Measles, whooping cough and infection: Why children's health is getting worse in the UK

Eight years ago, measles had been eliminated in the UK. There had been no cases for three years. But last month a child died of the highly-infectious disease and doctors have sounded the alarm about the rising number of cases.

There were 362 measles cases reported in the UK in 2023. This hit almost 3,000 cases in 2024.

Measles is prevented through vaccination but spreads quickly among those who are not protected. Rates of childhood vaccinations have been declining for the last decade, and new figures from the World Health Organization (WHO) and UNICEF show that this trend has continued.

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One in 10 children missed out on the first dose of the measles vaccine last year, while 15% did not have full coverage. And it is not just measles – other conditions such as whooping cough (pertussis) are also on the rise. All childhood vaccinations in the UK have an uptake below the WHO target of 95%.

“Childhood vaccination rates in the UK are falling, and entirely preventable yet deadly diseases like measles are on the rise,” said Joanna Rea, director of advocacy at the UK Committee for UNICEF. “This isn’t just a public health issue, it’s a matter of fairness and easy access.”

Researchers have found correlation between low levels of childhood vaccination and areas of poverty and deprivation, with children in poverty facing the “greatest barriers” to accessing vaccination. They suggest this is a result of difficulties in accessing services, misinformation, and lack of engagement with healthcare workers.

Dr Helen Stewart, a consultant in paediatric emergency medicine at the Sheffield Children’s NHS Foundation Trust and the officer for health improvement at the Royal College of Paediatrics and Child Health (RCPCH), said: “Measles is incredibly infectious. It is very easy to start spreading. Young children who are vulnerable, who aren’t able to get vaccinated, are more at risk.

“We know that vaccination rates are lower in those living in poverty. There is misinformation, and there are those who are adamant they will not vaccinate, but there are also barriers that make it harder to vaccinate your children, and some of that is financial.”

More than three quarters (78%) of paediatricians have seen an increase in poverty-related health conditions over the past two years, according to new figures from the RCPCH and the Child Poverty Action Group (CPAG).

As many as 99% said poverty is contributing to ill health among the children they treat.

This is not only the result of low uptake of vaccinations – it is also caused by poor housing conditions and the cost of accessing healthcare support, whether that be for transport or having to take time off work.

Stewart said: “One of the things that we’re seeing more recently, which has definitely increased, is the number of parents saying that they can’t afford to get their child to an outpatient appointment. 

“You might need to take several buses. You might have other children you need to get childcare for. If you have insecure employment or zero-hour contracts, how easy is it to take a day off work?”

Stewart said she has seen instances where parents have been unable to get their children to appointments and their conditions have deteriorated, meaning they have ended up in the emergency department. 

Nearly all paediatricians (95%) said poverty is preventing children from attending medical appointments, sometimes resulting in the need for emergency care.

Meanwhile, 96% said that poor housing conditions such as overcrowding and damp are affecting the health of children they treat. 

“We get a lot of children with respiratory issues – so asthma and infectious diseases that are much more likely to spread when they’re in overcrowded housing or they’ve got damp,” Stewart added.

Two-year-old Awaab Ishak died in December 2020 due to a respiratory condition caused by exposure to mould in his family’s one-bedroom flat on a social housing estate in Rochdale. 

It led to the government establishing Awaab’s Law, due to come into force in October, which will require social landlords to  investigate and fix issues like dangerous damp and mould within specific timeframes. It is set to be expanded to the private rental sector through the Renters’ Rights Bill.

“Landlords cannot be allowed to rent out dangerous homes and shamelessly put the lives of their tenants at risk,” said deputy prime minister Angela Raynor. “Our new laws will force them to fix problems quickly, so that people are safe in their homes and can be proud to live in social housing.”

However, with a record 4.3 million children living in poverty in the UK, and that figure expected to rise without government action, there remain concerns that children’s health will continue to deteriorate.

Alison Garnham, chief executive of the CPAG, said: “Poverty is exacting an appalling toll on the nation’s children. Blue lights are flashing at the government, and without urgent action the health of the next generation will be compromised.”

GPs in deprived areas are now responsible for caring for 2,450 patients per head – around 300 more patients than in more affluent areas of the country, according to figures from the Royal College of GPs.

It means that primary care services are “more overstretched in poor areas” and patients have greater difficulties accessing healthcare appointments.

Stewart explained that parents “often feel that they don’t have a trusted healthcare professional that they’ve been able to build a relationship with to ask questions” – whether that be about their child’s health or vaccinations.

The NHS vaccination strategy, released in 2023, was welcomed – but Stewart said there needs to be improvement on how this is delivered.

The government is also working on its child poverty strategy and has promised “ambitious” measures to tackle the numbers of children in hardship, due to be announced in autumn. 

RCPCH and CPAG are calling on the government to invest in social security for families, starting with abolishing the two-child limit on benefits to lift hundreds of thousands of children out of poverty.

“It might cost the government some money, but the savings in the long term and elsewhere in the system of lifting children out of poverty is huge,” Stewart said.

The groups are also urging the government to unfreeze local housing allowance, help families afford to attend healthcare appointments, and introduce binding targets to eliminate child poverty.

Meanwhile, UNICEF UK is calling on the government to invest in early childhood health services and tackle child poverty to ensure that every child is protected – and that preventable illnesses like measles are relegated to the history books.

“There’s a lot of motivation there to make things better and to help children be healthier, stay healthier,” Stewart said. “But it needs political will, and it needs people to keep pressing the case.”

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