Tags: vaccination

Boosting immunity with changes to the childhood vaccine schedule

Helen Bedford, Professor of Children’s Health Population, Policy and Practice Research and Teaching Department – UCL Great Ormond Street Institute of Child Health, and iHV Expert Advisor for Immunisations, provides an update on some very important changes to the child health vaccination schedule.

The UK childhood vaccination schedule is highly successful with protection against 14 diseases currently routinely offered to children under five years of age. Despite some current challenges in vaccine uptake, specifically a small year-on-year decline over the past 12 years and growing inequalities between areas and communities, most parents vaccinate their children without hesitation. This is in no small part due to advice from health visitors (HV) who are reported by parents as one of the main sources of vaccine information.

It is therefore vital for HVs to keep up to date with the vaccine programme; as it is continually amended, this can be challenging. During 2025/26 significant changes are being introduced which are summarised here along with their rationale. The changes are to be introduced in two phases.

From 1 July 2025:
  • Change to the timing of MenB (meningococcal group B – which can cause meningitis) and PCV (pneumococcal infections which can cause pneumonia and meningitis) in the infant schedule – the second dose of Men B will be brought forward from 16 weeks to 12 weeks and PCV vaccine moved from 12 to 16 weeks.
    • MenB disease cases have declined since the vaccine was introduced, but the peak age for this infection is now younger (1–3 months), with more severe disease in this age group. Bringing forward the second MenB dose aims to protect infants earlier.
  • MenC (meningococcal group C – which can cause meningitis)/Hib vaccine (protects against Haemophilus influenzae type b which can cause Hib meningitis) given at 12 months is to be discontinued as the manufacturers are stopping its production; once stocks are used up this vaccine will no longer be offered.
    • MenC is now very well controlled in young children as a result of the vaccine programme and the main focus for continued control is through the offer of MenACWY vaccine to adolescents.
  • For infants at increased risk of Hepatitis B who are recommended additional doses of the vaccine, the 12 months dose will be discontinued. Instead, they will be offered the 6-in-1 vaccine at 18 months of age at a new routine vaccine visit. These babies continue to need to have their blood tested for infection and this can be done via the Dried Blood Spot test at any time between 12 and 18 months.
From January 2026:
  • The new 18-month routine vaccine visit is a major addition to the vaccine programme. At this visit, toddlers born on or after 1 July 2024 will be offered a fourth dose of the 6-in-1 vaccine and a second dose of MMR (Measles, Mumps and Rubella) vaccine.
    • Although MenC is well controlled in infants, a booster of Hib vaccine is needed for continued protection and the discontinuation of Hib/MenC given at 12 months leaves a gap. It will also boost immunity to polio. This brings the UK in line with other countries e.g USA, Canada and some European counties, which offer a fourth dose of the primary vaccines.
    • The second dose of MMR is being brought forward to 18 months from current 3 years 4 months. Research has shown that offering the second dose earlier improves uptake which is especially important in light of current outbreaks of measles and low coverage in some areas and communities.
  • The introduction of routine varicella (V)(chicken pox) vaccine has been recommended by the Joint Committee on Vaccination and Immunisation (JCVI), but at the time of writing this has not received final approval. When it is introduced, it will be offered in combination with MMR as MMRV vaccine with doses at 12 and 18 months. There will also be a catch-up programme for older children.

Many parents (and professionals) will have questions about these changes. For example, the introduction of a new vaccine always raises questions about its safety and effectiveness. Varicella vaccine maybe new as a routine vaccine in the UK, but many countries have included in their schedules for decades and so there is vast experience to support its safety and effectiveness.

Personal Child Health Record (Red Book)

Pages reflecting the revised schedule and for recording vaccines given will be available as inserts for babies who already have a record and new PCHRs issued from later this year will include this updated information.

These significant updates to the UK childhood vaccination schedule in 2025–26, include timing adjustments for existing vaccines, the discontinuation of MenC/Hib and the introduction of a new 18-month vaccination visit, are designed to improve early protection and overall vaccine uptake.

