Prompted by public concern, a National Audit Office (NAO) investigation into pre-school vaccinations has looked at why NHS England has missed the Department of Health and Social Care’s (DHSC) 95% performance standard for the uptake of nearly all pre-school vaccinations in England since 2012.
The NAO identifies that better access to appointments, improved data recording and more positive public campaigns are necessary if the declines in pre-school vaccination uptake are to be reversed.
The report outlined that NHS England and Public Health England have identified the following potential factors behind declining uptake, including:
- An inconsistent system for reminding parents when their children are due for vaccination.
- Difficulties in timely access to healthcare professionals.
- Inadequate engagement with under-served populations where uptake rates are especially low, including traveller communities, migrants, and some religious groups.
- Incomplete data on vaccination uptake.
The NAO report cites the Royal Society for Public Health’s (RSPH) 2019 Moving the Needle report in identifying the timing and availability of appointments and childcare as barriers to getting one’s child vaccinated. Moving the Needle also found that two in five (41%) parents are exposed to negative messages about vaccines on social media, with this figure increasing to one in two (50%) among parents of children under five – though it is not clear exactly how much effect this has had on coverage rates to date. While we must be vigilant of – and take steps to guard against – the dangers of online misinformation, the focus of work to improve coverage should remain on improving delivery of and access to vaccinations.
RSPH is now calling for the Government to publish and swiftly implement its new Vaccine Strategy, and deliver positive campaigns that seek to reassure parents of the importance, safety, and effectiveness of vaccines.
Shirley Cramer CBE, Chief Executive of RSPH, said: “With the loss of the UK’s measles-free status, this report from the Government’s chief auditor couldn’t be more timely. Recommendations around improving access, as well as making the case for vaccines through campaigns, echo longstanding calls to action from RSPH.
“Our research has found that while parents found it difficult to access appointments, many were at the same time being exposed to negative messages about vaccines on social media. These are signs of the current system not working. Indeed, this year the WHO named vaccine hesitancy among its top ten threats to global health.
“Those working on the ground delivering vaccinations need the training, organisation and support to be responsive to the needs and concerns of parents. It’s therefore important that a broad range of health professionals are trained so they can promote and even deliver vaccinations at all available opportunities.
“The key issues around delivery and access highlighted in this report have been known for some time, so we’re pleased that a new Vaccine Strategy is now being produced. We urge the Government to move ahead with publishing and implementing this strategy as soon as possible, before we see further falls in coverage.”