Search

Table of contents

The level of need in the population

Background papers: children :: Immunisations and vaccinations [Update in progress] :: The level of need in the population

COVER (Cover of Vaccination Evaluated Rapidly)

The COVER programme monitors immunisation coverage data for children in the United Kingdom who reach their first, second or fifth birthday during each evaluation quarter. This is a mandatory collection at a local level which is then collated nationally and comparators are made available. Historically in Medway vaccination uptake rates in children have been high. In 2010/11 they were above those achieved in England and within the South East Coast Strategic Health Authority (SEC SHA) area for all childhood immunisations, exceeding the 90% level in all and the 95% level in several. However, analysis at practice level (link to APHR 2011/12) has shown considerable variation, which needs further investigation and action.

The following tables show the most recent COVER data for Medway and comparators where available.

Table 1: Percentage of children immunised by their first birthday, by PCT 2010–11
Table 1: Percentage of children immunised by their first birthday, by PCT 2010–11.[1]
Table 2: Percentage of children immunised by their second birthday, by PCT 2010–11
Table 2: Percentage of children immunised by their second birthday, by PCT 2010–11.[1]
Table 3: Percentage of children immunised by their fifth birthday, by PCT 2010–11
Table 3: Percentage of children immunised by their fifth birthday, by PCT 2010–11.[1]
Key to tables 1 to 3
Key to tables 1 to 3

Hepatitis B vaccine uptake

In 2010/11, 81.3% of babies of mothers with Hepatitis B infection (13 of 16), in Medway, had received three doses of Hepatitis B vaccine before reaching their 1st birthday, but only 40% had received four doses before their 2nd birthday (four of 10).

  Denominator 1 Percentage coverage at 12 months Denominator 2 Percentage coverage at 24 months
Apr - Jun 2011 4 100 6 50
Jul - Sep 2011 7 71 3 66
Table 4: Number and percentage of children given Hepatitis B vaccination.[2]

The BCG (Bacilus Calmette–Guérin) programme

Until 2005, all children aged 10–14 were offered a tuberculin skin test in school to see whether they had immunity against TB and then BCG vaccination if they had not. This ceased following a continued decline in TB rates in the indigenous UK population.

The BCG programme is now a risk based programme. BCG vaccination should be offered in the neonatal period to all infants (0–12 months) living in areas of the UK where the annual incidence of TB is 40 per 100,000 or greater. In areas with lower incidence (fewer than 40 cases of TB per 100,000 population) like Medway, BCG is offered selectively to infants at increased risk due to having a parent or grandparent who was born in a country where the annual incidence of TB is 40 per 100,000 or greater.

Neonatal BCG is offered via the chest clinic with referrals from both midwives and health visitors.

BCG should also be offered to previously unvaccinated older children who were born, or have lived for at least 3 months, in a country where the annual incidence of TB is 40 per 100,000 or greater or who have a parent or grandparent who was born in such a country. Children over 6 years of age require tuberculin testing prior to vaccination.[3] The number of children and adults who have received BCG vaccination via the chest clinic is shown in Table 6.

2008/09 2009/10 2010/11
All ages Age under 1 Age 1 and over All ages Age under 1 Age 1 and over All ages Age under 1 Age 1 and over
Medway 582 321 261 560 339 221 447 292 155
South East Coast 12,761 7,988 4,773 11,986 9,383 2,603 6,727 5,547 1,180
England 239,241 148,948 90,293 223,167 115,611 67,556 225,316 153,253 72,063
Table 5: The number of BCG vaccinations per 1,000 population over the past 3 years in Medway compared to SEC SHA and England.[1][4]

In 2005 when the changes occurred, Kent and Medway PCTs decided to screen in Year 9 via a questionnaire and then offer Mantoux testing followed by BCG vaccination by school nurses to those found to be at high risk.

The HPV (Human Papillomavirus) programme

This was first introduced in the school year 2008/09 and is made available to girls in school year 8. A catch up programme for older girls also occurred. The type of HPV vaccine used will change in 2012/13 to one that also protects against genital warts.

Figure 1: Uptake of HPV vaccination in school year 8, past 3 years in Medway by date of birth
Figure 1: Uptake of HPV vaccination in school year 8, past 3 years in Medway by date of birth.[4]

School leaving booster

In Medway the school leaving booster is offered to young people in school in year 10, which is the school year when they are or become 15 years of age, with catch up via GP practices. Table 7 shows in addition that MMR continues to be offered by GP practices to those children who have not had both doses earlier in life.

2008/09 2009/10 2010/11
Number of children DT/IPV reinforcing doses Courses of MMR completed Number of children DT/IPV reinforcing doses Courses of MMR completed Number of children DT/IPV reinforcing doses Courses of MMR completed
13 3,551 10 3 3,657 9 12 3,567 8 17
14 3,716 28 5 3,582 815 10 3,669 50 18
15 3,594 2,137 17 3,819 1,990 15 3,876 2,474 35
16 3,696 41 9 3,983 1,133 19 3,892 35 29
17 3,903 7 1 3,851 11 13 3,983 15 67
18 3,916 5 2 4,002 5 22 4,048 15 62
Total 22,376 2,228 37 22,894 3,963 91 23,035 2,597 228
Table 6: Immunisations given to school leavers and other children aged 13–18 in the academic year 2010/11.[4]

References

[1]   The NHS Information Centre for Health and Social Care. NHS Immunisation Statistics, England 2010-11 http://www.ic.nhs.uk/statistics-and-data-collections/health-and-lifestyles/immunisation/nhs-immunisation-statistics-england-2010-11
[2]   Public Health England. Quarterly Vaccine Coverage Data Tables
[3]   Department of Health. Immunisation against infectious disease. Update to chapter 32. Tuberculosis 2007;: 397.
[4]   Child Health Records Department.