NEW surveillance data from the UK Health Security Agency (UKHSA) indicate that almost one in five children starting primary school in England remain incompletely protected against serious vaccine-preventable diseases.
The figures, published for April 2024–March 2025, show that 18.6% of 5-year-olds had not received their 4-in-1 pre-school booster, which provides extended protection against diphtheria, tetanus, pertussis, and poliomyelitis. Uptake of this vaccine peaked at 86.3% in 2015–2016 but has since declined to 81.4% nationally, with London consistently underperforming relative to other regions. By contrast, coverage in some northern authorities such as Cumbria (94.3%) and County Durham (93.7%) approached the ≥95% level recommended for herd immunity.
Other antigens show mixed progress. Uptake of three doses of the hexavalent 6-in-1 vaccine by age 5 rose slightly to 92.8%, although this remains 2.8 percentage points below the 2016–2017 high of 95.6%. Early evidence suggests stabilisation of MMR1 coverage, with 91.8% of children receiving a first dose by age 5. While encouraging, these figures remain below WHO elimination thresholds and leave significant immunity gaps, particularly for measles, which has already demonstrated the capacity to trigger outbreaks in under-vaccinated communities.
UKHSA and NHS England have expanded mitigation strategies through additional GP-led clinics, school catch-up programmes and targeted outreach in low-uptake populations. Mary Ramsay, Director of Immunisation at UKHSA, warned that persistently suboptimal coverage risks re-establishing transmission of highly contagious pathogens, describing measles as a “canary in the coalmine”. Health Minister Stephen Kinnock stressed the need for parents to verify vaccination records and for healthcare providers to facilitate timely catch-up.
Ensuring children are up to date with vaccinations before starting school is essential to preventing outbreaks of vaccine-preventable diseases. With uptake rates still below historic peaks, continued engagement by healthcare professionals remains critical.
Reference
GOV.UK. Almost 1 in 5 children starting primary school are not fully protected against several serious diseases. 2025. Available at: https://www.gov.uk/government/news/almost-1-in-5-children-starting-primary-school-are-not-fully-protected-against-several-serious-diseases. Last accessed: 08 September 2025.
