Open access to ‘UK Health Security Agency (UKHSA) Pertussis Update’

The UK Health Security Agency (UKHSA) recently presented a national update on Pertussis at the iHV Evidence-based Practice Conference on 3 July 2024. With UKHSA’s permission, we have now made the recording of this session ‘open access’ so it can be shared and viewed more widely with health visitors and health visiting team members across the UK.

UKHSA is calling on frontline clinicians to promote the uptake of the pertussis vaccine. Pregnant women should receive a pertussis-containing vaccination between 20- and 32-weeks’ gestation and with every pregnancy. Health visitors have a crucial role in discussing vaccinations with pregnant women and promoting vaccine uptake.

Watch the recording of the UKHSA Pertussis Update at iHV Evidence-based Practice Conference here.

In her presentation, Dr Helen Campbell (Lead Clinical Scientist at the UKHSA Immunisation team) highlights the clinical features of pertussis:

It is a bacterial infection affecting the lungs
Initial symptoms resemble a cold, such as a runny nose and sore throat
After about a week, severe coughing bouts can develop, typically worse at night (known as the 100-day cough)
Young babies may make a distinctive ‘whoop’ sound or have difficulty breathing after coughing.

Helen shared a very powerful video which shows a young baby who is experiencing a long bout of coughing and whooping: https://youtu.be/S3oZrMGDMMw (WARNING: this video may be upsetting for some viewers).

New data published by UKHSA show a concerning increase in Pertussis cases:

May 2024: 2,591 confirmed cases
April 2024: 2,106 confirmed cases
March 2024: 1,427 confirmed cases
February 2024: 920 confirmed cases
January 2024: 555 confirmed cases

This brings the total number of cases from January to May 2024 to 7,599.

Sadly, there have been 9 infant deaths since the current outbreak began in November last year with one death in December 2023 and eight deaths between January and May 2024.

Young babies are at the highest risk of severe complications and death from pertussis. Evidence from England shows that vaccination at the right time in pregnancy is highly effective, giving 92% protection against infant death. However, the latest uptake data for the vaccination offered to pregnant women shows a decline:

March 2024: 58.9% coverage
March 2017: Peak coverage of 72.6%

Timely vaccination during pregnancy and in childhood is crucial to protect vulnerable and young babies from serious diseases. Babies should receive three doses of the 6-in-1 vaccine at 8, 12, and 16 weeks, followed by a pre-school booster. Health visitors have a vital role in:

recommending pertussis vaccination
checking vaccine status
providing guidance on where and when to obtain vaccinations
addressing any queries parents or caregivers may have.

For further information and to access UKHSA resources on Pertussis, click here.

UKHSA has recently published a powerful new blog post by Jenny, a parent who shares her terrifying experience of her three week old daughter, Layla and her struggle with pertussis.

Whooping cough infections rise

New data published by the UK Health Security Agency (UKHSA) shows there has been a continued increase in pertussis (whooping cough) cases at the start of this year, with 553 confirmed in England in January, compared with 858 cases for the whole of last year (2023).

The increase in whooping cough across England is occurring after a prolonged period of low case numbers due to restrictions and reduced social mixing patterns during the COVID-19 pandemic. Cases of whooping cough rise cyclically every few years, with the last peak year in 2016 recording 5,949 cases. The current increase is coming at a time when there has been a steady decline in uptake of the vaccine in pregnant women and in children.

Vaccination programme for children and pregnant women

In response to increasing case numbers, the UKHSA is reminding mums-to-be to get protected against whooping cough so that their young baby has protection from birth against this serious disease and to ask their midwife if they are unsure. UKHSA is also urging parents to check that their children are vaccinated against whooping cough, which is offered to all infants at 8, 12 and 16 weeks of age (as part of the 6-in-1 combination vaccine) with an additional dose included in the pre-school booster vaccine.

This reminder is part of the UKHSA’s new Childhood Immunisation Campaign urging parents to check the vaccination status of their children against measles and other serious diseases. This campaign went live across a range of media channels at the start of this week. Parents are being asked to respond to invites from the NHS or to book an appointment with their GP practice if their child has not received all their routine vaccines.

Data for January show that there were 22 infants aged under 3 months diagnosed with whooping cough. These infants, who are too young to be fully vaccinated, are at greater risk of severe disease, including death. UKHSA is strongly encouraging expectant mothers to take up the maternal vaccine. Vaccination of pregnant women is 97% effective at preventing death in young infants from whooping cough.

Useful links

NHS Vaccinations and when to have them

NHS Whooping cough information

UKHSA launches campaign as measles cases continue to rise

The UK Health Security Agency (UKHSA) has launched a new multi-media marketing campaign across England to remind parents and carers of the risk of their children missing out on protection against serious diseases that are re-emerging in the country – with an urgent call to action to catch up on missed vaccinations.

The campaign went live today (4 March) with a powerful video advert told from the perspective of children and in their voices. “Our generation’s risk of illnesses like measles and whooping cough is rising” they tell their parents and carers looking straight into camera – “If we’re not vaccinated, we’re not protected.”

The campaign theme and materials, based on insight and feedback from parents in the North West, were developed by UKHSA in partnership with DHSC Marketing, Liverpool City Council, NHS England, NHS North West and NHS Greater Manchester.

The campaign comes as the latest weekly update today on measles cases in England shows there have been another 69 cases in the past week, bringing the total number of laboratory confirmed measles cases reported since 1 October 2023 to 650.

Professor Helen Bedford, Professor of Children’s Health at UCL Great Ormond Street Institute of Child Health (GOS ICH) and iHV Expert Adviser: Immunisations, said:

Every year, vaccination saves millions of children’s lives, so it is a huge concern that uptake of vaccines has been in decline in England for the past ten years. This has left many children and young people unprotected against potentially serious diseases and we are already seeing numbers of cases of measles and whooping cough increasing. However, we can prevent this taking further hold. Vaccines are free, highly effective and have a good safety record – and it is never too late to catch up if they have been missed. We owe it to our children to ensure they are protected.

Uptake levels of childhood vaccines offered through the routine NHS vaccination programme in England have been falling over the past decade across all vaccines, including whooping cough, measles, mumps and rubella, polio, meningitis and diphtheria – with England no longer having the levels of population immunity recommended by the World Health Organization that is needed to prevent outbreaks. Crucially, lower vaccine uptake within communities is directly linked to wider health inequalities.

To counter this decline, UKHSA is co-ordinating its national marketing campaign with an NHS operational MMR catch up campaign. Areas with low uptake will be a focus for support and parents of children aged from six to 11 years will be contacted directly and urged to make an appointment with their child’s GP practice for any missed MMR vaccines.

In addition to the TV advert, the campaign will be seen across a range of channels and formats including radio advertising, digital display, online and on social media. Additional advertising will be seen in the West Midlands, North West and London where there are larger pockets of low uptake. The campaign will be supported by a number of key stakeholders, including local authorities and NHS organisations.

Also listen our our recent podcast with Professor Helen Bedford - Stemming the measles surge

Health Visitors – please share your views on immunisations!

The UK Health Security Agency (UKHSA) is responsible for protecting everyone in the community from the impact of infectious diseases, and vaccines play an important part in this.

UKHSA would like to invite you to take part in the UKHSA survey of Health Visitors to share your experiences and thoughts on vaccination, and your views on possible new immunisations. They welcome all opinions.

We know that parents really value and trust health visitors’ advice and this anonymous survey will help UKHSA better support you in your work.

This is not a test of knowledge and there are no right or wrong answers. It will only take about 15 minutes of your time.

The survey is being conducted in collaboration with the Institute of Health Visiting and University College London Institute of Child Health.

How to take part in the survey

If you are an iHV member, you should have received an email in the last day or so with a link to the UKHSA survey – please email us at [email protected] if you did not receive this.

If you are not an iHV member (and you are a health visitor), you can still complete the UKHSA survey – please email us at [email protected].

Preparing for measles resurgence in England

Yesterday, the UK Health Security Agency (UKHSA) issued an urgent letter regarding preparing for measles resurgence in England. Tackling this issue will require a whole system approach and health visitors have an important role to play.

The UKHSA recent measles risk assessment concluded that although the risk of a UK-wide measles epidemic is considered low, a measles outbreak of between 40,000 and 160,000 cases could occur in London, due to sub-optimal uptake of the Measles Mumps and Rubella (MMR) vaccine in the capital. Evidence also shows that, outside of London, there is a high risk of cases linked to overseas travel leading to outbreaks in specific population groups. There has been a steady rise in measles cases this year.

Health visitors can play a crucial role in increasing uptake of the MMR immunisation programme to meet the WHO target of 95% coverage with two doses of MMR vaccine by age 5 years. Achieving this target is essential to maintain measles elimination status for the UK and prevent measles outbreaks from occurring. This is a NHS Long-Term Plan (LTP) commitment and high priority within NHS England.

Key messages:

Raising awareness of the complications of measles and enabling access to immunisations will be important parts of the solution.

Measles is highly infectious and can lead to serious complications, particularly in immunosuppressed individuals and young infants.
It is also more severe in pregnancy, and increases the risk of miscarriage, stillbirth, or preterm birth.

Individuals with suspected or known measles:

should be isolated immediately on arrival when attending health care settings to reduce the risk of other patients being exposed
all suspected measles cases should be promptly notified by phone to the local Health Protection Team (HPT) to facilitate timely public health action.

MMR vaccine:

all healthcare workers should have satisfactory evidence of protection against measles to protect both themselves and their patients. Satisfactory evidence of protection includes documentation of having received two or more doses of a measles containing vaccine and/or a positive measles IgG antibody test. Occupational Health service should have ready access to up-to-date records to support outbreak response.
children should receive their two doses of MMR vaccine on time at 12 months, and 3 years and 4 months.
the MMR vaccine can be given from six months of age before travel to a high-risk country.
patients over the age of three years and four months who do not have two recorded doses of MMR vaccine should be caught up opportunistically. There is no upper age limit to offering MMR vaccine.
new entrants from abroad and newly registered patients should have their immunisation history checked and missing doses caught up.
unvaccinated postnatal women should be offered any outstanding doses.

Under-vaccinated communities:

Health professionals who work with under-vaccinated communities should collaborate with local partners to raise awareness about measles with those most at risk and ensure unregistered populations can access immunisation services.
Resources including national guidelines for health professionals and free to order posters and leaflets for patients are listed in the appendix section in the full letter here.

Read Measles resurgence letter for professional organisations

Please also see: