Pre-school vaccination rates disappointing

NHS England has missed the Department of Health and Social Care (DHSC) performance standard for the uptake of nearly all pre-school vaccinations in England in 2018-19, according to a report by the National Audit Office (NAO).

Uptake of most pre-school vaccinations has declined since 2012-13 and in 2019 the World Health Organization withdrew the UK’s measles elimination status.

Public Health England (PHE) estimated that around 90,000 children in England (1 in 7) had not had both doses of MMR at the age of five. Current levels of uptake of the second dose of the measles, mumps and rubella vaccination (MMR) are 86.4 per cent, below the 95 per cent recommended by the WHO to give “herd immunity”.

No factor on its own explains the decline in pre-school vaccination rates according to the NAO report. Among potential causes is the 2013 health system reorganisation in England which resulted in fragmentation in the way the vaccination programme has been delivered.

The report cites inconsistency in the way healthcare professionals remind parents to vaccinate their children. NHS England took responsibility for commissioning call/recall when primary care trusts were abolished in 2013 but has not set out the requirements of GPs under the new arrangements, leading to inconsistencies in how the system works in different parts of the country.

Some parents report difficulty in accessing vaccination services due to the timing and availability of appointments. This could be a particular problem for “under-served” communities, such as travelers.

NHS England is creating an MMR catch-up programme for children aged 10-11 and published guidance in August 2019 for regional teams on how to improve uptake of MMR vaccination. The DHSC has announced plans to launch a new strategy on vaccination by spring 2020 and the Prime Minister has since requested it be brought forward to Autumn 2019.