13th August 2026
There is a generation in Scotland for whom measles, mumps, whooping cough and chickenpox were simply part of childhood.
Some children were seriously ill. Some ended up in hospital. And some diseases that are now largely forgotten could cause permanent disability or even death.
Today, vaccination has transformed that picture. We tend to notice vaccinations when there is a controversy, a new programme or an outbreak of disease. What we notice much less often is the enormous number of illnesses that simply do not happen because people have been vaccinated.
Scotland's vaccination programme is therefore one of the quieter successes of modern public health. But the latest figures also contain a warning: maintaining that success cannot be taken for granted.
Scotland still has remarkably high vaccination rates
The latest Public Health Scotland figures show that most Scottish children continue to receive their routine vaccinations.
For example, among children reaching the relevant age, more than nine in ten receive vaccines protecting them against diseases including diphtheria, tetanus, whooping cough, polio, meningitis, pneumococcal disease and rotavirus.
MMR vaccination remains particularly important because measles is extraordinarily infectious.
The latest figures show that 92.1% of Scottish children had received their first MMR dose by 24 months, rising to 95.4% by age five.
However, the second dose tells a different story. Only 89.7% had received the second dose by age five, rising to 90.0% by age six.
Those numbers may still look impressive, but they matter because vaccination programmes work best when coverage is consistently very high across the whole population.
Measles provides the warning
The importance of maintaining vaccination rates can be seen in the return of measles cases.
As of 22 July 2026, Scotland had recorded 13 laboratory-confirmed measles cases during 2026. There were 28 cases in 2025 and 24 in 2024.
That is not a public-health catastrophe. In fact, compared with the number of people living in Scotland, the numbers are small.
But that is precisely the point.
Vaccination has made diseases such as measles sufficiently uncommon that people can forget just how serious they can be. Once vaccination coverage falls far enough, however, diseases that seemed to belong to the past can begin to return.
The success of vaccination can therefore create its own paradox: the better vaccination works, the easier it becomes to forget why it was necessary in the first place.
Scotland is changing its vaccination programme
Vaccination is not standing still.
From January 2026, Scotland changed its routine childhood programme so that the combined MMRV vaccine protects against measles, mumps, rubella and chickenpox. It replaced MMR in the routine programme.
This is significant because chickenpox is often regarded as an unavoidable childhood illness.
For many children it is relatively mild. But it is not always harmless, particularly for vulnerable people.
The Scottish programme is therefore increasingly about preventing a wider range of diseases rather than simply responding to the illnesses that people traditionally associate with childhood.
The vaccination programme now follows us throughout life
Perhaps one of the biggest changes is that vaccination is no longer something that happens mainly in childhood.
Scotland now has vaccination programmes covering pregnancy, babies, children, teenagers, working-age adults and older people.
One particularly important development is the RSV vaccination programme.
Scotland launched its RSV programme in 2024. For people turning 75 between August 2025 and July 2026, 36,043 RSV vaccinations were administered, giving an uptake rate of 68.8%.
The programme has subsequently been expanded. From 2026, the offer includes all adults aged 75 and over, care-home residents and certain additional groups. RSV vaccination is also offered during pregnancy to help protect newborn babies.
This is an excellent example of how modern vaccination policy is changing.
Instead of waiting for vulnerable people to become seriously ill, the NHS increasingly tries to prevent serious illness before it happens.
And then there is influenza and COVID
The same principle applies to seasonal respiratory infections.
During the spring 2026 COVID-19 vaccination programme, uptake among people aged 75 and over was 65.9%, compared with 75.9% among older care-home residents. Uptake among people with a weakened immune system was lower, at 41.1%.
These figures demonstrate another important lesson.
A vaccination programme can be scientifically successful while still having difficulty reaching everybody who could benefit from it.
The question is therefore no longer simply:
"Does the vaccine work?"
It is also:
"Can we persuade, inform and enable enough people to receive it?"
