Background to the report
Health professionals consider that vaccinations are a crucial tool in protecting the health of individuals and that of the wider population, particularly for people with existing health problems who are more vulnerable to infectious diseases and for those who cannot receive vaccinations themselves. For vaccinations to be most effective, the World Health Organization (WHO) recommends that enough people need to be vaccinated to stop disease spreading across the population. This is called ‘herd immunity’.
There are seven types of vaccines (which protect against 13 diseases) routinely provided to children by the National Health Service (NHS) before they go to school aged five. In 2017‑18, the Department of Health & Social Care (the Department) set NHS England a performance standard of 95% uptake for pre-school vaccinations (except flu). There has been a general fall in uptake of pre-school vaccinations in England since 2012-13 and, in many cases, uptake of these vaccinations is below the Department’s performance standard.
Content and scope of the report
This investigation sets out the system for providing vaccinations to pre-school children in England. It is prompted by public concerns about the levels of uptake of pre‑school vaccinations. It sets out:
- the current levels of vaccination uptake and cases of disease across England;
- Public Health England (PHE)’s and NHS England’s understanding of the problem; and
- PHE’s and NHS England’s response to the problem.
We use the MMR vaccination, the 4-in-1 booster and the Hib/MenC booster to highlight many of the challenges that exist in the system for pre‑school vaccinations and illustrate in more detail how uptake of vaccinations is falling.