The spectre of measles is creeping around the nation’s nurseries. Since 1 January 2026, there have been 1,003 laboratory-confirmed cases of measles in England. How did we go from the World Health Organisation in 2017 declaring England was free of measles, to this? Much of the blame can be laid at the feet of both a burgeoning anti-vax movement led by conspiracists and our nation’s shrinking support services.
London is a measles hotspot with 50% of all cases – an increase on 2025. Hertfordshire has 6% (63 out of 1,003). Three measles-related deaths have been reported to date in 2026. This year, measles activity started to increase in February, peaked in May and has declined since then. Time will tell if 2027 repeats this pattern. Parents are urged to seek vaccine appointments to avoid another surge.
Why is a perfectly preventable illness now haunting parents and our young? The answer to that is a complex mix of the banal administration changes borne of austerity and the development of online rumours.
The consequence of a scandal
Since the great MMR vaccine scandal of the late 1990s, people have reduced taking up the vaccination of children. In 1998 the now-disgraced British doctor Andrew Wakefield wrote a paper falsely claiming a link between the measles, mumps and rubella (MMR) vaccine and the growth in the number of children with autism. Despite all the evidence that it is false – a Danish study of over a million children has shown no link – this notion went on to spark a global conspiracy theory. It is still being played out in real-time in today’s US, with the gutting of their public health agency, the Centres for Disease Control and Prevention (CDC).
In Britain, it has resulted in the MMR vaccine uptake being below the recommended 95% target of two doses by the age of five. The doses are staggered, with the first at age one, and the second between three years and four months to five years old. According to NHS England, now one in six children is not fully vaccinated by the age of five. Over 10% of children have not received any dose of the MMR vaccine by the age of two.
What happened? Some of this must be laid at the door of the multiple anti-vax communities that sprang into being first after the MMR scare and then exacerbated by the Covid pandemic. Online influencers muddying anti-Covid and anti-MMR conspiracies have damaged parents’ confidence in immunising their children. These influencers range from the strange sovereign citizens to ex-medical personnel peddling mistruths. Even health professionals have been struggling with the barrage of online hate when posting about the Covid vaccination programme.
So why the decline now?
Many parents participate in online forums to address their concerns and receive support in parenting. Mumsnet is one such community. It’s an online platform for parents, with around 8 million unique users per month and over 700,000 posts monthly. In that group, as elsewhere, there is an ongoing debate about vaccination online. The balance is in favour of vaccination, but even small drops in take-up endanger everyone if take-up falls below the target of 95%, as it allows the disease to spread much more rapidly.
Is this a general reaction against vaccination? It appears that since the pandemic’s height, there has been a decline in the acceptance of seasonal vaccinations, such as flu overall, and this may be influencing attitudes toward other vaccinations. So ‘vaccine fatigue’ may be part of the puzzle.
What other reasons are there for people not participating? The first jab reminders are often given by health visitors and those monitoring children’s development. But their workforce numbers have declined rapidly since 2015, with a third lost. Austerity has impacted how public health is being delivered.
By the time your child is a three-year-old, you are back to engaging with GP practices. Since the pandemic, many of us can vouch for the 8 am appointment queue. Busy lives and struggling through the early years make fighting for a GP appointment harder.
Keeping up appointments is also more difficult for parents to fit in without family support – and when your own parents are also having to work until 67. For many, partly due to the high cost of nursery places, grandparents remain a significant source of childcare. One in four working families and one in three working mothers use grandparents for childcare. Almost two-thirds of all grandparents regularly look after their grandchildren. The ability to support vaccination can be more difficult, as non-parental child-carers cannot book appointments for their charges, so the risk of missed appointments increases.
Memory and mistrust
Maybe part of the slide is that vaccinations have been so successful for so long, we have collectively forgotten what these diseases do to lives. There is a loss of memory about their severity and the implications of measles compared to chickenpox. The Times ran a recent article with the mother of an unvaccinated child who caught measles:
This is the public health dilemma: the sovereign individual, mistrusting science, armed with incomplete knowledge from surfing the internet, versus the scientists and specialists employed by the state and local health services.
Globally, the anti-vaccination movement is mixed in with a cheeseboard of anti-establishment offerings and a fear of authoritarian takeover. Why are we letting bots and foreign bad actors amplify these destructive messages? There are attempts to fight back, but vaccination appears to have complicated roots in distrust of the state, personal liberty and anti-medicine. The most extreme case recently is that of Paloma Sheminrani, who died from cancer after it is alleged her mother’s anti-medication conspiracy theories led to her refusing cancer treatment.
We all love our children, but why do these anti-vax belief systems sometimes obscure the need to keep them safe? What does disinformation do to warp our minds? Being in a group of like-minded people appears to provide folks with something they are missing in the modern, high-pressure world, especially since the collective trauma of lockdown – a sense of belonging in a community. Somewhere to gather online and have a unifying collective belief based on special information gives them a greater sense of themselves. That those newfound identities can become conflicted with public health messages and the need for compliance regardless of your fears becomes a problem for everyone when your choice not to vaccinate endangers other children.
So how do we get from the risk to tiny tots in nurseries from measles, to those holding extreme viewpoints? There are many stops along the way, from the mundane – such as waiting in the morning 8 am queue for a GP appointment – to the bizarre, where falling down the internet’s rabbit holes can lead to becoming a healthcare avoider.
Addressing these issues will require significant effort from public health authorities and all of us. We must have open conversations. It is essential to gently include those who are currently excluded, even those who choose to exclude themselves. Failing to do this will increase the threat to the nation’s children from another self-inflicted measles epidemic.
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