Information for parents and health professionals

UKHSA has produced a range of information materials to support the schedule changes. These include a slide set for health professionals, updated guidance on vaccination of individuals with uncertain or incomplete vaccination and updated leaflets for parents. These are all available at https://www.gov.uk/government/collections/immunisation

More information about the changes to the childhood schedule can be found here:
https://www.gov.uk/government/publications/childhood-schedule-changes-from-1-july-2025-information-for-healthcare-practitioners/childhood-schedule-changes-from-1-july-2025-information-for-healthcare-practitioners

iHV members can also find more information on vaccinations through:

  • Our A-Z resource section on our website which has recently been updated with thanks to UKHSA – click here.
  • iHV Insights webinar – Protecting lives: Health Visitors’ role in vaccination success. If you missed this webinar on 20 March 2025 – you can catch up on the recording by clicking here.

Please note, you need to log in as a member to access these resources.

New NHS vaccination programmes against respiratory syncytial virus (RSV)

From 1 September 2024, there will be two new vaccination programmes against respiratory syncytial virus (RSV) – during pregnancy (for infant protection) and older adults in England, Wales and Northern Ireland, with the rollout in Scotland already commenced in August. The new vaccinations have been introduced following guidance from the Joint Committee on Vaccination and Immunisation (JCVI).

It is important that everyone working in health visiting is aware of the programme and the underpinning evidence, to support their work in promoting RSV vaccine uptake.

Why vaccinate against RSV?

RSV has been described as “maybe the most common virus you have never heard of” by GP and journalist Dr Mark Porter.

RSV causes respiratory illnesses which are most frequently seen over the winter months between November and February1. In the majority of people, it presents as a cough/cold which gets better by itself within 1 or 2 weeks2. However, in vulnerable populations, such as babies under 6-months-old, those born preterm, adults over 75 years and anyone with a weakened immune system, long-term lung or heart conditions, RSV can be much more serious requiring hospitalisation and, in some cases, causing death.

Many babies with RSV infection are undiagnosed, but they will struggle to breathe and feed due to bronchiolitis or pneumonia over the winter months. On average in England, 20,000 infants are admitted to hospitals each winter due to RSV. The vast majority have no underlying medical conditions. Many need intensive care, and sadly 20 to 30 will die due to RSV infection. RSV has wider impacts too, cancelling major paediatric surgery because critical care beds are needed to keep children with RSV breathing.

The maternal vaccine is a major step forward for child health. It offers infants 70% protection against severe RSV lower respiratory tract infection over the most vulnerable first 6 months of life. Commenting on the new vaccination programme, The Royal College of Paediatrics and Child Health has called it “game changing”.

The new RSV schedule – what you need to know:

  • Pregnancy
    • All women who are at least 28 weeks pregnant on 1 September 2024 should be offered a single dose of the RSV vaccine. After that, pregnant women will become eligible as they reach 28 weeks gestation and remain eligible up to birth. The ideal opportunity to offer vaccination would be at the 28-week antenatal contact, following prior discussion about the vaccine earlier in pregnancy. Providers should aim to vaccinate those already eligible on 1 September as soon as possible.
  • Older adults
    • All adults will be offered the vaccination at 75-years-old.
    • There will be a catch-up programme which will start for those aged 75–79-years-old on 1 September 2024.
    • They will remain eligible until the day before their 80th birthday, with the aim to complete the catch-up programme by the end of August 2025.

It is expected that the majority of the two population groups will have their vaccinations in September and October in preparation for the start of the RSV season.

Role of the health visitor

It is important that health visitors and their teams are aware of these new vaccination programmes. They are ideally placed to have conversations about the benefits of the maternal vaccination during the antenatal and interpregnancy periods, to ensure families who are pregnant or are planning a pregnancy are aware of the new RSV vaccination and how it protects babies. Through their extensive reach to millions of families across the UK each year, they can also play an important role in raising awareness of the new older adult vaccination programme for extended family members, or with grandparents helping with childcare. They are in the ideal place to explain to families what the new programme is, answer any questions that they may have, and direct them to the GP surgery for more information. This will help to protect the whole family, offering lifesaving protection against RSV for young babies and other vulnerable groups.

Further information, guidance and resources to support healthcare practitioners and raise awareness of the new RSV vaccination

As there are two new RSV vaccination programmes (one for pregnant women for infant protection and a separate one for older adults), there are different supporting resources available for each. It is important that anyone involved in RSV immunisation, or promoting vaccine uptake, is aware of which resources to use. More details are also available in the green book, chapter 27a: respiratory syncytial virus.

