Vaccination gap widens as England's poorest children miss critical boosters

A new study has revealed deepening inequalities in childhood vaccination rates across England. Research published in The Lancet Regional Health – Europe shows that children in the poorest communities are far less likely to receive vital pneumococcal booster doses. The gap has widened since changes to the immunisation schedule in 2020, leaving disadvantaged children at greater risk of serious illness. The study tracked pneumococcal conjugate vaccine (PCV) uptake over a decade, from 2013 to 2025. It examined the impact of England's shift from a '2+1' to a '1+1' PCV schedule in January 2020, a move intended to streamline resources while maintaining protection. However, the change coincided with a sharp decline in booster coverage, particularly in deprived areas.

During the COVID-19 pandemic (2020–2021), vaccination rates in the most disadvantaged neighbourhoods—measured by the Index of Multiple Deprivation (IMD) quintile 1—either stalled or fell. By mid-2023, coverage in these areas had only partially recovered to around 70–75%, compared to 85–90% in wealthier regions. The gap between the least and most affluent groups reached 10–15 percentage points, according to UKHSA and NHS Digital data. Researchers stressed that simplifying the vaccine schedule was not enough on its own. Persistent barriers, such as uneven access to healthcare, low health literacy, and broader social inequalities, continue to hinder fair delivery. The decline in booster uptake began before the pandemic, suggesting long-standing systemic issues rather than temporary disruptions. The findings highlight that disadvantaged children now face a higher risk of invasive pneumococcal diseases. Without targeted action, these inequalities are likely to persist or worsen.

The study underscores the need for stronger outreach and flexible vaccination programmes tailored to local needs. Current efforts have failed to close the gap, leaving children in deprived areas vulnerable. Experts are calling for urgent interventions to ensure all communities receive equal protection against preventable diseases.