Catherine Forward a Specialist Community Public Health Nurse and Lecturer talks to Country Child about how immunisations have changed and are changing. Are you up to date?
Last year saw a lot of changes to the UK’s immunisation schedule. Whilst some of these do not yet affect all children, it is important for all parents and carers to be aware of these changes which are being implemented by 2015/16. There were several changes to the baby schedule last year which included the introduction of an oral immunisation for Rotavirus as well as the removal of a dose of Meningitis C at 16 weeks. Instead, Meningitis C has now been added to the schedule for teenagers from January 2014 alongside the staged introduction of flu which began last year for 2-3 year olds.
Meningitis C Since its introduction to the UK immunisation programme in 1999, it is estimated that about 13,000 cases and 1,300 deaths have been prevented by the vaccine. (Public Health, 2013) Recent research into the MenC vaccination has shown that one dose of vaccine at around three months now provides sufficient protection to cover children until the booster dose at 12 to 13 months of age. Protection from the booster declines by the teenage years, and so the advice is now to administer a booster dose be given in early adolescence at the same time as the teenage tetanus, diphtheria and polio vaccine (Td/IPV) to extend protection later into life.
In 2012, the UK Government announced that it was going to offer free flu vaccinations to all 2-17 year olds. Children are the highest transmitters of infection of the population and whilst the elderly population and sick are most affected by flu, approximately 50 of the 600 deaths a year are children. The Chief Medical Officer, Prof Dame Sally Davies estimates that if there was a 30% update, this would reduce hospital admissions by 11, 000 and result in 2000 fewer deaths.
The aim of the universal flu programme in childhood is to prevent the symptoms and spread of infection of the influenza virus. More effective than the injectable, the use of a live nasal spray suspension Fluenz® is the vaccine of choice for all children including those with long-term conditions (diabetes, lung, or heart disease). Eligible adults continue to be offered the injectable.
Currently, all children aged 6 months and over who are in clinical risk groups should be offered seasonal flu immunisation. Last autumn, the nasal flu immunisation was offered to pre-school-aged children who were aged 2 years and 3 years on 1st September 2013. Seven pilot areas across the country have also delivered the immunisation to 4 to 10 year olds. Learning from these pilots will assist with the implementation of the full programme which intends to make the nasal flu vaccine part of the routine schedule for all 2 to 16 year olds by 2015/16. (Table 1)
When should children not have the flu vaccine?
Children should not have the nasal flu vaccine if they have severe asthma or active wheezing at the time of vaccination; have a weakened immune system; have egg allergy; are taking salicylate treatment (a painkiller used in conditions such as childhood rheumatoid arthritis) or are allergic to any of the vaccine ingredients, such as neomycin and gelatine. (NHS Choices, 2014).
As reported in the press, the Fluenz® nasal spray contains tiny amounts of pork gelatine. The NHS Choices website advises that this is ‘certified as acceptable by many faith groups including representatives from Jewish and Muslim communities’ although may still impact on a parent’s decision to give their child the vaccine or not. Gelatine is used to stabilise live viral vaccines and is contained in many pharmaceutical products, not just Fluenz®.
Where can I find out more?
The NHS Choices website contains comprehensive, detailed information about immunisations including how they work, the schedule and vaccine myths. Parents can also create online vaccination planners for their children and the information is also translated into other languages. As well as the NHS choices website and GP surgery, school nurses are also a useful source for information and advice about immunisations. Your school office can provide details of the NHS school nurse allocated to your child’s school.
Table 1 – Roll out plan for Childhood Influenza programme (Public Health England, 2013)
|2013/14||Routine 2 and 3 year olds and Pilot 4-10 years|
|2014/15||Routine 2-10 years and Pilot 11-16 years|
|2015/16||Routine 2-16 years|
Other Helpful sites to visit:
CHECK OUT THIS VACCINATION PLANNER HERE: NHS Choices: Immunisations http://www.nhs.uk/conditions/vaccinations/Pages/childhood-vaccination-schedule.aspx
Public Health England Resources: Influenza
Flu immunisation programme 2013 to 2014 https://www.gov.uk/government/publications/flu-immunisation-programme-2013-to-2014
Public Health England Resources: Meningitis C
Improving Protection Against Meningitis C A5 leaflet https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/223626/Improving_protection_against_meningitis_C_A5_leaflet.pdf