Immunisation Horizon Scanning Bulletin Volume 2 Issue 6

July 14, 2010
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Telephone and internet surveys will improve estimates of flu incidence, experts say

July 6, 2010

Source: British Medical Journal, 2010; 340: c3379

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Date of publication: June 2010

Publication Type: News Item

In a nutshell: Experts have admitted that accurate predictions of the incidence of the H1N1 flu pandemic in the United Kingdom proved a near impossible challenge.  Huge discrepancies existed between the data collected by different organisations, they said. For example, the Royal College of General Practitioners reported far fewer confirmed cases of H1N1 flu than Flu Watch, a national cohort study of flu transmission and immunity (www.fluwatch.co.uk).  However, much of this variation was explicable, experts were told at the UK Health Protection Agency’s conference on pandemic flu held in London on 21 and 22 June. Andrew Hayward, of University College London and chief investigator of the Flu Watch study, noted that conventional flu surveillance assesses only “the tip of the iceberg”—those people who consult their doctor. So the royal college’s figures took into account only people who sought out health services for their flu symptoms, whereas Flu Watch recruited whole households . . .

Length of publication: 1 page news-item


Referrals to a pediatric immunization service: Findings from a practice-based audit of a UK specialist immunization clinic.

July 2, 2010

Source: Human Vaccine, 2010 May 17; 6(5)

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Date of publication: May 2010

Publication Type: Journal Article

In a nutshell: Against a background of new developments and updated clinical guidelines, health care professionals (HCP s) administering childhood and adolescent immunizations require access to expert advice and support when appropriate. The clinical records of all pediatric referrals seen at a UK-based facility-the Stockport Specialist Immunization Clinic (SS IC)-between 01/10/2006 and 31/03/2007 were reviewed to determine the stated reason(s) for referral to a specialist immunization service and the outcome of that process. During the 6 month audit period, 430 case notes were identified and 410 (95%) were audited. Reasons for referral were primarily due to the medical condition of the child [118/410 (29%)], the child having experienced a previous vaccine adverse event [86/410 (21%)], or preterm birth of the child [86/410 (21%)]. The majority of referrals were from primary care [234/410 (57%)]. A total of 351 (85.6%) cases were categorized as appropriate referrals and 36 (11.6%) and 23 (5.6%) were categorized as inappropriate and equivocal, respectively. Four hundred and eight children completed a primary program; for two children the parents declined the advice offered. National data show that a small number of children remain susceptible to vaccine preventable diseases because they fail to access or complete immunization programs through their General Practitioner (GP) and this may be in part because the HCP is unsure about vaccine indications/contra-indications. Clearly a number of referring HCP s in this audit had some level of uncertainty when immunizing children with a pre-existing medical condition or a previous history of vaccine associated AE FI in the child/family, and this may be indicative of a more general problem among HCP s. A consistent approach to providing expert advice and support to primary care professionals in the UK would therefore be expected to make a significant impact on the immunization service by building confidence for parents/guardian, professionals and organizations involved in delivering it. The authors recommend a dedicated specialist immunization clinical service be considered as one approach to achieving this.

Length of publication: Unknown


Inequalities in immunisation and breast feeding in an ethnically diverse urban area: cross-sectional study in Manchester, UK.

July 2, 2010

Source: J Epidemiol Community Health, 2010 May 12. [Epub ahead of print]

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Date of publication: May 2010

Publication Type: Journal Article

In a nutshell: Objectives: To examine inequalities in immunisation and breast feeding by ethnic group and their relation to relative deprivation. Design: Cross-sectional study. Setting: Manchester, UK. Participants 20 203 children born in Manchester (2002-2007), who had been coded as of white, mixed, Indian, Pakistani, Bangladeshi and black or black British ethnicity in the Child Health System database. Main outcome measures: Breast feeding at 2 weeks post partum; uptake of triple vaccine (diphtheria, pertussis and tetanus) at 16 weeks post partum; uptake of the measles, mumps and rubella vaccine (MMR) by the age of 2. Results: Black or black British infants had the highest rates of breast feeding at 2 weeks post partum (89%), and South Asian infants had the highest triple and MMR vaccination rates (Indian, 95%, 96%; Pakistani 95%, 95%; Bangladeshi 96%, 95%) after area level of deprivation, parity, parenthood status and age had been controlled for. White infants were least likely to be breast fed at 2 weeks post partum (36%), and to be vaccinated with triple (92%) and MMR vaccines (88%). Within the white ethnic group, lower percentages of immunisation and breast feeding were significantly associated with living in a deprived area and with increasing parity. This was not found within black or black British and Pakistani ethnic groups. Discussion: Practices that are protective of child health were consistently less likely to be adopted by white mothers living in deprived areas. Methods of health education and service delivery that are designed for the general population are unlikely to be successful in this context, and evidence of effective interventions needs to be established.

Length of publication: 7 page article


Why should older adults receive the shingles vaccine?

July 2, 2010

Source: J Gerontol Nurs, 2010 May 24:1-5 [Epub ahead of print]

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Date of publication: May 2010

Publication Type: Journal Article

In a nutshell: This article seeks to educate health care providers in understanding the need for immunization of older adults with the new herpes zoster vaccine, Zostavax((R)). Herpes zoster (shingles) is a painful and disabling condition that can result in significant morbidity, loss of productivity, and decrease in quality of life. Herpes zoster is a reactivation of the varicella zoster virus, the same virus that causes chicken pox. Anyone who has had chickenpox can get shingles. Evidence found in the literature demonstrates that the vaccine prevents shingles in approximately half of adults 60 and older.

Length of publication: 5 page article


Further dissemination

July 2, 2010

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