By Emily May, Manager, Deloitte Centre for Health Solutions

A wide body of research demonstrates that vaccines saves lives and are a highly cost-effective public health intervention that protects people’s health, improves a country’s resilience and productivity, and ensures a safer, healthier world.¹ Like all medicines, vaccines are not completely risk-free, but rigorous clinical research and development and continued surveillance, helps ensure vaccines are safe for the vast majority of people.² The COVID-19 pandemic ushered in a new era for vaccines, with scientific breakthroughs and novel technologies, like mRNA vaccines, expediting the development and delivery of  preventative treatments. However, it also increased vaccine hesitancy, undermining public confidence in, and uptake of, vaccines. This has led to a resurgence of diseases that were on the verge of being eradicated.³ This week’s blog explores the impact of vaccinations on public health and strategies for effective immunisation programmes.

The importance of vaccines

Vaccinations have played a significant role in improving public health and wellbeing for more than 70 years with immunisation (the process of getting thevaccine and stimulating the immune system to develop resistance) saving more human lives than any other medical invention in history.⁴ Today, routine vaccinations play a pivotal role in protecting from serious illness and death, lowering the spread of infectious diseases and, more recently, reducing the risk of developing certain cancers.

Immunisation is a vital component of primary health care, reaching more people than any other health or social service, and is especially important for protecting vulnerable populations such as infants, the elderly, and those with weakened immune systems. It also has a significant economic impact, reducing healthcare costs and increasing economic productivity by preventing severe illness and decreasing care costs and sickness absence.

In helping to eradicate deadly diseases such as smallpox, reduce the prevalence and severity of others such as polio, measles, and mumps and preventing millions of deaths worldwide, vaccines have:

• reduced the mortality rate of children under 5 years of age by nearly a quarter between 2010 and 2017
• prevented 25.5 million deaths from measles alone since 2000
• made enormous progress towards the eradication of polio, reducing cases by over 99 per cent since 1988.⁵

Immunisation was also the principal tactical response to the COVID-19 pandemic, and significantly increased the public’s awareness of vaccination programmes. In fact, 84.8 per cent of the EU adult population were vaccinated at least once against the virus by August 2023.⁶ This high rate of vaccination since the first vaccine was launched in December 2020, is estimated to have reduced deaths by at least 57 per cent, saving more than 1.4 million lives across the WHO European Region.⁷

In 2021, to optimise the impact of vaccines in general, the WHO launched, the Immunisation Agenda 2030, an ambitious global strategy aiming for a world where everyone, everywhere, at every age fully benefits from vaccines for good health and well-being.⁸ Estimates suggest that between 2021 and 2030, immunisation could help avoid some 51.5 million deaths.⁹ To achieve these numbers, however, a crucial aspect of the programme is to increase access to and uptake of vaccines.

Challenges in improving the uptake of vaccines

The pandemic resulted in other essential immunisation levels decreasing in over 100 countries, due to overburdened health services, closed clinics, and disrupted imports and exports of vials, syringes and other medical supplies. This has led to rising outbreaks of measles, diphtheria, polio and yellow fever. In response, in April 2023, many global and national partners including the WHO, UNICEF, Gavi, the Vaccine Alliance and the Bill & Melinda Gates Foundation, joined forces to call for ‘The Big Catch-up’, a targeted global effort to boost vaccination among children.¹⁰

UK vaccine uptake

In the UK, vaccine uptake decreased in 13 out of the 14 programmes for children up to five years old, in 2021-2022.¹¹ Uptake also decreased in 12 out of the 14 routine programmes in 2022-23 with and no vaccination programmes achieving the World Health Organisation (WHO) 95 per cent target.¹² These statistics correlate with increases in several well-documented rises in infection rates across the UK:

• the annual number of suspected measles cases, more than doubled in each of the past two years (from 360 in 2021 to 735 in 2022 and 1,603 in 2023).¹³ Around nine out of ten people who are not protected are likely to be infected following exposure to the measles virus. The rise in measles outbreaks and the increased risk of morbidity and mortality is being replicated throughout the world and is expected to continue while people remain under-vaccinated.¹⁴
• approximately one in eight young adults who were expected to start university in September 2023 are at risk of contracting meningitis as a result of failing to obtain their meningitis (MenACWY) vaccine.¹⁵ This jab protects against four strains of meningococcal bacteria each of which can cause long term disability, serious health complications and can be life threatening. The MenACWY vaccination rate fell to 79.6 per cent in 2021-2022, meaning that around one in five students starting university in a few years’ time will be unprotected if they fail to catch-up with their vaccinations.¹⁶

