Royal College of Paediatrics and Child Health 2025 Quick read: Vaccination in the UK: access, uptake and equity
Findings from the RCPCH Commission on Immunisation, 2024-25
1. The issue
2. Our findings
• Vaccinations are one of the most powerful tools we
• Significant emphasis in research and policy is currently given to hesitant or ‘anti’ vaccination beliefs, attitudes and behaviours. The RCPCH commission recognise the challenges posed by anti-vaccine sentiment, misinformation, and associated forms of vaccine hesitancy, but from their work, the commission conclude that it does not account for the whole picture in the decline of childhood vaccination. • The commission emphasise that in the UK, where vaccine confidence is still relatively high, undervaccination is more often due to difficulties accessing services for practical or logistical reasons. The report underscores the importance of understanding these access-related barriers, as these can discourage families - particularly those already uncertain about vaccination - from actively pursuing immunisation for their children. • The commission highlighted the growing disparity in vaccine uptake among some ethnic minority groups, socioeconomically disadvantaged families and migrant communities. These groups reported specific challenges such as limited access to information due to language difficulties, digital exclusion, challenges in navigating the NHS, and a lack of targeted outreach. • There are also barriers stemming from costs associated with vaccination and inaccurate or incomplete NHS records making it difficult to know if vaccinations have been missed and harder to contact families about upcoming vaccinations. • Communities that experience inequality and marginalisation may have reduced trust in the government and the healthcare system, impacting confidence in health-based interventions such as vaccination, resulting in a lower uptake in these groups.
have in preventing ill health. Vaccines have saved millions of children’s lives, protecting them from serious illness and life changing complications; they have transformed the world we live in. • However, over the last decade the uptake of vaccines in the UK has stalled and is in many cases declining. • In 2020, one in five children worldwide was not fully vaccinated, with 1.5 million deaths annually from preventable disease (UNICEF, 2020). • The World Health Organization (WHO) recommends a target of 95% vaccination coverage to protect vulnerable groups - like newborns, the elderly, and the immunosuppressed - who may not be able to be vaccinated themselves. • In the UK, data shows that none of the routine childhood vaccinations have met the 95% coverage target since 2021. Early data from 2024-25 indicate that rates of vaccination look set to continue to decline. • Declining rates of routine vaccination in a wealthy country such as the United Kingdom, with a well-established universal healthcare system, are extremely concerning. • The decrease in childhood vaccination rates pose a significant public health risk, with outbreaks of preventable diseases such as measles and pertussis (whooping cough) already being seen. • Declining vaccine uptake represents an inefficient use of public health resources and reduces the effectiveness of the UK’s pandemic preparedness and disease control strategies. • Compounding this, inequality in vaccine uptake – particularly among socioeconomically disadvantaged families, some ethnic minority groups, and migrant communities – has been increasing in recent years, with disparities becoming more pronounced since the COVID-19 pandemic. RCPCH convened a commission of experts for 12 months to explore the decline in childhood vaccination in the UK. The commission used a multi-pronged approach to review quantitative and qualitative evidence, including national and local data, recent research, expert opinion, and lived experience to understand barriers to vaccination in the UK today. 1 of 5