New data published by the UK Health Security Agency (UKHSA) shows there has been a continued increase in pertussis (whooping cough) cases at the start of this year, with 553 confirmed in England in January, compared with 858 cases for the whole of last year (2023).

The increase in whooping cough across England is occurring after a prolonged period of low case numbers due to restrictions and reduced social mixing patterns during the COVID-19 pandemic. Cases of whooping cough rise cyclically every few years, with the last peak year in 2016 recording 5,949 cases. The current increase is coming at a time when there has been a steady decline in uptake of the vaccine in pregnant women and in children.

Vaccination programme for children and pregnant women

In response to increasing case numbers, the UKHSA is reminding mums-to-be to get protected against whooping cough so that their young baby has protection from birth against this serious disease and to ask their midwife if they are unsure. UKHSA is also urging parents to check that their children are vaccinated against whooping cough, which is offered to all infants at 8, 12 and 16 weeks of age (as part of the 6-in-1 combination vaccine) with an additional dose included in the pre-school booster vaccine.

This reminder is part of the UKHSA’s new Childhood Immunisation Campaign urging parents to check the vaccination status of their children against measles and other serious diseases. This campaign went live across a range of media channels at the start of this week. Parents are being asked to respond to invites from the NHS or to book an appointment with their GP practice if their child has not received all their routine vaccines.

Data for January show that there were 22 infants aged under 3 months diagnosed with whooping cough. These infants, who are too young to be fully vaccinated, are at greater risk of severe disease, including death. UKHSA is strongly encouraging expectant mothers to take up the maternal vaccine. Vaccination of pregnant women is 97% effective at preventing death in young infants from whooping cough.

Useful links

The UK Health Security Agency (UKHSA) has launched a new multi-media marketing campaign across England to remind parents and carers of the risk of their children missing out on protection against serious diseases that are re-emerging in the country – with an urgent call to action to catch up on missed vaccinations.

The campaign went live today (4 March) with a powerful video advert told from the perspective of children and in their voices. “Our generation’s risk of illnesses like measles and whooping cough is rising” they tell their parents and carers looking straight into camera – “If we’re not vaccinated, we’re not protected.”

The campaign theme and materials, based on insight and feedback from parents in the North West, were developed by UKHSA in partnership with DHSC Marketing, Liverpool City Council, NHS England, NHS North West and NHS Greater Manchester.

The campaign comes as the latest weekly update today on measles cases in England shows there have been another 69 cases in the past week, bringing the total number of laboratory confirmed measles cases reported since 1 October 2023 to 650.

Professor Helen Bedford, Professor of Children’s Health at UCL Great Ormond Street Institute of Child Health (GOS ICH) and iHV Expert Adviser: Immunisations, said:

Every year, vaccination saves millions of children’s lives, so it is a huge concern that uptake of vaccines has been in decline in England for the past ten years. This has left many children and young people unprotected against potentially serious diseases and we are already seeing numbers of cases of measles and whooping cough increasing. However, we can prevent this taking further hold. Vaccines are free, highly effective and have a good safety record – and it is never too late to catch up if they have been missed. We owe it to our children to ensure they are protected.

Uptake levels of childhood vaccines offered through the routine NHS vaccination programme in England have been falling over the past decade across all vaccines, including whooping cough, measles, mumps and rubella, polio, meningitis and diphtheria – with England no longer having the levels of population immunity recommended by the World Health Organization that is needed to prevent outbreaks. Crucially, lower vaccine uptake within communities is directly linked to wider health inequalities.

To counter this decline, UKHSA is co-ordinating its national marketing campaign with an NHS operational MMR catch up campaign. Areas with low uptake will be a focus for support and parents of children aged from six to 11 years will be contacted directly and urged to make an appointment with their child’s GP practice for any missed MMR vaccines.

