December 4, 2025

expert reaction to Chief Medical Officer’s Annual Report 2025: Infections

Scientists comment on the Chief Medical Officer’s Annual Report for 2025: Infections. 

Professor Arne Akbar, Chair of the British Society for Immunology Immune-Ageing Network, CARINA, and Professor of Immunology at University College London, said:

“As we age, our immune systems change and become less effective at keeping us healthy.  This means that older people are more likely to catch infections, to have more severe symptoms and secondary complications and to take longer to recover.  It’s important that we educate the public, healthcare professionals and decision-makers on how we can keep our immune systems functioning optimally in older age to enable people to live healthier lives for longer.  As well as exercise, healthy eating and getting enough sleep, vaccines are a key enabler of preventing infection in older adults. 

“Preventing and better managing infections into older age had huge potential to enable people to enjoy a better quality of life for longer as well as being a significant route to alleviate pressure on health and social care systems.  We welcome the focus of the Chief Medical Officer’s report on infections in older age and hope it will catalyse a renewed focus on researching how we can prevent disease and improve health outcomes from infection in this age group.”

Darius Hughes, UK General Manager at Moderna, said:

“We welcome the Chief Medical Officer’s report, which rightly highlights the essential role that vaccination, scientific innovation and strong system partnerships play in protecting the UK from current and future infectious disease threats. The CMO’s emphasis on rapid vaccine development and scaled manufacturing – particularly for pandemic preparedness – are areas where the UK has shown genuine global leadership.

“With the Moderna Innovation and Technology Centre in Harwell now operational, we are committed to working with the NHS, the UK Health Security Agency, regulators and wider partners to ensure the UK can fully benefit from the next generation of mRNA vaccines. This means strengthening preparedness, enabling the timely adoption of new technologies, and working together to deliver better public health outcomes for people across the UK.”

Dr David Elliman, Honorary Associate Professor in Child Health at University College London, GOSH ICH, said:

“The topic of the CMO’s annual report, published today is infection. This recognises that while antibiotics and vaccines have made an enormous difference in this field, infections still remain an important cause of death and suffering, particularly in young children and the older members of the population. We know have safe and effective vaccines against what used to be major killers of children – e.g. smallpox, diphtheria, polio, whooping cough and measles. These diseases are all much less common than in the pre-vaccine era, but, apart from smallpox, all remain an ever-present danger, with some on the rise again. While part of this is due to parents’ concerns about vaccine safety, recent research has shown that access to vaccines, plays a significant role. This is not mentioned in the report. In UK, the RSV vaccine to protect infants and the older members of the population against a severe form of respiratory disease was introduced last year and chickenpox vaccine will become part of the routine childhood schedule in the New Year.

“New vaccine technologies, such as the use of RNA and virus vectors in some of the highly successful COVID vaccines, allow vaccines to be produced rapidly in the face of an epidemic of a new infection. It is important that UK, as well as other countries, continues to support research into these and related vaccines at a time when the USA has severely curtailed funding in this field. It is very important, as Wes Streeting has said in another context, to continue to ensure that policy is led by the evidence, rather than the other way around. It is only in this way that we can ensure that we maintain and expand the benefits of our vaccination programme and are properly equipped to defend ourselves against new threats. We should be proud of the UK’s record in preventing infection, but we cannot afford the be complacent.”

Prof Andrew Morris, Director of Health Data Research UK:

“Half a million people missed out on life-saving blood-pressure medication during the pandemic — an insight we uncovered only because of the large-scale health data research accelerated by COVID-19. The Chief Medical Officer is right to call for the same data-driven approaches that proved so effective during the pandemic to be applied to infections outside of emergencies. It is also time to bring this urgency beyond infectious disease to cancer, diabetes, cardiovascular disease, and other conditions that claim millions of lives. Failing to enable secure, safe and responsible access to data for research now would mean turning our backs on the very tools that could prevent harm and improve care.”

Prof Jennifer Quint, Co-lead of the Health Data Research UK’s Inflammation and Immunity Driver Programme, Associate Director of the Respiratory Data Science Catalyst and Professor of Respiratory Epidemiology at Imperial College London:

“With respiratory illnesses being the leading cause of death from infectious diseases in older adults, it is important that we do all we can to reduce this and improve people’s quality of life. Using high quality, robust population-level health data for research and day to day clinical practice can provide vital insights that improve our understanding of respiratory infections and know whether the approaches we are using to reduce them are working. In addition, carrying out whole-population research is the most effective way to answer the big questions, including whether newer vaccines such as the RSV immunisation programme are making a difference.”

