In the week where Sajid Javid announced the UK Government’s intentions to drop mandatory Covid vaccination for NHS workers, there have been truly staggering scenes broadcast from Ottawa of the protests led by Canadian truckers. Looking on, it seems ludicrous that Justin Trudeau would mandate vaccines for the small minority who choose to decline them, when Covid cases in Canada have been falling steeply for weeks. One wonders if he is oblivious to the many unintended consequences of digging in his heels over the issue.
Back in the UK, it has been reported that childhood vaccination rates have fallen to their lowest level in a decade. As a country, we have an excellent track record of immunising children with safe and effective vaccines against a host of serious diseases, from measles to polio. It is therefore hugely concerning to see that families are increasingly not taking up the offer of these vaccines, potentially putting their children at risk from significant illness, and increasing the likelihood of preventable outbreaks. Yet again, there is evidence of how an unerring focus on one respiratory virus can serve to undermine other aspects of healthcare.
As a GP, I have observed an increased level of vaccine scepticism amongst my patients over the course of the pandemic. When I gently ask about vaccination, it is now not unusual to see patients bristle or become defensive. The use of vaccine passes, mandatory vaccination for carers, and the input of the Behavioural Sciences Unit (in nudging the population to take the vaccine); may well have diminished the hard-earned trust in other vaccination programmes, and even medical advice more broadly.
It does not surprise me that the many changes brought in during the pandemic have contributed to a decline in childhood vaccination rates. It has been widely reported that the population has struggled to access health services. GP surgeries have displayed “Do not enter” signs on their doors, switching to remote consultation methods. Families tell me they do not know how to access a health visitor, and have often not seen one in person at any stage in their child’s life. Toddler groups were closed, leaving parents with reduced access to valuable peer-support. I fear that falling rates of childhood immunisation are indicative of the many health harms experienced by this generation. The data on vaccinations will be carefully measured and reported upon; whereas problems with socialisation, communication skills, physical dexterity, and emotional well-being are far harder to quantify.
Children, who have not been at undue risk from Covid, have experienced all manner of restrictions, and had their access to services limited. We have seen an intergenerational transfer of harm, where young people have been asked to make sacrifices to protect vulnerable, mostly older, groups. Yet, if children are the future, it is crucial that our society recognises their value, and guards their interests carefully. The JCVI have clearly advised that children without underlying vulnerabilities are at low risk from Covid and “considerations on the potential harms and benefits of vaccination are very finely balanced”. Yet somehow, in the Government’s eagerness to promote Covid vaccines, they have omitted to ensure the uptake of routine vaccinations is maintained.
The Government has frequently been accused of focussing on Covid at the expense of other health or societal needs. As the pandemic recedes, our leaders should be increasingly turning their attention to long standing, evidence-based health interventions. Let us offer routine immunisations, access to primary care, improved cancer and hospital services; alongside open schools, sports facilities, toddler groups, and children’s centres. Heavy-handed and coercive messages will only serve to alienate the population. The UK should be a country that offers readily accessible health and community services, without ever resorting to the use of threats or manipulation. Justin Trudeau take note.