The real warning sign is inequality
This may be the most important part of the Scottish story.
Overall vaccination figures can look reassuring while hiding substantial differences between communities.
Public Health Scotland has identified differences in vaccination uptake associated with deprivation and other demographic factors. The result is that some Scottish children are considerably less likely to receive full protection than others.
That changes the nature of the problem.
It is tempting to describe lower vaccination rates simply as a matter of individual choice.
But a parent who misses an appointment because of work, transport difficulties, childcare problems, poor access to information or difficulty navigating NHS services is facing a different problem from somebody who deliberately refuses vaccination.
For rural Scotland there is an additional question.
Does living a long distance from services make it harder for some families to keep up with vaccination appointments?
That is why national averages do not tell the whole story.
We should be careful about blaming parents
There is also a lesson here for how vaccination is discussed.
The answer to declining uptake is unlikely to be simply telling people that they are wrong.
Public Health Scotland's recent childhood vaccination campaign is called "One less thing to worry about". The message recognises that being a parent can already be overwhelming and presents vaccination as something that removes one potential worry rather than creating another.
That is a sensible approach.
People need accurate information, but they also need accessible services and confidence that the health system is acting in their interests.
The vaccination debate can too easily become a battle between "pro-vaccine" and "anti-vaccine" camps.
Public health needs something more practical: high levels of trust, good information and easy access to vaccination.
There is a lesson for older generations
For people of an older generation, there is perhaps a particularly powerful way of looking at this.
You remember diseases that younger generations may never have encountered.
We remember children being off school with measles. We remember mumps. We remember whooping cough. We remember the concern surrounding German measles and the consequences it could have for unborn children.
And remember that there was no internet to search for every possible side effect or frightening story.
Information was provided largely by doctors, nurses, schools, newspapers and public-health campaigns.
Today we have vastly more information available.
But having more information does not necessarily mean having better information.
A frightening story shared thousands of times online can appear more convincing than decades of carefully collected medical evidence.
That creates one of the biggest challenges facing vaccination programmes today.
Vaccination is a victim of its own success
Perhaps the best way to explain the problem is this:
Vaccines have been so successful that many people have never seen the diseases they prevent.
That changes perceptions of risk.
A parent may look at the small possibility of a vaccine side effect and compare it with a disease they have never seen.
But that comparison can be misleading.
The reason the disease seems so unlikely is partly because previous generations were vaccinated.
The protection has become invisible.
This is why outbreaks such as measles are important. They remind society that infectious diseases have not disappeared. They have simply been pushed back.
Scotland's vaccination programme is becoming more sophisticated
There is also plenty of good news.
Scotland is not simply maintaining the old vaccination programme. It is adapting it.
The introduction of MMRV, the expansion of RSV vaccination and targeted programmes such as MenB vaccination for eligible young people demonstrate how vaccination policy is evolving as medical knowledge changes.
The Scottish Government and Public Health Scotland are also monitoring uptake and disease levels rather than assuming that yesterday's success will automatically continue tomorrow.
That is exactly what a successful public-health system should do.
The real challenge is maintaining trust
The Scottish vaccination story is therefore neither a story of failure nor one of complete success.
It is a story of remarkable achievement combined with a warning about complacency.
More than nine out of ten Scottish children receiving most routine vaccinations is an extraordinary public-health achievement.
But when second-dose MMR coverage is below 90%, measles cases continue to occur and significant differences exist between communities, there is little room for complacency.
The objective should not be to frighten people into vaccination.
It should be to make vaccination so accessible, understandable and trusted that most people see it as the obvious thing to do.
That is particularly important now because Scotland is entering an era in which vaccination is no longer simply about protecting children from diseases their grandparents remember.
It is becoming a lifelong form of preventive healthcare.
And perhaps that is the quiet success story we should be talking about.
Vaccination has changed what childhood looks like in Scotland.
The challenge now is making sure that the next generation understands why.