Why are child vaccination rates the lowest they have been in more than a decade?

Sky News

2 days ago

Child vaccination uptake is the lowest it has been in more than a decade, with a death from measles in Liverpool reigniting calls for increased awareness of the dangers of not getting jabs.
A report from the Royal College of Paediatrics and Child Health (RCPCH) this month reiterated that none of the routine child vaccinations have met the World Health Organisation's recommended target of 95% since 2021.
Uptake in some local authorities is as low as 60%, while the England-wide rate for the final quarter of 2024/25 for measles, mumps, and rubella (MMR) was 88.8%, down from 92.7% 10 years ago.
The latest UK Health Security Agency (UKHSA) figures show there were 145 new measles cases in England in July.
With outbreaks across Europe and elsewhere, public health officials are concerned families may bring the virus back to the UK when they return to school from the summer holidays.
We look at why vaccination rates have declined, and the reasons some parents are still hesitant to get their children immunised.
When did uptake start declining - and where is it worst now?
Routine childhood vaccinations largely consist of the 6-in-1 vaccine, which covers diphtheria, tetanus, pertussis, polio, Hib, and hepatitis B; the MMR vaccine for measles, mumps, and rubella; and the MenB vaccine, which covers the meningococcal group B bacterium that can cause meningitis and sepsis.
They are all administered free of charge across two or three doses before children are five, with most in the first year.
WHO recommends countries set targets of 95% coverage of all three to ensure herd immunity and to protect those who are immunocompromised and cannot have the vaccines themselves.
In the UK, MMR rates have consistently been the lowest. The most recent decline began in 2013/14, when uptake at two years peaked at 92.7%.
Overall, they have been lower in England than Scotland and Wales, with areas such as London and the North West seeing particularly low levels.
In Hackney, east London, only 60% of children had received both their MMR jabs by their fifth birthday in the year 2023/24.
The North West, and Liverpool in particular, also had lower uptake, with only 73% vaccinated against MMR by the age of five.
Of the 674 measles cases reported in 2025, almost half (48%) have been in London, 16% in the North West, and 10% in the East of England.
At local authority level, the most cases were reported in Hackney (12%), Bristol (7%), and Salford (5%), with almost all cases concentrated in either children under 10 or teenagers and young adults.
1:04
Why have rates declined?
Although the recent drop began a decade ago, a much sharper decline happened in the 1990s.
It saw the two-year MMR uptake in England go from 91.8% in 1995/96 to 79.9% in 2003/04.
In 2006, person-to-person measles transmission was re-established in the UK, and a year later, rates exceeded 1,000 for the first time in 10 years.
This came after the British doctor Andrew Wakefield published a now-discredited report in the prestigious medical journal The Lancet in 1998, which linked the MMR vaccine to autism.
The study was reported by media outlets worldwide and resulted in the safety of the jab being questioned.
After it proved baseless, The Lancet retracted the study in 2010. Wakefield was banned from practising medicine after being found guilty of dishonesty and the "abuse" of developmentally delayed children by subjecting them to unnecessary and invasive medical procedures without ethical approval.
However, hesitancy around childhood vaccinations persisted.
Professor Stephen Griffin, a virologist at the University of Leeds, says: "As widely debunked as it was, it set the cat among the pigeons and poisoned everything."
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What could be behind the latest drop?
The increased prevalence of vaccines during the COVID-19 pandemic saw a resurgence in "anti-vax" sentiment, with many questioning the quick rollout of the jabs.
Others pushed back against mandatory vaccines in certain settings, such as health and social care in the UK, and across most federal government departments in the US, citing a breach of freedom of choice.
Hesitancy also proved stronger in some minority communities, which experts have linked to a general mistrust in healthcare services due to the disproportionate outcomes experienced by those groups.
"Well-organised and well-funded anti-vaccine movements latched onto mRNA (messenger RNA) vaccines, because while it's not a brand new technology, COVID was the first time they had been used en masse," Professor Griffin says.
"There was a lot of disinformation around them, and they just seized on it."
However, WHO had already highlighted "vaccine hesitancy" as one of the top 10 global health threats in 2019, before the pandemic began.
Some of this was attributed to Wakefield's study. Separately, with the rise of social media and misinformation, unevidenced conspiracy theories around vaccines have circulated, such as them being used by Microsoft founder Bill Gates to track people's movements.
More recently, US President Donald Trump has expressed sentiments that nod to views shared by vaccine sceptics.
In an interview with Time Magazine in 2024, he was asked if he would consider ending childhood vaccination programmes in the US. He said he would have a "big discussion" with Robert F. Kennedy Jr, who he appointed as his health secretary and who has consistently expressed vaccine sceptic views.
Mr Trump said: "The autism rate is at a level that nobody ever believed possible. If you look at things that are happening, there's something causing it."
While not directly referencing it, his comments appeared to echo the baseless claims made in Wakefield's study.
Professor Griffin says that "reputable" figures, such as politicians and scientists who continue to endorse the view of Wakefield, and other false narratives around vaccine efficacy, have legitimised the anti-vax movement and "normalised" the decision not to immunise children.
"They've essentially said 'there's no smoke without fire' and drawn attention to a question that they've created themselves," he says.
"It's really upsetting because we've got this brilliant vaccine that people aren't taking because of basic nonsense, and that has serious consequences. A person infected with measles is likely to infect between 15 and 20 others if they are unvaccinated.
"But the MMR vaccine is a victim of its own success. Measles was a large cause of infant mortality before we had the vaccine, but now people don't remember why we tried to make vaccines against it in the first place.
"So we need to educate people because they aren't aware of how dangerous it is."
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'Lack of access'
One children's health expert told Sky News the main issue is a lack of access.
Helen Bedford, a professor of children's health at the UCL Great Ormond Street Institute, says everything from knowing how to book an appointment, to having the means to get there can be a barrier to children getting vaccinated.
"People may not know when vaccines are due, how to make an appointment, then there's actually getting to the appointment," she says.
"For some parents who are suffering the impact of poverty, paying a bus fare to get your child to a GP surgery may be a step too far, even though they understand vaccination is very important."
A shortage of health visitors and other staff who can answer questions from vaccine-hesitant parents is also having an impact, she says.
"We want parents to ask questions but unfortunately, due to lack of personnel, they can't always get answers or even an opportunity to have a discussion," she said.