Last week, an observational study published in BMJ shed light on the concerning issue of childhood vaccination disparities in England. These disparities are having a significant impact on the health and well-being of young children, particularly those from low-income areas.

Uncovering the Hidden Crisis of Childhood Vaccination Disparities in England

Measles, Mumps, and Rubella Vaccination Disparities

The University of Liverpool-led study evaluated data on the uptake of the first and second doses of the measles, mumps, and rubella vaccine (MMR1 and MMR2) among more than 2.4 million 5-year-old children from April 2019 to March 2023. Vaccine coverage remained below the 95% recommended by the World Health Organization throughout the study. The greatest absolute inequality in vaccine coverage at baseline was for MMR2, with a slope index of inequality (SII) ranging from -9.6% to -13.4%. This indicates a significant gap in vaccination rates between different income groups. The uptake SII also rose for all studied vaccines, highlighting the growing disparity. In the least deprived areas, the number of children unprotected against measles climbed 15-fold, from 1,364 to 20,958. In the most deprived areas, it jumped 20-fold, from 1,296 to 25,345. These figures clearly show the severity of the problem and the urgent need for action.

Rotavirus Vaccination Disparities

Rotavirus vaccination also showed significant disparities. Among the least deprived, the number of unprotected children increased 14-fold, from 2,292 to 32,981. In the most deprived areas, there was a 16-fold rise, from 2,815 to 45,201. Reduced access to and acceptability of childhood vaccinations, along with more prevalent vaccine hesitancy in disadvantaged groups, likely contribute to these inequalities. It is crucial to address these issues to ensure that all children have access to essential vaccinations and are protected against preventable diseases.

Pneumococcal Conjugate Vaccine (PCV) Booster Disparities

The PCV booster also experienced disparities. The SII for PCV ranged from -7.9% to -9.7%, indicating a significant gap in vaccination rates. This highlights the need for targeted interventions and catch-up campaigns in underserved populations. By addressing these disparities, we can improve vaccination rates and protect children from serious infections.

Impact of Vaccine Hesitancy in Disadvantaged Groups

Vaccine hesitancy is more prevalent in disadvantaged groups, which further exacerbates the vaccination disparities. According to global studies, barriers to vaccine uptake in these groups include perceptions of risk, low confidence in vaccinations, distrust of services, barriers to access, lack of community endorsement, and poor communication from trusted providers and community leaders. Addressing these barriers is essential to increase vaccination rates and reduce the spread of preventable diseases.The authors called for stronger vaccination systems, interventions, and catch-up campaigns in underserved populations. By taking these steps, we can work towards reducing the vaccination disparities and ensuring that all children have access to the protection they need.