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Helen’s work highlights the structural and practical barriers that shape vaccination uptake and shows how early, trusted conversations with families can help ensure every child has access to life‑saving vaccines.

Helen Skirrow, a Clinical Lecturer and public health researcher, focuses on understanding and addressing inequalities in routine vaccination uptake among pregnant women and children. In this blog, she shares insights from her research and recent engagement with families and healthcare professionals on how to make vaccination conversations more accessible, timely, and effective.

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Measles has been back in the news a lot recently with the outbreak in Enfield, North London and the UK losing its measles elimination status. It is a timely reminder that less children getting their routine vaccines put all of us at risk of dangerous infectious diseases like measles. Declining vaccination coverage in England over the last decade is to blame and all of us working in child public health need to urgently address this.

My research focuses on understanding which pregnant women and children are not receiving routine vaccinations, and why. Vaccination uptake varies - some communities and regions experience lower uptake than others, reflecting wider structural inequalities in accessing healthcare. Though when we get outbreaks the focus is often on vaccine hesitancy.

While concerns about vaccines can influence some parents’ decisions, my research, particularly co-production research with communities in North-West London has found that the picture is often more complex. For many families, practical barriers play an important role. Difficulties booking or attending appointments due to competing work and childcare responsibilities can make it challenging to attend vaccination appointments for some families. Understanding these issues is important because by recognising the barriers that parents face engaging with services can help develop more targeted and accessible approaches to improve vaccine uptake.

Families want time and space for conversations with trusted health professionals to answer their vaccine questions.

My research has also found that families want time and space for conversations with trusted health professionals to answer their vaccine questions. This does not mean they are anti-vaccination but they may just have some simple questions they want answering before they get their child vaccinated. Often they might want these conversations to take place earlier than at the actual vaccine appointment – for example with their midwives in pregnancy or with their health visitors. I also found that pregnancy is a really important time for vaccine decisions – getting vaccinated in pregnancy is an independent predictor of whether a mother’s child will go onto get their MMR vaccine.

My findings echo research from the Royal College of Paediatrics and Child Health and also the UK Health Security Agency national surveys of parents. Parents overwhelming want to protect their children and are not anti-vaccination. Improving vaccination uptake means making vaccines easier to access and ensuring parents have clear, trustworthy information. But these approaches need to be tailored to each community. What works in one place may not work in another, so it is important to work with communities to understand the barriers families face and how best to address them.

One of the next stage’s of my research is about working with families to understand how we improve these vaccine conversations between pregnant women and healthcare workers. I recently took this next project idea to the People’s Research Café organised jointly by 911½ñÈÕºÚÁÏ College’s Centre for Paediatrics and Child Health, the Mohn Centre for Children’s Health and Wellbeing, 911½ñÈÕºÚÁÏ NIHR Biomedical Research Centre, and West London Children’s Healthcare. It was fantastic to get feedback on this next stage of my research from parents, midwives, GPs and obstetricians.

Over the next few years I hope my work can inform policies to ensure every child has the opportunity to benefit from life-saving vaccines and news headlines about measles outbreaks become confined to the history books.