Childhood vaccination is a lifesaving public health measure, and some vaccines, such as for whooping cough and respiratory syncytial virus (RSV), can even be given during pregnancy to protect babies in infancy. However, uptake of childhood vaccination has been declining since 2013, leading to outbreaks of preventable disease such as measles.
There are disparities in vaccination uptake across the UK linked to deprivation and ethnicity. Lambeth and Southwark are two ethnically and socioeconomically diverse London boroughs where rates are below national levels (89.2% and 88.2% respectively, compared with 91.8% across England).
The reasons for this are not fully understood. Vaccine hesitancy may explain some of the variation, but evidence suggests that changes in how and where vaccines are offered across the UK may be more significant factors.
So far, no combination of strategies has reversed the UK’s vaccination uptake decline. This study will examine the relationship between vaccination during pregnancy and the subsequent uptake of routine childhood vaccines and explore whether the antenatal period is an opportunity to intervene to support their uptake.
By identifying which groups in south-east London are most at risk of not receiving vaccinations, the findings can help shape local public health policy and guide the allocation of resources at both borough and Integrated Care Board levels. In turn, this evidence could help inform national strategies to reduce vaccine inequalities.
This work is deeply rooted in the current disparities in childhood vaccination uptake in south-east London and the resultant vulnerability of children and families to infectious diseases which are preventable through vaccines.
The researchers will first carry out a systematic review of the interventions in the antenatal period that may increase childhood uptake of vaccination, and their effectiveness.
Next, they will use data from a large group of families in south-east London (including medical records from pregnancy through to childhood, with a particular focus on underserved groups) to:
The researchers will then carry out in-depth interviews with parents in antenatal and childhood periods to understand their experiences of seeking and receiving vaccinations, and how to develop ways to better support their vaccination needs.
All the findings will be combined into knowledge to be shared with policy makers, public health colleagues, the academic community, and most importantly, with families.
Researchers will work with families and professionals to design ways we might support vaccination uptake in the antenatal period, with a focus on the groups who are most underserved by vaccination.
Patient and public involvement (PPI) and stakeholder engagement will be embedded throughout the study to ensure its relevance and impact.
A group of recent users of antenatal and children’s services and individuals from King’s College Hospital, primary care and community organisations form the PPI group. The stakeholder group of experts in this area consists of colleagues in public health, the UK Health Security Agency, primary care, paediatrics, pharmacy and midwifery.
Both groups will meet regularly to guide the research content, develop and test written research materials, consider means to ensure diverse recruitment to the research and discuss the research findings and implications.
Additional collaborators come from across King's College Hospital, King’s College London, the Fetal Medicine Institute and the Royal College of Paediatrics and Child Health.
This project is expected to complete by the end of 2030.
Read about the other work of our children and young people's theme.