SCHOOL IMMUNISATION TEAM KERRY

Transcription

1 SCHOOL IMMUNISATION TEAM KERRY A COLLABORATIVE PRESENTATION ON BEHALF OF SCHOOL IMMUNISATION TEAMS IN CORK AND KERRY. THANK YOU TO ALL WHO CONTRIBUTED, NURSING, MEDICAL, ADMIN, RESEARCH SCIENTISTS IN PRIMARY CARE AND HEALTH AND WELLBEING.

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3 Ireland

4 70 HPV 1 Uptake Percentage Uptake % Community Healthcare Organisation

5 Community Healthcare Organisation 4 Cork and Kerry Population 665, census 689, census Cork City Pop + 5.4% Cork County + 4.2% Kerry + 1.4% Kerry Pop 147, Cork Pop 542, Geographic spread West Kerry to Youghal 230KM

6 Region % Uptake North Lee 51.9 South Lee 48.5 North Cork 47.5 West Cork 42.6 Kerry 39.3

7 Population 147, 554 Towns Tralee Pop 23,000 (City status?) Killarney Pop 14,240, Listowel 4832 Castleisland 2513 Killorglin 2082 Kenmare 2175 Dingle 1965 Schools 22 Cohort HPV 2016/ / Tdap 2016/ /

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9 HPV Uptake Cork Kerry % Uptake HPV 1st and 2nd Dose st Dose 2nd Dose 10 0 SL NL NC KY WC SL NL NC KY WC SL NL NC KY WC

10 HPV 1st Dose Sep 2016 Kerry HPV HPV HPV % Uptake % Refused % CNR % Abs/Def

11 School Cohort Vaccinated HPV1 % Vaccinated 2016 HPV1 % Vaccinated 2014 Castleisland Comm Killorglin Comm Causeway St Josephs, Ballybunion Kenmare, Scoil Pobail inbheear Sceine Killorglin Intermediate St Brigid, Killarney Milltown Castleisland Pres Tralee Pres Listowel Pres Tarbert Comprehensive Col Gleann Li Tralee Mop Up Gael Col Tralee Mercy MountHawk Rathmore Listowel Comm Killarney Comm Col Na Sceilge, Caherciveen Corca Dhuibhne, An Daingean Col Ide An Daingean Mean Scoil Nua, Castlegreg Total

12 HPV 1 % Uptake in Kerry Schools % Uptake HPV Schools Ranked 1 to 22

13 Tdap and MenC Uptake % Uptake Tdap and MenC Tdap MenC SL NL NC KY WC SL NL NC KY WC SL NL NC KY WC

14 Fri, May 7, 2010, 01:00 HPV vaccine programme to start The HPV vaccination programme against cervical cancer is to begin this month, Minister for Health Mary Harney has confirmed. Up to 30,000 girls in first year at secondary schools across the country are to be offered the cervical cancer vaccine from May 17th. Oct HPV vaccine -- what about the boys? It's not cost effective to include teen boys in the HPV immunisation programme even though they would benefit from it

15 Why did HPV uptake rates fall off the cliff in Kerry? Local Influences School Influences Parental influence Teenage influences Local Media Social media National Media International reports Anti establishment

16 September 2014, parent concern in North Cork school October 2014, GP communication Nov 2014, letter to school, requesting the board to stop the administration of the vaccine Jan 2015 letter forwarded to NIO Feb 2015, NIO reply to letter, confirming the vaccines safety profile July 2015 Kerry HPV 2015/16 Local activity North Cork and Kerry Denmark experiences avalanche of girls seeking treatment after HPV vaccinations In March 2015, a Danish national television station (TV2) aired a documentary focusing on girls who suspected they had been injured by the HPV vaccine Gardasil REGRET July 2015 National Media Reports Local Kerry/North Cork activity

