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Part of: Infectious Diseases and Pandemics

Related to: Sexual Health, Respiratory Infections, Cervical Cancer, Wellbeing, Children and Young People

Key Facts:

  • Overall vaccination rates for childhood vaccinations are better than regional and national rates.
  • MMR Vaccination coverage in B&NES is good and better than nationally, but still lower than recommended targets (95%). It was 94%  in 2013/14 for the first dose and 92% for the second dose.
  • Whooping cough vaccinations amongst pregnant women are low, at 40%.
  • 60% of respondents to the 2015 Voicebox Resident Survey said they were in one of the groups eligible for the free flu vaccination last winter.
  • 78% of respondents to the 2015 Voicebox Resident Survey who said they were eligible for the free flu vaccination chose to have it.

MMR- Infographic

Childhood Vaccinations

Unicef’s 2013 immunisation rates in rich countries comparative overview 1

In Unicef’s 2013 immunisation rates (average vaccination coverage for measles, polio and DPT3) in rich countries comparative overview, Unicef compares 29 of the world’s most advanced economies.

Routine immunization rates in the developed nations are generally maintained at high levels, averaging close to 95%. The relatively small differences between countries can therefore be said to reflect a commitment to the ideal of reaching out to every single child, including the most marginalised, with an essential preventive health service to which all children have a right.

According to Unicef’s report, in the UK there is on average a 96% immunisation coverage for measles, polio and DPT3 for children aged 12 to 23 months.  This is mid table of the 29 countries.  Greece and Hungary head the table with 99% immunisation coverage. Three of the richest countries in the OECD – Austria,Canada and Denmark – are the only countries in which the immunisation rate falls below 90%.

It is important to note that one of the limitations of these league tables is that internationally comparable data on children’s lives is not sufficiently timely. Between the collection of data in a wide variety of different settings and their publication in quality-controlled, internationally comparable form, the time-lag is typically two to three years. This means that most of the statistics on child well-being used in this report, though based on the latest available data, apply to the period 2009–2010.

Bath and North East Somerset 2

MMR

Nationally MMR vaccination coverage was 92.7 % in 2013/14, the highest it has been since 1997/98 but still below the WHO target of at least 95% coverage 3  4  

In B&NES rates are better than national rates and  have also increased, from 84% in 2001/02 to 94%  (1,862 children) in 2013/14 for the first dose by the age of two, and from 78% to 92% for the second dose by the age of five. However, rates are still below the national target of 95% 5 6   

In the South West, there were 118 laboratory confirmed cases of measles in young people aged 19 and under in 2013/14. 7   

Vaccinations are now delivered by practice nurses rather than health visitors 8

There are considerable variation in uptake rates between practices - lowest 71% uptake rate of 2 doses by 5th birthday compared to highest of 92% (Hope House Surgery) 9

The 2013 measles outbreaks in Wales and North East England 10 have prompted over 500 people to have catch up vaccinations and it is likely that this will also prompt some people in B&NES to vaccinate their children with a possible increase in vaccination coverage in the next quarter.

In 2013 estimates suggested that up to 1 in 12 children (approximately 1400) were still not vaccinated against measles 11

Pertussis (Whooping Cough)

Whooping cough is a highly contagious infection of the lungs that can have serious complications in young children or babies. Higher numbers of cases occur in 3-4 year cycles and 2012 was expected to be a peak year but has been significantly higher than the previous peak year (2008).
 
Up to the end of October 2012 there have been 7728 laboratory confirmed cases of Pertussis in the UK. This is ten times higher than the whole year for 2008. 13 babies have died so far in 2012 and whilst babies are routinely vaccinated for pertussis at 2 months, an emergency vaccination programme for pregnant women has been established to cover the time straight from birth. 12
 
95 pregnant women had the vaccination in B&NES during the first month of the campaign, this is 42% of eligible pregnant women and is slightly lower than the national rate of 44%. In November B&NES vaccinations dropped slightly to 40.2% of eligible women. 13

Dtap / IPV / Hib  14  15

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 2013/14 in B&NES 1,916 2 year olds were given the DTaP/IPV/Hib vaccination, a coverage of 96.9%. The coverage of the DTaP/IPV/Hib vaccination for 2 year olds in the South West was 97.4%, and 96.1% in England.

HPV

85.4% 12-13yr old females in B&NES received all three doses of HPV vaccine in 2011/12.

Looked After Children (Children in Care) immunisations 16   

In B&NES 95% of children looked after continuously for at least 12 months as at 31st March 2014  (excluding those children in respite care) had their immunisations up-to-date according to their age. This coverage was higher than the England avverage of 87.1%.

What does the community say?

Voicebox Resident Survey - Questions about Flu Vaccination uptake 17

The large scale Voicebox Resident Survey aims to provide an insight into Bath and North East Somerset and its local communities and to capture resident’s views on their local area and council services.

In 2015 the questionnaires were posted to 3,650 addresses selected randomly in the local authority area, and a total of 1,067 residents completed it, a response rate of 29%.

The 2015 Voicebox Survey asked residents about:

  • Groups eligible for the free NHS flu vaccination
  • How people found out they were eligible for the free flu vaccination
  • People who were eligible for the free flu vaccination who chose to have it
  • Reasons people chose not to to have the free flu vaccination
  • What would make people more likely to have the free flu vaccination in the future

Groups eligible for the free NHS flu vaccination

When respondents were asked whether they were in one of the groups eligible for a flu vaccination last winter...

How people found out they were eligible for the free flu vaccination

When people were asked how they found out they were eligible for the flu vaccination...

People who were eligible for the free flu vaccination who chose to have it

When those that said they were eligible for the free NHS flu vaccination were asked if they chose to have it...

Reasons people chose not to to have the free flu vaccination

Of those who were eligible to have a free flu vaccination but chose not to have the flu vaccination, 39% chose not to have the vaccination because they do not usually get flu and 32% outlined another reason for not choosing to have the vaccination, these included: 

  • negative previous experience of the vaccination
  • and that they were advised not to have it due to conflicting medical conditions.

25% were worried about side effects of the vaccination.

What would make people more likely to have the free flu vaccination in the future
When those respondents that said they were eligible for a free flu vaccination but chose not to have the vaccination were asked what would make them more likely to have a flu vaccination in the future...
Each of the following were identified by less than 10% of these respondents as things which would make them more likely to have the vaccination in the future:
  • weekend appointments
  • Clinics in other venues
  • more publicity about the flu vaccination