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Immunisation

Immunisation

Immunisation is a cost effective and critical element of preventive care around the world. The World Health Organization (WHO) estimate that it prevents between two and three million deaths each year.

Nurses have a major role in advising and promoting immunisation. This includes administering vaccinations included in the childhood immunisation programme and those recommended for adults, including travel vaccines and the annual influenza vaccination.

Immunisation policy for the UK is available in Immunisation against infectious diseases – the Green Book. The book includes the rationale for the policy. It also has the individual disease epidemiology and evidence on the efficacy and safety of the appropriate vaccines. It also contains general information on immunisation administration and best practice.

The book is written and updated by the Department of Health in conjunction with the public health agencies across the UK. All health care professionals involved in immunisation should have access to the online version.

The Joint Committee on Vaccination and Immunisation (JCVI) advises the UK health departments on immunisations for the prevention of infections and/or disease following due consideration of the evidence on; the burden of disease, on vaccine safety and efficacy and on the impact and cost effectiveness of immunisation strategies.

Current issues

Beat the flu

The RCN is encouraging members to beat the flu this winter by getting their flu vaccine.  It is a professional responsibility for all nursing staff to have the flu vaccine to help protect vulnerable patients and clients. The RCN also believes the flu vaccine should be freely available to nursing students, not only to protect them and their patients, but to instill best practice in the health care professionals of the future.
 
Members are encouraged to take part in the RCN’s social media campaign to help beat the flu and to raise awareness of the benefits of the vaccine. The RCN has produced a number of resources to support nursing staff to deliver a quality flu vaccination programme.  See: Beat the flu

Read the Blogs: 

BCG

The BCG vaccine, now available for the UK for the national BCG programme, is manufactured by AJ vaccines (formerly the Statens Serum Institut (SSI). It is available to order via the usual channels. See: Important update on supply of UK-licensed BCG vaccine.

MMR / Measles

PHE has released new leaflets and posters designed to promote MMR vaccination, particularly to those who may have missed vaccination as children, and to alert people to symptoms of measles so they can minimise spread of infection. See:

General Guidance

Immunisation policy for the UK is available in the Department of Health (DH) publication Immunisation Against Infectious Diseases: The Green Book.

Immunisation policy in the UK is informed by the Joint Committee on Vaccination and Immunisation (JCVI). The JCVI's remit is to advise UK health departments on immunisations following due consideration of the evidence on the burden of disease, on vaccine safety and efficacy and on the impact and cost effectiveness of immunisation strategies.

Immunisation resources

Department of Health guidance “What to expect after vaccinations”

BMA vaccinations and immunisation guidance

NICE pathway - Immunisation for children and young people

The World Health Organization (WHO) provides country-specific immunisation schedules.

The European Centre for Disease Prevention and Control (ECDC) vaccine scheduler provides European vaccination schedules.

Administration of vaccines

See: Practical and clinical guidance for vaccine administration.

Immunisation training

All staff involved in administering vaccines should be suitably trained and competent to fulfil the role and be able to answer questions with accuracy and confidence in line with nationally agreed standards.

New e-learning resource resource for Immunisation 

A new interactive e-learning programme has been developed to support the training of healthcare practitioners involved in advising on and/or delivering immunisation accross the life course. The programme is free to access, just register to use the e-lfh portal. The course is designed around the updated National Minimum standards and the competency assessment tool.

View the Immunisation e-learning programme.

Keeping up to date

The immunisation programme in the UK is constantly evolving to best protect the public by controlling vaccine preventable diseases. Health professionals must keep up to date with these changes.

The vaccine supply newsletter, ‘Vaccine Update’ comes out approximately every four to six weeks and can be emailed directly to individuals upon request. Email: Vaccine.Supply@dh.gsi.gov.uk. This newsletter gives advice on current vaccine availability, any changes to the schedule and updates to the Green Book.

