Immunisation Horizon Scanning Bulletin Volume 2 Issue 8

Pertussis jab coverage may need to expand

Source: Healthcare Republic

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Date of publication: September 2010

Publication Type: News Item

In a nutshell: Whooping cough jabs may need to be given to adolescents and adults to boost falling immunity and to pregnant women to protect unborn children, HPA research suggests. Dr Helen Campbell, who is based at the HPA’s Centre for Infections, said that a number of future strategies were needed to tackle rising case numbers. Speaking at the HPA’s health protection conference in Coventry last week, she said that concern had been raised by data showing an increase in cases since 2006.

Length of publication: 1 page news item

GPs should give swine flu warning for seasonal jab, GMC says

Source: Healthcare Republic

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Date of publication: September 2010

Publication Type: News Item

In a nutshell: GPs should alert patients who refused last year’s swine flu vaccine that it is included in this year’s seasonal flu jab, the GMC has advised. The GMC and the Medical Defence Union (MDU) advised GPs to explain this to patients who had previously refused the vaccine. This year’s trivalent seasonal flu jab contains swine flu antigens because experts believe swine flu will circulate this winter. A DoH information leaflet has been produced to explain the contents of the vaccine. GMC assistant director of standards Jane O’Brien told GP it would be wise to explain this to patients who previously rejected the vaccine. ‘If you know a patient has previously refused the single swine flu vaccine, it’s likely they would want to know this year’s seasonal vaccine includes the swine flu strain,’ she said. However, GPs must be careful not to put pressure on patients to accept advice.

Length of publication: 1 page news item

The epidemiology of chickenpox in UK 5-year olds: An analysis to inform vaccine policy

Source: Vaccine, 2010 Sep 22. [Epub ahead of print]

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Date of publication: September 2010

Publication Type: Journal Article

In a nutshell: Varicella vaccine is not routinely administered to children in many countries including the UK. Longitudinal data are lacking to inform optimal schedules. We report the prevalence of VZV infection at 5 years of age, cumulative incidence between 3 and 5 years and socio-demographic associations with risk of infection using longitudinal data on 12,509 children from the UK Millennium Cohort Study. VZV prevalence by 5 years was 76.9% [95% CI: 75.9%, 78.0%]. The cumulative incidence between 3 and 5 years was 32.2% [95% CI: 31.1%, 33.3%]. Risk of infection by 5 years was associated with higher maternal socio-economic status, larger household size and formal day-care attendance at 9 months and 3 years. If universal varicella immunisation were introduced in the UK, where 40% children have attended some formal day-care by 3 years, a schedule commencing early in the second year of life would be indicated.

Length of publication: Unknown

Doctors warn over homeopathic ‘vaccines’

Source: BBC News

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Date of publication: September 2010

Publication Type: News Item

In a nutshell: Homeopaths are offering “alternative vaccinations” which doctors say could leave patients vulnerable to potentially fatal diseases, a BBC investigation has found. Three practitioners admitted giving patients a homeopathic medicine designed to replace the MMR vaccine. Inverness-based Katie Jarvis said she only offered “Homeopathic Prophylaxis” to patients who expressed an interest. But the discovery has prompted a shocked reaction from doctors.

Length of publication: 1 page news item

Families should get flu jabs to protect young children

Source: Healthcare Republic

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Date of publication: September 2010

Publication Type: News Item

In a nutshell: Vaccinating family members is likely to be the best way of preventing young children from being admitted to hospital with flu, a leading GP researcher has argued. Dr Douglas Fleming, director of the RCGP’s research and surveillance centre, presented results at the Health Protection Agency conference in Coventry this week. His research team analysed excess winter hospital admissions for respiratory syncytial virus (RSV) or flu among UK children. The researchers showed that, if vaccination were to reduce hospital admissions, it would need to be possible to provide vaccinations to children under six months of age.  Vaccination of children older than 24 months against flu or RSV is not likely to reduce hospital admissions, they concluded.

Length of publication: 1 page news item

Influenza vaccine preference and uptake among older people in nine countries

Source: Journal of Advanced Nursing, 66 (10), pp. 2297 – 2308

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Date of publication: Published online August 2010

