute for Health Visiting
- UK Health Security Agency
- Independent nurse representatives
- London School of Hygiene & Tropical Medicine
- Bristol Vaccine Centre
- Oxford Vaccine Group
- Community paediatricians
- General practitioners
- Starlight Children's Foundation
The programme has been funded by educational grants from GSK, Sanofi and AstraZeneca.
The set up of the Commission allows for an impartial space for all stakeholders to review evidence and contribute to the discussion.
In accordance with the Association of the British Pharmaceutical Industry (ABPI) Code of Practice, a ‘grant’ is a provision of funds freely given for the purpose of supporting healthcare, scientific research or education, with no expectation to receive any service, benefit or privilege in return.
In order for RCPCH to accept funding from commercial organisations, the organisation must meet our strict due diligence criteria. Our Acceptance and refusals of donations policy ensures that commercial organisations meet our robust criteria and safeguards before any funding can be considered. These criteria are in line with Charity Commission guidance. See our Due diligence on accepting funding, including the downloadable Acceptance and refusals of donations policy.
- 1Watson et al, 2022; Nnaji et al, 2021; Lee, 2020; Streefland, 2001
- 2Kennedy, 2019; Remy et al, 2015.
- 3Paules, C., Marston. H. and Fauci, A. (2019) ‘Measles in 2019: Going Backward’, New England Journal of Medicine, 380:2185-2187; Johnson, S. Warnings of global child health crisis as tens of millions miss vaccinations, The Guardian, 15 July 2022.
- 4UNICEF (2020). Ending Preventable Child Deaths: How Britain Can Lead The Way.
- 5World Health Organization (2023). Immunization coverage fact sheet.
- 6Childhood Vaccination Coverage Statistics - England, 2021-22 - NDRS (digital.nhs.uk).