Excellence in Pediatrics Institute LifeCourse
Volume 5 · Vaccination equity June 2026

This Issue

Equitable Access Requires Far More Than Free Vaccines

Child poverty is linked to falling vaccination rates. The implication is also clear: you cannot clinic your way out of an inequality that is rooted in the social conditions of children’s lives.

Context

In the United Kingdom, childhood vaccines are provided at no cost to families, and yet, vaccination rates fall in deprived areas. This pattern is consistent across major childhood vaccines, and it is neither a coincidence nor a mystery.

In RSV prevention, the key question is about who gets seriously ill. In a large US study, 65.8% of infants admitted to intensive care for RSV were born as healthy, full-term babies.

The mechanisms are clear once we look beyond the assumption that “free” means accessible. Vaccination requires commuting, time away from work, and repeated visits, all of which carry real costs for families facing financial insecurity.

The EiP Vaccination Equity Campaign presents the shared commitments and Action Framework for vaccination equity from the December 2025 LifeCourse Prevention Summit.

Continue reading on the campaign page →

Featured Interview

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Prof. David Taylor-Robinson

Professor of Public Health and Policy, University of Liverpool; Honorary Consultant in Public Health, Alder Hey Children’s Hospital, UK

‘Child Poverty, Vaccination Inequity, and Why Reducing Inequality is a Prerequisite’

Prof. David Taylor-Robinson presents evidence that child poverty causally drives lower vaccination rates and argues that reducing inequality is a prerequisite for vaccination equity.

Watch the interview →

Key Points from the Interview

1

There is a perfect social gradient in childhood vaccination in England.Vaccination rates decline at every step down the social gradient across all vaccines studied.

2

Child poverty is a key driver of vaccination coverage.Increases in child poverty are associated with declines in MMR coverage.

3

Poverty works through concrete, traceable mechanisms.For families facing access barriers, these mechanisms translate poverty into missed vaccinations.

4

Cutting early years services in deprived areas made everything worse.Years of austerity cut the preventive services that had sustained vaccination uptake.

5

There is no single solution, but reducing child poverty is a prerequisite.Reducing child poverty and restoring investment in preventive services are the conditions on which everything else depends.

The Report

Report cover

“Poverty isn’t being mediated through parents not being able to afford the vaccine.”

Professor Sir Terence Stephenson, December 2025 LifeCourse Prevention Summit

Read the full report →

From the Summit Briefings

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Dr Pauline Paterson

Associate Professor, London School of Hygiene and Tropical Medicine, UK & Vaccine Confidence Project

‘Vaccine Confidence, Institutional Trust, and the Limits of Communication’

Vaccine confidence is shaped by the experience of institutions, not just communication.

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Key Points from the Briefing

Vaccine confidence is inseparable from institutional confidence. When trust in government and public health institutions declines, vaccination confidence falls with it.
Frequent changes in guidance undermine credibility even when the science is sound. Inconsistent or rapidly changing guidance can lead communities to conclude that “they don’t really know.”
Trust cannot be fixed with messaging; it has to be earned through system performance. Rebuilding confidence requires rebuilding systems.

About the Campaign

The EiP Vaccination Equity Campaign shares the findings of the December 2025 LifeCourse Prevention Summit, which examined why vaccination inequities persist and what must change.

Explore the full campaign →