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expert reaction to new NHS Digital / UKHSA childhood vaccination coverage statistics for England, 2021-22

A statistical report by NHS Digital and the UK Health Security Agency (UKSHA) reports on childhood vaccination coverage statistics for England in 2021-22.


Dr David Elliman, consultant paediatrician at Great Ormond Street Hospital, said:

“This week saw the publication of annual and quarterly data for the uptake of childhood vaccines.  The more timely quarterly figures show the same pattern.  To anyone working in the field, this is depressing, but not surprising.  Prior to COVID there had been a slow but steady fall in vaccination rates which was accelerated by COVID.  This was in part due to mixed messages – keep away from healthcare facilities, including your GP, except for urgent issues – and parents wanting to isolate their children.  This period has now passed but uptake continues to decline.

“In 2009 and again earlier this year, NICE issued guidance on immunisation.  Their advice has changed very little but is still not implemented.  One of the things that was emphasised was flexibility.  If a child is taken to their surgery for anything, is the opportunity to immunise them with any missing vaccines taken?  It appears that many opportunities are not taken.  How many people realise that although there are recommended timings for vaccines, some can be given early, particularly the second dose of MMR.  By taking these opportunities more children could be immunised and it would save visits which would be of benefit to parents and hard pressed practice nurses.  A win-win situation.  Another opportunity would be when a child attends a clinic or is admitted to hospital.

“We need innovative approaches.  We cannot continue ‘business as usual’.  If we do, then we will need recurring catch-up campaigns as we currently have with polio (London only) and MMR.”


Prof Helen Bedford, Professor of Child Public Health, Institute of Child Health, UCL, said:

“The UK has a highly successful childhood vaccination programme which resulted in many once common diseases such as measles, becoming vanishingly rare.  Due to the measures brought in to reduce social contact during the pandemic, we saw infection rates drop to extremely low levels.  However, these infections have not gone away.  The reported decline in vaccine uptake in 21/22 compared with previous years is of great concern.  However, this decline comes as little surprise given the difficulties for some parents accessing immunisation services during the pandemic.  But now we are back to normal, and this leaves us with the concerning double whammy of many children being unprotected and the inevitability of disease rates increasing.  In this situation, as night follows day, significant outbreaks of disease are likely.  Measles disease is a particular concern as it is so highly infectious that any small decline in vaccine uptake results in outbreaks.  Fortunately, it is never too late to be vaccinated.  I would urge parents to check their children’s vaccination status which is recorded in their Red Book, or if in doubt, to check with their GP.  Parents with questions or concerns about vaccines can speak to their health visitor, practice nurse, GP or school nurse.  Vaccination works, is highly effective and has an excellent safety record.  No child needs to face the potentially serious consequences of a vaccine preventable disease.”


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

“It’s really disappointing to see that childhood vaccination rates for many key diseases are down.  To protect communities against measles outbreaks for example, we need to see MMR vaccine uptake at around 95%.  These aren’t trivial diseases.  Many of these infections can kill, yet vaccination has been so good at banishing them that it is easily forgotten just how serious they can be.

“It’s important to understand why uptake isn’t as high as we would like, so that we can introduce measures to increase this.”


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

“Today’s publication of the childhood vaccination statistics in England is extremely worrying, showing decreases in the uptake of 13 out of the 14 routine vaccinations compared with last year and marking yet another year where the 95% target set out by the World Health Organization has not been met on any of the childhood vaccinations at the correct timepoint.

“Immediate action to reverse this alarming multi-year downward trend and protect our communities from preventable diseases is urgently needed.  In particular, the 2021-22 statistics show that only 85.7% of five-year-olds have received both MMR vaccines.  Measles is a highly infectious disease and to stop its spread we must meet the 95% uptake level recommended by the World Health Organization.

“Vaccines save lives and are the safest and most effective method to protect our children against disease.  Low levels of vaccination coverage matter as it means these diseases have the potential to spread within our communities, infecting unvaccinated people, including vulnerable individuals unable to have vaccinations such as young babies or people with cancer.  We can and must do better.

“The British Society for Immunology is calling once again on urgent action from the Government – the promised Vaccine Strategy outlining the plan to increase childhood vaccine uptake is still yet to be published.  The COVID-19 pandemic is not over but the negative impact of these other preventable diseases isn’t either.  The Government’s Vaccine Strategy must be released as a matter of priority and significant investment on routine vaccination services must be made to implement the lessons learnt from the success of the COVID-19 vaccine rollout.  This includes strengthening the role of local immunisation co-ordinators, ensuring services are accessible, widening community outreach and increasing engagement with parents to answer their questions on vaccines.

“The UK is a world leader in vaccine research and the British Society for Immunology is committed is working with healthcare professionals to ensure that this excellence is reflected in the provision of vaccines to our children to prevent disease.”



Declared interests

Dr David Elliman: “None.”

Prof Helen Bedford: “No conflicts.”

Dr Doug Brown: “Trustee of the Association of Medical Research Charities.”

Prof Jonathan Ball: “None.”

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