VacciNation: Putting the vaccination triple-win at the heart of the new Government’s policy agenda

Executive summary

The importance of vaccines to protect public health was clearly demonstrated during the pandemic. The UK was the first country in the world to approve a COVID-19 vaccine and begin rollout.5 A 2022 report from the National Audit Office found that the ‘collective efforts of many national and local public bodies, scientists, vaccine manufacturers, and individual staff and volunteers, as well as government’s power as a coordinator and funder, (meant) that so many of the programme’s objectives have been met and in some areas exceeded.’6 Such unprecedented action reflected the UK’s history as being a leading country for the development and rollout of vaccines.

Innovation is creating opportunities to use vaccines in the future to tackle a much wider variety of important conditions. In June 2024, the Government announced a new vaccination programme for respiratory syncytial virus (RSV) for older adults and pregnant women.7

However there are concerns that a health service under pressure in England is f inding tackling variations in vaccination uptake challenging. Such signs were in evidence before the pandemic, where the UK had lost its ‘measles-free’ status.8 Parts of the country are not meeting WHO uptake targets in important programmes such as flu.9

Our research finds variation in uptake across each of the four adult vaccination programmes (COVID-19, flu, pneumococcal disease and shingles) analysed of between 10 and 20% across England. Seven of the ICBs with the highest uptake rates across the four programmes are in the South West and South East. All five London ICBs are in the bottom 10 for adult vaccination uptake. North Central London ICB is the lowest ranked overall. Eight of the bottom ten ICBs are based in and around major cities: the five London ICBs, plus the two Birmingham ICBs and Greater Manchester ICB. Whilst there is evidence that some progress in increasing vaccination rates has been made, these data reflect similar regional variations observed in our previous research from 2021/2022.10

The reasons for variations in vaccine uptake are multi-faceted and complex, including demographics, levels of deprivation, accessibility, convenience and public confidence.11

With the health system under significant strain, vaccination can help provide an important level of protection, particularly in reducing hospital admissions for the associated conditions during the busy winter months. More widely – and with persistent issues around the under-performance of the UK economy and growing numbers of people out of work due to illness – effective vaccination programmes can improve productivity and deliver economic returns on investments.12 Our research finds that if across two vaccination programmes – for flu and COVID-19 – variations in uptake could be addressed thousands of hospital admissions, sick days and premature deaths could be avoided.

NHS England published a welcome vaccination strategy in December 202313 and vaccination is an embedded priority within important NHS policy frameworks, such as the Core20PLUS5 health inequalities scheme14, the Oversight Framework for NHS Integrated Care Boards15 and the Quality and Outcomes Framework (QOF).16 But improving vaccine uptake requires Government leadership, investment and action to really succeed and despite specific commitments such as those in the Life Sciences Vision, cross Government action and co-ordination remains piecemeal.17

A new Government creates a new opportunity for concerted action and the development of cross departmental Government ‘missions’ is a chance for a different policy approach. This report argues that improving vaccination uptake should be part of an NHS pivot to prevention; but also part of wider cross government plans both for reducing the gap in healthy life expectancy through the health mission; and improved economic growth through the economic mission and the work of the Industrial Strategy and Life Sciences Council.18,19

In making improved vaccination uptake a Government mission priority for both improved health and wealth, the Government will be able to deliver a vaccination triple win of improved health outcomes, reduced NHS pressures and stronger economic growth.