Are Vaccine Uptake Rates High Enough to Prevent Outbreaks?

England's MMR vaccination rate stood at 89.3% for two doses by age 5 in 2022/23 — more than five percentage points below the 95% threshold required for herd immunity against measles.^[1] The gap has consequences: the UK lost its WHO measles-free status in 2019, and in the year to October 2024 England notified 2,978 measles cases, the highest annual total in three decades. A concentrated outbreak in Birmingham in early 2024 infected over 300 children.^[2] Whooping cough (pertussis) is also resurgent: more than 15,000 cases were confirmed in 2024, with at least 10 infant deaths — a disease that a functioning vaccination programme should render vanishingly rare.^[4]

The roots of the current shortfall run back to 1998, when Andrew Wakefield published a since-retracted and fraudulent paper claiming a link between MMR and autism. Vaccination rates collapsed during the following decade and never fully recovered in the cohorts affected. London, where vaccine hesitancy is most concentrated and communities most diverse, records just 84.1% MMR coverage — 11 percentage points below the herd immunity threshold, with some boroughs below 80%.^[3] The problem was compounded by COVID-19: research shows that areas with high refusal of COVID vaccines saw correlated declines in routine childhood immunisation, a spillover effect that affected the 2020 and 2021 birth cohorts in particular. DTaP coverage (diphtheria, tetanus and pertussis) has fallen to 91.7%, down from 95.2% in 2016/17.