Barriers are limiting UK childhood vaccination, say doctors

Parents in the UK are being blocked from arranging routine vaccinations for their children due to logistical issues, according to a new report, which suggests vaccine hesitancy may be less of an issue than previously thought.

The analysis by the Royal College of Paediatrics and Child Health suggests the main barriers to access are factors like hard-to-book and limited appointments, difficulties in attending clinics, a lack of continuity in care, and a lack of reminders for jabs.

The Vaccination in the UK: Access, uptake and equity (PDF) report notes that, over the last decade, the uptake of vaccines in the UK has stalled and is in many cases falling, leading to outbreaks of preventable diseases such as measles and whooping cough.

While there has been a lot of emphasis in research and policy deliberations on hesitancy or 'anti-vax' beliefs, attitudes and behaviours, the RCPCH has concluded that "these do not account for the whole picture in the decline of childhood vaccination" and "vaccine confidence in the UK is still relatively high."

As a result, it has recommended that there is investment to expand NHS vaccination capacity to enable easier access, deployment of the NHS App to make it easier to book and deliver reminders, making sure health visitor services are sufficiently funded to deliver vaccination advice, and making sure there is a comprehensive assessment of the obstacles at play.

Other recommendations include finalising the development of a digital version of the 'red book', which contains child health records, so it can be easier for parents to keep track of immunisation schedules.

"By addressing systemic barriers, including those which may more frequently affect underserved communities, by improving NHS data systems and by ensuring widespread access to accurate vaccine information and communication – for both healthcare professionals and parents/carers – the UK can work towards restoring and sustaining high immunisation coverage," said the RCPCH.

Dr Ben Kasstan-Dabush, assistant professor in global health and development at the London School of Hygiene & Tropical Medicine, said that the study "adds to the urgent need to address a decade-long trend of declining immunisation coverage in the UK, and what needs to be considered as we approach changes to the childhood immunisation schedule."

Since 2022, no childhood vaccine in the UK has met the World Health Organization (WHO) target of 95% of children vaccinated.

"A striking finding from the report's survey is the difference in how healthcare professionals view misinformation as a key barrier for parents, but parents hold entirely different concerns around practicalities of access to support and a strong desire for continuity of care for their children," added Kasstan-Dabush.

"These parents are telling us that they are being failed by an inflexible and fragmented immunisation system across the UK."

The report comes just days after a study concluded that millions of children around the world are at risk of serious infectious diseases because immunisation programmes have stalled, or even gone into reverse, in the last 20 years.