In addition to the TV advert, the campaign will be seen across a range of channels and formats including radio advertising, digital display, online and on social media. Additional advertising will be seen in the West Midlands, North West and London where there are larger pockets of low uptake. The campaign will be supported by a number of key stakeholders, including local authorities and NHS organisations.

As the new school year starts, with children about to start school for the first time, many parents will have a list of things needed for the big day: haircut, new shoes, school bag, etc. This is an exciting time for families. One important thing for the list is whether their child needs any vaccines. As children starting school will be mixing in larger numbers, the risk of catching infections increases.

Fortunately, although unpleasant, most of these such as cough and colds will be mild even if they are frequent! However, where numbers of unvaccinated children gather, there is also a risk of outbreaks of more serious infections.

Measles is top of the list of potentially serious infections where outbreaks are likely. This is because it is so highly infectious – considered the most infectious – and, to prevent outbreaks, very high uptake (95%) of two doses of measles, mumps, rubella (MMR) vaccine are needed. Unfortunately, this target vaccine uptake has never been met in the UK and current MMR vaccine uptake is the lowest for a decade: 2 in every 10 children in England have not had two doses of vaccine. In London, this figure is as high as ¼ of 5-year-olds entering school, while in some parts of the capital as many as a half of children are not fully vaccinated (NHS Digital 2023).

The situation is such in London that UKHSA has advised that, based on current vaccine uptake, there is the potential for an outbreak of between 40,000 and 160,000 cases (UKHSA 2023). These numbers make it inevitable that there would be many hospital admissions for measles, with complications such as pneumonia and encephalitis as well as deaths. Although large outbreaks are less likely in the country as a whole, there is this possibility where there are pockets of susceptible children, young people and adults.

So, what can be done? Fortunately, we have the means to prevent measles outbreaks through MMR vaccination. It is easy to check children’s vaccination status, by either looking at their red book or, if not available, checking with the GP surgery. Where vaccines are missing, they can be caught up at the GP surgery. Even though vaccines may have been missed at younger ages, for most there is no upper age limit, they can be caught up at any age. This does not require starting the course all over again – they just need the missing vaccines. Older children and young adults are also recommended to have had two doses of MMR vaccine, particularly those who are starting university in the next few months. This is particularly important as many young people missed out on their vaccines when they were young, and we have seen many cases of measles in recent outbreaks in this age group when disease is often more severe.

Don’t forget to also remind parents about the pre-school-booster vaccine. Usually offered at 3 years 4 months along with the second dose of MMR vaccine. This boosts immunity to diphtheria, tetanus, whooping cough and polio through the early school years and is an important part of the vaccine schedule.

Professor Helen Bedford – Professor of Children’s Health, Population, Policy and Practice Research and Teaching Department, UCL Great Ormond Street Institute of Child Health


Also see:

Parent Tips

  • PT – Childhood Immunisations Part 1: An introduction to childhood immunisations
    This Parent Tip provides some useful information on the childhood vaccination programme, explaining how vaccines work, how they are regulated and why it is important to ensure that your baby receives all the recommended immunisations.
  • PT – Childhood Immunisations Part 2: Frequently asked questions
    It is natural to have questions about your baby’s immunisations. This second part of our Parent Tip series on immunisations provides answers to “Frequently Asked Questions” and has been written by leading national experts. It covers FAQs on getting your baby immunised and what to expect, including information on things such as soothing your baby during and after vaccinations, and what to do if they are poorly on the day of their appointment.

Good Practice Points

  • GPP – Promoting the Uptake of Childhood Immunisations
    The immunisation programme in the United Kingdom (UK) is a key component of the Healthy Child Programme. It is important for health visitors to be aware of current research and practice to promote immunisation uptake and know where to go for information.

As part of  World Immunization Week 2020, our resources on childhood immunisations have been updated with the latest information and advice during the current COVID-19 pandemic – two Parent Tips and one Good Practice Points for Health Visitors.