UKHSA and Public Health agencies for the devolved nations have produced several resources to support practitioners in raising awareness of the new programmes. Some of the resources are available in other languages. Follow the links below to access the resources.

References

  1. UKHAS (2024) What is RSV and is there a vaccine?. Available at: https://ukhsa.blog.gov.uk/2024/07/17/what-is-rsv-and-is-there-a-vaccine/
  2. NHS (2024) Respiratory syncytial virus (RSV). Available at:
    https://www.nhs.uk/conditions/respiratory-syncytial-virus-rsv/

New RSV vaccination of pregnant women from September 2024

From 1 September 2024, pregnant women can have a free vaccine in each pregnancy to protect their babies against respiratory syncytial virus (RSV). Make sure you are up to date about this important new vaccination to raise awareness and promote uptake.

Why the RSV vaccine is needed

RSV is a common virus which can cause a lung infection called bronchiolitis. In small babies this condition can make it hard to breathe and to feed. Most cases can be managed at home but around 20,000 infants are admitted to hospital with bronchiolitis each year in England. Infants with severe bronchiolitis may need intensive care and the infection can be fatal in some cases. RSV is more likely to be serious in very young babies, those born prematurely, and those with conditions that affect their heart, breathing or immune system.

RSV accounts for approximately 33,500 hospitalisations annually in children aged under 5-years-old. It is a leading cause of infant mortality across the world and results in 20 to 30 deaths per year in the UK. RSV infects up to 90% of children within the first 2 years of life and frequently re-infects older children and adults.

How the RSV vaccine protects babies

The vaccine boosts the mother’s immune system to produce more antibodies against the virus. These antibodies then pass through the placenta to help protect babies from the day they are born. RSV vaccination reduces the risk of severe bronchiolitis by 70% in the first 6 months of life. After this age, babies are at much lower risk of severe RSV.

Older children and adults can also get RSV infection, but the disease is more serious for small babies and people aged 75 and over.

Find out more: A guide to RSV vaccination for pregnant women

Read UKHSA Guidance:  RSV vaccination of pregnant women for infant protection: information for healthcare practitioners

Read UKHSA blog: What is RSV and is there a vaccine?

UKHSA encourages timely vaccination as whooping cough cases rise

Yesterday, the UK Health Security Agency (UKHSA) published a news story urging timely whooping cough vaccination in pregnancy and in childhood to protect vulnerable young infants from serious disease:

  • Pregnant women are offered a whooping cough vaccine in every pregnancy, ideally between 20 and 32 weeks – protecting their baby from birth in the first months of their life when they are most vulnerable and before they can receive their own vaccines.
  • All babies are given three doses of the 6-in-1 vaccine at 8, 12 and 16 weeks of age to protect against whooping cough and other serious diseases.

New data published yesterday by UKHSA shows cases of whooping cough continue to increase with 2,591 cases confirmed in May. This follows 555 cases in January 2024, 920 in February, 1,427 in March and 2,106 in April – bringing 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 (one in December 2023 and 8 between January to end May 2024). Young babies are at highest risk of severe complications and death from whooping cough. Evidence from England shows that vaccination at the right time in pregnancy is highly effective, giving 92% protection against infant death.

From January to May 2024, while most cases (53.4%, 4,057) were in those aged 15 years or older who usually get a mild illness, high numbers (262) continue to be reported in babies under 3 months of age who are at greatest risk from the infection.

Whooping cough cases have been rising across England, as well as in many other countries, since December 2023 due to a combination of factors. Whooping cough is a cyclical disease that peaks every 3 to 5 years. The last cyclical increase occurred in 2016. However, in common with other diseases, cases fell to very low numbers during the pandemic due to restrictions and public behaviours. A peak year is overdue and the impact of the pandemic also means there is reduced immunity in the population.

The latest uptake data for the vaccination offered to pregnant women to protect newborn infants against whooping cough continues to decline – with coverage in March 2024 at 58.9% compared to the peak coverage (72.6%) in March 2017.

Timely vaccination in pregnancy and in childhood are both important to protect vulnerable young infants from serious disease. All babies are given three doses of the 6-in-1 jab at 8, 12 and 16 weeks of age to protect against whooping cough and other serious diseases such as diphtheria and polio, with a pre-school booster offered at 3 years 4 months.

