Immunisation Horizon Scanning Volume 3 Issue 3

The school nurse, the school and HPV vaccination: A qualitative study of factors affecting HPV vaccine uptake

Source: Vaccine, 2011 Feb 26. [Epub ahead of print]

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Date of publication: February 2011

Publication Type: Journal Article

In a nutshell: School nurses in the United Kingdom are largely responsible for delivering the human papillomavirus (HPV) vaccine to 12–13 year old girls. In order to assess the impact of HPV vaccination on school nurses’ roles, we gave a questionnaire to all 33 school nurses who offered Cervarix ™ in two Primary Care Trusts one year ahead of the national vaccine programme. Key organisational issues raised by the school nurses were the size of the team and its skill mix. A few found their schools uncooperative and were dissatisfied with mechanisms for problem resolution. On average, nurses spent an additional 69 h (0.80 h per child) on vaccine-related activities. In semi-qualitative interviews (n = 17), school nurses complained of work overload and described the difficulties of establishing good relationships with some of their schools. Nurses expected schools to take some responsibility for ensuring good uptake and were frustrated when help was not forthcoming. We conclude that variation in uptake between schools in part reflects a difficult relationship with the school nurse which may be attributed to characteristics of the school, schools’ attitudes towards health interventions, organisational problems, multiple school nurse roles and/or personal ability. Some of these issues will need to be addressed to ensure continued high vaccine coverage as HPV vaccination becomes a less prioritised, routine activity. Keywords: HPV vaccination; School nurses; Schools; Workload; Roles

Length of publication: Unknown

Human papillomavirus vaccination and social inequality: results from a prospective cohort study

Source: Epidemiology and Infection, 2011 Mar;139(3):400-5. Epub 2010 Mar 25.

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Date of publication: March 2011

Publication Type: Journal Article

In a nutshell: We investigated the effect of social inequalities on the uptake of human papillomavirus (HPV) vaccination, combining data from a feasibility study conducted in 2007-2008 in 2817 secondary schoolgirls in two UK primary-care trusts, with census and child health records. Uptake was significantly lower in more deprived areas (P<0·001) and in ethnic minority girls (P=0·013). The relatively small proportion of parents who actively refused vaccination by returning a negative consent form were more likely to come from more advantaged areas (P<0·001). Non-responding parents were from more deprived (P<0·001) and ethnic minority (P=0·001) backgrounds. Girls who did not receive HPV vaccination were less likely to have received all their childhood immunizations particularly measles, mumps and rubella (MMR). Different approaches may be needed to maximize HPV vaccine uptake in engaged and non-responding parents, including ethnic-specific approaches for non-responders.

Length of publication: 5-page article

Challenges for development of meningococcal vaccines in infants and children

Source: Expert Review of Vaccines, 2011 Mar;10(3):335-43.

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Date of publication: March 2011

Publication Type: Journal Article

In a nutshell: Neisseria meningitidis causes significant disease in the form of severe sepsis syndrome or meningococcal meningitis. Owing to the susceptibility of the immune system in early life, the risk of disease after infection is significantly higher in infants. Thus far, vaccines targeted against meningococcal serogroups have struggled to provide lasting protection in young children. Even conjugate vaccines that are now routinely used in the immunization of infants require multiple dosing and the duration of protection has been shown to wane over time and require repeated booster doses. After briefly summarizing the current epidemiology according to age and serogroup, this article will consider the reasons for poor immunogenicity of vaccines in infants and will discuss the relative efficacy of the different vaccine types in this age group. It will then go on to consider strategies for optimizing the protection of infants against meningococcal disease.

Length of publication: 8-page article

Mumps outbreaks in four universities in the North West of England: Prevention, detection and response

Source: Vaccine, Article in press, Uncorrected proof, Available online 27 March

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Date of publication: March 2011

Publication Type: Journal Article

In a nutshell: Evidence suggests that primary and secondary vaccine failure have contributed to recent university-based mumps outbreaks. We describe the epidemiology and public health management of two such outbreaks that occurred simultaneously in two areas of the North West of England, affecting four universities, using data from routine surveillance, serology testing, and telephone interviews and electronic questionnaires. Vaccination status was obtained from GP records. Cases were predominantly first year students living in university halls of residence. Public health response involved active surveillance, isolation advice and targeted vaccination clinics. Many students lack natural immunity and mumps vaccination. Factors hindering the public health response include delayed notifications, inability to readily define the ‘at risk’ population, low vaccine uptake, and lack of an evidence-based, cost effective strategy. Keywords: Mumps; Outbreak; University students; MMR; Vaccine; Prevention; Control

Length of publication: Unknown

Call to vaccinate against possible H2N2 flu pandemic

Source: BBC News

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Date of publication: March 2011

Publication Type: News-Item

In a nutshell: Governments should launch a vaccination programme now to guard against a possible H2N2 flu pandemic, according to an article in the journal Nature.

Length of publication: 1-page news-item

Incidence and clearance of genital human papillomavirus infection in men (HIM): a cohort study

Source: The Lancet, 377 (9769): 932 – 940, 12 March 2011

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Date of publication: March 2011

Publication Type: Journal Article

In a nutshell: Background: Human papillomaviruses (HPVs) cause genital warts and cancers in men. The natural history of HPV infection in men is largely unknown, and that information is needed to inform prevention strategies. The goal in this study was to estimate incidence and clearance of type-specific genital HPV infection in men, and to assess the associated factors. Interpretation: The data from this study are useful for the development of realistic cost-effectiveness models for male HPV vaccination internationally.

Length of publication: Unknown

Also see: Story in Nursing Times “Call for boys to get HPV vaccine”

Mumps: an overview of the diagnosis and complications

Source: British Journal of School Nursing, 6(2): 73 – 76 (Mar 2011)

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Date of publication: March 2011

Publication Type: Journal Article

In a nutshell: Despite the MMR vaccine programme and a dip in cases, mumps still occurs in non-immunized children and young people. Mumps is a notifiable disease and it is important that school nurses are aware of its presentation.

Length of publication: 4-page article

Effectiveness of influenza vaccination in the UK

Source: Eurosurveillance

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Date of publication: February 2011

 Publication Type: Article

In a nutshell: This study provides mid-season estimates of the effectiveness of 2010/11 trivalent influenza vaccine and previous vaccination with monovalent influenza A(H1N1)2009 vaccine in preventing confirmed influenza A(H1N1)2009 infection in the United Kingdom in the 2010/11 season. The adjusted vaccine effectiveness was 34% (95% CI: -10 – 60%) if vaccinated only with monovalent vaccine in the 2009/10 season; 46% (95% CI: 7 – 69%) if vaccinated only with trivalent influenza vaccine in the 2010/11 season and 63% (95% CI: 37 – 78%) if vaccinated in both seasons.

Length of publication: 6-page document

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