‘Vaccine Update’ is available to health care professionals across the UK. However, for country specific information, see:

Travel health vaccination

UK figures for overseas travellers have more than tripled since 1981 (Office for National Statistics, 2012) and travel health medicine is a fast growing specialist area of practice. The RCN guidance ‘Travel health nursing: career and competence development' defines the standards of care expected for a competent registered nurse, experienced/proficient nurse and a senior practitioner/expert nurse working in travel health nursing.

The National Travel Health Network and Centre (NaTHNaC) provides advice on travel health, including travel vaccination.

TRAVAX from Health Protection Scotland (HPS) provides similar information to NaTHNaC.

NHS Wales has an organisational subscription to TRAVAX which is therefore freely available to NHS Wales users (via HOWIS (Health of Wales Information Service)).

The Department of Health (DH) publication, Health Information for Overseas Travel: The Yellow Book, provides information for health professionals on health risks to travellers and how to reduce them. Copies of this book can been ordered via the NaTHNaC publications online ordering service.

The British Medical Association (BMA) publication, Focus on Travel Immunisation offers clarity around the immunisation issues within the General Medical Services (GMS) contract and how travel immunisations may be funded.

More people in the world are migrating today than at any other point in human history and the Health Protection Agency (now part of Public Health England) has produced a Migrant Health Guide, which supports practitioners making decisions around best protecting the health of migrants. An accompanying video looks at how to catch up immunisations for migrants to the UK.

The RCN guidance, Travel Health Nursing: Career and Competence Development provides information on current guidelines and standards and defines the standards of care expected for a competent registered nurse, an experienced/proficient nurse and a senior practitioner/expert nurse working in travel health nursing.

Additional information

It is good practice to support any advice you give with written information. Check that the information printed from websites is up to date, evidence based and from a credible source.

As a general guide when searching the web for information, ask yourself and encourage patients, parents and carers to ask the following questions:

  • who or what is behind the information?
  • is the information biased, or possibly selected to present one view point?
  • does the author have a vested interest in the information they are presenting?
  • is it dated? There may be more current advice available.
  • is it referenced and are uncertainties acknowledged?

In addition look for websites providing reliable and trustworthy health information which have the Health on the net HONcode.

Useful websites and resources:

  • World Health Organization. The WHO Global vaccine safety initiative provides links to web sites which meet agreed standards on what is good information. See: Vaccine safety websites meeting good information practices criteria. The Vaccine safety Net provides further information and links to WHO validated web sites and reputable sources of evidence related to vaccines and vaccine preventable disease 

  • These websites will provide you with further information:

  • British Foreign and Commonwealth Office
  • Centre for Public Scrutiny (CfPS). The CfPS and Sanofi Pasteur MSK, have developed resources to support local authorities scrutinise immunisation services: 10 questions guide to scrutinising immunisation services. The report includes case studies of best practice.
  • European Centre for disease prevention and control
  • Health Protection Scotland
  • HSC Public Health Agency Northern Ireland:health protection
  • International Longevity Centre - Immuneresponse. Adult immunisation in the UK
  • Meningitis Research Foundation- has a range of information about meningitis and septicaemia. 'Vital Signs Vital Issues' is a useful resource and includes answers to many of the questions parents frequently ask about vaccination
  • NHS24 - health information and self care advice for Scotland.
  • NHS Choices: The NHS vaccination schedule - information from the NHS choices web site can be printed off to give to patients.
  • NHS Direct Wales
  • Oxford Vaccine Group (OVG): Vaccine KnowledgeProject - this site is aimed at informing parents about VPDs and has useful films on decision making
  • PHE Immunisation pages
  • PHE Health protection, infectious diseases
  • Public Health Wales: health protection
  • *The Children’s Hospital of Philadelphia Vaccination Education Centre
  • *USCentres for Disease Control and Prevention - vaccines andimmunizations. This American website contains useful sources of information including Vaccine Information Statements, and Interpreting abbreviations on records
  • WHO: Immunisation schedules by country
  • * denotes American websites where vaccine schedules may vary to those followed in the UK.

    Page last updated - 06/11/2018