Immunisation Horizon Scanning Volume 5 Issue 6

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Combining the delivery of the human papillomavirus vaccine and the Td/IPV teenage booster

Source: British Journal of School Nursing, 8 (1): pp 20 – 24

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Date of publication: 2013

Publication Type: Journal Article

In a nutshell: The school nursing service in East Berkshire follows the national immunisation schedule and offers the human papillomavirus vaccine (HPV) to girls aged 12-13 years (year 8). A booster dose of tetanus, diphtheria and polio (Td/IPV) is offered to girls and boys aged 14-15 years (year 10).  In the autumn of 2011, the school nursing service offered the HPV vaccine to girls in year 8 and the Td/IPV vaccine to boys and girls in year 8 on the same day.
This had a number of important advantages including an improvement in the uptake of both vaccines. There were additional benefits to the school nursing service in terms of cost savings, and to the school such as minimising disruption to classes and the students.

Length of publication: 4-page article

Persistence and partnerships: School nurses, inequalities and the HPV vaccination programme

Source: British Journal of School Nursing, 8(2): pp 71 – 77

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Date of publication: 2013

Publication Type: Journal Article

In a nutshell: This study examines the role of school nurses in the delivery of the HPV immunisation programme. A qualitative study, including 80 semi-structured interviews, was conducted with health professionals (primarily school nurses) from across the four UK nations. Interviews explored the role of the school nurse in the HPV programme and efforts to address health inequalities. Many school nurses were persistent and flexible when targeting vulnerable young women and addressing health inequalities. In addition, understanding why parents and girls rejected the vaccine and working in partnerships were central to addressing health inequalities in the HPV vaccination programme. School nurses are a valuable part of the workforce tackling health inequalities in young people. Persistence and partnerships improved school nurses’ ability to address health inequalities. Future vaccination programmes can benefit from better understanding how differences in the delivery of an immunisation programme affects uptake and health inequalities.

Length of publication: 6-page article

School nurses on frontline in response to measles outbreak

Source: British Journal of School Nursing, 8(5): pp. 219 

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Date of publication: June 2013

Publication Type: Comment

In a nutshell: Many school nursing teams in areas affected by the recent measles outbreaks have had to respond quickly. Some of these examples of good practice show the important role they can play in the prevention and management of infectious disease outbreaks.

Length of publication: 1-page

Meninigitis immunisation: challenges, successes and new developments

Source: British Journal of Nursing, 22 (1); pp 20 – 25

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Date of publication: 2013

Publication Type: Article

In a nutshell: Meningitis, defined as the inflammation of the lining surrounding the spine and the brain, can be caused by bacteria, viruses and fungi. Bacterial meningitis is the most serious form of the disease, causing around 170000 deaths worldwide each year. Most cases of bacterial meningitis are caused by three bacteria-Streptococcus pneumoniae, Neisseria meningitidis and Haemophilus influenzae type B. In the UK, vaccines are available to combat most of these, yet, according to the Meningitis Research Foundation, around 3400 cases of bacterial meningitis and septicaemia occur every year in the UK and the Republic of Ireland. This article reviews the history of vaccination against meningitis, explores the challenges facing nurses who are at the interface of immunisation policy and public expectations, outlines the current schedule and discusses advances in vaccine technology that offer the potential of a new immunisation against N meningitidis B, the leading cause of meningitis in the UK.

Length of publication: 6-page article

HPV Vaccination: Too Soon for 2 Doses?

Source: JAMA, 2013; 309(17): pp. 1832-1834.

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Date of publication: May 2013

Publication Type: Editorial

In a nutshell: Cervical cancer is the second most common cancer among women globally, according to age-standardized incidence rates. Approximately 530 000 women are diagnosed with cervical cancer and 275 000 die of the disease every year; 88% of deaths occur in developing regions of the world. Human papillomavirus (HPV) infection is a well-established cause of cervical cancer as well as other anogenital and oropharyngeal cancers; therefore, prophylactic HPV vaccines have the potential to substantially reduce the incidence of cervical cancer and other HPV-associated diseases. Three-dose schedules of the bivalent vaccine (HPV-16 and -18) and the quadrivalent vaccine (HPV-6, -11, -16, and -18) have been shown to be highly efficacious in preventing persistent infection with HPV-16 and -18, which cause approximately 70% of cervical cancers, as well as precancerous lesions associated with these types. The quadrivalent vaccine has also been shown to prevent anogenital warts associated with HPV-6 and -11.

Length of publication: 3-page editorial

Face to face interventions for informing or educating parents about early childhood vaccination

Source: The Cochrane Library, 2013 May 31;5:CD010038. 

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Date of publication: May 2013

Publication Type: Review

In a nutshell: Childhood vaccination (also described as immunisation) is an important and effective way to reduce childhood illness and death. However, there are many children who do not receive the recommended vaccines because their parents do not know why vaccination is important, do not understand how, where or when to get their children vaccinated, disagree with vaccination as a public health measure, or have concerns about vaccine safety.

Face to face information or education sessions with parents about vaccination is one strategy that may improve vaccination rates and parental knowledge or understanding of vaccination. This review found seven studies with a total of 2978 participants that looked at the effects of face to face vaccination information or education for parents in a mix of high- and low-income countries. The interventions were single- or multi-session educational sessions, delivered to individuals or to groups of parents or soon-to-be parents.

The studies suggest that face to face strategies do not consistently improve either immunisation rates or parent knowledge and understanding of vaccination, but the evidence was low to very low quality for these outcomes. Only one study measured the cost of a face to face case management strategy. In this study, the cost of fully immunising one additional child was eight times the cost of usual care, but the quality of this evidence was very low. No studies measured parents’ intention to vaccinate their child or parent experience of intervention, and none of the studies looked at possible harmful outcomes related to the intervention. The results of this review are limited by the small number of included studies, small number of outcomes measured and problems with the way the researchers decided who should receive the intervention and with the way outcomes were assessed.

Length of publication: 91 pages (Full Review)

Preventing the spread of measles

Source: Practice Nursing, 24 (6): pp 294 – 296 

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Date of publication: June 2013

Publication Type: Article

In a nutshell: Jean Watkins considers the prevention and management of measles in light of  the recent outbreak.

Length of publication: 2-page article

Rotavirus immunisations could cause ‘administrative nightmare’

Source: Independent Nurse, 17 June 2013

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Date of publication: June 2013

Publication Type: News

In a nutshell: General practices may face an ‘administrative nightmare’ when the rotavirus vaccination is added to the childhood immunisation schedule in July, nurses have warned. NHS England has opted not to produce a Patient Group Direction (PGD) for the oral rotavirus vaccine, Rotarix, which is given in two doses at two and three months. This means non-prescribing nurses must obtain a Patient Specific Direction (PSD) for each child, on an individual basis.

Length of publication: 1-page news item

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