Why aren’t parents getting their kids vaccinated?

0:00Hello, Ed Conway here. Here is what might sound like a slightly random question. What do AirPods, bananas and a pair of shoddily made running trainers from the 1970s have in common? On the surface, not very much. But on my podcast, Stuff Matters, I will uncover the deeper stories behind each of them. You will see how together they tell a fascinating new story about the world we live in. The first full series of Stuff Matters is out now. Just search for it on your podcast app and follow. Coming up on the Sky News Daily with me, Neil Patterson. As the percentage of children receiving the measles vaccine reaches its lowest level in 16 years, we simply ask, why?

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1:30You will see how, together, they tell a fascinating new story about the world we live in. The first full series of Stuff Matters is out now. Just search for it on your podcast app and follow. A little less than 10 years ago, the World Health Organisation proudly announced to the world that the United Kingdom had eradicated measles. Fast forward to today and look, things are a little different. Now we'd known for a long time that the vaccination rates across the United Kingdom had been in decline. What the data today shows is that in fact in England it's at its lowest in 16 years, well below the target of 95 % by the age of five.

2:14In fact, if you look just a little bit more closely at the data, you will discover that the rate in England is less than that in any of the other home nations and it's particularly bad in areas like London and the North West. Hackney, for example, in London, 60 % uptake. And when we look north, take somewhere like Liverpool. A quarter of children there haven't had the full vaccine for measles by the age of five. And of course, with the recent death of a child at Alderhey Hospital in Liverpool because of measles, attention really has been focused on what can be done. Because, of course, measles can prove fatal.

2:51Take Becky Archer's daughter, Renee. She caught measles at just five months old. Too early, of course, for the vaccine. But the condition can be carried for years and lie dormant. Ten years later, she sadly lost her life. Becky was talking to Sky's Greg Milam. It does make me quite sad and angry because they are potentially putting their children at risk and we just want people to open their eyes really to someone that's actually been through it. and not the nonsense that's been spreaded on social media. And I just want people to be knowledgeable of how serious the situation can be. She was a really caring person.

3:35She wouldn't have wanted any other family to go for losing the child. OK, so let's try and work out exactly what is going on here. Professor Helen Bedford is a vaccines expert. She's Professor of Children's Health at UCL. She also works with Great Ormond Street Hospital. Helen, look, this is all very worrying, isn't it? This is very predictable because particularly with reference to measles, to keep measles away, you need extraordinarily high levels of vaccine uptake of the order of 95 % of two doses. And it's not just a question of getting to that level. You have to keep at that level to keep the disease away.

4:17And this is because it's so highly infectious. it's considered to be up there as, if not the most, certainly one of the most infectious diseases of humans. We most commonly hear that 95 % figure associated with the phrase herd immunity. Just explain exactly what that means. I think community immunity is a better expression than herd immunity, which conjures up baby cows and things. But basically what it means is if you have high enough levels of vaccination in the community, this acts to protect people who can't be vaccinated, maybe because they're too young or they have a health condition or they're pregnant.

5:01So it's a really important concept. And incredibly important when it comes to conditions like measles, which, as you say, incredibly infectious, incredibly dangerous. And yet people still tend to think of it as a routine childhood illness. I think part of the problem is that a lot of people have forgotten about measles altogether because vaccine levels, although not as high as we would like, have been for many years such that we've had very, very little disease. And this means that people forget about it. They forget how serious it is or they think, well, that disease has gone away. We don't need to be vaccinated.

5:36So it's not so much in the public consciousness. Just explain, in what ways does measles affect young people and indeed adults who have not been vaccinated? Well, measles is a viral infection. And people who have it often feel, even in an uncomplicated situation, can feel very unwell. So it's a combination, usually starts off with the symptoms like a cold. So there might be a cough, runny nose, sore eyes. But then it develops over the course of a few days and people can get very high fevers and a rash and feel very unwell. And that's an uncomplicated case of measles. But complications are very common.

6:20About one in 15 cases of measles will have complications. and these include things like ear infections but also more seriously pneumonia and encephalitis which is inflammation of the brain and then uncommonly it's about one in a thousand to one in five thousand even in a high income country like ours people can die of measles. So when we're looking at the data the most recent data about the outbreaks in the United Kingdom are we seeing correlation then between areas with lower vaccination and areas with increased distribution of measles? Oh, absolutely. We know there are pockets around the country that have lower vaccine uptakes.

7:05So, for example, in London, vaccine uptake tends to be lower. And in some parts of London, it's as low as about 60 % for two doses of NMR, which is really, you know, way below what we need to keep the disease away. And it's in these areas of low vaccine uptake that we tend to see the outbreaks. I mean, can we generalise about this? Do we know if this is associated with class, if it is associated with ethnicity, if it's just geolocation, where you are in the country? It's associated with poverty. Low vaccine uptake goes hand in hand with disadvantage. And when we think about the groups that aren't vaccinated, the reasons for that, it's not all down to people saying they don't want the vaccine.

7:52The main reason children are not vaccinated in this country is because of a lack of access to services. And this can look different in different places, but people have difficulty making appointments, getting to appointments. If you're poor and you're thinking about how do I feed my children this week, actually paying the bus fare to get your child to the GP to be vaccinated may not be your priority. But we also know there are some ethnic minority groups who have poor uptake. And this was very much reflected during the pandemic with the uptake of COVID vaccine. It's the same ethnic minority groups who tend not to have their children vaccinated with the childhood vaccines.