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22 Human papillomavirus (HPV) and cervical cancer Fact sheet Updated June 2016 Key facts Human papillomavirus (HPV) is a group of viruses that are extremely common worldwide. There are more than 100 types of HPV, of which at least 13 are cancer-causing (also known as high risk type). HPV is mainly transmitted through sexual contact and most people are infected with HPV shortly after the onset of sexual activity. Cervical cancer is caused by sexually acquired infection with certain types of HPV. Two HPV types (16 and 18) cause 70% of cervical cancers and precancerous cervical lesions. There is also evidence linking HPV with cancers of the anus, vulva, vagina and penis. Cervical cancer is the second most common cancer in women living in less developed regions with an estimated new cases in 2012 (84% of the new cases worldwide). In 2012, approximately women died from cervical cancer; more than 85% of these deaths occurring in lowand middle-income countries. Vaccines against HPV 16 and 18 have been approved for use in many countries

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24 Parents GPs Inform Parents group Principals/ Teachers Boards of management Students Local media

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26 Infertility Will I be in a wheelchair, Will I be sick after this, What if I faint, I have read about this on Facebook Some students are worried about side-effects of the HPV vaccine and some were afraid something terrible was going to happen to them eg paralysis. Students are all very concerned about the side effects The fact that girls who were very motivated full of energy are now under performing suffering from tiredness and have to stop participation in sports Lethargy seems to be a big concern Negative publicity on facebook is feeding a lot of these concerns I am led to believe some girls have been very ill after this injection, that some of them are bed bound for several months. So we are just scared of...getting very ill... We are not happy to give... the HPV although her sister had it. One of the girls locally reacted adversely to it with three girls severely affected by it....has eczema and asthma and allergies and we won t take a chance on it. She will be responsible for her own health I do not wish... to have the HPV vaccine as I have concerns about possible side effects. I realize that this concern is only based on anecdote but this is enough to persuade me. I do not want this vaccine for her. We feel more research is required regarding the HPV vaccine. Adverse reaction re fellow pupils Risks- side effects Too many concerns about the side effects We refuse to the administration of HPV to... on medical grounds. We consent only to administration of Tdap and Men C Because of the side effects of the vaccine I do not want... to be vaccinated I read that bad things can happen after the HPV vaccine and I am scared about my daughter s health I know a girl who has severe hip pain as result of receiving the HPV vaccine. Listening to people on the radio and newspapers I feel there are very traumatic side effects and it is unnecessary for my child to go through this at such an age.i will pay for it if necessary when she gets older and she can get the HPV vaccine then but not now I signed a consent for my daughter to have HPV vaccine.i have since done some research on the vaccine and have decided not to administer the vaccine to my daughter at this present time Concern re medical complications/side effects Do not feel this is necessary for my daughter so she does not need this HPV The risk of side effects i.e. neurological not 100% proven to be effective I don t want...to get the HPV vaccine I want her to get Tdap vaccine and Men C vaccine Losing their class room/pe hall, children coming back to class after vaccination getting ill, What are principals worried about? Girls who are out of school for a prolonged time ie chronically unwell, arising from an incident (vaccination) which was provided in the school. Teachers in schools where they have been cases are expressing concern about girls who were really excellent students but are now suffering from tiredness To start Principal wanted to know if HPV vaccination on site in school will be ongoing as `principal has issues around same Further dialogue between principal and School PHN identified the following issues in relation to ongoing use of school premises as location for delivery of SIP-- Room space on site in schools to accommodate school immunisation team and flow through of students for immunisation is an issue. Extra correspondence from parents of students is received by school secretary, in relation to withdrawal of parental consent for HPV vaccine the handling of which correspondence adds to secretary s workload Another consideration voiced by principal is that schools do not like to be associated with negative press which currently pertains in relation to HPV. Once school immunisation team leaves school premises following a day s immunisation work, students who have received vaccines can present to teachers complaining of feeling unwell ;teachers then require to respond to this situation; principal notes that doing so places an added responsibility on teachers. Principal has spoken with his colleagues in Education other principals- who share the same issues. The subject of HSE teams continuing to visit schools for delivery of SIP will be up for discussion at the next Regional meeting of principals While acknowledges that SIP team members are doing the work which they have been asked to do in relation to visiting schools for delivery of SIP, Principal raises the question as to why delivery of SIP and immunisation work related is not caries out at Health service clinics

27 Will I be in a wheelchair? Paralysis So we are just scared of...getting very ill... Infertility Will I be sick after this What if I faint, I have read about this on Facebook I know a girl who has severe hip pain as result of receiving the HPV vaccine. What are the side effects?

