Concerns over low vaccine rates amid whooping cough outbreak
Public health officials are facing calls to improve whooping cough vaccination rates in England’s most deprived areas, as experts fear the housing and cost of living crises may be contributing to low uptake.
Rates of uptake of the “six in one” vaccine, which protects against whooping cough among other diseases, are at the lowest level in the top 10% most deprived local authorities in England, according to a Guardian analysis of UK Health Security Agency data.
The UK may be experiencing its biggest outbreak of whooping cough in two decades. Five infant deaths were reported in England between January and March.
The Guardian’s analysis shows that 87% of the children living in more deprived areas had been fully vaccinated at the age of one as of December, compared with 94% in the wealthier parts of England.
London where 86.2% of children had taken the three doses of the vaccine at 12 months, had the lowest rate of vaccination, compared with 95.6% in the north-east.
The cost of living crisis, precarious and poor housing, and the current socioeconomic climate have all been cited by experts as reasons for poor vaccine uptake in the most deprived communities across England.
Dr Ben Kasstan-Dabush, a professor in global health and development at the London School of Hygiene & Tropical Medicine, said the deaths of the five infants from whooping cough reflected “the strain and limitations that the immunisation and public health systems are working under”.
Kasstan-Dabush said that lower levels of vaccine uptake in deprived areas were due to a wide range of factors and should not be dismissed as simply “vaccine hesitancy”. “If we look at urban settings like London, the populations are much more mobile and diverse, and living in extremes of inequality. We live in a context of an awful cost of living crisis which is putting parents under immense strain,” he said.
Kasstan-Dabush added that in a mobile population, people can “fall through the cracks of the system, which can affect the vaccination services offered”.
Putting vaccination clinics in community centres such as Sure Starts could be part of the solution to improving uptake in harder-toreach communities, according to Kasstan-Dabush. “I think the need for flexibility and creativity in immunisation services is most needed in these areas,” he said.
Prof Andrew Preston from the University of Bath said the need for vaccines to be administered primarily by GPs may contribute to lower uptake in deprived communities, and that widening access could help.
Among the worst local areas, 13 of the top 20 are in London. Areas outside London with the lowest coverage include Rochdale and Knowsley in the north-west, Birmingham in the West Midlands, and Liverpool, Salford and Blackburn with Darwen in the north-west.
England had the lowest coverage of the whooping cough vaccine in the UK; 91.3% of children had completed immunisation at 12 months, compared with 94.8% in Scotland, 94.5% in Wales and 92% in Northern Ireland.
A Department of Health and Social Care spokesperson said: “Our sympathies are with the families of the children in these tragic cases.
“We are committed to improving vaccination uptake rates to fully protect the public from preventable diseases, and are urging people to make sure they and their children have received all appropriate jabs. The vaccine is proven to be safe and effective.”