Recent developments around childhood vaccinations—both in the UK and the US—have stirred concern. Some are reassuring, others troubling. As someone who spent years in public service, I find myself reflecting not just on the data, but on the shifting attitudes beneath it. What’s at stake here isn’t just immunisation—it’s trust, responsibility, and the quiet dignity of collective care.

📉 Falling Uptake, Rising Risk

The UK Health Security Agency (UKHSA) reports that none of the main childhood vaccines met the 95% herd immunity target in 2024–25. MMR uptake among five-year-olds has dropped to 83.7%—the lowest since 2009. The four-in-one pre-school booster sits at 81.4%. London trails at 69.6%, while the North East leads at 90.2%.

Measles is resurging. Chicken-pox remains prevalent. In both cases, vaccination dramatically lowers risk. Dr. Mary Ramsay of UKHSA called measles the “canary in the coalmine”—a warning we ignore at our peril. A child died in July 2025. That should shake us.

🏥 The NHS Response: Practical, Persistent, and Principled

On 1 September, the NHS launched its autumn vaccine campaign. Flu vaccines are now offered to children aged 2–16, with nursery-based clinics for the youngest. COVID-19 vaccines are available for high-risk groups, including immunosuppressed children and pregnant women. Booking is straightforward—via the NHS App, website, or by calling 119.

This is the NHS at its best: practical, inclusive, and quietly persistent. No one can claim ignorance of the campaign or the risks of non-vaccination.

🏫 Then and Now: The Role of School Nurses

In the 1990s and early 2000s, school nurses were the linchpin of childhood immunisation. Delivering MMR, booster jabs, and catch-ups in schools achieved uptake rates north of 88% for many cohorts. Familiar surroundings, on-site reminders and follow-up visits made vaccination part of the school day—and part of civic life.

Today, that model has shifted:

Early-childhood jabs (6-in-1, initial MMR doses, MenB) now happen at GP practices. School nurses still run adolescent programmes via School Age Immunisation Services (SAIS), but the personal, neighbourhood touch of nurses in every primary school has largely receded.

⚖️ Barriers—or Evasion?

We hear much about barriers: difficulty booking, lack of reminders, disrupted relationships with health professionals. Some of these claims are valid—but many, I find hard to reconcile with experience.
In my time, surgeries were proactive. Appointments were flexible. Reminders came from Child Health, practices, even personal calls from GPs. That wasn’t just good practice—it was care.
Yes, family dynamics can complicate consent. One parent may agree, the other refuse—practices cannot adjudicate domestic disagreement. But that’s not a system failure; it’s a fracture of shared responsibility.
What I saw more often was quiet evasion: parents declining vaccination without much thought, or simply failing to turn up. That’s not a logistical failure—it’s a societal one. A slow erosion of civic duty, masked by convenience and softened by silence.

🌍 The US Influence: A Troubling Drift

Across the Atlantic, the CDC’s vaccine advisory panel has been reshaped: 17 members replaced by seven hand-picked advisers, some with anti-vaccine leanings. The ripple effect is reaching the UK, muddying waters and sowing doubt.

Yet here, parental confidence remains high. 85% believe vaccines are safe and effective. Most trust NHS professionals over social media. That’s heartening—but fragile. Trust, once lost, is hard to rebuild.

🧭 A Personal Reflection

What troubles me most isn’t the data—it’s the erosion of trust, the fading of shared responsibility. Vaccination isn’t just a personal choice; it’s a public one. It’s about protecting the vulnerable, honouring the quiet dignity of collective care.

We mustn’t let misinformation, apathy, or imported cynicism undermine what generations have built. The NHS, for all its pressures, still offers something remarkable: a system rooted in fairness, access, and trust. We’d do well to defend it—not just in policy, but in practice.

Yes, there is free choice. But every parent must understand the reasoning behind these vaccinations. They carry a responsibility to the child—and whatever they choose will shape that child’s life, for better or worse. That is not a burden to be taken lightly.

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