21 million children miss the first dose of measles vaccine every year BSIP/UIG via Getty Images

The UK should consider introducing compulsory measles vaccinations before children start school, according to a team of researchers in Italy. Their analysis of international measles data suggests that current vaccination policies are not enough to keep the virus under control.

The team looked at vaccination trends in multiple countries, including the UK, US, Australia, and Ireland. They concluded that, in order to keep the percentage of the population susceptible to catching measles under 7.5 per cent by 2050 – the level at which measles is regarded as eliminated – further action is needed.

Either far more people need to be vaccinated, or a schools policy should be brought in, say the team.


In their analysis, they found that an estimated 3.7 per cent of the UK population across all ages was susceptible to measles in 2018. Without any change to vaccination policies, this is expected to increase to more than 5.5 per cent by 2050.

But compulsory vaccination at school entry, in addition to current routine immunisation programs, would enable the UK, Ireland and US to reach stable herd immunity levels in the coming decades, says team member Stefano Merler, of the Fondazione Bruno Kessler in Trento.

There were 966 measles cases in England last year, up from 259 in 2017. Anti-vaccination groups may be behind a number of parents choosing not to vaccinate their children with the combined measles, mumps and rubella vaccine (MMR).

Read more: 21 million children miss first dose of measles vaccine every year

“Vaccine rejection is a serious and growing public health time-bomb,” says Simon Stevens, of NHS England. Social media firms should have a zero-tolerance approach towards dangerous and inaccurate stories, he says.

But there is doubt over whether compulsory vaccinations would work. “Only about 1 to 2 per cent of UK parents refuse all immunisations,” says David Elliman, of Great Ormond Street Hospital in London. “Before we even consider going down this route, we should ensure that we have efficient appointment systems and reminders and adequate numbers of well-trained staff with time to talk to parents,” he says.

“Making vaccination mandatory might have unintended consequences,” says Sonia Saxena, of Imperial College London. “It risks disenfranchising parents and carers, as well as risking a rise in unvaccinated children being excluded from school – which could carry stigma for children whose parents do not comply.”

Journal reference: BMC Medicine

Read more: Italy bans unvaccinated children from schools after measles outbreaks