Pre-school vaccination rates failing to meet government standards, National Audit Office report reveals

Declining vaccine rates for children mean that NHS England has missed its target for 2018/2019.

Pre-school vaccination rates failing to meet government standards, National Audit Office report reveals

Uptake of nearly all pre-school vaccinations in England has declined since 2012/2013, meaning that NHS England has failed to meet performance standards set by the Department of Health and Social Care (DHSC), a report from the National Audit Office (NAO) has revealed.

This comes after the World Health Organization (WHO) stripped the UK of its ‘measles-free’ status earlier in 2019, three years after the virus was eliminated in 2016.

According to the NAO report, in 2018/2019, 86.4% of children in England aged five years had had two doses of the measles, mumps and rubella (MMR) vaccination, below the 95% recommended by the WHO to give herd immunity. This is nearly two percentage points less than in 2013/2014, when 88.3% of of children in England aged five years had received two doses of the MMR vaccination.

In July 2019, Public Health England (PHE) estimated that 90,000 five-year-olds in England in 2019 had not had both doses of MMR.

Of the seven types of pre-school vaccination routinely provided in England in 2018/2019, the 4-in-1 pre-school booster — which vaccinates against diphtheria, tetanus, whooping cough and polio — had the lowest uptake of all pre-school vaccinations at 84.8%. In 2013/2014, this vaccination had an uptake of 88.7%.

The report, published on 25 October 2019, also highlighted that NHS England data showed regional variation in vaccination uptake, with the lowest levels seen in London.

It said that PHE and NHS England believed that the lower levels may be, in part, owing to children’s medical records not being updated as they move; challenges with the GP workforce; and a “highly mobile” population.

The NAO also said that the way healthcare professionals reminded parents to vaccinate their children was “inconsistent”; that parents can find it difficult to access vaccinations services; and that a small minority of parents were reluctant to have their children vaccinated because of concerns about vaccinations.

“The decline in vaccination rates for children in recent years is worrying, as is the degree of variation,” said Sarah Wollaston, chair of the House of Commons Health and Social Care Committee. My committee will be questioning the DHSC, NHS England and PHE at a hearing in November 2019 to press them on their plans to protect children and their wider communities by improving the uptake of vaccinations.”   

According to the NAO: PHE, NHS England and the DHSC are currently developing a joint communications strategy to promote positive messages about vaccinations and to help overcome vaccine hesitancy.

Last updated
The Pharmaceutical Journal, October 2019;Online:DOI:10.1211/PJ.2019.20207238