Visible public health leadership needed to boost vaccine coverage

Public health expert Professor John Ashton is calling for local directors of public health to provide visible leadership to address the recent systematic deterioration of vaccine coverage levels. Writing in the Journal of the Royal Society of Medicine, he describes recent falls in the uptake of other preventative programmes, including bowel, breast and cervical cancer and aortic aneurysm. This, he writes, indicates the fragmentation and weakening of the arrangements for public health, and especially the links with the NHS, since the 2013 reorganisation when directors of public health moved to local government.

With over 900 cases of measles over the last 12 months in Britain, Prof Ashton writes that the current weaknesses in the public health delivery system should be resolved before resorting to legislation. The Secretary of State for Health, Matt Hancock, has recently suggested the possibility of fines for parents who refuse to have their children vaccinated, together with a ban on anti-vaccination posts on social media.

"Part of the problem is making the seeming invisibility of prevention, visible; this requires imagination and creativity, together with leadership and the effective delivery of services." The alternative, Prof Ashton says, is to wait for a public health disaster to shake up the inertia and the forces of darkness.

"That it does not have to be like this is shown by the recovery in the measles, mumps and rubella vaccination in the north-west of England, with one of the strongest public health systems and visible public health leadership, to herd immunity levels, following the initial dip after the publication of the claims of discredited former doctor Andrew Wakefield."