Falling Vaccination Rates: How School Aged Immunisations Show the Way Forward

School Aged Immunisations

When we read the Royal College of Paediatrics and Child Health’s (RCPCH) recent report, "Vaccination in the UK: Access, uptake and equity," it was clear from the start that this report wasn’t going to pull its punches and rightly so.

It opens with some of the most powerful and unequivocal statements we’ve seen on the importance of childhood vaccination:

"After clean water, vaccines are considered the most successful public health measure in history. No single intervention has averted more child deaths.”

"No other public health measure provides comparable societal benefit for the same per capita cost. Investment in immunisation is one of the most cost-efficient of the available public health financing domains. Failure to optimise universal access to and uptake of known, safe, available antigens is a failure of government and good health governance at the highest level.”

The report makes it clear. Routine childhood vaccination coverage in the UK hasn’t met the WHO’s 95% herd immunity target since 2021. Preventable diseases like measles, mumps, and whooping cough are making a return and behind each of those statistics is a real child, unnecessarily at risk.

What sets this report apart is its directness and depth. It doesn’t just sound the alarm it identifies where and how change can happen.

Crucially, it shifts the focus away from “vaccine hesitancy” as the default explanation. The research shows primary barriers aren’t about belief, they’re about access. Most missed vaccinations are due to practical, supply-side issues such as: rigid appointment systems, limited clinic hours, and the logistical pressures of travel, time off work, or managing multiple children. These challenges hit hardest for financial disadvantaged families.

Yes, demand-side issues like misinformation and mistrust exist but they’re not the main story. The majority of parents want to vaccinate their children. The problem is that the system isn’t designed around the realities of their lives. Language barriers, low health literacy, lack of accessible reliable information only deepen the divide.

To address this, the RCPCH calls for action in three key areas: 

• Make access easier through more flexible, outreach-based and community-delivered services.

• Fix the digital infrastructure, ensuring better data recording, sharing and real-time access to records, including a Single Unique Identifier (SUI) for every child.

• Strengthen public communication with clear, accessible information, staff training, and targeted campaigns to build trust and counter misinformation.

It was refreshing to read a piece that goes deeper than just “people aren’t turning up.” Because the truth is, most families do want to protect their children, they’re just stuck in a system that doesn’t work for their day-to-day lives and while the national picture is worrying, what the report helped us see more clearly is this: We already have a working model of accessible, community-based vaccinations and it’s happening through school-aged immunisation programmes and there is a lot we can learn from its successes.

School-aged immunisation teams are quietly solving part of the problem, although they are often underfunded and overstretched. By going to children, in the place they’re already required to be, school immunisations bypass many of the challenges that families face with GP-based appointments. No travel. No rescheduling. No disruption. Just access.

These programmes prove that when health services go to where children already are, barriers start to fall away. School nurses are uniquely positioned within communities they understand the local context, they build trust over time, and they can deliver care equitably across a wide range of local challenges.

Schools offer a consistent point of contact with almost every child, regardless of background. They bring reach, familiarity, and the infrastructure to deliver preventative care at scale especially in disadvantaged communities where access can be hardest.

When we look at the coverage data from our school-aged immunisation partners, we see just how well this approach can work. Yes, the national picture shows a dip in coverage since 2021 but the local authority data tells a more hopeful story. With the right tools, systems and support, high coverage is possible even in the most disadvantaged areas with teams actively closing the gap in local health disparities.

There are some big wins happening in school immunisations. In our next blog, we’ll share the stories and data behind those successes and show how school aged vaccination teams are helping to level the playing field, bringing equity and access to children’s healthcare.