Whooping cough, clinically known as pertussis, is a bacterial infection which affects the lungs. The first signs of infection are similar to a cold, such as a runny nose and sore throat, but after about a week, the infection can develop into coughing bouts that last for a few minutes and are typically worse at night. Young babies may also make a distinctive ‘whoop’ or have difficulty breathing after a bout of coughing, though not all babies make this noise which means whooping cough can be hard to recognise.

If anyone in your family is diagnosed with whooping cough, it’s important they stay at home and do not go into work, school or nursery until 48 hours after starting antibiotics, or 2 weeks after symptoms start if they have not had antibiotics. This helps to prevent the spread of infection, especially to vulnerable groups, including infants. However, vaccination remains the best protection for babies and children.

UKHSA Blog

Alongside the updated data, UKHSA also published a powerful new blog post, “Whooping cough: my daughter spent the third week of life in an induced coma”. In this blog post, Jenny, from Hampshire, shares the story of her daughter Layla and her struggle with whooping cough at 3-weeks-old.

Read the UKHSA blog post

Health visitors’ role to promote uptake of the pertussis vaccine

UKHSA is calling for frontline clinicians to promote uptake of the pertussis vaccine. Pregnant women can have a pertussis-containing vaccination between 20 and 32 weeks’ gestation – they should also be vaccinated with every pregnancy.

Health visitors have a vital role to play in discussing vaccinations with parents and caregivers and promoting vaccine uptake. As a universal service, they visit every family, building trust through regular visits, often in the family’s home. Resources are available for health visitors and their team members to support communication around vaccines with pregnant women.

Pertussis (Whooping cough) case numbers in England continue to rise

Worrying new 2024 data published by the UK Health Security Agency (UKHSA) show an increase in cases of pertussis across all regions in England this year.

UKHSA are calling for frontline clinicians to promote uptake of the pertussis vaccine. Pregnant women can have a pertussis-containing vaccination between 16 and 32 weeks’ gestation – they should also be vaccinated with every pregnancy.

Pertussis is a serious disease that can lead to pneumonia and permanent brain damage. Infants who are too young to be fully protected through vaccination are at greatest risk of serious complications or, rarely, death. A large majority of infants who develop symptoms of pertussis will require hospitalisation.

The UKHSA has published an updated briefing note which summarises current epidemiology, trends in vaccine coverage and an update to national public health guidance during periods of heightened transmission.

UKHSA warn that incidence of pertussis is highest in infants under the age of 3 months, with 181 laboratory-confirmed cases identified between January and April 2024, and state that “this is of particular concern since these infants are at greatest risk of severe disease and are too young to benefit from complete vaccination”.

The most recent data show that there were 8 deaths reported in infants who developed pertussis in England between January to April 2024. Since the introduction of pertussis vaccination in pregnancy, from 2013 to the end of April 2024, there have been 29 deaths in total among infants with confirmed pertussis who were all too young to be fully protected by infant vaccination. Of the 29 infants that died, 23 had mothers who were not vaccinated at any point in pregnancy.

In the context of the current increase in pertussis case numbers, UKHSA’s briefing note contains useful updates on:

  • National guidance on the public health management of pertussis during periods of heightened transmission.
  • NICE Clinical Knowledge Summary and the NHS website which clarify approaches to, and requirements for testing for case confirmation and surveillance.
  • Guidance on the management of outbreaks in nurseries and other childcare settings for Local Authority Health Protection Teams.

General Practices remain the core providers for this vaccination programme. However, health visitors have a vital role to play in discussing vaccinations with parents and caregivers and promoting vaccine uptake. As a universal service, they visit every family, building trust through regular visits, often in the family’s home. Resources are available for health visitors and their team members to support communication around vaccines with pregnant women.

UKHSA are also calling for help to bolster uptake through the routine childhood vaccination programme. Vaccination against pertussis through the routine programme is offered at 8,12 and 16 weeks of age, with a preschool booster offered in primary care settings. This offers direct protection to infants and children against severe outcomes from pertussis.

Health visitors can promote vaccine uptake by checking vaccine status, as well as providing guidance on where and when to obtain them, and addressing any queries parents or caregivers may have. It’s important that parents and care givers are given the opportunity to ask questions about their child’s vaccinations with a trusted practitioner. This is a crucial part of the health visitor’s role. Trusted healthcare professionals provide the best support for parents and pregnant women regarding vaccinations. Health visitors, by building trusting relationships with families, are essential in boosting vaccine confidence and ensuring the success of the childhood vaccination programme.

Read the updated UKHSA briefing note here

Read our recent Voices blog from Dr Helen Campbell, Lead Scientist, Immunisation Division, UKHSA

iHV and Barnardo’s launch new MMR vaccination film #WorldImmunizationWeek

As highlighted by Professor Helen Bedford in the February 2024 iHV podcast “Stemming the measles surge”, measles is on the rise in the UK, with 6/10 of the confirmed cases in the under 10s in England1.

At the same time, rates of MMR vaccination continue to decline2, this can be seen in the graph below, which highlights the recovery in MMR vaccination uptake, following the discrediting of the Wakefield study. However, from 2019/20 the rates start to fall again. In 2022/23, for the uptake of both doses, this had fallen to 84.5% in England, 89.5% in Wales, 90.2% in Scotland and 87.9% Northern Ireland, all of which are below the World Health Organization (WHO) target of 95%2.

There are a number of reasons why parents choose not to have their children fully vaccinated against MMR. In some cases, there is a lack of awareness of the potential severity of measles, mumps and rubella if contracted. For some parents, vaccination appointments are delivered in locations that are not easily accessible for them, with limited choice or flexibility around timings to make sure that they are available at convenient times for busy families. Some parents may also be anxious about the MMR vaccine and its side effects.

It is therefore important that all families have access to accurate information and opportunities to have their questions answered by trusted health professionals.

New Video

iHV and Barnardo’s have worked together to develop a film for families about the MMR vaccination to improve vaccine uptake. It features a real-life couple, Radhika and Manish, discussing their decision to get their son, Kabeer, vaccinated and their experience of the process. They share their initial challenges finding trusted information online, and the importance of vaccination, not only for their own child but for vulnerable family and friends at greater risk of serious complications linked to these diseases. They also strongly advise parents who may have doubts about the MMR vaccine to talk to a health professional, such as their health visitor or GP, who can provide trusted and evidence-based advice. A lovely moment in the video is hearing them describe how proud their son Kabeer was of his vaccination certificate, as he showed it to his friends at nursery.

The video is freely available on the link below, so please share with families and on your social media.

Watch iHV and Barnardo's short video on the importance of MMR vaccinations

Health visitors’ vital role

When discussing the MMR vaccination with families, as well as encouraging them to have their child/ren vaccinated, it is important to remind them that:

  • Unvaccinated children are at high risk of contracting measles, mumps and rubella – these are all potentially serious diseases that can cause significant health problems.
  • Measles can lead to pneumonia, meningitis, blindness and seizures in children; and miscarriage, stillbirth, premature birth or a baby born with a low birthweight in those who are pregnant3.
  • Mumps can cause viral meningitis, although serious complications are thankfully rare4.
  • And while rubella is rare in pregnancy, it can cause miscarriage and serious problems in the baby including with their sight, hearing, heart or brain5.
  • There is a measles surge in the UK now – it is never too late to get their child vaccinated to protect them and the wider community.

Health visitors and the wider skill-mix team have a vital role to play in improving vaccine uptake. Please use every opportunity to support families to check their child’s vaccine status, answer any questions that they might have with accurate information, and connect families to their GP, or local vaccine initiatives in your area, to promote vaccine uptake.

RCPCH resources

The Royal College of Paediatric and Child Health has some great resources about measles which you can access here.

References
  1. UKHSA (2024) News story Latest measles statistics published.
    https://www.gov.uk/government/news/latest-measles-statistics-published 
  2. Harker, R. (2024) Childhood Immunisation Statistic. House of Commons Library. Number 8556. https://researchbriefings.files.parliament.uk/documents/CBP-8556/CBP-8556.pdf
  3. NHS (2022) Measles.
    https://www.nhs.uk/conditions/measles/
  4. NHS (2021) Mumps.
    https://www.nhs.uk/conditions/mumps/
  5. NHS (2022) Rubella (german measles).
    https://www.nhs.uk/conditions/rubella/

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

NHS publishes Vaccination Strategy for all vaccination programmes

Today, NHS England has published the first national Vaccination Strategy, bringing together all vaccination programmes, to protect communities and save lives. The strategy outlines how getting vaccinations will be made easier than ever before, including through expansion of the NHS App, ‘one stop shops’ and community outreach.

Vaccinations provide one of the most effective public health interventions, preventing between 3.5 and 5 million deaths every year across the globe through childhood vaccinations alone. Whilst the UK has a comprehensive childhood immunisation programme, falling rates of vaccine uptake over the last decade are a source of considerable concern. Tackling this issue will require a whole system approach and health visitors have an important role to play.

At the end of October, the UK Health Security Agency (UKHSA) issued an urgent letter regarding preparedness for measles resurgence in England. Measles is a highly infectious disease which can only be controlled by vaccination. Through their universal work with all families, health visitors can support 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.

The new national Vaccination Strategy outlines three clear priority areas to reverse these downward trends in vaccine uptake and prevent deaths and hospitalisations from vaccine-preventable diseases. These include:

  • Improving access including an expansion of online services: Many more people will be able to book their vaccines online quickly and easily, including via the NHS App. Families will be able to view their full vaccination record with clear information and guidance on what vaccinations they should have to keep them well.
  • Vaccination delivery in convenient local places, with targeted outreach to support uptake in underserved populations: Bespoke outreach services should be tailored to communities that are un- or under-vaccinated, building trust and confidence.
  • A more joined-up prevention and vaccination offer: Vaccination services and activities should be holistic, offering multiple vaccinations for the whole family where appropriate.

The Strategy sets out its plans for improved integration with clinical pathways and greater joint working across all local service providers, including acute, community, mental health and local authorities. Systems should consider how they can:

  • Make vaccination the business of everyone working in patient-facing settings, through training and awareness campaigns. This includes using key contacts to talk to the person about relevant vaccinations, answer questions and, if they cannot deliver the vaccination there and then, signpost to the appropriate services.
  • Base vaccinators in healthcare settings accessed by people who may benefit most from vaccination. This may include emergency departments, outpatient departments, family hubs and community diagnostic centres. The report highlights that, “Family hubs may be especially beneficial for babies and children where parents may be less likely to access a standard offer.”
  • Train and deploy a wider set of professionals to deliver vaccinations. The reports states that, “Local authority services for 0–5 year-olds, for example, have unparalleled contact with underserved communities. Health visiting teams as well as school nursing teams have successfully delivered vaccinations in the past and continue to do so in parts of the country, making use of their extensive skills and relationships. Any such arrangements would need to be locally planned and take into account workforce capacity and funding requirements.”

Whilst the Vaccination Strategy does not set out all the specifics of implementation (and there will be a range of considerations that will need to be addressed), NHS England has indicated that they will continue their work with stakeholders (including the iHV) to develop their plans in order to deliver the proposals. With sufficient resource, there are significant opportunities to build on the work that has already started in Integrated Care Systems to provide more ‘joined-up’ vaccination programmes in the future, across the whole pathway including through integrated neighbourhood, place and system teams.  We are particularly pleased to see the emphasis on reaching all parts of the community, with a specific focus on underserved and marginalised communities that will be needed to tackle widening health inequalities.

Professor Helen Bedford, Professor of Children’s Health, Population, Policy and Practice Programme, UCL Great Ormond Street Institute of Child Health and iHV Expert Adviser: Immunisations, commented:

The UK vaccination programme is among the most successful worldwide, yet there is room for improvement to ensure we offer maximum protection to the population against infectious disease. Each year for the past ten years, small declines in uptake of childhood vaccines, together with large disparities in uptake between geographical areas and social and economic groups, are a cause for concern. If fully implemented, the Vaccination Strategy will be vitally important to ensuring we improve our current position and placing us well to maintain the success of the programme into the future. Through their contacts with families, and the trusting relationships they build, health visitors play a key role in boosting vaccine confidence and in securing the success of the childhood vaccination programme.

Read NHS Vaccination Strategy

Read NHS Vaccination Strategy online

Read iHV Good Practice Points: Promoting the Uptake of Childhood Immunisations which contains advice on health visitors’ role supporting vaccination uptake as part of an integrated approach.

 

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].