Vaccine uptake in the general population

Context

Vaccinations provide personal and population-level protection against many diseases. High vaccine uptake rates create population-level protection, leading to herd immunity. This protects both immunised and non-immunised people. Examples of non-immunised people include those who are highly susceptible to disease such as newborn babies and older people, and people who cannot be vaccinated for medical reasons or for whom vaccines are contraindicated. By contrast, vaccines for some diseases such as shingles only protect those who receive them and provide minimal indirect protection to other people.

The UK routine vaccination schedule covers key vaccinations for different stages in life including childhood, adolescence, pregnancy and old age (currently 65 years and older). Although vaccination coverage in general in the UK is relatively high, uptake varies between vaccines, areas and the age groups they are targeted at. For example, 5-in-1 coverage of children measured at 5 years was 95.2% in 2019/2020, whereas 83.9% of Year 9 girls completed the 2‑dose HPV (human papillomavirus) vaccination course in 2018/19. By contrast, from April 2018 to March 2019, shingles vaccine uptake for the 70‑year‑old routine cohort was only 31.9%, pneumococcal vaccine uptake for all people aged 65 and over was 69.2% and pertussis vaccine coverage in pregnant women was 68.8%.

Vaccination coverage needs to be actively maintained, and ideally increased, in the face of increasing vaccine scepticism and misinformation. In addition, certain population groups (such as Travellers, Gypsy and Roma, refugees and asylum seekers) have lower levels of vaccination than the general public. Additional or different actions may be needed to increase their vaccination rates.

Reasons for low uptake may include poor access to healthcare services; inaccurate claims about safety and effectiveness, which can lead to increased concerns and a reduction in the perceived need for vaccines; and insufficient capacity in the healthcare system to provide vaccinations. In addition, problems with the recording of vaccination status and poor identification of people who are eligible to be vaccinated may have contributed to low uptake.