September 18, 2018

expert reaction to NHS Digital report on childhood vaccination coverage

Reactions to a report published by the NHS from Public Health England (PHE) on the decline in coverage of childhood vaccinations.

Dr David Elliman, Consultant at Great Ormond Street Hospital, said:

“Although the UK has high uptake rates for the routine vaccinations, excluding influenza, they are not high enough to maintain herd immunity. The consistent fall in uptake over a number of years is worrying. It may be due to a number of factors. Difficulties with data collection, particularly in London, may be a factor. General Practice, where most of the preschool immunisations are given, is under immense pressure and there is a shortage of practice nurses who actually give the vaccines. There is no evidence, in the UK, of any increase of concerns about vaccination. Communication between IT systems in NHS, use of reminders and staffing of General Practice should be addressed.”

Prof Adam Finn, Professor of Paediatrics at the University of Bristol, said:

“The main message of these figures is that we have a very effective vaccine programme with very high levels of public support and engagement. The differences between regions and slight ongoing downward trends in some cases point us towards the need to optimise both delivery and communication to bring all areas up to the highest achievable levels. As in all areas of public health, this drives constant efforts to improve and optimise.”

Dr Doug Brown, Chief Executive of the British Society for Immunology, said:

“Vaccination saves lives. It is one of the safest and most cost-effective methods we have to prevent the spread of disease.

“Today’s publication of the annual vaccination statistics for England paints a concerning picture with decreases observed in the uptake of nine of the twelve routine vaccinations. Worryingly, this decline follows an ongoing trend from previous years and we are not reaching the World Health Organization target of 95% coverage nationally with any of the vaccines at the correct timepoint.  Lower levels of vaccination mean that these harmful diseases can spread within our communities, infecting people who have not been vaccinated, including vulnerable individuals who are unable to have vaccinations such as young babies, people with compromised immune systems or people with cancer.

“Today’s statistics show that 87.2% of five-year-olds have received both MMR vaccines – well below the 95% level recommended by the World Health Organization.  We are currently witnessing the impact of this lower vaccination rate in the ongoing measles outbreak in England.  To date, 876 cases of measles have been confirmed this year, more than three times the number recorded in the whole of 2017. Measles is a highly infectious disease that can lead to serious consequences for those infected. However, we have at our disposal a safe and effective vaccine that can stop the spread of measles in its tracks if enough people are immunised.  We need to redouble efforts to ensure that vaccination rates improve and that our communities benefit from continued protection against this serious disease.

“There is positive action we can take to increase vaccine uptake.  The Government needs to work with the NHS and local authorities to prioritise immunisation services and learn lessons from regions that are performing well. This includes making sure that services are accessible and that parents have ready access to reliable, evidence-based information about the huge health benefits that vaccines confer.  The UK is a world leader in vaccine research and the British Society for Immunology is committed is working with doctors and scientists to ensure that this excellence is reflected in the provision of vaccines to our children to prevent disease.”

Prof Jonathan Ball, Professor of Molecular Virology at the University of Nottingham, said:

“The decline in vaccine uptake is worrying – particularly as many of these infections can cause serious disease and even death. Measles is one of the most contagious viruses out there, and to prevent outbreaks you need to have around 95% of the population vaccinated to create what’s known as herd immunity. It’s herd immunity that is so important in preventing outbreaks.

“It is really important to try to understand why people are not getting their children vaccinated so that measures can be put in place to overcome these barriers. If uptake continues to decline then we will see increasing numbers of outbreaks and with them, inevitably serious illness and possible death.”

Declared interests

Prof Finn: Conflicts: I undertake vaccine-related research and provide expert advice on behalf of my employers (university and NHS) funded by government, various charities and vaccine manufacturers. I receive no personal remuneration for this work but have some control over the way that income is used for academic purposes.

No others received.