Ireland has emerged as one of the poorest performers globally for childhood vaccination coverage, ranking third lowest among high-income nations and falling well short of the threshold needed to protect communities from preventable diseases.
New research published in The Lancet reveals that Ireland’s childhood vaccination coverage stands at just 91%, significantly below the 95% milestone required for herd immunity. The country also ranks sixth lowest among European nations and second lowest in Western Europe for vaccine uptake.
The data paints a concerning picture of Ireland’s vaccination landscape. The number of “zero-dose” children – those who have never received any routine childhood vaccines – more than doubled from 2,460 in 2019 to 4,942 in 2023. This gives Ireland the seventh highest number of unvaccinated children in Western Europe.
Dr Illona Duffy, a GP in Monaghan, attributes Ireland’s poor performance to several factors, with misinformation playing a significant role. She reports that vaccine-hesitant parents frequently cite debunked claims, particularly the false link between the MMR vaccine and autism.
“Most of them are getting it from blogs and they’re still talking about concerns of the MMR vaccine causing autism,” Dr Duffy explained. “There is no link between the MMR vaccine and autism, yet that fallacy continues.”
This persistent myth stems from a fraudulent 1998 study by Andrew Wakefield, later retracted by The Lancet and described as “perhaps the most damaging medical hoax of the last 100 years.” Despite numerous studies disproving any connection between vaccines and autism, the false belief persists.
Dr Duffy also highlighted the role of social media in spreading vaccine skepticism, noting that the COVID-19 pandemic has intensified these concerns. “A huge amount of scepticism is coming from social media,” she said, explaining that parents see negative experiences shared online while positive vaccination stories go unreported.
Professor Kingston Mills from Trinity College Dublin points to structural issues within Ireland’s healthcare system as another contributing factor. The absence of an integrated patient identifier system means vaccination records don’t follow patients when they change doctors or locations.
“If somebody moves from a GP practice or moves location, the records don’t normally travel with them,” Mills explained. “So we’re relying on the parent to remember whether they have done something or not.”
This fragmented approach makes it difficult to track vaccination status and issue reminders, contributing to missed opportunities for immunization.
The implications of low vaccination rates extend beyond individual families. Mills emphasized that vaccines work – the measles vaccine is 99% effective with two doses. However, Europe experienced a measles epidemic in 2024, with 127,350 cases reported, double the previous year and the highest since 1997.
Of European measles cases with known vaccination status, 90% of affected children aged one to four were unvaccinated. In Ireland, only 89.2% of junior infants received their MMR vaccine in 2023, well below the 95% threshold needed for community protection.
“By not vaccinating your child, you’re not only leaving your own child at risk, but others,” Dr Duffy warned. “If we achieve high rates of vaccines we get herd immunity, which keeps the amount of these diseases in the community low and protects everybody.”
The Health Service Executive acknowledges the challenges facing Ireland’s vaccination program. In a statement, the HSE said it “remains committed to reversing recent declines in vaccine uptake and ensuring every child has access to life-saving vaccines.”
The organization has launched a 2024-2027 Strategic Plan through its National Immunisation Office, aiming to achieve 95% uptake of all routine childhood vaccines. The plan focuses on reducing zero-dose children, improving monitoring systems, and strengthening vaccine delivery in communities with the lowest uptake rates.
“Clear, empathetic communication with parents and caregivers is essential to building trust and confidence in vaccines,” an HSE spokesperson said.
Dr Duffy identified specific challenges within certain communities, particularly among families of Eastern European origin, where vaccine confidence tends to be lower. A 2022 European Commission report confirmed that “steep declines in vaccine confidence are a worrying trend most notable in Eastern and Central Europe.”
She also called for targeted outreach to pregnant women, as “uptakes of vaccines that are encouraged for pregnant women tend to be low.”
Both experts emphasized the need for better research into why parents refuse vaccines and more effective public health messaging to counter misinformation. Dr Duffy urged the HSE to study unvaccinated cohorts to understand their specific fears and concerns.
Ireland currently trails its 2030 target of 97.7% vaccination coverage by a significant margin. With only Moldova, Bosnia and Herzegovina, Ukraine, North Macedonia, and Austria performing worse in Europe, the country faces an urgent need to rebuild public confidence in one of medicine’s most successful interventions.
As Professor Mills noted, “You don’t need to be a scientist or medic to figure out that if parents don’t take their children to get vaccinated, they’re increasing the risk of their children getting measles.”