Introduction: A Growing Vaccine Confidence Gap
The COVID-19 pandemic did more than strain health systems; it appears to have weakened public trust in routine childhood vaccines. A new international study led by the Azrieli Faculty of Medicine in the Galilee at Bar-Ilan University, published in Vaccine, shows a noticeable decline in coverage for core childhood immunizations such as measles-mumps-rubella (MMR) and diphtheria-tetanus-pertussis (DTP) after the pandemic. The findings come amid one of the most severe measles outbreaks in Israel in decades and a sharp uptick in measles activity in England and across other countries.
Key Findings: Declines in MMR and DTP Coverage
The study surveyed 2,047 parents of children born before and after the pandemic in Israel and the United Kingdom, revealing a clear shift in vaccination behavior. In the UK, 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 declines were observed for DTP-containing vaccines. The trend suggests that even populations with historically high vaccine adherence are experiencing disruption in timely immunization.
Alarmingly, 5% of UK parents and 6.6% of Israeli parents who had vaccinated an older child before the pandemic chose not to vaccinate a younger child born afterward for at least one childhood vaccine. This pattern, though seemingly small, can have outsized effects on community protection and outbreak risk.
Public Trust Decline: A Pandemic Legacy
The study identifies a broader shift in attitudes: 37% of parents reported a decline in trust in vaccines after the pandemic. Experts warn that even modest reductions in vaccine uptake can undermine herd immunity and precipitate outbreaks of preventable diseases. The researchers emphasize that the erosion is not isolated to one country or demographic; it reflects a broader, potentially global shift in confidence with lasting public health consequences.
Dr. Michael Edelstein, a public health expert and lead author from Bar-Ilan University, notes that the pandemic’s impact on vaccine confidence appears to be a durable phenomenon rather than a temporary blip. The implications are stark: unless addressed through proactive communication, education, and community-based initiatives, decades of progress in disease prevention could be jeopardized.
Measles Outbreaks: Real-World Consequences
The consequences of waning vaccination coverage are already visible. In 2024, England reported nearly 3,000 laboratory-confirmed measles cases—the highest annual total since 2012. Israel has seen a sharp rise in measles cases in recent months, with more than 1,800 infections by October and at least eight deaths in toddlers under two and a half years old, all of whom were unvaccinated. This resurgence reverses years of gains that had nearly eliminated measles in the country.
Root Causes: Fear of Side Effects and Demographic Variations
Across the study, fear of vaccine side effects emerged as the primary driver of hesitancy. Even before COVID-19, concerns about safety existed, but the pandemic intensified them. UK parents cited safety concerns as a reason for delaying or refusing vaccines in 92% of cases, while 63% of Israeli parents reported the same. The data also reveal demographic disparities: in the UK, declines were more pronounced among parents of Asian descent; in Israel, larger drops occurred within ultra-Orthodox and Arab communities.
Implications for Public Health Strategy
Public health officials say that small declines in vaccination coverage can derail herd immunity and enable outbreaks of life-threatening diseases. To counter this trend, researchers call for targeted, credible communication; education that addresses specific safety concerns; and community-based programs that rebuild trust. The study underscores the need for transparent, consistent messaging and accessible vaccination services to prevent further deterioration in vaccine confidence.
Conclusion: Rebuilding Trust to Protect the Next Generation
Prof. Edelstein concludes that the pandemic’s impact on vaccine confidence is a global challenge requiring sustained, collaborative action. “The data indicate that the impact of the pandemic on public trust in vaccines is not only temporary or local, but rather a broad and deep phenomenon with global implications. Dedicated interventions are needed to restore trust and reduce concerns in order to prevent further deterioration,” he said. As measles and other vaccine-preventable diseases threaten vulnerable populations, restoring trust in childhood vaccines is essential to preserve public health gains and safeguard children’s futures.
