World Immunisation Week is promoted towards the end of April, throwing a somewhat controversial topic into the limelight. As healthcare professionals, we dentists are often keen to emphasise the benefits and encourage all to move forward with recommended vaccinations. However, it is important that we understand why some individuals are hesitant to proceed.
Vaccines in numbers
Vaccination coverage has been declining in the UK, with decreases in all 14 recorded immunisation areas in 2023-2024 of between 0.1 and 1% compared to the previous year’s results. No vaccines have fulfilled the national target of 95% since 2020-21 – this is true at any of the recommended vaccination ages (typically 12 months, 24 months and 5 years or a combination of these).[i]
As a result of lower immunisation rates in the UK, we are already seeing the re-emergence of previously eradicated diseases such as measles and mumps.[ii] This puts people at risk of potentially life-threatening health conditions that could have been easily preventable.
Understanding barriers
Various studies have attempted to determine the drivers for this decline in vaccinations. One found that uptake was lowest in the most socioeconomically deprived regions of the UK.[iii] Another revealed ethnicity to have an influence, with the black community and people of Pakistani or Bangladeshi heritage least likely to be immunised.[iv] Other reasons for low uptake may include poor access to healthcare services; inaccurate claims of vaccine safety and effectiveness; and insufficient healthcare capacity to deliver programme.[v]
Following the Covid-19 pandemic, there is also a body of recent research looking further at vaccine hesitancy. Education level has been identified as a potential factor, with those who completed more schooling more likely to be vaccinated.[vi]
In an age of information where facts and myths are almost indistinguishable even to the most discerning individual, health literacy may be particularly important for immunisation uptake. Research by the UK Health Security Agency (UKHSA) in 2023 found that 67% of parents surveyed had seen information relating to vaccines online – almost 30% used the NHS website, 24% saw it on Facebook and 18% saw it on parenting websites. Of the same participants, 88% believed vaccines were safe (down from 92% in 2022) and 89% thought they worked (also lower than in 2022).[vii]
Healthcare providers are, therefore, tasked with educating patients about both the effectiveness of vaccines and the reliability of associated information available online.
A dental perspective
Although we’re not directly involved with the provision of vaccines, we are well-placed to ensure patients are fully informed on the potential risks and benefits. Even something as simple as sharing government-hosted webpages on the latest research and statistics could help individuals make the right decisions for them. We’re not here to lecture or judge, but we can share educational resources and show patients that we are here to help.
[i] NHS England. Childhood vaccination Coverage Statistics, England, 2023-24. https://digital.nhs.uk/data-and-information/publications/statistical/nhs-immunisation-statistics/england-2023-24/6in-1-vaccine [Accessed March 2025]
[ii] NHS England. Why vaccination is important and the safest way to protect yourself. https://www.nhs.uk/vaccinations/why-vaccination-is-important-and-the-safest-way-to-protect-yourself/ [Accessed March 2025]
[iii] Flatt A, Vivancos R, French N, Quinn S, Ashton M, Decraene V et al. Inequalities in uptake of childhood vaccination in England, 2019-23: longitudinal study BMJ 2024; 387 :e079550 doi:10.1136/bmj-2024-079550
[iv] NHS. Vaccination: race and religion/belief. https://www.england.nhs.uk/south-east/wp-content/uploads/sites/45/2021/05/Vaccination-and-race-religion-and-belief-A4.pdf [Accessed March 2025]
[v] Evidence review for the barriers to, and facilitators for, vaccine uptake: Vaccine uptake in the general population: Evidence review B. London: National Institute for Health and Care Excellence (NICE); 2022 May. (NICE Guideline, No. 218.) Available from: https://www.ncbi.nlm.nih.gov/books/NBK581885/
[vi] Kountouris, Yiannis & Remoundou, Kyriaki, 2024. “Education and vaccine hesitancy: Evidence from the Covid-19 pandemic,” Economics Letters, Elsevier, vol. 240(C).
[vii] UK Health and Security Agency. Childhood vaccines: parental attitudes survey 2023 findings. Published March 2024. https://www.gov.uk/government/publications/childhood-vaccines-parental-attitudes-survey-2023/childhood-vaccines-parental-attitudes-survey-2023-findings#key-findings [Accessed April 2025]