Publication Type: Journal Article

In a nutshell: Aim: This paper is a report of a study delineating factors that influence older people’s preferences and uptake of the influenza vaccine in nine countries. Background: Vaccination uptake for the aging population in many countries still remains below the World Health Organization recommended rate. Older people who perceive higher susceptibility to and severity of influenza, and more benefits from vaccination and action cues prompting vaccination, tend to accept the vaccine, but those with more perceived barriers to vaccination are less likely to accept it. Method: A total of 208 older people from China, Indonesia, Turkey, Korea, Greece, Canada, the United Kingdom, Brazil and Nigeria were recruited to 14 vaccinated and 12 unvaccinated focus groups. They shared their experiences of influenza, and influenza vaccination, and promotion of influenza vaccination in focus groups. The data were collected in 2007. Findings: We identified five themes and generated a hypothetical framework for in-depth understanding of vaccination behaviour among older people.  Participants’vaccine preferences were determined by their behavioural beliefs in vaccination, which were based on their probability calculation of susceptibility to and severity of influenza and vaccine effectiveness, and their utility calculation of vaccine, healthcare and social costs. Action cues prompting vaccination and vaccine access further affected the vaccine uptake of participants with vaccine preferences. Vaccination coverage was likely to be higher in the countries where normative beliefs in favourof vaccination had formed. Conclusion: The hypothetical framework can be used to guide healthcare providers in developing strategies to foster normative beliefs of older people in vaccination, provide effective action cues and promote vaccine access.

Length of publication: 12 page article

The human papillomavirus vaccination programme

Source: British Journal of School Nursing, 5 (7), pp 348 – 349

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Date of publication: September 2010

Publication Type: Commentary

In a nutshell: Rachel Wigin comments on the HPV vaccination programme, and shares the experiences and progress of the programme in her area. The vaccination programme aims to help protect women against infection with some of the oncogenic types of human papillomavirus (HPV). HPV infections are very common sexually transmitted infections which are often killed off by the body’s immune system, but not always. It is hoped that the vaccine will greatly reduce the risk of getting cervical cancer by protecting girls against infection with HPV 16 and 18 (two of the strains most commonly associated with cervical cancer) (Health Protection Agency, 2010). Prevalence of the virus is low in girls aged under 14 years in the UK, but rates rise sharply from this age until the early 20s, as it is often acquired in the first few months of sexual intercourse (Department of Health (DH), 2008)…

Length of publication: 2 page article

Girls’ preferences for HPV vaccination: A discrete choice experiment

Source: Vaccine, 28 (41): 6692-6697

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Date of publication: September 2010

Publication Type: Journal Article

In a nutshell: A discrete choice experiment was developed to investigate if girls aged 12–16 years make trade-offs between various aspects of human papillomavirus (HPV) vaccination, and to elicit the relative weight that girls’ place on these characteristics. Degree of protection against cervical cancer, protection duration, risk of side-effects, and age of vaccination, all proved to influence girls’ preferences for HPV vaccination. We found that girls were willing to trade-off 38% protection against cervical cancer to obtain a lifetime protection instead of a protection duration of 6 years, or 17% to obtain an HPV vaccination with a 1 per 750,000 instead of 1 per 150,000 risk of serious side-effects. We conclude that girls indeed made a trade-off between degree of protection and other vaccine characteristics, and that uptake of HPV vaccination may change considerably if girls are supplied with new evidence-based information about the degree of protection against cervical cancer, the protection duration, and the risk of serious side-effects.

Length of publication: 6 page article

The 2009–2010 influenza pandemic: effects on pandemic and seasonal vaccine uptake and lessons learned for seasonal vaccination campaigns

Source: Vaccine, 28 (Supp 4): pages D3-D13

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Date of publication: September 2010

Publication Type: Journal Article

In a nutshell: Individual and national/cultural differences were apparent in response to the 2009–2010 influenza pandemic. Overall pandemic influenza immunization rates were low across all nations, including among healthcare workers. Among the reasons for the low coverage rates may have been a lack of concern about the individual risk of influenza, which may translate into a lack of willingness or urgency to be vaccinated, particularly if there is mistrust of information provided by public health or governmental authorities. Intuitively, a link between willingness to be vaccinated against seasonal influenza and against pandemic influenza exists, given the similarities in decision-making for this infection. As such, the public is likely to share common concerns regarding pandemic and seasonal influenza vaccination, particularly in the areas of vaccine safety and side effects, and personal risk. Given the public’s perception of the low level of virulence of the recent pandemic influenza virus, there is concern that the perception of a lack of personal risk of infection and risk of vaccine side effects could adversely affect seasonal vaccine uptake. While governments are more often concerned about public anxiety and panic, as well as absenteeism of healthcare and other essential workers during a pandemic, convincing the public of the threat posed by pandemic or seasonal influenza is often the more difficult, and underappreciated task. Thus, appropriate, timely, and data-driven health information are very important issues in increasing influenza vaccine coverage, perhaps even more so in western societies where trust in government and public health reports may be lower than in other countries. This article explores what has been learned about cross-cultural responses to pandemic influenza, and seeks to apply those lessons to seasonal influenza immunization programs.

Length of publication: 10 page article