There has been a fall in uptake of nearly all pre-school vaccinations, such as Measles, Mumps and Rubella vaccination (MMR) since 2012-13, a report by the National Audit Office has found.
In July 2019, PHE estimated that around 90,000 children in England had not had both doses of MMR at the age of five. Current levels of uptake of the second dose of the MMR are 86.4%, below the 95% recommended by the World Health Organization to give herd immunity.
‘Each missed target means children are put at risk of disease so it's alarming we have once again missed this important marker,’ said RCN Professional Lead for Public Health Helen Donovan.
‘For nurses, the findings of the report are all too familiar as they are often the healthcare professionals grappling with a fragmented public health system, which doesn't support everyone working together to ensure children receive their vaccinations. There isn’t only one barrier to increasing vaccine uptake as the report says but not having enough nurses makes it more difficult to make strides in other areas.’
Of the potential causes identified by NHS England and PHE, no factor on its own explains the decline in pre-school vaccination rates. NHS England and PHE say they do not know the relative impact of each potential cause. There is evidence that the 2013 health system reorganisation in England resulted in fragmentation in the way the vaccination programme has been delivered, with the way healthcare professionals remind parents to vaccinate their children becoming inconsistent.
According to PHE, parents are contacted to book an appointment through being called and recalled by healthcare professionals. When primary care trusts were abolished in 2013, NHS England took responsibility for commissioning call/recall, but has not set out the requirements of GPs for call/recall under the new arrangements. This has led to inconsistencies in how the system works in different parts of the country.
‘Rather than laying the blame for the resurgence of measles solely at the door of those spreading myths on social media, policy makers should read this report which provides more evidence that we need to improve the services we provide for children and families,’ added Ms Donovan.
‘Instead of focusing on kneejerk reactions to this crisis like mandatory vaccinations, for which there’s no sound evidence, the health secretary should make clear how he will reverse the record nurse vacancies across England which are making the job of nurses working in vaccination even more difficult.’