Childhood immunisations

Introduction

Immunisations reduce the occurrence of infectious diseases by protecting individuals from contracting them and spreading them to others. Vaccination coverage is the best indicator of the level of protection a population will have against vaccine preventable communicable diseases. This is highlighted in the World Health Organisation YouTube video infographic:

 YouTube video link

Babies below the age of two months who are too young to be immunised are particularly vulnerable to whooping cough. These babies are protected because other children, including their siblings have been routinely immunised as part of the childhood immunisation programme and by the maternal pertussis vaccination programme which provides immunisation prior to birth.

When vaccine coverage is high enough to provide high levels of population immunity, infections may even be eliminated, e.g. diphtheria. However, if high vaccination coverage is not maintained, diseases can return.

Immunisations are commissioned by the National Health Service (NHS) England Local Area Team, from GPs and other providers. The role of local public health is to monitor and scrutinise the delivery of the vaccination programmes. Local public health teams also gives assurance to the Health and Wellbeing Board for their area on the how these programmes are being delivered to the local communities.

Key inequalities and risk factors

NICE guidance sets out various reasons why children and young people might not be up-to-date with their vaccinations:

  • logistical difficulties associated with large families
  • children, young people and their families who are homeless, asylum seekers or drug users (or whose parents are drug users)
  • services not accessible to children from minority ethnic groups and those whose first language is not English
  • children, young people and their families who may be in contact with children's services and other health services but not necessarily immunisation services, e.g. young offenders, those in the care of child and adolescent mental health services and looked after children

Public health inequalities data consistently shows deprivation as a key factor in lower levels of vaccination and immunisation.

Facts, figures and trends

The World Health Organisation 95% target for vaccination coverage has been adopted by the Department of Health for UK routine childhood vaccination programmes, with at least 90% coverage in each local authority area.

DTaP/IPV/Hib

The combined DTaP/IPV/Hib is the first in a course of vaccines offered to babies to protect them against diphtheria, pertussis (whooping cough), tetanus, haemophilus influenzae type b (an important cause of childhood meningitis and pneumonia) and polio (IPV is inactivated polio vaccine).

In 2014/15, the number of Bracknell Forest children who had received the diphtheria, tetanus and pertussis (DtaP)/polio (IPV) and haemophilus influenzae type b (Hib) vaccine at the age of 12 months was 1,421 (94.7%) and above the 90% minimum coverage threshold.  Bracknell Forest performs well against the vaccination rates for both the south east and England:

Maternal Pertussis

Infants less than three months old are particularly vulnerable to whooping cough. The maternal pertussis vaccination programme - immunisation prior to birth - has been highly effective at preventing cases and deaths from pertussis in infants.

From 1 April 2016, immunisation will take place from week 16 of pregnancy (previously 28 weeks) following a recent study that showed that maternal immunisation against pertussis in the second trimester significantly increased neonatal antibodies. In practice, the most appropriate time to offer pertussis immunisation will be after the foetal anomaly scan, (also known as the 20-week scan) which usually takes place between 18 and 20 weeks gestation although pertussis immunisation can be offered at any time after the scan.  Uptake data at Public Health England Regional Centre Level is reported from April 2014 onwards and available from Gov.UK.

Hib/MenC

Haemophilus influenzae type b (Hib) and meningitis C infections are serious and potentially fatal. They can both cause meningitis and septicaemia (blood poisoning). The number of children who had received the Hib/MenC vaccine by 2 years of age was 1,431 (91.5%) and above the 90% minimum coverage threshold.  Higher levels of deprivation are linked to reduced take up:

Pneumococcal (PCV) booster

The PCV vaccine protects against pneumococcal infections that can cause pneumonia, septicaemia or meningitis.  The number of children who had received the pneumococcal (PCV) booster vaccine by 2 years of age was 1,430 (91.4%) and above the 90% minimum coverage threshold:

For the number of children who received the booster by 5 years of age, please visit the immunisation and vaccination section of the Developing Well chapter.

MMR

MMR is the combined vaccine that protects against measles, mumps and rubella. Measles, mumps and rubella are highly infectious, common conditions that can have serious complications, including meningitis, swelling of the brain (encephalitis) and deafness. They can also lead to complications in pregnancy that affect the unborn baby and can lead to miscarriage.

The number of children who had received the first dose of the measles, mumps and rubella (MMR) vaccine by 2 years of age was 1,436 (91.8%) and above the 90% minimum coverage threshold. Higher levels of deprivation are linked to reduced take up: 

For the number of children who received two doses of the vaccine by the age of 5 years, visit the immunisation and vaccination section of the Developing Well chapter.

Want to know more?

Complete immunisation schedule - the ages of when the vaccines should be given.

Dynamic Report for Bracknell Forest (National Child and Maternal Health Intelligence Network) – gives high level statistical data and analysis on vaccination coverage.

Health Matters: Giving every child the best start in life (accessed 8 June 2016) is a resource for parents and professionals using or commissioning services, which brings together important facts, figures and evidence of effective interventions to tackle issues arising in the period from pregnancy to the age of two.

Immunisation against Infectious Diseases ( “Green Book”) - explains how the immunisation program has developed and has the latest information on vaccines and vaccination procedures for all the vaccine preventable infectious diseases that may occur in the UK.

Immunisations: reducing differences in uptake in under 19s (NICE, 2009) – guidance to support increase in immunisation uptake among those aged under 19 years from groups where uptake is low.

Public Health Outcomes Framework – an aggregate of data and performance measures relating to immunisation and vaccinations.

Vaccine Update (Public Health England) - a regular newsletter describing the latest developments in vaccines, and vaccination policies and procedures.  Also available direct to your inbox throuh online subscription.

NHS Vaccination planner

Go to NHS Choices homepage

 

This page was created in February 2014 and last updated on 16 June 2016. Next review due November 2016.

Cite this page:

Bracknell Forest Council. (2016). JSNA – Immunisation and Vaccination (0-4 years). Available at: jsna.bracknell-forest.gov.uk/starting-well/0-4-years-age/immunisation-and-vaccination-0-4-years (Accessed: dd Mmmm yyyy.)

 

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