Amid measles outbreaks, U.K. launches vaccination ad campaign to boost childhood immunizations

LONDON — Facing a growing outbreak of measles, the U.K. on Thursday unveiled an advertising campaign aimed at boosting vaccination rates in children, which have steadily fallen over the past decade and took an even greater dip during the height of the Covid-19 pandemic.

The campaign, starting March 4, features children talking about their lack of protection from infections like measles and whooping cough if they’re not vaccinated. The ads, which tell parents to contact their general practitioners if they’ve missed getting their kids immunized, are designed to capture parents’ desires to keep kids safe.

Since October, England has seen more than 600 measles cases, officials at the U.K. Health Security Agency said as they previewed the campaign for reporters Wednesday. Most of the cases have been in children under 5 years old.

While the outbreak was initially centered in Birmingham, clusters have started to appear elsewhere, including in London, pockets of which have among the lowest vaccination rates in the country. The more widespread circulation of the virus indicates the Birmingham outbreak has been seeded in other communities where enough people are susceptible, officials said.

Given the drop in vaccination rates, “it’s not really a surprise to us that we’ve seen a resurgence of measles,” said Vanessa Saliba, a consultant epidemiologist at UKHSA.

A modeling study from the UKHSA released last year estimated that London could see an outbreak of between 40,000 and 160,000 cases. Vulnerable people would also include adults who were not vaccinated as children and who were never infected thanks to high levels of population immunity.

It’s estimated that 95% of people need to have received the two doses of the measles vaccine, which is given in a shot known as MMR (it also protects against mumps and rubella), to stop the spread of the virus in a population. In England, where children are meant to receive their first shot at 1 year old and their second at 3 years old, only 83.8% of 5-year-olds have had both doses. The rate of 2-year-olds who’ve had their first shot has fallen from nearly 93% to 89.4% over the past decade.

The situation in the U.K. is not unique. Globally, measles cases have been rising. World Health Organization officials have been calling on countries to redouble efforts to shore up childhood vaccination rates and ensure they catch up with children who missed routine vaccinations because of disruptions to care during the pandemic.

Earlier this month, the European Centre for Disease Prevention and Control warned that an already elevated level of measles is “expected to continue increasing … in the coming months due to sub-optimal vaccination coverage for measles containing vaccines in a number of [European] countries, the high probability of importation from areas experiencing high circulation, and the fact that the coming months represent the seasonal peak of the virus.”

The United States has seen clusters of cases as well, most recently at a school in Florida’s Broward County.

The U.K. officials noted that the situation today is a far different one than existed before measles vaccines were introduced starting in the 1960s. The country saw epidemics of hundreds of thousands of cases every two years, with virtually everyone being infected in their first few years of life. The fact that an outbreak of several hundred cases is notable now is evidence of the power of the vaccines, officials stressed.

For most, measles entails a flu-like illness with an itchy, full-body rash. But the U.S. Centers for Disease Control and Prevention estimates that about 1 in 5 unvaccinated people who are infected will be hospitalized. One in 20 infected kids will develop pneumonia, and about 1 in 1,000 will develop encephalitis, or swelling of the brain, which can leave a child deaf or cognitively impaired. In some cases, measles can be deadly.

Measles outbreaks can also serve as a canary in the coal mine for the return of other vaccine-preventable diseases. The virus is so incredibly infectious that it’s likely to be the first disease to flare up once immunization coverage declines.

U.K. officials said it’s not just rates of measles vaccination that have declined.

“The fall in uptake is not specific to any particular vaccine,” Saliba said. “It’s really across the board for all childhood vaccinations.”

The ad campaign in the U.K., which will include TV, radio, and online spots, is part of a broader effort to boost vaccination rates. Clinics are doing vaccine drives, and primary care offices are sending letters to parents. The campaign is targeting communities with lower vaccination rates and enlisting community centers and faith leaders. Materials are being distributed in multiple languages.

While some parents are opposed to vaccination, Mary Ramsay, the UKHSA’s head of immunization, said surveys show that parents’ attitudes about vaccines have not become more negative even as uptake dropped over the past decade. It’s likely that many parents just didn’t take their children in for all their vaccine appointments amid the busyness of life. The issue was exacerbated by the pandemic, as many doctors’ visits turned virtual.

“The pressure on the health service in terms of chasing people up and all of those things they used to do, during the Covid pandemic, that was obviously a lower priority,” Ramsay said.

But that, Ramsay said, means that “the bulk” of parents whose children needed additional vaccinations would be open to the message.