Dr Andrew Freedman, Consultant in Infectious Diseases and Vaccine Clinical Trials, Cardiff University, said:

“This is a timely and wide-ranging report on various aspects of infectious diseases in England in 2025. Of particular note, it highlights the increasing problem of infections in older adults, who are more susceptible to infection and tend to have worse outcomes in relation to both morbidity and mortality.  It also draws attention to the potential longer term sequelae of infection in this group, including stroke and cardiovascular disease.

It contains a number of important recommendations, particularly in relation to vaccination in specific groups including the elderly, pregnant women and underserved communities.  It draws attention to the relative lack of research studies in those groups and the need to include them in clinical trials.  It also stresses the importance of all clinicians gaining experience and training in infection prevention and management.  Other key issues covered include the ongoing problem of antimicrobial resistance as well as preparedness for future epidemics and pandemics, building on the experience of COVID-19.

The various chapters are authored by renowned experts in the field.  It should prove a valuable resource for both infection specialists as well as clinicians working in other fields.  In addition it contains some key messages aimed at both the public as well as those involved in national and local government.”

Dr Michael Head, Senior Research Fellow in Global Health, University of Southampton, said:

“The CMO’s annual report shows how there is still a significant burden of infectious diseases in the elderly. This includes the high mortality from COVID-19, and also diseases that greatly affect quality of life such as scabies. Institutional outbreaks, such as care homes and hospitals, are challenging to control and will contribute to both illness and mortality. One key factor is that older people are more likely to also have other conditions, multimorbidity, which can make an infection more severe than in those who do not have multimorbidity.

“For example, a diagnosis of COPD may also contribute to higher mortality from COVID-19, and the presence of other skin disease such as dermatitis or carcinomas means that a scabies infection may be misdiagnosed or not reported at all.

“The Academy of Medical Sciences has highlighted multimorbidity as ‘a priority for global health research’. There is a need for a joined-up approach to managing healthcare across these multiple conditions rather than in silos. “

Prof Emma Thomson, Director, MRC-University of Glasgow Centre for Virus Research, University of Glasgow, said:

“The Chief Medical Officer’s report sets out with clarity the scale and complexity of the infectious disease challenges England and the rest of the UK face. It rightly highlights that infections remain dynamic threats: they evolve, cross species, adapt to our interventions and exploit ongoing changes in global travel, climate and demographics. The evidence presented; rising imported infections, expanding vector risks, and increasing pressure from high-consequence pathogens, shows why sustained preparedness is essential.

“A central theme of the report is that science is the foundation of resilience. Such science needs to include not only sophisticated diagnostics, vaccines and genomics, but the basic molecular virology and fundamental biological research that allow us to understand how pathogens work, how they change, and how they interact with immunity and therapeutics. Without this depth of knowledge, rapid innovation during emergencies is impossible. COVID-19 vaccines were developed at unprecedented speed, but only because they stood on decades of fundamental RNA and viral vector research, long before SARS-CoV-2 emerged. The report also emphasises that the UK must maintain capability across all major transmission routes; respiratory, sexual, oral, touch and vector-borne, because future epidemics will not follow a predictable pattern. 

“That requires long-term investment in the scientific infrastructure that provides national resilience. Institutes such as the MRC-funded Centre for Virus Research (CVR) and other academic centres across the UK deliver the specialised expertise, containment facilities and technology platforms needed to detect and respond to new threats at pace. Clinical research facilities embedded within the NHS across the UK also require ongoing investment, directly facilitating the development of new therapeutic approaches through clinical trials. These capabilities take decades to build and must be protected between crises.

“Looking forward, embedding artificial intelligence into pathogen research, surveillance and response will be essential. AI can accelerate viral discovery, predict evolutionary trajectories, support real-time outbreak analytics and enable faster development of medical countermeasures. But effective AI systems rely on high-quality fundamental data – sequencing, phenotyping, experimental virology and in-depth biological insight generated by UK research centres.

