Falling childhood immunisation rates across England risk a resurgence of “deadly and life-changing” diseases of the past, a leading nurse has warned, after new figures revealed a decline in coverage in nine out of 12 routine jabs.
The latest data from NHS Digital shows the percentage of children who had received their first measles, mumps and rubella (MMR) vaccine by their second birthday decreased for the fourth year in a row to 91.2% in 2017-18.
“It is vital we understand the full reasons behind the decline in vaccination coverage and take steps to improve before it is too late”
Take-up of both doses of the MMR shot by age five dropped to 87.2% – well below the 95% level recommended by the World Health Organization.
The new figures come amid a serious European measles crisis, which has claimed the lives of at least 37 people across the continent. In England, there been 876 confirmed measles cases so far this year.
The NHS Digital report, Childhood Vaccination Coverage Statistics, also shows uptake of the five-in-one vaccine for diphtheria, whooping cough, tetanus, polio and Hib disease at 12 months dropped for the fifth successive year to 93.1%.
“We are working closely with the NHS, and with staff in general practice, to improve uptake”
Responding to the figures, Helen Donovan, professional lead for public health at the Royal College of Nursing, said: “For the first time last year, Britain was declared free of endemic measles, but these figures show we are turning the clock back and leaving thousands of children unprotected.
“Coverage for this vaccine is now at 91.2%, the lowest it has been since 2011, and this year we’ve seen more than 800 cases of measles in England alone,” she said.
“This is just the tip of the iceberg,” she said. “Coverage declined in nine out of 12 of the routine vaccination measures compared to last year.
RCN warns of ‘profound public health challenges’
“This means immunity against deadly or life-changing diseases such as tetanus, diphtheria and polio is dropping. These were diseases of the past - they should not be part of our future,” she said.
Ms Donovan said successful vaccination programmes required a “system-wide approach” but warned that services had become “fragmented” since changes were made to public health commissioning in 2012.
She added: “It is vital we understand the full reasons behind the decline in vaccination coverage and take steps to improve before it is too late.”
Dr Doug Brown, chief executive of the British Society for Immunology, said the new figures painted a “concerning picture” of England’s immunisation efforts.
“Lower levels of vaccination mean that these harmful diseases can spread within our communities”
He added: “Lower levels of vaccination mean that these harmful diseases can spread within our communities, infecting people who have not been vaccinated, including vulnerable individuals who are unable to have vaccinations such as young babies, people with compromised immune systems or people with cancer.”
Dr Brown said the government needed to work with the NHS and local authorities to increase uptake, including making sure services were accessible and that parents were given enough information about the benefits of vaccines.
The rotavirus vaccine was the only one that had an increase in uptake in 2017-18, compared to the previous year, rising from 89.6% to 90.1%.
Coverage of the five-in-one vaccine stayed the same when measured at 24 months and five years.
The meningococcal group B (MenB) vaccine was introduced into the routine immunisation programme in September 2015. Coverage information has been published for the first time in this NHS Digital report and show 92.5% of eligible children were immunised in 2017-18.
Dr Doug Brown
Dr Michael Edelstein, consultant epidemiologist at Public Health England, highlighted that England still had one of the most comprehensive vaccination programmes in the world.
He said: “PHE research shows that parental confidence in the vaccine programme remains high which is reflected in the overall high rates of uptake across the vaccine programme.
“We are seeing small reductions in uptake for most of the childhood vaccines which is why we continue to encourage all parents to get the best protection for their children by ensuring they are fully immunised,” he said.
Dr Edelstein added: “We are working closely with the NHS, and with staff in general practice where most vaccinations are delivered, to improve uptake.”
Pat Cattini, vice-president of the Infection Prevention Society, said: “This data suggests we have grown slightly complacent about infectious diseases. This may be because people haven’t seen the devastating effects of diseases such as measles, diphtheria, typhoid, or polio for many years.
”The reported drop in vaccination rates is extremely worrying, especially given the outbreak of measles which are now affecting the UK,” she said. ”I would urge everyone to ensure they take full advantage of available vaccinations, both for themselves and their children.”