Vaccination in the UK: Access, uptake and equity

RCPCH's Commission on Immunisation policy report, published in July 2025, 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.

Read our quick read report

You can also download the quick read and full policy report at the bottom of this page.

Findings and recommendations: three areas to strengthen vaccination access, uptake and equity 

Access to vaccination services

Significant emphasis in research and policy is currently given to hesitant or ‘anti’ vaccination beliefs, attitudes and behaviours. The RCPCH commission recognise the challenges posed by anti-vaccine sentiment, misinformation and associated forms of vaccine hesitancy. But from their work, the commission conclude that these do not account for the whole picture in the decline of childhood vaccination.

Vaccine confidence in the UK is still relatively high, and under-vaccination is more often due to difficulties accessing services for practical or logistical reasons such as inflexible appointment systems and limited availability. The report underscores the importance of understanding these access-related barriers, as these can discourage families - particularly those already uncertain about vaccination - from actively pursuing immunisation for their children. 

The commission recommends: ​​​​​​

1. Invest in and expand vaccination service capacity to enable easier access
2. Utilise NHS apps to improve the experience of booking a vaccination
3. Ensure sufficient funding for health visitors to be able to undertake their vital role in delivering vaccines
4. Research into barriers to vaccination should ensure there is a comprehensive assessment of issues rather than just on vaccine hesitancy

Improved immunisation data systems

The commission’s evidence sessions raised data and data systems as an important domain within which vaccination tracking and immunisation services uptake could be significantly strengthened.

Restricted data-sharing can result in missed opportunities for real-time immunisation coverage monitoring as well as planning for catch-up vaccinations as healthcare professionals are not easily able to check a child’s vaccination status.

The commission recommends:

• Implement the NHS number as a Single Unique Identifier for children
• Finalise the development of the digital red book and ensure integration with the planned NHS digital health record
• National data is needed to identify successful approaches in vaccination strategies for reaching target populations

Strengthen public information, education and communication in vaccines and immunisation

Despite excellent work in recent years to develop and share more public information on vaccinations, families continue to report that they would like further (or different) information, and in forms and places where it is easy to find, digest and use. Some healthcare providers are themselves asking for more training and support with specific public information, education and communication (IEC) as well as additional information materials to feel confident to better advise families on vaccination. 

The commission recommends:

1. Invest in improving the accessibility of health information for families including online information and other formats (recognising that the adverse effects of digital poverty might compromise the utility of purely online information)
2. Provide standardised information at a national level translated into multiple languages and in multiple accessible formats
3. Public health campaigns and vaccine positive information should be shared through multiple communication channels, including on social media
4. Provide an online resource for healthcare providers to share good practice for reaching underserved and seldom heard communities
5. Invest in the training and development of all staff to be able to promote vaccinations
6. Protect funding for school nurses
7. Educate young people about the benefits of vaccination in personal health lessons

By addressing systemic barriers, including those which may more frequently affect underserved communities, by improving NHS data systems and by ensuring widespread access to accurate vaccine information and communication – for both healthcare professionals and parents/carers – the UK can work towards restoring and sustaining high immunisation coverage.