8:37But this may be as a result of disadvantage. The two things are very difficult to pull out from each other. As of this point, if I were to ask you, why would a specific ethnic group not have the same vaccine uptake as white Britons? We can't really put a definitive answer on that. Maybe about mistrust in the NHS. We know that some groups say that, you know, they've had previous poor experience of the NHS. Those sorts of things can be very influential. But if you look back 20, 30 years, our vaccine uptake is much higher than it was. But it is in these pockets of disadvantaged communities where it may be very difficult to improve things noticeably for lots of different reasons.

9:30Can you give me some examples of the rationale that these communities give when quizzed about this? I understand that you've done some work with the traveller community in the United Kingdom about vaccine uptake in the past. And I'm just wondering, can we can we identify the rationale for these specific groups? And because if we identify that rationale and it can be rebutted, we can do something about it, can't we? Yes. Well, it was very interesting. We did conduct a study. This is almost 10 years ago now amongst gypsy travellers and Roma communities. So it was conducted amongst six different types of community.

10:04And these communities, although they're very different in terms of their history and their culture, but they do share experiences of social exclusion and discrimination and overall experience much poorer health outcomes than the general population. And we did an in-depth study with them talking to the communities, community members, to find out their views about vaccination. And what we found out was that their views and their attitudes were very little different from the general population, But the problems for them were around language with some of the communities, so difficulty speaking English and other barriers such as discrimination, not attending schools.

10:51So this is where many vaccines are offered. So what was very interesting was that they valued trustful relationships with health professionals and continuity of care, which wasn't always available to them. None of which I presume is to say that social media, the internet in general, the anti-vax community that exists there hasn't itself had an effect on vaccine uptake. I think the issue with social media is quite clear, is that for some people, they have questions and concerns about vaccination, which is good. We want to encourage that. We want people to ask questions. But it's not always obvious to people where they can get answers to the questions.

11:35And we know that the health services are really sort of stretched at the moment. For example, health visitors who are the public health nurses who visit every family in the country with a young child, their numbers have been reduced by over 40 % since 2015. And in that sort of situation, people who've got questions about vaccination may think, well, I don't know who to ask. You may turn to social media, look on the internet for answers to your questions. and we know that a lot of the information out there is not always reliable. I think it's had some impact but it's very difficult to measure and what is interesting is if you do surveys of parents and you ask them who do you trust with information about vaccination, health professionals come top of the list.

12:27It's always GPs, practice nurses, health visitors. Social media is right down at the bottom, with only about 5 % of parents in some studies saying they trust social media. Now, they may be giving what they feel is a socially acceptable response, but it's very interesting that people themselves say they trust health professionals far, far more than anything they read on social media. Is it perhaps possible, Helen, that vaccines have been the victim of their of their own success. I think it's true to say that vaccination is a victim of its own success. So we've achieved very high levels of vaccination.

13:07These diseases have become very uncommon. So most modern young parents have no experience of their children being particularly ill. You know, people don't understand how sick these diseases can make you. So I think this is true. to a certain extent. But nevertheless, even when a measles vaccine was first introduced into this country in the 60s, there were still people who said, oh, this is not a serious disease, even when they were surrounded by it. There might be hundreds of thousands of cases and many, many children dying. There's always been a bit of scepticism amongst the population, but you're probably right that it is amplified now because of the lack of disease.

13:58Can we look at this from the other end, just for a second? We live in an era of bodily autonomy, a time where people have command over their bodies and the medical treatment that they receive. If a parent, for whatever reason, does not wish their child to have any medical procedure, including vaccination, that remains their right, doesn't it? Yeah, in this country, we have no mandation requiring vaccination. I think we could do an awful lot more with communicating to people the seriousness of the disease and the safety of the vaccines. I think that can be improved. I think health professionals and advocates of vaccination need to try and occupy the same space where a lot of people get misinformation about vaccination.

14:44We need to improve how we do that. But I also think there's room to do more vaccine education earlier. I mean, as young as primary school age, to be talking to young people, not just about vaccination, but how to critically appraise evidence, because that's what it boils down to at the end of the day. It's how people look at scientific evidence and understand it. So to try and bring our conversation to a positive conclusion, Helen It strikes me that you appear quite confident that this is a situation These are a set of circumstances, the vaccine uptake, lowest in 16 years That can be turned around Absolutely I do, but it requires commitment and it requires a lot of resource And that resource needs to be sustained over time Professor Bedford, thank you so much for your time, really appreciate it Well, look, that is the problem.

15:40The solution, well, it might just be found in the government's fit for the future 10 year plan for the NHS, published, in fact, just this month. It says this vaccines prevent between an estimated 3.5 to 5 million deaths globally each year. They remain one of our best means to protect people against disease. We will continue to work with local government, civil society, voluntary organisations and community groups to support the public trust in vaccines needed to restore childhood immunisation rates more broadly. We will also work with families and schools to improve the consent process to help children get vaccines at school and help parents book vaccinations and check they are up to date through the NHS app.

16:24And of course, if you want more information about vaccines, speak to your GP or head to the NHS website. The Sky News Daily is back again tomorrow.

16:41Hello, Ed Conway here. Here is what might sound like a slightly random question. What do AirPods, bananas and a pair of shoddily made running trainers from the 1970s have in common? On the surface, not very much. But on my podcast, Stuff Matters, I will uncover the deeper stories behind each of them. You will see how, together, they tell a fascinating new story about the world we live in. The first full series of Stuff Matters is out now. Just search for it on your podcast app and follow.