Pandemic-Affected Trust Spurs Declines in Childhood Vaccination
A new international study led by the Azrieli Faculty of Medicine in the Galilee at Bar-Ilan University shows that the COVID-19 pandemic has contributed to a sustained erosion of public trust in childhood vaccines. Published in the peer-reviewed Vaccine journal, the research surveyed 2,047 parents in Israel and the United Kingdom and found notable drops in essential immunizations, including measles–mumps–rubella (MMR) and diphtheria–tetanus–pertussis (DTP) containing vaccines. These declines are occurring even as measles outbreaks resurface in several parts of the world.
Key Findings: Drops in MMR and DTP Coverage
The study reveals concrete declines in vaccination coverage for children born before and after the pandemic. In the United Kingdom, MMR vaccination rates fell from 97.3% for children born before COVID-19 to 93.6% for those born afterward. In Israel, MMR coverage declined from 94.3% to 91.6%. Similar reductions were observed for DTP-containing vaccines. Alarmingly, a notable proportion of families—5% in the UK and 6.6% in Israel—who vaccinated an older child before the pandemic chose not to vaccinate a younger child born after the pandemic, at least for one immunization. These shifts, while seemingly small, can quickly threaten community protection.
Public Trust Takes Center Stage
The researchers emphasize that the pandemic’s impact extends beyond numbers. About 37% of parents reported a decline in trust in vaccines after COVID-19. Even a 5% movement away from vaccinating younger children can push communities toward outbreaks, underscoring how fragile herd immunity can be when confidence wanes.
Why Trust Has Plummeted: The Fear of Side Effects
The study identifies fear of side effects as the principal driver of hesitancy. While concerns existed before the pandemic, they have intensified in its wake. Across the UK and Israel, the fear of adverse reactions remains the dominant reason cited by parents who delay or refuse childhood vaccinations. In the UK, concerns are more pronounced among parents of Asian descent, whereas in Israel, larger decreases surfaced within the ultra-Orthodox and Arab communities, signaling the role of cultural and social dynamics in vaccine decisions.
Alarming National Trends: Measles Resurgence
The consequences of eroding trust are already visible. England reported nearly 3,000 laboratory-confirmed measles cases in 2024—the highest annual total since 2012. In Israel, measles infections have surged, with more than 1,800 cases by October and at least eight toddler deaths—all among unvaccinated children. Historically, Israel had nearly eliminated measles, making this resurgence a stark warning of what can happen when confidence and coverage dwindle.
Implications for Public Health Policy
Experts warn that even modest declines in vaccination uptake can compromise herd immunity and spark preventable disease outbreaks. The Bar-Ilan study calls for renewed, evidence-based strategies to restore trust and tackle residual fears about side effects. Clear communication, robust education, and targeted community engagement are presented as essential steps to halt further deterioration and safeguard decades of progress in disease prevention.
What Comes Next
Prof. Michael Edelstein, the study’s lead author and a public health expert at Bar-Ilan University, stresses that the pandemic’s impact on vaccine trust is not a temporary blip but a broad, global challenge. The authors advocate for dedicated interventions that address specific concerns, verify safety information, and actively involve communities in decision-making. Without such measures, the authors warn, the gains achieved in vaccination coverage over the past decades could unravel, leaving societies more vulnerable to preventable illnesses.