Overcoming vaccine hesitancy

The benefits conferred by vaccination ultimately depends on the willingness of people to get vaccinated. Vaccine hesitancy is not a new issue, with research identifying multiple societal and individual level factors, such as risk concerns, reduced trust in vaccines and waning confidence in the healthcare system, but also access and affordability issues, all of which vary within and between countries. However, over the past decade hesitancy has escalated in scope and scale, amplified by social media. Multiple surveys examining the sentiments expressed about Covid-19 vaccination, exposed new levels of volatility around vaccine hesitancy, with spikes in hesitancy often coinciding with new information, new policies, or newly reported vaccine risks.¹⁷

Overcoming vaccine hesitancy requires a comprehensive approach involving collaboration between stakeholders such as public health officials, healthcare providers and community leaders. The COVID-19 vaccination programme demonstrated how increasing education and tackling the spread of misinformation as well as increasing access to and ease of receiving a vaccine can increase uptake. Paediatricians and family doctors have a key role in helping parents appreciate the benefits of vaccination; with consistent advice from clinicians shown to be the most important predictor of vaccine acceptance.¹⁸

To educate the population effectively requires common misconceptions and concerns about vaccines to be confronted and individuals to be provided with clear, fact-based information about the benefits and risks of vaccination. Trusted sources of research evidence on the safety record of vaccines and the potential consequences of not vaccinating, is crucial to enable the public to make informed decisions about their health. Healthcare providers need to adopt a variety of targeted approaches to educate and inform patients about vaccinations both during their routine visits and through community out-reach programmes.

Equally important is achieving equitable and widespread vaccination coverage by ensuring that vaccines are readily accessible for all. This may include strategies such as mobile vaccination clinics to reach people in hard-to-reach areas, and information campaigns to raise awareness about vaccination programmes.

Closing comments

Infections are rising across the country with vaccine hesitancy undermining the achievements made in reducing the burden of disease. Today there is an unprecedented level of evidence on the role of vaccines during the COVID-19 pandemic in both stemming the spread and enabling restrictions to be lifted, sharing this evidence widely is essential. However, increasing vaccination rates requires a comprehensive approach to building trust, based on strong and consistent mass communication, and evident collaboration between public health officials, healthcare providers, and the community to ensure that accurate information is accessible, and vaccines are readily available to all.

Emily May, Assistant Manager, UK Centre for Health Solutions

Emily is an assistant manager in the Centre for Health Solutions where she applies her background in both scientific research and pharmaceutical analytics to produce supported insights for the Life Sciences and Healthcare practice. Emily leads the research and publication of the life sciences insights, performing thorough analysis to find solutions for the challenges impacting the industry and generating predictions for the future. Prior to joining the centre, Emily worked as an Analytical Scientist conducting physical chemistry analysis on early stage drug compounds and previously lived in Antwerp, Belgium where she researched and developed water-based adhesive films.

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[1] https://www.who.int/news-room/feature-stories/detail/counting-the-impact-of-vaccines

[2] https://vaccineknowledge.ox.ac.uk/vaccine-side-effects

[3] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9942647/

[4] https://www.who.int/news-room/spotlight/history-of-vaccination/a-brief-history-of-vaccination

[5] https://www.who.int/news-room/feature-stories/detail/counting-the-impact-of-vaccines

[6]https://commission.europa.eu/strategy-and-policy/coronavirus-response/safe-covid-19-vaccines-europeans_en

[7] https://www.who.int/europe/news/item/16-01-2024-covid-19-vaccinations-have-saved-more-than-1.4-million-lives-in-the-who-european-region--a-new-study-finds

[8] https://www.immunizationagenda2030.org/

[9] https://www.sciencedirect.com/science/article/pii/S0264410X2300854X

[10] https://www.who.int/news/item/24-04-2023-global-partners-announce-a-new-effort-the-big-catch-up-to-vaccinate-millions-of-children-and-restore-immunization-progress-lost-during-the-pandemic

[11] https://digital.nhs.uk/news/2022/childhood-vaccinations-2021-22

[12] https://digital.nhs.uk/data-and-information/publications/statistical/nhs-immunisation-statistics/england-2022-23

[13] https://www.bbc.co.uk/news/uk-england-birmingham-68007804

[14] https://www.cdc.gov/globalhealth/measles/data/global-measles-outbreaks.html

[15] https://www.gov.uk/government/news/around-1-in-8-new-students-unprotected-against-meningitis

[16] ibid

[17] https://www.nejm.org/doi/10.1056/NEJMra2106441

[18] https://www.thelancet.com/journals/lanchi/article/PIIS2352-4642(19)30092-6/fulltext