Despite the success of vaccines in saving millions of lives worldwide, vaccine uptake is falling in many parts of the UK leading to outbreaks of preventable diseases such as measles.

A recent rise in measles cases in Liverpool has led to a surge in seriously unwell children being admitted to Alder Hey Children’s Hospital, and tragically a child’s death after contracting the disease. In this Q&A, Professor Tom Solomon, Director of The Pandemic Institute, explores the complex reasons behind this decline – from access and misinformation to trust and social media. He also shares how the The Pandemic Institute is funding researchers working with communities to improve vaccine confidence, and why public engagement is key to pandemic preparedness.

Q: Why is vaccine uptake falling?

A: It’s a mix of factors. We often talk about “vaccine hesitancy,” but it’s more complex than just people being sceptical. Sometimes it’s simply about access—people being too busy, not having transport, or not knowing where to go. We know that the easier we make it to get vaccinated, the more likely people are to do it. In Liverpool, for example, public health teams are setting up pop-up vaccination centres  to make access easier. People can also talk to their GP. It’s all about convenience and trust.

Q: Is misinformation still a factor?

A: Yes, it is. The MMR-autism myth, for example, originated from a false study by Andrew Wakefield that was later retracted. He was struck off the medical register, but the damage lingers. Most people do trust vaccines and want their children protected, but misinformation spreads fast, especially on social media.

That’s why we work with trusted local voices, community leaders, volunteers, council staff, to co-produce messaging. Researchers at the Liverpool School of Tropical Medicine are doing vaccine equity projects, helping communities develop messages that resonate and build trust.

Q: Has social media made things worse?

A: In some ways, yes. Social media amplifies everything, especially bad news. False claims spread much faster than careful, evidence-based information. That’s a real challenge.

We’re doing research at the Institute to understand the role social media plays in shaping health beliefs, including around vaccination. We need to monitor it and find better ways to get trusted messages out, from the NHS, UKHSA, local public health teams, and people themselves.

Q: Why do you think trust in vaccines didn’t increase after COVID?

A: That’s a good question. You’d think that after vaccines saved millions of lives during COVID, people would have even more faith in them. But in reality, the pandemic also fuelled mistrust of government, of authorities, which spilled over into mistrust of vaccines.

Still, it’s important to remember that anti-vaccine activists are a small but vocal minority. Most people got the COVID vaccine and were grateful for it. In Liverpool especially, I’ve found people to be very engaged and supportive of our work.

Q: Can you give an example of that engagement?

A: Absolutely. During the pandemic, Liverpool led the way on mass testing and reopening events. That happened because people here were willing to participate. We also contributed more participants to the national trial of the Oxford AstraZeneca vaccine than any other city, even more than Oxford itself.

That says a lot about the city’s commitment to public health and research. It’s a strong partnership between universities, hospitals, and communities. I’m really proud of that.

Q: Any final thoughts on what needs to happen now?

A: The key is to make vaccination as easy and accessible as possible. Yes, we need to tackle misinformation and build trust—but the simplest and most powerful action is just helping people get the jab.