The UK should consider a “no jab, no school” policy for all small children, researchers have said after finding that current immunisation rates will not keep measles outbreaks at bay.

The research comes from Italy, which brought in mandatory vaccination before primary school in 2017 because of low immunisation rates and measles outbreaks. France did the same in 2018. Populist politicians have opposed mandatory vaccination, saying parents should have freedom to choose.

In the UK there is increasing concern about low vaccination rates in some communities. The health secretary, Matt Hancock, has said all options should be considered and did not rule out compulsory vaccination.

Researchers at the Bruno Kessler Foundation in Trentino and Bocconi University in Milan modelled the effects of current immunisation policies on vaccination rates in seven countries between 2018 and 2050.

In their paper, published in the journal BMC Medicine, they say high vaccine coverage in Singapore and South Korea is likely to continue, but rates in Australia, Ireland, Italy, the UK and the US could drop to levels where measles outbreaks will happen. Coverage needs to be 95% to prevent outbreaks.

Dr Stefano Merler, one of the authors of the study, said: “Our results suggest that most of the countries we have studied would strongly benefit from the introduction of compulsory vaccination at school entry in addition to current immunisation programmes.

“In particular we found that this strategy would allow the UK, Ireland and the US to reach stable herd immunity levels in the next decades, which means that a sufficiently high proportion of individuals are immune to the disease to avoid future outbreaks. To be effective, mandatory vaccination at school entry would need to cover more than 40% of the population.”

UK public health experts disagreed. Dr David Elliman, of the Royal College of Paediatrics and Child Health, said: “The UK has not escaped the worrying global increase in measles cases. Clearly, the only way to counter this and prevent future deaths is to increase vaccine uptake. However, the conclusion drawn by Trentini and colleagues that the only way to achieve this is through a ‘no jab, no school’ policy lacks evidence for the UK.

“Only about 1-2% of UK parents refuse all immunisations. A larger proportion may have concerns that are readily addressed by healthcare professionals, while a significant number still have problems accessing appropriate family-friendly services. Introducing compulsory vaccination in this country might reduce the very high level of trust that people have in the NHS and prove counterproductive. It could even result in lower levels of vaccination.”

Elliman added: “Before we even consider going down this route, we should ensure that we have efficient appointments systems and reminders, and adequate numbers of well-trained staff with time to talk to parents in family-friendly clinics. Compulsion may work in some countries but it is not for us.”

Sonia Saxena, a professor of primary care at Imperial College London, said compulsion could have unintended consequences. “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,” she said.

Andrew Pollard, a professor of paediatric infection and immunity at Oxford University, said that although mandatory vaccination had been shown to boost immunisation rates, “it seems sensible to first understand why vaccine uptake has fallen across the UK and address these factors”.

He said: “We must prioritise improving access to immunisation services in the NHS and communicating the importance and value of vaccination for the individual child and for the wider community.”