National Immunisation Programme changes 2013-14 Michael Baker Wessex Public Health England Centre
Changes to the Meningococcal serogroup C conjugate (MenC) vaccine schedule in 2013 2 Immunisation Programme changes 2013-14
What is meningococcal serogroup C disease? Meningococcal disease occurs as a result of an invasive bacterial infection Transmission is by aerosol, droplets or direct contact and usually requires frequent or prolonged close contact Incubation period 2-7 days Meningococcal infection most commonly presents as either meningitis or septicaemia, or a combination of both In the UK Meningococcal C is one of 13 serogroups: B&Y are currently the most common, less common serogroups include C&W 3 Changes to MenC conjugate vaccine schedule
Impact of MenC vaccination programme Number of laboratory confirmed serogroup C cases in England and Wales, 1998-2010 Source: Public Health England, Infectious Disease Epidemiological Data http://www.hpa.org.uk/webw/hpaweb&hpawebstandard/hpaweb_c/1234859709051?p=1201094595391 4 Changes to MenC conjugate vaccine schedule
Key message: Why is there a change to the MenC vaccination schedule? One dose of MenC in infancy has been shown to provide sufficient protection until booster at 12/13 months However, individual protection in young children wanes A booster dose for adolescents will provide longer-term protection and maintain herd protection to help protect infants and younger children freshers (temporary catch up for new starters at university setting under 25 years commencing in 2014) are also being offered another dose of MenC vaccine because of an increased risk of disease and sub-optimal protection from vaccination under 10 years of age 5 Immunisation Programme changes 2013-14
The infant rotavirus vaccination programme 6 Immunisation Programme changes 2013-14
What is rotavirus? Rotavirus is a virus that causes gastroenteritis, in particular in infants and young children Estimated that all children will become infected with rotavirus at least once by the time they are 5 years old Estimated that rotavirus causes around half of all gastroenteritis in children aged under 5 years Image courtesy of PHE/SPL 7 The infant rotavirus vaccination programme
8 Immunisation Programme changes 2013-14
Epidemiology of Rotavirus Most common cause of childhood diarrhoea and vomiting 45% of hospital admissions 27% of NHS Direct calls 25% of GP consultations In England and Wales, in children <5 years of age each year: 90 000-133 000 GP consultations 37 000 NHS Direct calls 30 000 A&E attendances 14 000 hospital admissions Major increase in each winter / spring period 9 Immunisation Programme changes 2013-14
Rotarix dosage and schedule 2 dose schedule Oral administration First dose of 1.5ml at 8 weeks (two months) of age Second dose of 1.5ml at least four weeks after the first (i.e. 12 week appointment) It is preferable that the full course of two doses is completed before 16 weeks of age. Rotarix must be given no later than 24 weeks (i.e. 23 weeks and 6 days) 10 Immunisation Programme changes 2013-14
Intussusception Intussusception is a naturally occurring condition of the intestines Research from some countries suggests that Rotarix may be associated with a very small increased risk of intussusception Even with this small potential risk, the benefits of vaccination in preventing the consequences of rotavirus infection outweigh any possible side effects 11 The infant rotavirus vaccination programme
Universal influenza vaccine programme for children 12 Immunisation Programme changes 2013-14
Flu vaccines for all children.. All two to 16-year-olds in the UK are to be offered annual flu vaccinations The children will be immunised using a nasal spray (Fluenz) rather than an injection, starting in 2014 at the earliest The Joint Committee on Vaccination and Immunisation (JCVI) said the new strategy would avert a large number of flu cases among children as well as many severe cases and deaths, mostly among the elderly and others vulnerable to the infection Chief Medical Officer for England, Prof Dame Sally Davies: "Even with moderate uptake of 30% it's estimated that this should result in 11,000 fewer hospitalisations and 2,000 fewer deaths each year. 13 Immunisation Programme changes 2013-14
Seasonal Influenza Extension Introduce annual influenza vaccination for all children age 2-16 by 2015/16 Current roll out plan: - 2013/14 Routine 2 yr olds Pilot 2-10 yr olds - 2014/15 Routine 2-10 yr olds Pilot 11-16 yr olds - 2015/16 Routine 2-16 yr olds 14 Immunisation Programme changes 2013-14
Fluenz (LAIV) (intensively monitored by UK safety regulators) Live attenuated influenza vaccine Greater protection for children Licensed for age 2 up to age 18 Intranasal administration Live vaccine but attenuated (weakened) and adapted to cold so cannot replicate at body temperature cannot cause influenza Contraindicated in immunosuppression, severe asthma (step 4 & above), pregnancy, egg allergy and those receiving salicylate therapy 15 Immunisation Programme changes 2013-14
Zoster vaccine programme for adults aged 70-79 16 Immunisation Programme changes 2013-14
Zoster Vaccine Zostavax (SPMSD) - Live, attenuated vaccine - Single dose given sub-cutaneously Given in primary care with Influenza commencing Sep 13 2013/14 - Aged 70 and 79 2014/15 - Aged 70, 78 and 79 - etc 17 Immunisation Programme changes 2013-14
Measles catch-up campaign 18 Immunisation Programme changes 2013-14
Trends in vaccine coverage 19 Immunisation Programme changes 2013-14
Measles catch-up programme 20 Immunisation Programme changes 2013-14
Continuation of temporary programme of pertussis vaccination of pregnant women 21 Immunisation Programme changes 2013-14
May 2013: JCVI have recommended that the programme be continued in 2013/2014 until further notice at least until 31 March 2014 and likely beyond https://www.gov.uk/government/publications/whooping-cough-vaccinationprogramme-for-pregnant-women-extension-to-2014 22 Immunisation Programme changes 2013-14
And one on the horizon.. 23 Immunisation Programme changes 2013-14
Meningitis B vaccine (Jan 13) http://www.nhs.uk/news/2013/01january/pages/new%20meningitis-b-vaccine-approvedfor-uk-use.aspx Meningitis B infections accounts for majority of invasive meningococcal infections in the UK European Commission have licenced Men B vaccine Bexsero (Novartis) from age 2 months of age JCVI to meet later this year to decide if vaccine will be introduced into UK schedule Vaccine will cover approx. 73% of circulating Men B strains in the UK number of cases likely to be reduced 24 Immunisation Programme changes 2013-14