Immunisation protects people and communities from serious infectious diseases. In the UK there are a number of routine vaccinations that are offered.
Vaccination is particularly important for infants and young children, as their immune system is less well developed than in older children and adults. Vaccinations are quick, safe and extremely effective. Once a child has been vaccinated against a disease, their body can fight it more effectively.
As well as the individual being protected themselves, vaccinated people are also less likely to be a source of infection to others. This reduces the risk of unvaccinated people being exposed to infection, this means that an individual who cannot be vaccinated will still benefit from the routine vaccination programme. Therefore immunisations are a highly effective way of maintaining the health of the population by reducing the occurrence of infectious diseases.
This concept is called population or “herd” immunity. For example, babies below the age of two months, who are too young to be immunised, are at greater risk of dying if they catch whooping cough. These babies are protected because other people , including their siblings have been routinely immunised as part of the childhood immunisation programme.
When vaccine coverage is high enough to provide high levels of population immunity, infections may even be eliminated from the country, for example: diphtheria. However, if high vaccination coverage is not maintained, it may be possible for the disease to return.
Immunisations are commissioned by the NHS England Area Team, from General Practices and other providers. The role of local Public Health is to monitor and scrutinise the delivery of the vaccination programmes. Local Public Health also gives assurance to the Health and Wellbeing board on how these programmes are being delivered to the local communities.
Uptake of childhood vaccinations in Slough is lower than the national target of 95%. While the rate of vaccinations in those under one is improving and approaching the target, vaccination rate for those aged two to five remains poor.
|Vaccination||Measured||Target||Slough value||England average||DOT|
|Three doses of Diptheria Tetanus Pertussis Polio Hib||By age 1||>95%||94.4%||94.2%||↑|
|Three doses of Pneumococcal (PCV)||By age 2||>95%||88.6%||↔|
|Hib/Men C booster||By age 2||>95%||88.2%||92.1%||↓|
|MMR first dose||By age 2||>95%||88.3%||92.3%||↓|
|MMR second dose||By age 5||>95%||82.2%||88.6%||↔|
|Diptheria Tetanus Pertussis Polio Hib booster||By age 5||>95%||81.7%||88.5%||↔|
Hepatitis B and BCG vaccines are offered to children at high risk of exposure, while chickenpox vaccine is offered to the siblings of children with suppressed immune system. Data from 2013/14 shows that 100% of at risk children in Slough correctly received their Hepatitis B vaccination.
The online Green Book has the latest information on vaccines and vaccination procedures for all the vaccine preventable infectious diseases that may occur in the UK.
The immunisationschedule comprises the recommended universal or routine immunisations which are offered to all children and young people, as well as selective immunisations which are targeted to children who are at higher risk from certain diseases.
NHS England South Central is developing a plan which involves working together with local stakeholders to improve immunisation coverage across Berkshire for the under 5’s age group, this includes MMR. Part of the plan will be to ensure that data is robust toto give an accurate picture of the actual coverage, along with supporting GP practices to improve their immunisation uptakes.
Work is continuing in all areas across Berkshire to increase the uptake of the second MMR injections. The NHS England South Central screening and immunisation team are regularly identifying those GP practices with low uptake and work with the local Child Health Information System (CHIS) team and relevant practices to increase uptake and improve data robustness.
The Berkshire School Health Nursing service is commissioned to catch up children with missing MMR dose 1, 2 or both during school based immunisation sessions.Enhanced outreach work is being undertaken in partnership with the Oxford AHSN in targeted practices and early years setting. A faith group led promotion of flu vaccine uptake, especially targeted at children is still underway.
In Berkshire, we are not achieving the national uptake target of 95% for any of the childhood vaccines. Slough has the lowest uptake among the six Berkshire Unitary Authorities, particularly for MMR. Though the number of measles cases has not increased in recent years, there is a potential for an outbreak.
Evidence has shown that the following groups of children and young people are at risk of not being fully immunised:
As illustrated above, there remains a significant proportion of two and five year olds in Slough who are not receiving the recommended vaccinations and so are less protected against infectious diseases than other children in the borough.
From what we know about children who are not fully immunised, they are more likely to have other vulnerabilities and so reaching and protecting this cohort is important.