MMR vaccine uptake in children has fallen to a 12-year low putting communities at higher risk of infection, according to the head of the British Society for Immunology.
Coverage for the first measles, mumps and rubella combined jab decreased to 92.5 per cent at five years, while MMR2 coverage at five years decreased to 84.5 per cent. Both figures represent the lowest level since 2010-11. The Royal College of GPs said it is “extremely worried” about the fall and urged parents to “trust the science” over vaccine safety.
The latest NHS Digital report for England, co-authored with the UK Health Security Agency (UKSHA), shows that vaccine coverage decreased for 12 of the 14 routine childhood immunisations reported in 2022-23, following a downwards trend in recent years.
Decreases were between 0.1 and 1.2 percentage points compared to the previous year and no vaccines met the 95 per cent target for the fifth consecutive year. The last vaccination with coverage above 95 per cent was the 5-in-1 one vaccine at age five years, reaching 95.2 per cent in 2020-21.
In the UK, babies are offered immunisation against meningitis B and rotavirus at eight weeks old, and are also given the “6-in-1” jab, which helps fight polio, tetanus, whooping cough, diphtheria, hepatitis B and haemophilus influenzae type b – a bacteria that can cause life-threatening infections. The doses are topped up at 12 weeks and 16 weeks.
One-year-olds should receive the first dose of the MMR jab, along with the Hib/MenC vaccine, which protects against haemophilus influenzae type b (Hib) and meningitis C. They are also offered the second dose of the pneumococcal vaccine and further protection against meningitis B. The second dose of the MMR is offered at three years and four months.
In 2022/23, 91.8 per cent of babies in England had the 6-in-1 vaccine by their first birthday, with 93.7 per cent up to date with the pneumococcal vaccine and 91 per cent protected against meningitis B. Only 88.7 per cent were vaccinated against rotavirus, which can cause diarrhoea in infants.
Dr Victoria Tzortziou Brown, Vice Chair of the Royal College of GPs, urged parents not to delay making sure their children’s MMR jabs are up to date.
She said: “The Childhood Vaccination Programme is one of the great successes of the NHS, but the MMR vaccine can only work if enough people have it, so we are extremely worried that take-up rates for all the routine childhood vaccinations are falling.
“Maintaining high vaccination rates is a top priority for GPs and our teams and we cannot afford to become complacent as a society. We cannot stress enough how important getting vaccinated is, as these highly infectious conditions can easily spread between unvaccinated people and lead to serious problems including meningitis and hearing loss.
“We urge anyone who might have concerns to trust the science and have faith in their family doctors when we say that the MMR vaccination is safe, effective, and essential to safeguarding the health of our children and that of the wider population. It would be such a backward step if these diseases make a comeback, and we will all suffer the consequences if they do.”
Practical issues that disproportionately impact lower socioeconomic groups are thought to be one of the key reasons behind falling uptake. This includes the cost of travelling to a clinic, difficulties in arranging childcare for other children, and competing demands for parents’ time. The pandemic is likely to also have had an effect, public health experts believe.
A recent Royal Society for Public Health public also found incorrect beliefs about side effects and “body load” as some of the reasons why parents and carers may be unsure about vaccinations.
The World Health Organisation (WHO) recommends that at least 95 per cent of children are immunised against vaccine-preventable diseases to ensure herd immunity.
Dr Doug Brown, chief executive of the British Society for Immunology, said: “It is particularly worrying that today’s statistics show that only 84.5 per cent of children receive the second MMR vaccine dose by age five – well below the 95 per cent level recommended by the WHO.
“Measles is one of the world’s most contagious diseases and cases are currently on the rise in England. We must ensure that vaccination rates improve to stop the spread of measles and give our communities the best possible protection available against this serious illness.
“Vaccines are the safest and most effective method to protect our children against disease. In the past year, 12 out of the 14 childhood vaccinations have seen their uptake decrease, putting our communities at higher risk of infection and illness.
“Lower levels of vaccination mean that harmful diseases can spread, 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.”
Dr Brown called on the Government to publish its long-awaited Vaccine Strategy as part of urgent action to tackle the problem.
“This publication should be a comprehensive strategy and a springboard to strengthen the roles of local immunisation co-ordinators, ensure services are accessible, widen community outreach and increase both investment in public health campaigns as well as engagement with parents to answer their questions on vaccines,” he said.
In July, health officials warned London faced an outbreak of measles after MMR vaccine rates dropped to just 70 per cent. In the first six months of this year there were 128 cases of the disease compared to 54 for the whole of 2022, two-thirds of which were in the capital.
A Department for Health and Social spokesperson said: “It is vital that routine childhood vaccinations are up to date as this remains one of our best defences for public health.
“The UK has a world-leading offer and we have run multiple catch-up campaigns to improve coverage – including a national catch-up campaign for MMR and London-specific campaigns for MMR and polio. We urge parents and carers to check that their children are up to date on their vaccines and if not they should book an appointment to catch up.”
Steve Russell, NHS director of vaccinations and screening, said: “The NHS continues to encourage and support parents and carers to ensure their children are up to date with their vaccinations to protect them against becoming seriously unwell from infectious diseases.
“While most children are up to date with their vaccinations, there is more to do, and the NHS is running an MMR catch-up campaign to support more families in coming forward, with targeted outreach work for those identified as at high risk and communities with the lowest uptake.
“Diseases such as measles, mumps and rubella can make children seriously ill, but they are preventable, and millions of vaccination doses are given every year to offer the best protection – so please check your child is up to date with their vaccines and contact your GP surgery to catch up with any missed doses as soon as possible.”
In July, MPs warned that the UK is at risk of losing its position as a global leader on vaccination without action to address challenges around uptake and bureaucratic processes in setting up clinical trials. Specific concern was put on the dwindling number of children receiving routine jabs which protect them from illnesses such as meningitis, measles and hepatitis B.
The Health and Social Care Committee’s report on vaccination called for urgent action to tackle declining rates among children, citing concern that England did not meet the 95 per cent target for any routine childhood immunisations in 2021-22. England was the only nation of the UK where coverage for all childhood vaccines at all ages was below the target, and coverage rates were consistently below the UK average.
The committee urged a more flexible delivery model to deliver vaccinations to overcome practical challenges over times or locations.
Nuffield Trust Senior Fellow Dr Liz Fisher said: “Vaccination coverage is the best indicator of the level of protection a population will have against diseases such as measles which can be very dangerous, so it’s worrying to see a reduction in coverage among children. We have been failing to meet WHO recommendations for 95 per cent of children to be immunised against vaccine-preventable diseases for several years.
“We know that the Covid pandemic has contributed to the decline in vaccination uptake in recent years, due to the strain on health services and other factors like school closures, but gaining a better understanding of all the reasons why families are not accessing vaccinations is key to addressing the problem.”