“Innovation in infection science does more than keep people safe. It protects the NHS, strengthens biosecurity, safeguards the economy and drives economic growth.  

“If we continue to support the scientific base that underpins the UK’s infection-response infrastructure, we will be better equipped to manage emerging threats and ensure resilience for the future.”

Dr Cheryl Walter, Senior Lecturer in Biomedical Science, Hull York Medical School, said:

“The CMO’s 2025 annual report on infections is both positive and comprehensive, while carefully considering current global challenges in infectious diseases.  The importance of the public, their continued trust in healthcare and how important it is that clear, consistent information is provided to them to help with their decision-making, is discussed.  The report highlights the excellent gains made in reducing certain cancers linked to viral infections, such as cervical cancer in women under 30 years old as a direct result of HPV vaccination of young girls and boys.  Reiterated in the report from convincing data, is how clearly the rates of vaccination are dropping.  Key examples include vaccine uptake by pregnant women and routine vaccination in children and young adults. 

“The report re-emphasis the significant ongoing challenge of antimicrobial resistance (AMR) and the much-needed pipeline for new drug development.  Another increasingly evident observation from this report, is the particularly high burden of infection in older adults.    Not only does this pose a risk as a life limiting event, but also one that can reduce the quality of life of those experiencing infections later in life.  Over the last decade, there has been a substantial increase in the number of imported infections into the UK, such as Malaria and Dengue fever.   This point really highlights how external events such as climate, disease vectors and mass migration, etc. can contribute towards the rapidly changing dynamics of infectious diseases. 

“Finally, the report emphasises that the emergence and re-emergence of infectious diseases impacting on human health are somewhat predictable upon reflecting on past epidemics and pandemics, however their timing of onset can be very difficult to foresee.  Commentary on the ongoing impact of the COVID-19 pandemic as well as the recent, significant re-emergence of mPox is useful and helps to inform on the recommendations given. The report emphasises very aptly, infections are global. “

Prof Gwen Knight, co-Director of the AMR Centre at the London School of Hygiene & Tropical Medicine (LSHTM), said:

“I think it is great to see that the focus on AMR sections is on reducing infections rather than just focusing on reducing the use of antibiotics. 

“In terms of the focus on reducing infections in the elderly this is also very important as our elderly populations grow. Whilst the absolute burden of AMR is higher in this group, we must also recognise that patterns of resistance can differ across age groups and by sex. This has been found in work that we’ve done on bloodstream infections in Europe. Understanding these differences will allow us to develop more nuanced, age- and context-specific antibiotic guidance and ultimately improve patient care and outcomes.”

Dr Raheelah Ahmad, Co-Lead – Informed Policy Pillar, Fleming Initiative, said:

“The Fleming Initiative supports the CMO’s report on infectious diseases, in particular the efforts needed to mitigate antimicrobial resistance. Today’s report reinforces the need for vaccine development and uptake, and the need for diagnostic innovation.

“We also welcome the emphasis on older adults, where resistant infection can impact livelihoods as well as lives. Innovations that recognise diversity within this population group, systems-based solutions across health and social care, reinforcing infection prevention and control, and antimicrobial stewardship are needed.

‘Chief Medical Officer’s Annual Report 2025: Infections’ was published at 15:00 UK time on Thursday the 4^th of December 2025.

Declared interests

Darius Hughes: Darius Hughes is an employee of Moderna

Dr David Elliman: I have no conflicts

Prof Andrew Morris: Andrew is the President of the Academy of Medical Sciences and Professor of Medicine and Vice Principal of Data Science at the University of Edinburgh.

Prof Jennifer Quint: No COIs.

Dr Andrew Freedman: Part of my work involves acting as local Principal Investigator for clinical trials of vaccines on behalf of various pharma. & biotech. companies (but I receive no remuneration from the companies involved).

Dr Michael Head: No COI to declare

Prof Emma Thomson: I am director of the CVR and I was PI for several clinical vaccine trials during COVID-19 including the Oxford vaccine trial, Valneva, Novavax phase III trials. I have no financial COIs.

Dr Cheryl Walter: I do not have any conflicts of interest to declare.

Prof Gwen Knight: “None.”

Dr Raheelah Ahmad: I have no conflict of interest to declare.