Improving protection through vaccination for all: updating the UKHSA Immunisation Equity Strategy for 2025 to 2030

by Dr Sharif Ismail, Consultant Epidemiologist in UKHSA's Immunisation Programmes Division

Immunisation is one of the most powerful tools available for improving public health and has helped save countless lives since the National Immunisation Programme was introduced in England in the 1950s. Although uptake for vaccinations remains very high in England by comparison with many other countries, there have been steady declines for many vaccines over the past 10 years. There is also evidence that inequalities in uptake for some vaccinations are widening over time, especially for those living in deprivation. We know that these effects are not distributed evenly, and that pockets of low vaccination coverage for diseases such as measles can increase the risk of cases and outbreaks of vaccine-preventable infections. And there continue to be important differences in the extent to which people are able to access, and gain protection from vaccination depending on who they are and where they live.

UKHSA has a key commitment to delivering more equitable outcomes and ensuring we keep all our communities safe from hazards to their health. Our updated Immunisation Equity Strategy 2025 to 2030 - published this week - forms a central part of our work with our partners to help address recent trends in vaccination uptake. The strategy has been updated to support health system colleagues as responsibilities for commissioning and delivery of immunisation services are delegated to Integrated Care Boards in England. It aims to help maximise vaccination uptake overall while closing the gap between different communities and across vaccine programmes. The strategy will help drive, monitor and demonstrate progress made to deliver on UKHSA’s strategic commitment to helping improve health outcomes through vaccination.  

We will work with our partners to achieve 4 immunisation equity outcomes by 2030. First, we will ensure there is more accountable system leadership to improve immunisation equity by developing a plan to implement the strategy and strengthening information sharing across the immunisation system, so that colleagues working at all levels are properly supported to act on immunisation inequities. This work will build on progress since 2021, such as mutual learning through a forum for sharing practice on how vaccinations are delivered to different populations across the 4 nations of the UK.

Second, we will improve access to timely, high-quality data for stakeholders at all levels of the immunisation system to support action on immunisation equity. This matters because by improving the visibility of inequities for different populations is a crucial first step to recognising and acting on them. Much work was done under the original strategy in this area including collating material on data and information sources that colleagues can use to help better understand variations in vaccination uptake and health needs for their populations. And we have already seen the impact that better data availability can have on informing public health responses and their evaluation – such as for the measles outbreak nationally in 2023-24. Over the next 5 years we will work with our partners to improve data availability and granularity, for example by increasing the number of vaccination programmes for which we can report on uptake by ethnicity.

Third, we will ensure practitioners and policy makers are better able to generate, share and use evidence to help reduce immunisation inequity. Under the first strategy, we worked with academic colleagues to develop an evaluation framework to help standardise approaches to understanding which interventions work for which populations. Under the updated strategy, we will continue to commission new research on immunisation inequities but also develop new ways of sharing key findings to help colleagues put evidence into action.

Finally, and most importantly, we will work to embed people and place-based approaches to communications and engagement – to ensure the meaningful partnership with different communities in order to improve vaccination uptake. This will again build on progress to date: for example, we have worked extensively with our partners to produce materials on vaccine-preventable diseases that are relevant to, and accessible to different populations. These materials are publicly accessible, and many have been co-produced with members of relevant communities. Over the next 5 years we will continue to support local level action by developing co-created materials for the public and for health professionals, and by collating evidence on what works in engaging people from different groups/backgrounds.

Ensuring that everyone can access vaccination at the right time, irrespective of who they are and where they live will depend on partnership work with communities and with partners across the immunisation system. Over the coming years, we will continue to share learning and highlight promising practice in improving immunisation equity.

Read the updated Immunisation Equity Strategy 2025 to 2030 here.