Overview: The Pandemic’s Ripple Effect on Childhood Vaccination
The COVID-19 pandemic has ripple effects that extend beyond infections and hospitalizations. An international study led by Bar-Ilan University’s Azrieli Faculty of Medicine in the Galilee reveals a concerning trend: diminished public trust in childhood vaccines in the aftermath of the pandemic. Published in Vaccine, the peer-reviewed journal, the study analyzed responses from 2,047 parents with children born both before and after the pandemic in Israel and the United Kingdom (UK). The findings align with a broader public health alarm: vaccination coverage for essential vaccines such as measles-mumps-rubella (MMR) and diphtheria-tetanus-pertussis (DTP) has declined, raising the specter of a resurgence in preventable diseases like measles.
Key Findings: Declines in MMR and DTP Coverage
The data show measurable drops in vaccine uptake after the onset of the pandemic. In the UK, MMR coverage fell from 97.3% among children born before COVID-19 to 93.6% for those born afterward. Israel saw a decline from 94.3% to 91.6% in MMR vaccination. Similar decreases were observed for DTP-containing vaccines. The study also found that a notable portion of families who previously vaccinated an older child shifted to not vaccinating a younger sibling. Specifically, 5% of UK parents and 6.6% of Israeli parents who vaccinated an older child before the pandemic chose not to vaccinate a younger child for at least one vaccine.
Why Trust is Eroding: Fear of Side Effects and Its Aftershocks
Beyond numbers, the study captures a psychology shift. About 37% of the parents surveyed reported a decline in trust in vaccines following the pandemic. The fear of side effects emerged as the most significant driver of hesitancy: 92% of UK parents and 63% of Israeli parents cited this concern as a reason to refuse or delay vaccines. While fear predated COVID-19, the pandemic appears to have intensified it. The researchers emphasize that even small reductions in vaccination rates can disrupt herd immunity, tipping the balance toward outbreaks of diseases that were once controlled or rare.
Geographic and Demographic Variations
The study notes disparities in hesitancy patterns. In the UK, higher declines were observed among parents of Asian descent. In Israel, larger decreases occurred in the ultra-Orthodox and Arab communities. These differences highlight that vaccine hesitancy is not monolithic; it is shaped by cultural, religious, and social contexts that influence risk perception, trust in institutions, and access to reliable information.
The Measles Resurgence: A Warning Sign for Public Health
The consequences of eroded trust are already visible. 2024 saw England report nearly 3,000 laboratory-confirmed measles cases—the highest annual total since 2012. Israel, meanwhile, has recorded rising measles activity with over 1,800 cases by October and several toddler deaths among the unvaccinated. These trends threaten decades of progress in disease prevention and threaten vulnerable populations who rely on community protection through vaccination.
Implications and a Path Forward
The researchers urge strategic interventions to restore confidence, including clear communication about vaccine safety, transparent data on side effects, and community-based outreach that respects diverse beliefs and languages. Education campaigns, partnerships with trusted local leaders, and accessible vaccination services can help rebuild trust and maintain high coverage. Even modest improvements in uptake can reinforce herd immunity and prevent outbreaks that endanger children and communities.
Expert Perspective
Prof. Michael Edelstein, a public health expert and lead author, notes that the observed effects are not merely temporary or localized. They reflect a broad, potentially global trend that could reverse years of progress unless addressed with concerted, evidence-based actions. The study underscores the urgency of restoring public trust to safeguard children against preventable diseases.
