Childhood vaccination rates in Britain are falling. In 2021 there were fewer vaccines administered across almost all routine programmes, data from the UK Health Security Agency (UKHSA) and NHS Digital shows. There were no vaccinations that met the World Health Organisation (WHO) target which recommends 95 per cent of children get immunised against preventable diseases.
Low-vaccination coverage means diseases that have been virtually eliminated in the UK are threatening a resurgence. Low polio immunisation in parts of London has increased the likelihood of new cases, with sewage showing traces of the poliovirus. The last known case was in 1984. Scientists have also raised concerns about measles and diphtheria.
Pharmaceutical companies and trade bodies told the Health and Social Care Committee this month that increasing vaccination coverage was an urgent issue, particularly in minority and disadvantaged groups. They called on the NHS and the government to publish their upcoming national vaccination strategy to tackle accessibility issues, misinformation and distrust surrounding vaccines.
Why have vaccination rates declined?
The disruption caused by the pandemic is partly to blame, as it interrupted regular public health services and diverted resources to dealing with the crisis.
But practical reasons aren’t the only issues at play. Despite the success of the UK’s Covid-19 vaccine rollout, it appears that the pandemic decreased confidence in healthcare institutions and governments globally. This was exacerbated by political scandals, the proliferation of anti-vax misinformation online, and healthcare inequalities in vaccine access and Covid-related deaths.
In the UK, research has found that people from certain ethnic or religious minority groups, those from lower socio-economic backgrounds, disabled people and people for whom English isn’t their main language, tend to have lower vaccination rates.
What is the national vaccination strategy?
The NHS is planning to publish a national vaccination and immunisation strategy, consulting with healthcare workers and the public last year. It aims to improve vaccination services for local populations by learning from the Covid-19 vaccine rollout. The NHS will work with the government, local authorities and the voluntary sector to implement it.
Rebecca Catterick, general manager at the pharmaceutical company Sanofi Vaccines UK & Ireland, urged the strategy’s publication at the committee hearing. As did Ben Lucas, a board member at the Association of the British Pharmaceutical Industry (ABPI). He told MPs that a “wraparound national service” for immunisation would be a “practical move” to bring expertise together to tackle challenges in vaccine uptake.
Stuart Carroll, director of market access and policy affairs at the pharma company Moderna, added that diversity issues in clinical trials also need to be addressed. “If we’re asking people to take a vaccine, they need to have confidence that it has been tested safely, effectively and with high quality on all of the population,” he said.
What was said about the anti-vax movement to the committee?
Anti-vax ideology was attributed as a key contributor towards falling vaccine rates. Lucas suggested the establishment of a government communications group to tackle anti-vaccine misinformation, an approach also recommended by the Conservative think tank Policy Exchange.
However, in a second parliamentary session, scientists cautioned against this approach, which they believed could reinforce false information. They advocated for positive healthcare messaging instead, and distinguished between people who are vocally anti-vax and those who are vaccine hesitant.
Professor Andrew Pollard, chair of the Joint Committee on Vaccination and Immunisation (JCVI) and co-inventor of the Oxford AstraZeneca Covid-19 vaccine, suggested that a taskforce focused on access to vaccinations should be set up. “The individuals who refuse vaccination are a relatively small proportion, and it can be much more difficult to have an impact there,” he said. “But [by] addressing access and having information from trusted sources for those who are somewhat hesitant… [this] can change the coverage figures.”
“The evidence is very much in favour of not reinforcing negative messages,” he added. “You have the impact of… making people more aware of it, rather than providing the correct information about the huge impact that vaccines have for human health.”
He said he was “extremely worried” about low vaccination rates: “We still have a lot more work to do to fully understand what the best solutions are to improve access, and where primary care at the moment has not been able to reach those communities, what would be a good alternative.”
Where can I find out more?
Watch the parliament sessions in full here.
Read New Statesman Spotlight’s interview with Andrew Pollard here.