COVID-19 pandemic linked to diminishing public trust in childhood vaccines

An international study led by the Azrieli Faculty of Medicine in the Galilee at Bar-Ilan University reveals that the COVID-19 pandemic has contributed to a diminishing public trust in childhood vaccines, resulting in declining vaccination rates and a resurgence of preventable, life-threatening diseases such as measles. The findings come amid one of the most severe measles outbreaks in Israel in decades, with thousands of infections and multiple child deaths reported nationwide.

Published in the peer-reviewed journal Vaccine, the study surveyed 2,047 parents with children born both before and after the pandemic in Israel and the UK and found that coverage for key childhood immunizations, including measles-mumps-rubella (MMR) and diphtheria-tetanus-pertussis (DTP) containing vaccines, has dropped sharply since the pandemic. Among surveyed UK parents, MMR vaccination rates fell from 97.3% among children born before COVID-19 to 93.6% for those born afterward. In Israel, the rate declined from 94.3% to 91.6%. Similar decreases were observed for DTP. Alarmingly, 5% of surveyed parents in the UK and 6.6% in Israel who vaccinated an older child before the pandemic chose not to vaccinate a younger child born afterward for at least one childhood vaccine.

The study shows that the COVID-19 pandemic has had a clear impact on parents' attitudes and behavior toward vaccination. Beyond the 37% of parents who reported a decline in trust in vaccines after COVID-19, a shift of just 5% who choose not to vaccinate their younger children is enough to rapidly trigger an outbreak. The detected decline in vaccination rates is also evident in populations that previously routinely vaccinated, which raises significant concern for the future."

Prof. Michael Edelstein, public health expert and lead author of the study at Bar-Ilan University's Azrieli Faculty of Medicine

The effects are already visible. There were nearly 3,000 laboratory confirmed measles cases in England in 2024, the highest number of cases recorded annually since 2012. Israel has seen a sharp rise in measles cases in recent months, with over 1,800 reported infections by October, and at least eight deaths in toddlers under 2 ½ years old, all unvaccinated. Until recently, Israel had virtually eliminated measles.

The study identified fear of side effects as the main driver of vaccine hesitancy, a concern that existed before COVID-19 but has intensified since. Ninety-two percent of parents in the UK and 63% in Israel cited this as a reason for refusing or delaying vaccinations. The data also revealed disparities across populations: in the UK, a sharper decline was observed among parents of Asian descent, while in Israel, larger decreases were noted among the ultra-Orthodox and Arab sectors.

The researchers emphasize that even small declines in vaccination rates can undermine herd immunity and lead to renewed outbreaks of infectious diseases. They warn that if this global erosion of confidence is not addressed through clear communication, education, and community-based initiatives, decades of progress in disease prevention could be lost.

Prof. Edelstein concluded: "The data indicate that the impact of the pandemic on public trust in vaccines is not only temporary or local, but rather a broad and deep phenomenon with global implications. Dedicated interventions are needed to restore trust and reduce concerns in order to prevent further deterioration."