28 I am led to believe some girls have been very ill after this injection, that some of them are bed bound for several months. So we are just scared of...getting very ill. I read that bad things can happen after the HPV vaccine and I am scared about my daughter s health Do not trust it We want to wait until she is older Not a hope in hell is she getting the HPV vaccine My child will choose wisely in her partners in the future

29 Loosing their class room/pe hall Extra work for school Children coming back to class after vaccination getting ill. Girls who are out of school for a prolonged time ie chronically unwell, arising from an incident (vaccination) which was provided in the school. Excellent students but are now suffering from tiredness Do not like to be associated with negative press which currently pertains in relation to HPV.

30 I have no concerns about the HPV vaccine-i must admit though that all the negative publicity about side effects made me wonder about it after the programme on TV3 and resulted in me looking at the research again in greater detail to be sure to be sure that it was definitely safe. Working in the HPV immunisation service has become more stressful for staff. Afraid will give the wrong vaccine. Students more anxious, staff more anxious I am terrified to give it to my own daughter, why are these girls unwell What about the girls who do not feel well but do not connect with a health professional?

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32 Focus groups Students Parents Teachers Staff Social media Radio/TV/Newspapers Expert Advice, national and international

33 Immunisation Teams Team support, encouragement, feedback, suggestions, debriefing. Resilience Enable and resource the teams, forward planning, replacing leaves. Immunisation Coordinators. Accurate relevant information Parents, students, teachers, colleagues, friends, peers, media, GPs, nurses, health promotion, consultants.

34 HSE Workers, 105,000 WTE s >30% Nursing 7.5% Med/Dental 15% admin/management PCC Health and Wellbeing Get the message out there, INMO, RCPI,IMO, NIO, ICGP, Health Matters, PHNs, Teachers, students, Home, Social. Focus back on health and wellbeing and child health nationally

35 3 May 2017 Article, quoted Simon Harris comments on HPV Uptake decline at IMO Conference He said he takes medical advice on immunisations from his chief medical officer, the European Medicines Agency and the World Health Organisation rather than random social media accounts. He said: If you want to give medical advice on vaccinations, become a doctor. If not, get out of the way and stay away from our public health policy. He added: We have vaccines in this country that can prevent death. We have a vaccine that can prevent girls from dying of cancer. And yet we have uninformed nonsense interfering with medical efforts to save lives. Shame on them.

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37 NIO Irish Cancer Society Depts of Public Health Health and Wellbeing HSE Communications Department Education SPHE Schools Dept of Health/Minister for Health RCPI Irish Cancer Register GPs Hospital Consultants Sexual Health Units WHO/ EMEA

38 Search engines HPV vaccine hse.ie/immunisations/hpv Traditional Media has changed its focus Irish Times( 21/3/17) Why are vaccinations, like the HPV vaccine, getting bad press? There is absolutely no scientific evidence of serious long-term effects (21/3/17) Irish Examiner 21/3/17 Experts advise vaccine take-up for combating HPV virus As the schedule of HPV vaccination gets under way in schools across the country, RCPI has asked parents to allow their daughters to be vaccinated as the jab protects against the two viruses that cause 70% of cervical cancers, HPV 16 and 18.

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41 HSE Workers, 105,000 WTE s >30% Nursing 7.5% Med/Dental 15% admin/management Team support, encouragement, feedback, suggestions, debriefing. School links, need to nurture relationships with secondary schools Immunisation Coordinators Get the message out there, INMO, RCPI,IMO, NIO, ICGP, National Cancer Registry, Health Matters, PHNs, Teachers, students, Home, Social. Focus back on health and wellbeing and child health nationally HSE Communications Department Education SPHE Schools Dept of Health Sexual Health Units

42 Region % Uptake % Uptake North Lee South Lee North Cork West Cork Kerry

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