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Philip Cruz

UK Vaccines Medical Director, GSK

A sense of complacency could be contributing to a decline in vaccine uptake rates.1 Read how increased public awareness and improved access to health services could be key in reversing the trend.


“The trouble with vaccines,” says Philip Cruz, UK Vaccines Medical Director at GSK, “is that they have become a victim of their own success. It’s only when health is in the news after a virus outbreak or the release of new data, that we are reminded of the crucial role vaccines play in safeguarding our health.”

“Vaccination has prevented millions of illnesses2 and, in terms of worldwide public health interventions, only clean drinking water is more effective in its ability to save lives.”3

Vaccination throughout life

We tend to associate immunisation largely with babies and children, but that mindset has to change, says Cruz. “As we age, our immune system does too, and this can make us more vulnerable to life-threatening diseases.”

“Ensuring we are fully vaccinated as adults can help protect us and those closest to us against some serious diseases.4 This is particularly important for vulnerable groups, such as those with chronic illnesses who are not able to receive vaccination due to weakened immune systems.”

The factors behind declining vaccination rates

Worryingly, vaccination rates have been dropping in recent years. One example is MMR (measles, mumps and rubella) immunisation.

To ensure ‘herd’ or ‘community’ immunity, and to prevent measles outbreaks, the MMR vaccine must achieve a coverage level of 95%. But, in 2019, MMR coverage levels fell to around 87%, and the UK lost its measles-free status.5

“Measles is a very infectious disease, so losing our status is a cause of concern for parents, policymakers and healthcare professionals,” says Cruz.

Some news stories have pinned the blame for falling vaccination rates on ‘vaccine refusers.’ But despite what you might read, these people are a small minority and not the main issue, says Cruz. Instead, the decline in vaccination rates is a multi-factorial challenge.

These challenges range from practical issues, such as timing, location and availability of appointments to complacency, with some believing elimination of certain diseases means they no longer need to receive the vaccine.6

Investment to tackle a system-wide challenge

More must be done to address the general lack of education about vaccination. This includes ensuring there is accurate, easily accessible information online. This is where concerned people are likely to look if they can’t get answers from their time-strapped clinical practice.

Falling uptake figures include people who received the first dose of a vaccination but didn’t return for their second or third dose. It has to be made clear to patients that they must receive a full vaccination course to experience the full benefit.

Only clean drinking water is more effective than vaccination in its ability to save lives.

“It sounds simple, but staff at a clinic, such as receptionists, can play a crucial role,” says Cruz. “They’re the ones talking to patients and scheduling appointments.”

Ensuring optimal access to appropriate services is a system-wide challenge. Therefore, Cruz welcomes the recent news that there will be an additional investment of £30million in UK primary care vaccination and immunisation services.

“There has to be clear and precise guidelines for the delivery of vaccines, and more accountability across the system. This can be helped by practices having a main vaccination lead,” he says.

“Increasing accessibility could include providing interpreters and translations for communities with non-English speaking parents and creating pop-up clinics out of hours for parents and others who can’t get time off work. Although all of this can be quite a logistical challenge.”

Working together to spread awareness

Industry can help, too: by spreading the word with vaccination awareness campaigns, while working in partnership with public health authorities and patient groups to find out where the pain points are.

“We’re currently studying communities with low MMR coverage and working with local health authorities on how best to advise parents and the public about vaccinations,” says Cruz.

GSK is also currently supporting the development of a coronavirus vaccine.7 This is a team effort, stresses Cruz — as is the work to ensure that uptake rates for available vaccinations will start to increase across the board.

“I’m optimistic that vaccination rates will rise again,” Cruz says. “Although in terms of increasing public awareness about their importance, we’re just getting to base camp. The summit is still some way off.”

Read more about vaccination throughout life at the GSK website: vaccinateforlife.com


References: 1 United Nations, 2019. ‘Complacency’ a factor in stagnating global vaccination rates, warn UN health chiefs. Accessed online: Mar 2020. | 2 Walter A. Orenstein & Rafi Ahmed, 2017. Simply put; vaccination saves lives. | 3Plotkin SL & Plotkin SA, 2012. A short history of vaccination. | 4 Vaccines.gov, 2017. 1-4: Adults Age 65 and Older. | 5 Public Health England, 2019. Measles in England. Accessed online: Mar 2020. | 6 Royal Society for Public Health, 2018. Moving the needle. | 7 GSK, 2020: Our contribution to the fight against novel coronavirus (COVID-19). Accessed online: Mar 2020.

CL code: NP-GB-ABX-WCNT-200001. Date of preparation: March 2020

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