Vaccines are a type of prescription-only medicine. Their purpose is to stimulate a
person's immune system to produce antibodies that fight a specific disease, so that
the person develops 'immunological memory'. If the body is later exposed to the same
infection, immunological memory enables the immune system to recognise and respond
to it rapidly, thereby preventing or modifying the severity of the disease.
Vaccines are an important part of preventative medicine and are described by the NHS
as “the most effective way to prevent infectious diseases.”
What is in vaccines?
The main ingredient of a vaccine is a "small amount of bacteria, virus or toxin that
has been weakened or destroyed in a laboratory first." This means that the vaccine
generates an immune response but does not cause disease.
There are different types of vaccines which are made using different processes. They
include:
Live attenuated vaccines, which contain bacteria or viruses that have been weakened.
Inactivated vaccines, which contain whole bacteria or viruses that have been killed
or altered so that they cannot replicate. Subunit vaccines, which feature small parts
from the surface of bacteria or viruses, such as proteins or sugars. RNA vaccines,
which contain genetic material (DNA or RNA) from viruses or synthetic copies of that
material. This is a new approach and has been used in the Pfizer/BioNTech and Moderna
vaccines against Covid-19.
Vaccination programmes
The UK’s current routine immunisation schedule provides protection against 14 infections,
including measles, meningococcal disease and polio. Most vaccinations are given during
childhood but some are aimed at adults, such as vaccination against shingles, where
those aged 70-79 years are eligible in the UK.
The Department of Health and Social Care (DHSC), and its devolved nation counterparts,
have adopted recommendations made by the World Health Organization (WHO) that at least
95% of children should be immunised against vaccine-preventable diseases.
In 2020-21, the UK only met the 95% target for the ‘DTaP/IPV/Hib’ vaccine at age five
(diphtheria, tetanus, pertussis, polio and Haemophilus influenzae type b). There is
also geographical variation in vaccine coverage. The National Audit Office, for example,
has highlighted lower levels of uptake in pre-school vaccinations in London, compared
with the rest of England.
According to NHS England and Public Health England, factors that affect the uptake
of childhood vaccines in England include:
inconsistent communication between healthcare providers and parents or carers; difficulties
making suitable and timely appointments; incomplete and potentially inaccurate data
on vaccination; 'under-served' (or 'hard-to-reach') populations; anti-vaccination
messages; vaccine hesitancy among a small minority of parents and carers.
Vaccination policy in England
Health is a devolved matter.
The DHSC provides national strategic oversight of vaccination policy in England, with
advice from the independent Joint Committee on Vaccination and Immunisation (JCVI)
and the Commission on Human Medicines.
NHS England is responsible for commissioning national immunisation programmes in England.
The DHSC sets performance targets and the UK Health Security Agency undertakes surveillance
of vaccine-preventable diseases.
Pre-school and adult vaccinations are usually delivered by GP surgeries. They are
commissioned through the NHS GP contract. School-age services are commissioned by
seven regional NHS England teams and delivered through School Immunisation Teams.
Additional support was put in place specifically for the Covid-19 vaccine programme.
This included a new UK Vaccine Taskforce to promote “the development and production
of a coronavirus vaccine”. Links to more resources on vaccination and Covid-19 from
the House of Commons and Lords Libraries, and the Parliamentary Office of Science
and Technology, are available on the Vaccination and Covid-19 webpage.
In August 2019, the WHO's European Regional Verification Commission for Measles and
Rubella Elimination (RVC) determined the UK had lost its measles elimination status.
The UK Government responded with measures to increase immunisation rates for the MMR
(measles, mumps and rubella) vaccination, such as promoting 'catch-up' vaccination
programmes for 10-11-year-olds.
The DHSC is also due to publish a wider 10-year vaccination strategy but it has been
delayed by the Covid-19 pandemic.
Mandatory vaccination
Vaccines offered through the national immunisation programme in the UK are not mandatory.
Vaccinations are also not currently mandatory in the UK during a pandemic. The Government
took steps in 2021 to make vaccination against Covid-19 a pre-requisite for working
in health and social care in England, with limited exemptions. These regulations,
however, are set to be revoked, subject to parliamentary approval. For further information,
see section 8 of the Commons Library briefing on Coronavirus: Adult social care key
issues and sources (February 2022).
