Thousands of children face an increased risk of catching deadly measles in England, senior health officials have warned, as “very worrying” figures reveal MMR vaccine rates have fallen to their lowest level in a decade. The UK Health Security Agency (UKHSA) and the NHS will launch a joint appeal on Tuesday urging parents and guardians to ensure their children have had their measles, mumps and rubella (MMR) vaccines – as well as other routine jabs – before starting school. Since the start of the Covid-19 pandemic in March 2020, there has been “a significant drop” in the number of children getting MMR jabs and other childhood vaccines, UKHSA said. Between July and September last year, the most recent figures available, just 88.6% of children had had their first MMR dose by the age of two while only 85.5% had had both doses at the age of five. It means that more than one in 10 children aged five are not up to date with their two doses of MMR vaccine. The World Health Organization (WHO) says 95% of children need to be vaccinated to keep measles away. Measles is highly contagious so even a small decline in MMR uptake could lead to a rise in cases, UKHSA said. With international travel resuming, it is also more likely that measles will be brought in from countries that have higher levels of the disease. “Even a small drop in vaccine coverage can have a big impact on population immunity levels and lead to outbreaks,” said Dr Vanessa Saliba, a consultant epidemiologist at UKHSA. Measles can lead to complications such as ear infections, pneumonia, and inflammation of the brain, which require hospitalisation and on rare occasions can lead to long-term disability or even death. “It is very worrying that more than one in 10 children are not fully protected against measles by the time they start school,” said Prof Helen Bedford, professor of children’s health at the UCL Great Ormond Street Institute of Child Health. “There has been so much focus on Covid over the past two years, but we mustn’t forget about measles, which has not gone away.” All children are invited for their first MMR vaccine on the NHS aged one, with the second dose given when they are three years and four months. The NHS says it has continued to prioritise routine vaccinations throughout the pandemic. However, some parents whose children haven’t been vaccinated against MMR have said they didn’t realise the NHS was still offering appointments, or they didn’t want to burden the NHS, according to UKHSA. Separate research commissioned by the Department of Health and Social Care and UKHSA, conducted by Censuswide, shows many parents are unaware of the risks measles poses to their unvaccinated children. Of 2,000 parents and guardians of children aged five or under surveyed, almost half (48%) were unaware measles can lead to serious complications such as pneumonia and brain inflammation. Just four in 10 (38%) were aware that measles can be fatal. Dr Nikki Kanani, medical director for primary care at NHS England, said: “It is incredibly important that all parents and guardians ensure their child is up to date with their routine vaccinations, including MMR, as these vaccines give children crucial protection against serious and potentially deadly illnesses and stop outbreaks in the community. “If your child has missed a vaccination, please contact your GP practice to book an appointment as soon as you can to make sure they have maximum protection against disease.”