A view from the ground what have we learned? Joanne Yarwood National Programme Manager Public Health England 1 st February 2017
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1 A view from the ground what have we learned? Joanne Yarwood National Programme Manager Public Health England 1 st February 2017
2 Vaccine delivery - supply, clinics Vaccine development Communication PLANNING Government & Surveillance Monitoring of coverage Components of vaccination JCVI/policy development programmes Training attitudes to INVESTMENT Surveillance vaccination of population susceptibility Predicting the Adverse future - events modelling surveillance Surveillance of diseases Budget/resource support
3 3 IAIM Madrid The whole of life
4 4
5 The Charedi Community, Hackney Figure 1. Map of Hackney wards according to percentage of Jewish residents, 2001 [1] Image 1: Photo courtesy dcasey photo via flickr, under Creative Commons licence Figure 2. Stamford Hill Group Practice, General Practice Profile, 2013 (PHE) 5
6 Measles epidemiology, Hackney ( ) Rate per 100,000 population Charedi population Non Charedi population Total number of cases ( ) Population Overall Rate per 100, Table 1: Overall cases of measles and estimated crude measles rates per 100,000 population by likely Charedi and non- Charedi population, Hackney 2006 to 2013 Measles rates in the Hackney Charedi community was found to be at least four times higher than in the rest of Hackney 6 IAIM Madrid Work by: Maria Saavedra-Campos, PHE FES
7 Conclusion Vaccine uptake in the community below required level to protect from disease Recurring outbreaks affect the community (high toll on families, resource intensive for health workers) and will continue until coverage is increased. No evidence of systemic religious or cultural objection to immunisation Evidence-informed suggestions for further tailoring of the children's immunisation services have been offered. 7 IAIM Madrid
8 Why do attitudinal work? informs planning and communication if we understand the environment and whose environment we can - base our understanding and approaches on research and give people the information they say they want listen to the user experience return on the investment is high we need the humility to know that what we know may not be what others want to know! 8 IAIM Madrid
9 Methodology the survey explores parental attitudes to childhood immunisation to inform strategic planning of the immunisation programme. 1,683 interviews were conducted across England with 1,084 interviews with parents of children aged interviews with parents of children aged 3-4 interviews were conducted face-to-face between February and April IAIM Madrid
10 10 IAIM Madrid Of parents of 0-4s who recall recent information and publicity, there has been a decrease of 3% points since 2015 who have been persuaded not to immunise (from 12% to 9%).
11 Of these parents, more than two in five say they had seen this on the Internet, particularly Facebook and Twitter. All parents who have seen something which might have persuded them not to immunise (114) All parents (1683) Internet (any) Word of mouth/speaking to friends/family/other parents 3% 1% 19% 42% 32% in 2015 Television programme 1% 18% Newspaper article Told by doctor/nurse 1% 1% 10% 9% 22% say it was via Facebook or Twitter Poster advert *% 6% Leaflet *% 6% Television advert *% 5% 11 IAIM Madrid
12 Whether ever refused or postponed any immunisations Had all when due Did not have when due 2010 (1730) 72% 28% Went on to have later 41% 2015 (1792) 90% 10% Intend to have later 9% Delayed: 2016: 62% 2016 (1683) 91% 9% Not sure whether to have later 11% 2015: 70% More likely to have refused or postponed an immunisation - Female (11% cf. 3% male) - Parents of 3-4s (12%) - Parents with a degree (10%) Equates to 3% of all parents No plans to have later Refused 16% 19% Base: All Parents who refused or delayed an immunisation (158) Refused: 2016: 35% 2015: 23% 12 IAIM Madrid
13 Whether automatically had child immunised or weighed up pros and cons Automatically had when due (parents of 0-2s) Weighed up pros and cons (parents of 0-2s) Automatically had when due (parents of 3-4s) Weighed up pros and cons (parents of 3-4s) 90% 86% 68% 70% 73% 72% 75% 87% 84%* 57% 61% 72% 41% 38% 30% 29% 26% 28% 22% 17% 7% 7%* 9% 10% Nov-03 Nov-04 Nov-05 Nov-06 Nov-07 Nov-08 Feb-10 Mar-15 Mar IAIM Madrid
14 Which health professionals discussed immunisations with (among parents of 0-2s) 77% 74% 80% 74% 79% 77% 76% 78% 79% 85% 76%* 77% 61% 57% 60% 53% 56% 53% 52% 50% 49% 52% 39%* 41% 23% 26% 14% 29% 30% 28% 26% 17% 17% 18% 18% 23% 15% 25% 26% 21% 19% 34% 34% 35% 29% 34% 33%* 13% 11% 14% 9% 9% 13% 10% 15% 15% 12% 9%* 10% Nov-00 Nov-01 Nov-02 Nov-03 Nov-04 Nov-05 Nov-06 Nov-07 Nov-08 Feb-10 Mar-15 Mar-16 Any HV GP PN Midwife 14 IAIM Madrid
15 Trust in all sources 68%* 60% 62%* 44% 10% 37% 24% 12% 51% 49% 43% 39% 34% 32% 15% 16% 17% 5% 55% 55% 43% 42% 20% 19% 19% 18% 3% 4% 56% 43%* 38% 33% 34%* 17% 14% GP/HV/PN NHS Pharmacist Government Media Nov-03 Nov-04 Nov-05 Nov-06 Nov-07 Nov-08 Feb-10 Mar-15 Mar IAIM Madrid
16 August Presentation title - edit in Header and Footer
17 MMR uptake at 16 months and proportion of mothers believing in complete or almost complete safety of MMR vaccine 90 Crohn s paper Autism paper Sustained negative media reportage % % mothers confident MMR uptake 60 Apr-94 Apr-95 Apr-96 Apr-97 Apr-98 Apr-99 Apr-00 Apr-01 Apr-02 Apr IAIM Madrid
18 Still top of mind in 2016 Spontaneous awareness Total awareness MMR 54% 85% Flu 39% 84%* 5 in 1 vaccine Meningitis C, MenC 27% 31% 71% 68%* Second dose of MMR Pre-school booster 13% 15% 64%* 63% Pneumococcal/PCV Hib/MenC Meningitis B/ MenB Tuberculosis(TB)/BCG Rotavirus 14% 13% 14% 13% 14% 51% 48% 47% 46% 43%* 18 IAIM Madrid
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20 Campaign logo Campaign logo ties all elements of the campaign together and is easily recognisable
21 21 IAIM Madrid
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23 23 IAIM Madrid
24 24 Introducing a new vaccine Celebrate!!
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