The two updated Parent Tips:

  • one providing some basic information on the childhood immunisation programme, explaining how vaccines work, how they are regulated and why it is important to ensure your baby receives all the recommended immunisations
  • the second,  provides answers to “Frequently Asked Questions” and has been written by leading national experts. It covers getting your baby immunised and what to expect, including information on things such as soothing your baby
    during and after vaccinations, and what to do if they are poorly on the day of their appointment.

Just to reassure you that despite the current COVID-19 pandemic, it is still recommended that your child receives their vaccines as this protects them against other serious diseases that can still cause them harm.

These updated Parent Tips, together with those published last week and yesterday, can be found in our **Parenting Through Coronavirus (COVID-19)** webpage


The Good Practice Points for Health Visitors:

The immunisation programme is a key component of the Healthy Child Programme. It is important for health visitors to be aware of current research and practice to promote immunisation uptake and know where to go for information.  Uptake of childhood vaccines in the UK is is generally high, although uptake of the MMR is a concern and the UK lost its ‘measles-free’ status last year. There are also concerns about the impact of the COVID-19 lockdown on immunisation uptake.

COVID-19 webpages
  • For Health Visitors– This updated GPP is available in our GPP resource section of our website and can also be found on our COVID-19 (coronavirus) guidance for health visitors webpage –
  • For parents and families– These updated Parent Tips are available in the Families Parent Tips section of our website as well as our Parenting through Coronavirus (COVID-19) webpage –

We have waivered our usual restrictions on resources for members and the COVID-19 sections of our website are “free access” to all to support the national response to this pandemic.




Parents of 2 and 3-year olds are urged to protect their children against flu, which can be a serious and fatal illness.

Those aged 65 and over, children and adults with underlying medical conditions and pregnant women are also urged to get their free vaccine in the next few weeks, before flu begins to circulate widely.

The primary schools-based flu vaccination programme is once again underway. This follows a temporary pause in the ordering of the nasal vaccine, which was caused by delays from the manufacturer.

Primary school clinics will be rescheduled as soon as possible and children in high risk groups should visit their GP if their school session has been delayed, to ensure that they are protected early. GPs have now been advised to call in all eligible children for vaccination by early December.

Read more here

In addition, England’s chief nursing officer has issued a new appeal to NHS staff urging them to fulfil their “duty” to get vaccinated against influenza this winter. Dr Ruth May has written an open letter to frontline nurses and other health professionals working in the health system to urge them to work together to achieve a high level of coverage this season.

Also read our guest blog from the National Infection Service, Public Health England: Help us help you this winter by getting your flu vaccination

Public Health England (PHE) is calling for all parents to get their children vaccinated against measles, mumps and rubella (MMR) when the vaccine is offered, or for them to take it up now if they didn’t have it at the scheduled time.

In the first quarter of 2019, there were 231 confirmed cases of measles. This figure is slightly lower compared to the same quarter last year. As measles is highly infectious, anyone who has not received two doses of MMR vaccine is at risk, particularly unvaccinated people travelling to countries where there are currently large outbreaks of measles. The recent measles cases are mainly occurring in under-vaccinated communities, particularly those with links to other countries with ongoing measles outbreaks. There has also been some spread into the wider population, such as those who may have missed out on the MMR vaccine when they were younger.

In the final quarter of 2018 94.9% of eligible children aged five received the first dose of MMR. To achieve herd immunity for measles at least 90-95% of the population need to be fully protected. One dose of the MMR vaccine is about 90-95% effective at preventing measles. After a second dose the level of protection is around 99%. Coverage of the second dose is at 87.4% for children aged five. PHE is therefore urging those who have only had one dose to ensure they are fully vaccinated with two doses.

This quarter, 795 cases of mumps have also been confirmed. No new cases of rubella were reported.

The MMR vaccine is given on the NHS as a single injection to babies as part of their routine vaccination schedule, usually within a month of their first birthday. A second injection of the vaccine is given just before starting school, usually at 3 years and 4 months. The vaccine is also available to all adults and children who are not up to date with their two doses. Anyone who is not sure if they are fully vaccinated should check with their GP and those planning to travel to Europe should check NaTHNaC travel health advice.

iHV welcomes the National Minimum Standards and Core Curriculum for Immunisation Training for Registered Healthcare Practitioners which have just been published.