Medical and ethical opinion is divided on immunisation policies that involve some
degree of coercion. Some countries, such as Italy and France, have mandatory vaccination
policies in place. In response to falling vaccination rates, some have extended existing
mandatory vaccination programmes, or introduced them for the first time, such as in
Germany. Such policies may, for instance, fine parents who refuse vaccination for
their children, or exclude unvaccinated children from state-run schools.
description
This Commons Library briefing paper provides an overview of UK vaccination policy.
It includes an introduction to the science of vaccination and covers UK vaccination
programmes, as well as considering the response of the Government to the UK's loss
of the World Health Organization's (WHO) measles elimination status.
disclaimer
<p>This information is provided to Members of Parliament in support of their
parliamentary duties and is not intended to address the specific circumstances of
any particular individual. It should not be relied upon as being up to date; the law
or policies may have changes since it was last updated; and it should not be relied
upon as legal or professional advice or as a substitute for it. A suitably qualified
professional should be consulted if specific advice or information is required.</p>
<p>This information is provided subject to our general terms and conditions
which are available online or may be provided on request in hard copy. Authors are
available to discuss the content of this briefing with Members and their staff, but
not with the general public.</p>
htmlsummary
<p>Vaccines are a type of prescription-only medicine. Their purpose is to stimulate
a person's immune system to produce antibodies that fight a specific disease, so that
the person develops 'immunological memory'. If the body is later exposed to the same
infection, immunological memory enables the immune system to recognise and respond
to it rapidly, thereby preventing or modifying the severity of the disease.</p>
<p>Vaccines are an important part of preventative medicine and are <a href="https://www.nhs.uk/conditions/vaccinations/why-vaccination-is-safe-and-important/">described
by the NHS as &ldquo;the most effective way to prevent infectious diseases.&rdquo;</a></p>
<h2>What is in vaccines?</h2>
<p>The <a href="https://www.nhs.uk/conditions/vaccinations/why-vaccination-is-safe-and-important/">main
ingredient</a> of a vaccine is a "small amount of bacteria, virus or toxin that
has been weakened or destroyed in a laboratory first." This means that the vaccine
generates an immune response but does not cause disease.</p>
<p>There are different types of vaccines which are made using different processes.
They include:</p>
<ul>
<li>Live attenuated vaccines, which contain bacteria or viruses that have been
weakened.</li>
<li>Inactivated vaccines, which contain whole bacteria or viruses that have
been killed or altered so that they cannot replicate.</li>
<li>Subunit vaccines, which feature small parts from the surface of bacteria
or viruses, such as proteins or sugars.</li>
<li>RNA vaccines, which contain genetic material (DNA or RNA) from viruses or
synthetic copies of that material. This is a new approach and has been used in the
<a href="https://www.pfizer.co.uk/mhra-grants-temporary-authorisation-for-Pfizer-BioNTech-COVID-19-mRNA-vaccine">Pfizer/BioNTech</a>
and <a href="https://www.gov.uk/government/news/moderna-vaccine-becomes-third-covid-19-vaccine-approved-by-uk-regulator">Moderna
</a>vaccines against Covid-19.</li>
</ul>
<h2>Vaccination programmes</h2>
<p>The <a href="https://www.gov.uk/government/publications/the-complete-routine-immunisation-schedule">UK&rsquo;s
current routine immunisation schedule</a> provides protection against 14 infections,
including measles, meningococcal disease and polio. Most vaccinations are given during
childhood but some are aimed at adults, such as vaccination against shingles, where
those aged 70-79 years are eligible in the UK.</p>
<p>The Department of Health and Social Care (DHSC), and its devolved nation
counterparts, have <a href="https://www.nao.org.uk/report/investigation-into-pre-school-vaccinations/">adopted
recommendations</a> made by the <a href="https://www.euro.who.int/__data/assets/pdf_file/0003/187347/The-Guide-to-Tailoring-Immunization-Programmes-TIP.pdf">World
Health Organization</a> (WHO) that at least 95% of children should be immunised
against vaccine-preventable diseases.</p>
<p>In 2020-21, the UK only met the 95% target for the &lsquo;DTaP/IPV/Hib&rsquo;
vaccine at age five (diphtheria, tetanus, pertussis, polio and Haemophilus influenzae
type b). There is also geographical variation in vaccine coverage. The <a href="https://www.nao.org.uk/report/investigation-into-pre-school-vaccinations/">National
Audit Office</a>, for example, has highlighted lower levels of uptake in pre-school
vaccinations in London, compared with the rest of England.</p>
<p><a href="https://publications.parliament.uk/pa/cm201919/cmselect/cmhealth/correspondence/NAO-vaccinations-report-2019-10-25.pdf">According
to NHS England and Public Health England, factors that affect the uptake of childhood
vaccines in England </a>include:</p>
<ul>
<li>inconsistent communication between healthcare providers and parents or carers;</li>
<li>difficulties making suitable and timely appointments;</li>
<li>incomplete and potentially inaccurate data on vaccination;</li>
<li>'under-served' (or 'hard-to-reach') populations;</li>
<li>anti-vaccination messages;</li>
<li>vaccine hesitancy among a small minority of parents and carers.</li>
</ul>
<h2>Vaccination policy in England</h2>
<p>Health is a devolved matter.</p>
<p>The DHSC provides national strategic oversight of vaccination policy in England,
with advice from the independent Joint Committee on Vaccination and Immunisation (JCVI)
and the Commission on Human Medicines.</p>
<p>NHS England is responsible for commissioning national immunisation programmes
in England. The DHSC sets performance targets and the UK Health Security Agency undertakes
surveillance of vaccine-preventable diseases.</p>
<p>Pre-school and adult vaccinations are usually delivered by GP surgeries.
They are commissioned through the NHS GP contract. School-age services are commissioned
by seven regional NHS England teams and delivered through School Immunisation Teams.</p>
<p>Additional support was put in place specifically for the Covid-19 vaccine
programme. This included a new <a href="https://www.gov.uk/government/publications/the-vaccine-taskforce-objectives-and-membership-of-steering-group">UK
Vaccine Taskforce</a> to promote &ldquo;the development and production of
a coronavirus vaccine&rdquo;. Links to more resources on vaccination and Covid-19
from the House of Commons and Lords Libraries, and the Parliamentary Office of Science
and Technology, are available on &nbsp;the <a href="https://commonslibrary.parliament.uk/coronavirus/coronavirus-vaccination/">Vaccination
and Covid-19</a> webpage.</p>
<p>In August 2019, the WHO's European Regional Verification Commission for Measles
and Rubella Elimination (RVC) determined <a href="https://www.euro.who.int/en/media-centre/sections/press-releases/2019/european-region-loses-ground-in-effort-to-eliminate-measles">the
UK had lost its measles elimination status</a>. The UK Government responded
with measures to increase immunisation rates for the MMR (measles, mumps and rubella)
vaccination, such as promoting 'catch-up' vaccination programmes for 10-11-year-olds.</p>
<p>The DHSC is also due to publish a wider 10-year vaccination strategy but
it has been delayed by the Covid-19 pandemic.</p>
<h2>Mandatory vaccination</h2>
<p>Vaccines offered through the national immunisation programme in the UK are
not mandatory. Vaccinations are also not currently mandatory in the UK during a pandemic.
The Government took steps in 2021 to make vaccination against Covid-19 a pre-requisite
for working in health and social care in England, with limited exemptions. These regulations,
however, are <a href="https://hansard.parliament.uk/commons/2022-03-01/debates/22030162000012/Covid-19VaccinationAsAConditionOfDeployment">set
to be revoked</a>, subject to parliamentary approval. For further information,
see section 8 of the Commons Library briefing on <a href="https://researchbriefings.files.parliament.uk/documents/CBP-9019/CBP-9019.pdf">Coronavirus:
Adult social care key issues and sources</a> (February 2022).</p>
<p>Medical and ethical opinion is divided on immunisation policies that involve
some degree of coercion. Some countries, such as Italy and France, have mandatory
vaccination policies in place. In response to falling vaccination rates, some have
extended existing mandatory vaccination programmes, or introduced them for the first
time, such as in <a href="https://www.theguardian.com/world/2019/nov/14/german-parliament-approves-compulsory-measles-vaccinations">Germany</a>.
Such policies may, for instance, fine parents who refuse vaccination for their children,
or exclude unvaccinated children from state-run schools.</p>
