CHILDHOOD IMMUNISATION

What we know
What information do we have about the Eastern Board area?
What is the result of this on our health locally?
Policies
What is happening in the Eastern Board area?

 

Statistics
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Links
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Documents
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What we know

Childhood immunisation programmes are a major public health success story, with major causes of disease and death becoming uncommon due to vaccination.  To prevent recurrence of these diseases in the community it is essential to achieve uptake rates (herd immunity) of 90-95%. 

In September 2004 new vaccines were introduced to the childhood vaccine programme.  The main changes were:

                  Oral polio vaccine was replaced with inactivated polio, which was incorporated into a combined                            preparation.  This change was made possible by the eradication of wild polio infection in                                        Europe.  Inactivated polio vaccine carries no risk of vaccine-associated paralytic polio, which is a                           rare complication of receiving oral polio vaccine.

            The whole-cell pertussis component was replaced with an acellular pertussis component                                    which is as effective but causes fewer side effects.

            The opportunity was taken to move to newer vaccines which contain no thiomersal.

Similar vaccines to these new ones have been used in other countries with very good results.  Early indications here are that they are effective and that (mainly minor) side-effects have reduced, but they remain under special surveillance.

At present the national childhood immunisation routine schedule is as follows:

New Childhood Vaccine Schedule (from September 2004)

When to immunise

Diseases Vaccine Protects Against

How it is Given

2, 3 and 4 months old

Diphtheria, tetanus, acellular pertussis, inactivated polio and Hib

Tradename: Pediacel

(DTaP/IPV/Hib)

Meningitis C

One injection

 

 

One injection

Around 15 months old

Measles, mumps and rubella

One injection

3 to 5 years

ie Pre-school

Diphtheria, tetanus, acellular pertussis and inactivated polio

Tradenames:

Repevax (dTaP/IPV)

Infanrix-Hib (DTaP/IPV)

Measles, mumps and rubella

One injection

 

 

 

One injection

10 to 14 years old (and sometimes shortly after birth)

Tuberculosis (BCG vaccine)

Skin test, then one injection, if needed

 

14-18 years old

ie School-leaving

Tetanus, diphtheria and inactivated polio

Tradename: Revaxis (Td/IPV)

MMR if have not had two previous doses

One injection

 

One injection

In addition to the routine schedule, children at higher risk are offered Hepatitis B vaccination and BCG shortly after birth.

In 2003, because of concerns about the rising incidence of Haemophilus influenza type b infections, an additional dose of Hib vaccine was offered to all children aged 6 months to 4 years as a one-off campaign.  The effectiveness of this is being kept under review.

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What information do we have about the Eastern Board area?

Immunisations given to children are reported to the Child Health System, and uptake rates calculated.  These uptake rates are reported quarterly to the Communicable Disease Surveillance Centre (CDSCNI) which collates them on behalf of DHSSPS.  Uptake rates in the Eastern Board area for the primary course of vaccinations (Diphtheria, Pertussis, Tetanus, Hib, Men C and Polio) are above 90%.

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What is the result of this on our health locally?

Suspected cases of diphtheria, tetanus, polio, whooping cough, meningitis caused by Hib, and septicaemia/meningitis caused by Men C, are notified to the Director of Public Health. 

Notifications of Hib, Meningitis C, Whooping Cough, Diphtheria, Tetanus and Polio

 

2003

2004

HIB Total

3

2

Meningitis C Disease

0

1

Whooping cough

10

11

Diphtheria

0

0

Tetanus

0

0

Polio

0

0

Total

13

14

Source: CoSurv

Cases of meningococcal disease (meningitis and septicaemia) due to the Group C strain of the Neisseria meningitidis bug have decreased markedly since the introduction of Men C vaccine in 1999 (see Meningitis section of this website).

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Policies

Immunisation for children under school age is carried out in General Practice, supported by Trust staff, under new arrangements brought in by the new GMS contract.  Routine vaccination for those of school-age ie Heaf testing/BCG and school-leaving booster/MMR is carried out by school health staff employed by Trusts.

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What is happening in the Eastern Board area?

An information campaign was carried out in the Eastern Board for health professionals working in primary care at the time of the introduction of the new childhood vaccines.  This work complemented information packs issued by DHSSPS, including new leaflets designed by the Health Promotion Agency. 

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For further information on this topic please contact us at publichealth@ehssb.n-i.nhs.uk

Eastern Health and Social Services Board Champion House, 12-22 Linenhall Street, Belfast BT2 8BS Telephone: (028) 9032 1313 Fax: (028) 9055 3681 Text Phone:(028) 9032 4980 Website: www.ehssb.org E-mail: pr@ehssb.n-i.nhs.uk
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