The National Minimum Standards and Core Curriculum for Immunisation Training for Registered Healthcare Practitioners sets the standards and lists the essential topics which should be incorporated into immunisation training for registered healthcare practitioners.

The aim of the national standards is to describe the training that should be given to all practitioners engaging in any aspect of immunisation so that they are able to confidently, competently and effectively promote and administer vaccinations.

Dr Cheryll Adams CBE, executive director, iHV, said:

“iHV welcomes this new guidance from Public Health England on the training and standards required to support a high quality, safe and effective immunisation programme that achieves high uptake.  It is important that HVs, who visit every baby and family, have a good knowledge of immunisation and are confident to advise parents. Comprehensive training and regular updates combined with supervision and support as laid out in the guidance will help support HVs to achieve this.”

Public Health England (PHE) has issued a press release highlighting recent measles outbreaks that are linked to ongoing large outbreaks in Europe, with Romania, Italy and Germany being the worst affected countries.

PHE calls on anyone travelling to Romania, Italy and Germany this Christmas to ensure they are up to date with their MMR jab

Measles is highly infectious and can lead to serious complications, particularly in immunosuppressed individuals and young infants. It is also more severe in pregnancy, and increases the risk of miscarriage, stillbirth or preterm delivery.

Members of the Romanian community and unimmunised individuals travelling to Romania, Italy and Germany are at particularly high risk of acquiring measles. Experience from recent outbreaks shows that, despite living in the UK for a number of years, many individuals infected with measles were unvaccinated, and that families are often not registered with a GP practice.

PHE is asking health professionals to note the following:
Individuals with suspected or known measles:

  • should be isolated immediately when attending health care settings to reduce the risk of other patients being exposed
  • recent travel to countries with ongoing measles outbreaks like Romania, Italy and Germany increases the likelihood of a measles diagnosis
  • all suspected measles cases should be promptly notified by phone to the local Health Protection Team (HPT) to facilitate timely public health action

MMR vaccine:

  • children should receive their two scheduled doses of MMR vaccine on time at the ages of 12 months and 3 years and 4 months
  • the MMR vaccine can be given from six months of age before travel to a high risk country
  • patients over the age of three years and four months who do not have two recorded doses of MMR vaccine should be caught up opportunistically. There is no upper age limit to offering MMR vaccine.
  • new entrants from abroad and newly registered patients should have their immunisation history checked and missing doses caught up
  • postnatal women should have their MMR status checked and offered any outstanding doses
  • all health professionals should make sure they are fully protected against measles, mumps and rubella

Under-vaccinated communities:
Health professionals who work with under-vaccinated communities should collaborate with local partners to raise awareness about measles with those most at risk and ensure unregistered populations can access immunisation services.

Measles resources

Measles resources including national guidelines for health professionals and free to order posters and leaflets for patients are :

National guidelines

Free copies of PHE leaflets and posters can be ordered through the Health and Social Care Orderline: Alternatively, you can call 0300 123 1003.

Guidance for healthcare professionals on the hexavalent vaccine programme for babies born after 1 August 2017.

From autumn 2017, all babies born on or after 1 August 2017 will become eligible for a hexavalent vaccine which includes hepatitis B (HepB) for their primary immunisations. This vaccine, called Infanrix hexa®, will replace the pentavalent infant vaccines Infanrix®-IPV+Hib and Pediacel®.

This guidance is intended to provide healthcare professionals with more information about vaccinating high risk infants in light of the new universal hepatitis B infant programme.

Premature babies have a higher risk of infection. They should be immunised in line with the recommended schedule from two months after birth, no matter how premature they were.

A leaflet for parents which describes the immunisations offered to premature babies: