Protecting children from measles: a targeted, community-based MMR catch-up programme in Blackpool

The programme combined data-led identification of under-vaccinated children, GP call and recall, home visits, community clinics, targeted outreach and clear, non-judgemental communications for parents and carers. Clinics were delivered in accessible community settings, including home and Family Hubs. The approach helped maintain Blackpool’s MMR coverage above national and regional comparators and supported improvement in second-dose coverage, while piloting a sustainable local model for vaccination outreach.

Measles is highly infectious and can cause serious complications, including hospitalisation, meningitis, hearing loss and risks during pregnancy. The UK has seen a resurgence of measles, with increased susceptibility following disruption to routine immunisation programmes during and after the COVID-19 pandemic.

In Blackpool, as elsewhere, the key risk was not simply overall coverage but the presence of children and communities who may have missed one or both MMR doses. The first MMR dose is routinely offered at 12 months and the second at three years and four months, but local intelligence showed that some children were not fully protected by the time they reached school age.

Blackpool’s context also required an approach that recognised wider inequalities. Families may experience barriers including appointment access, competing pressures, lack of confidence, uncertainty about vaccination status, language or literacy needs, and mistrust or anxiety about services. A traditional “come to the clinic” model was unlikely to reach all children who could benefit from catch-up vaccination.

The public health challenge was therefore to increase protection against measles while avoiding stigma, blame or deficit-based messaging. The programme needed to support the continuing GP programme, strengthen partnership working, and take vaccination opportunities closer to families.

Blackpool Council worked with partners including NHS England, Lancashire and South Cumbria ICB, primary care, Fylde Coast Medical Service (FCMS), Family Hubs, schools, nurseries and community partners to develop a practical, targeted MMR catch-up approach.

The programme had several linked components:

• Data-led identification of need: Local vaccination coverage and child health data were reviewed to identify where additional catch-up activity could add most value. This included looking beyond borough-level averages to understand missed doses, second-dose gaps and opportunities to target outreach.
• Community-based MMR clinics: Blackpool Council and FCMS delivered community MMR clinics in homes and accessible venues, including Family Hubs. These clinics were designed to be simple for families to use, with drop-in access, no appointment required, and staff available to answer questions. The first clinics offered first and second MMR doses for children aged one to five years.
• A non-judgemental communication approach: Public messaging, led by Better Start Community Connectors encouraged parents and carers to check their child’s vaccination status and catch up on missed doses. The tone was deliberately supportive: “there is no judgement here”. Communications emphasised that families may be unsure, busy or anxious, and that staff would help them understand what was needed.
• Strengthening the GP programme: The community model was positioned as complementary to routine primary care delivery. Families outside the target clinic age range were encouraged to contact their GP to check vaccination status and arrange catch-up vaccination where needed.
• Outreach through trusted settings: The programme used settings and relationships already familiar to families, including  their own homes, Family Hubs, nurseries and schools. This helped move the programme from a purely clinical model to one rooted in local access, trust and early years support.
• Partnership coordination: The Director of Public Health played a convening role, bringing together partners across the council, NHS, primary care and community providers. This helped align communications, clinic delivery, data review and operational problem-solving.
• Learning into wider vaccination work: The MMR work built on Blackpool’s wider vaccination improvement approach, including home-based COVID-19 vaccination, outreach, targeted call and recall, care home vaccination learning, primary care collaboration and use of local intelligence to identify gaps.

The programme supported a proactive local response before Blackpool experienced a large measles outbreak. It helped ensure families had accessible opportunities to catch up on missed vaccination and reinforced the importance of two-dose MMR protection.

MMR1 coverage at 24 months in Blackpool rose from 90.4 per cent in 2023–2024 to 91.7 per cent in 2024–2025. Over the same period, England’s coverage remained static. Six-year mean coverage in Blackpool was significantly higher than the national average across all three indicators. MMR2 at aged five also increased during the project period from 86.2% in 2023/24 to 87.4 per cent in 2024/25.

Overall, 229 Blackpool residents were vaccinated, almost 80 per cent (181) were children and young people aged 0-18 years, 39 per cent were children aged four to 10 years with just over a third (84) vaccinated at targeted sites.

The programme’s impact included:

• improved access to MMR catch-up vaccination through community-based delivery
• a stronger partnership model between Public Health, NHS commissioners, primary care, FCMS and community settings
• greater public visibility of the importance of MMR vaccination
• a supportive communications approach that reduced blame and encouraged families to come forward
• better local understanding of missed-dose patterns and where targeted action is needed
• strengthened foundations for future vaccination outreach programmes.

No cashable cost savings have been formally calculated. However, preventing measles transmission is likely to avoid significant costs associated with outbreak control, contact tracing, exclusion from education settings, clinical complications and avoidable use of NHS services. The programme is therefore best understood as an early intervention and health protection investment, rather than a short-term savings initiative.

The work is being sustained through integration into Blackpool’s wider vaccination and health protection partnership arrangements.

The approach also supports the wider role of the Health and Wellbeing Board and local system partners in encouraging integrated working between health, public health, children’s services and related local government functions.

• Coverage averages can hide risk: overall Blackpool coverage compares favourably with regional and national figures, but measles risk is driven by susceptible individuals and clusters. Local action needs to focus on missed doses and under-vaccinated groups, not just borough-level averages.
• Second-dose MMR needs particular attention: many families accept the first dose but do not complete the schedule. Second-dose catch-up is essential for full protection and should be a visible part of communications and delivery.
• Tone matters: non-judgemental message is critical. Families may have missed vaccination for many reasons, and blame-based communications risk increasing avoidance. The most effective message is: check, ask, catch up.
• Trusted places increase accessibility: Homes and Family Hubs and other community settings can reduce practical and psychological barriers. Taking vaccination closer to families supports equity and increases opportunities for conversation.
• Community delivery should complement primary care: outreach clinics are not a replacement for routine general practice vaccination. They work best when they support the GP programme and provide additional routes for families who might otherwise be missed.
• Data and relationships are equally important: data can identify need, but relationships make the response deliverable. The programme depended on operational collaboration between Public Health, NHS commissioners, FCMS, primary care and community partners.
• Vaccination is a whole-system public health function: although vaccine delivery is commissioned through NHS routes, local authorities have an important role in intelligence, convening, community engagement, inequalities work and trusted communications.

Dianne Draper, Consultant in Public Health, Blackpool Council

Email: [email protected]