NHS Access Issues Driving Down Childhood Vaccine Uptake

Medscape

3 days ago

The Royal College of Paediatrics and Child Health (RCPCH) has raised concerns over difficulties parents face getting NHS care for their children, warning that "stubborn" barriers to access have contributed to declining vaccination rates in the UK.
According to the college, uptake of vaccines has stalled over the past decade and is now falling in some areas. None of the routine childhood vaccinations have met the 95% coverage target since 2021.
NHS Digital figures show that in 2023-2024, coverage dropped for all 14 standard childhood vaccinations, falling by between 0.1% and 1.0% compared with the previous year.
In the context of the current measles outbreak, MMR1 coverage at 24 months declined to 88.9%, the lowest level since 2009-2010. Early data from 2024-2025 suggest the downward trend is continuing, the college said.
Disparities in Uptake and Systemic Shortcomings
The latest findings come from the RCPCH Commission on Immunisation Access, Uptake, and Equity, which was launched in response to growing concern over vaccination rates. The 12-month investigation examined quantitative and qualitative data, including national and local statistics, research, expert opinion, and the views of parents.
The commission found 'significant inequalities in vaccine uptake' across population groups and geographic areas in the UK. Despite high overall confidence in vaccines, it said families were being failed by a fragmented and hard-to-navigate system.
There was a 'growing disparity' in uptake, particularly among ethnic minority groups, socioeconomically disadvantaged families, and migrant communities. These groups may have lower trust in the government and healthcare system, the report noted.
Practical Barriers Deter Families
The report concluded that the problem lies less in vaccine hesitancy and more in the lack of access. It said many parents who wanted to vaccinate their children faced a range of barriers, including:
Difficulty booking appointments.
Inflexible time slots that clash with work or childcare.
Inconvenient locations or limited transport options.
Poor continuity of care and absence of trusted clinicians or health visitors.
Inadequate reminders and difficulty accessing children's vaccine records.
Limited or unclear information from professionals.
Health professionals lacking knowledge or discouraging vaccination.
Fear of injections or side effects, and reluctance to cause distress.
Fear of being judged for raising concerns.
Language barriers, digital exclusion, and lack of targeted outreach.
Call for Action on Infrastructure and Access
The RCPCH said improving vaccine delivery and uptake requires addressing these systemic issues.
"The UK must prioritise investments in infrastructure, digital health records for children, staffing levels, and staff training," the college said. Delivery and access to vaccinations could be improved if the systemic barriers to access were addressed, particularly those that may more frequently affect underserved communities.
Dr Helen Stewart, RCPCH officer for health improvement, said parents currently have no easy way to check if their child is up to date with vaccinations.
In the foreword to the report, she noted that in her work in a paediatric emergency department, the most common response from parents when asked if their child was up to date with their vaccinations was: "I think so".
NHS England Response
Dr Julie Yates, deputy director for immunisation programmes at the UK Health Security Agency, said the report was a reminder that parents and carers have busy lives and may struggle to find time for routine appointments.
She said that NHS England was already working to improve the 'front door' to vaccination, with plans for more flexible appointment booking, improved access across locations, and tailored services to meet the needs of specific communities.