Liverpool epidemiologist joins House of Lords inquiry on declining childhood vaccination uptake

The University of Liverpool's Dr Dan Hungerford gave evidence at a House of Lords Childhood Vaccinations Committee this week (16 March 2026).

Seeking to understand the evidence on routine childhood vaccination coverage in England and the reasons behind its gradual decline over the past decade, the inquiry aims to identify actions to reverse the decline and reduce inequalities in coverage.

A non-clinical infectious disease epidemiologist, Dr Hungerford has worked in public health, primarily on vaccine preventable diseases, for the last 14 years, with a focus on real world, data-driven approaches to maximise the impact of vaccines for those that need them most.

Commenting on the need for the inquiry, Dr Hungerford said: "After clean water, vaccination is the most effective public health intervention in the world for saving lives and promoting good health. But we need to be delivering them equitably.

"Vaccine preventable diseases can kill and also lead to lifelong chronic illness and consequences that will pile more pressure on NHS - costing the NHS £6 billion annually for secondary care services alone."

"Inequalities in childhood vaccination uptake are persistent and have widened, leaving vulnerable communities the most susceptible to disease and poor outcomes"

Evidence backed by research

Dr Hungerford presented evidence across a range of themes at the inquiry, informed by numerous academic research projects he collaborated on. These included:

Widening inequalities
With childhood vaccination uptake falling nationwide, Dr Hungerford noted that the steepest declines are in the most deprived communities, with inequalities at their widest for booster doses.

Structural drivers
Rising child poverty reduced early-years services, and cuts to public health and health visiting during government austerity policies have weakened families' ability to access vaccination, with system fragmentation across different stakeholders affecting coordination and accountability.

Trust and misinformation
Declining trust in government and institutions-especially in underserved communities-contributes to lower uptake. In turn, inequalities and mistrust interact with misinformation, increasing hesitancy where disadvantage is greatest.

Access barriers
Universal offer does not equal universal access - research shows that inflexible GP appointments, limited school access, and transport barriers disproportionately affect deprived families.

Data and evaluations gaps
National datasets are strong, but granular data quality is variable, especially ethnicity data of which 18-32% is missing in healthcare. Fragmented systems, barriers to data sharing and limited local evaluation capacity hinder targeted, evidence-informed action.

Outreach models show promise
Dr Hungerford praised community-led models, such as ReCITE, which improve confidence and uptake for some vaccines - noting that their impact is limited by short-term funding, workforce pressures, and lack of long-term embedding in routine services.

Recommendations for system reform

Dr Hungerford advised that reversing the decline in childhood vaccination will require system-wide action, not individual-behaviour interventions. Policies for poverty reduction, sustained re-investment in public health infrastructure, high-quality shareable data and evaluation, community-led delivery, and easier access are the most effective levers. These priorities work together to strengthen trust, reduce inequity, and rebuild a resilient vaccination system.

The evidence presented were generated based on collaborative projects conducted in Liverpool City Region with the University's Institute of Population Health Health Inequalities Policy Research Group (HIP-R, led by Professor David Taylor-Robinson with Aidan Flatt and Dr Yu Wei Chua), Institute of Veterinary and Ecological Sciences (Professor Neil French and Sherif Amin), Liverpool City Council (Matt Ashton and Emer Coffey) and the Liverpool School of Tropical Medicine-led ReCITE team, led by Professor Miriam Taegtmeyer).

The team would also like to acknowledge and thank the community partners, Explore Community Innovation Team, Lighthouse Community Innovation Team, Brownlow, and the North and Central Primary Care Networks, as well as all the organisations, communities, participants and researchers who contributed to these projects.

Click here to watch the inquiry: https://parliamentlive.tv/event/index/b523faf1-9d04-45ce-adf3-11ad98cae607