A significant measles outbreak in north-east London has laid bare a deepening crisis in childhood vaccination, with health experts warning that the NHS system is “clearly failing” to protect children from a highly contagious and dangerous disease. In Enfield, where vaccination rates are among the lowest in the country, 34 confirmed cases were reported in the first weeks of 2026 alone, representing over a third of England’s total. One in five of those infected children required hospital treatment, and all were not fully immunised.
A National Picture of Decline
The situation in Enfield, where only 64.3% of five-year-olds had received both doses of the Measles, Mumps, and Rubella (MMR) vaccine in 2024/25, is a stark symptom of a nationwide problem. According to the UK Health Security Agency (UKHSA), just 84.4% of children in England were fully vaccinated by their fifth birthday that year, a figure far below the World Health Organization’s 95% target for herd immunity. This decline has been relentless for over a decade; coverage for the first MMR dose at age two has fallen from 92.7% in 2013-14 to 88.9% in 2023-24, marking the third consecutive year below 90%.
The consequences are being measured in soaring case numbers. England recorded 2,911 laboratory-confirmed measles cases in 2024, the highest number in over two decades. This followed 959 cases in 2025 and 481 in 2023, a dramatic rise from just 63 cases in 2022. The resurgence has been so severe that the UK lost its measles elimination status in early 2026.
The Severe Risks of a Preventable Disease
Measles is a serious airborne disease whose initial cold-like symptoms can swiftly give way to severe and life-threatening complications. These include pneumonia, encephalitis (brain swelling), meningitis, blindness, deafness, and seizures. In rare cases, it can lead to subacute sclerosing panencephalitis (SSPE), a fatal neurological condition that can develop years after infection. The UKHSA has warned that modelling suggests a large-scale outbreak in London could result in between 40,000 to 160,000 infections.
The current outbreak in Enfield, which has seen 60 children contract measles and 15 hospitalised, has reignited public and medical anxiety. Five “catch-up clinics” have been established in local community centres to vaccinate children who missed doses. The borough’s MMR coverage rate of 64.3% places it on a par with rates in Afghanistan (62%) and below Malawi (69.3%), underscoring the scale of the failure.
Systemic Failure and Calls for Radical Change
MPs and health leaders point to a system in crisis. Ben Coleman, a Labour MP on the Commons health and social care select committee, said the long-term decline in MMR uptake shows the current model is “clearly failing”. He accused NHS England of “complacency” for failing to halt a decade-long drop in the proportion of fully vaccinated five-year-olds, from 88.2% to 83.7%.
The system, where GP practice nurses deliver the first and second MMR doses at 12 and 18 months with schools hosting catch-up events, is under intense scrutiny. Contributing factors to the decline include fragmented immunisation services with complex commissioning, short-term funding that limits outreach, disruption from the COVID-19 pandemic, and a gradual decline in public confidence in vaccines since 2015. Declining rates disproportionately affect children in disadvantaged areas.
There is now a growing consensus that pharmacies must be mobilised to reverse the trend. “Given that under-vaccination poses real risks to public health, it’s time for the NHS to accept that GPs and schools on their own appear not to be able to provide the 95% coverage the WHO rightly insists on,” said Coleman.
This view is supported by major health bodies. Professor Steve Turner, President of the Royal College of Paediatrics and Child Health, said enabling pharmacists to deliver MMR would “make it faster and easier for parents and guardians to get their children vaccinated”. Olivier Picard, Chair of the National Pharmacy Association, stated that the decade-long reduction “is a sign that the current system is simply not working and needs urgent reviewing”. Helen Bedford, a professor of child health at University College London, noted that pharmacies could be particularly helpful as some schools, including faith schools, do not participate in catch-up campaigns.
Pilots, Opposition, and Public Campaigns
A pilot scheme is already underway in the North West of England, allowing community pharmacies to administer MMR vaccines to children aged 5-11 who have missed doses. However, expansion faces hurdles. Dr Mary Ramsay, the UKHSA’s director of public health programmes, admitted to MPs that opposition from GPs to pharmacies being paid for a role currently undertaken by family doctors was a complicating factor.
The government has launched a new childhood immunisation campaign, “Stay Strong, Get Vaccinated”, to encourage uptake. A Department of Health and Social Care (DHSC) spokesperson said urgent action was being taken with partners in London, and highlighted that from January, children can receive their second MMR dose sooner for earlier protection. The spokesperson also noted the introduction of chickenpox protection into the childhood programme via the MMRV vaccine. The DHSC did not indicate if pharmacies might start delivering MMR jabs more widely, though the retailer Superdrug has said it would do so if asked.
A Warning of Future Outbreaks
Experts warn that without drastic improvement, further outbreaks are inevitable. Professor Andrew Pollard, director of the Oxford Vaccine Group, said there was “a real risk of further spread both locally and in other parts of London”, as the virus easily spreads in communities with sub-95% vaccination. He warned that outbreaks would die down only to return explosively as more unvaccinated children are born.
The safety of the MMR vaccine is well-established, with hundreds of millions of children safely receiving it worldwide. Common side effects are mild and temporary, such as fever or a mild rash. Concerns about a link to autism have been thoroughly debunked by numerous scientific studies and global health organisations. The risks of the disease far outweigh those of the vaccine.
Globally, the picture is similarly alarming, with an estimated 95,000 measles deaths in 2024, mostly among unvaccinated children under five. The WHO reports that only 76% of children worldwide received both measles vaccine doses in 2024, far short of the 95% target. The death of a child from measles at Alder Hey children’s hospital in Liverpool last summer serves as a tragic reminder of the stakes at home. As Professor Turner stated, the goal is clear: to use every available resource, including pharmacies, to protect children from a preventable threat.
