"As a country, we need to reverse the increasing inequality we've seen since 2008. That would be the single biggest thing we could do."
In this expert interview, Sir Terence Stephenson, Nuffield Professor of Child Health and Chair of EiP2026, offers both a systemic diagnosis and a clear prescription.
Terence identifies two forces driving falling vaccination rates: a post-pandemic erosion of trust in government and experts, and the relentless widening of child poverty since 2008 both documented, both preventable. He is careful to note that in England, vaccines are free. Poverty is not mediating access through cost. It mediates through education, logistics, time, the ability to take a morning off work, and the accumulated friction of navigating a system that was not designed with disadvantaged families in mind.
His proposed solutions span the practical, a digital health record so any clinician can check and fill vaccination gaps, to the structural: reverse growing inequality by reinvesting in deprived communities, and make every clinical contact count by routinely asking about immunization status. He also flags a finding that challenges easy stereotypes: a study of the Bangladeshi community in East London, which, despite being relatively deprived, has some of the UK's highest childhood vaccination rates, a reminder that uptake is not determined by deprivation or cultural background alone, and that trusted relationships and community dynamics can outweigh commonly assumed barriers.
Key takeaway: There is no magic bullet. Vaccination equity is the product of a more equal society, better systems, and professionals who listen before they speak.
