The latest annual report on Childhood Vaccination Coverage Statistics for England, was published by NHS Digital on 20 September. Our immunisation programme is universally admired internationally and the UK remains at the forefront of vaccines discovery, development, manufacture and delivery. However, although overall immunisation coverage remains high in the recent report, average uptake has decreased for a fourth consecutive year and, on average, England is not hitting the 95% coverage target set by the World Health Organization (WHO) for any of the individual vaccines.
More concerning still is the significant regional variation across England. Vaccine coverage between local authorities across the country differs significantly. For example, the percentage of children receiving both the required doses of the Measles, Mumps and Rubella vaccine (MMR 1 and MMR 2) by their fifth birthday ranges from 96.2% in South Tyneside to 57.1% in Westminster, with the London boroughs ranking consistently low for all vaccines.
Obtaining 95% coverage for each vaccine, as the WHO recommends, is essential to achieve herd immunity. This is the concept of conferring protection to the population as a whole. Simplistically, it’s ensuring that the ratio of immune individuals (those who have been vaccinated) to susceptible individuals (those not vaccinated) is high enough so that those immune can form a protective shield surrounding those susceptible. This prevents infection spreading to individuals who are unable to get vaccinated, such as those with a compromised immune system (e.g. cancer patients) or very young babies. With this image in mind, it is clear why pockets with exceptionally low vaccination uptake are cause for concern.
Also of concern is the decreasing trend in overall annual vaccine uptake. Where vaccine uptake decreases, the risk of outbreaks increases; failure to achieve adequate levels of coverage has historically led to a resurgence of the disease. 2012 saw an outbreak of measles across England and Wales, which resulted in more than 2,000 cases. This was followed by another outbreak across Europe just last year, which is still ongoing. Reflecting its lower vaccination coverage, London has repeatedly been a focus of disease outbreaks. With some London boroughs showcasing a mere 47.4% coverage for diseases such as diphtheria, further outbreaks wouldn't be surprising.
The important question that needs to be addressed, therefore, is why is there significant regional variation and how can we prevent pockets of poor vaccine coverage? Some regions excel; in Redcar and Cleveland in the north east of England, for instance, 99.3% of children had both their primary and booster vaccination of the 5 in 1 vaccine by their fifth birthday, compared to some areas of London where not even half of eligible children are receiving the routine immunisations. Much could be learnt from the north east who have consistently achieved above average coverage rates. Sufficient resources are needed to ensure access and delivery of the vaccines and the implementation of best practice.
Following the publication of the statistics, Professor Peter Openshaw, President of the British Society for Immunology (BSI) said, “It is crucial that the Government, NHS and local authorities work together to learn lessons from those areas that are performing well to ensure that vaccination rates increase and prevent the spread these harmful but preventable diseases.”
Vaccination has saved millions of lives. Since their introduction in the 18th century, vaccination has led to the eradication of smallpox and, with the development of comprehensive vaccination programmes, the near disappearance of other serious infections such as polio. With sufficient investment in research and delivery strategies, vaccination has huge potential to bring about the complete eradication of more diseases in the future.
At the BSI, we remain committed to not only supporting the development of new vaccines and immunisation programmes, but also to supporting efforts to increase uptake of these vaccines.
Intern, British Society for Immunology
For access to the Childhood Vaccination Coverage Statistics for England follow the link provided.
To find out more about the facts behind vaccination, download our free guide to childhood immunisations.