Rapid Responses to:
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Rapid Responses: Rapid Responses published:
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Catch-up campaigns are a nightmare in practice
- Nigel Higson (30 May 2003)
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no incentive for parents
- J G Daniels (5 June 2003)
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Paediatricians not informed about Haemophilus Influenzae B Booster
- Daniel B Hawcutt, Dr. Dilip Nathan, Consultant Community Paediatrician (27 June 2003)
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Booster campaign information reaching some parents
- Claire M Pillar (27 June 2003)
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Nigel Higson, General Practitioner & Chairman Primary Care Virology Group Brighton BN3 3DX
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Heath and Ramsay raise the possible scenarios of regular "catch- up"campaigns for vaccine-preventable diseases. Such campaigns have been relatively successful but do result in considerable stress in primary care. Regrettably those who decide on campaigns seem unable to talk to those of us who have to administer the campaign and rely on the effects of bribery to try and encourage compliance. A Catch-up campaign requires a plentiful supply of vaccine, storage facilities at the site of administration, an accurate database of cohort, an understanding of the need for the vaccine, software developments to allow the data to be entered on the vaccinee's clinical record and the ability to chase-up defaulters. Time is also required to adminster the call-up, educate the parent/vaccinee, administer the vaccine and undertake the necessary administration Not one of these essential requirements has been pre-planned in the current campaign. Vaccine is being despatched to practices in pre-defined inaccurate quantities on a weekly basis over four months. No additional storage facilities have been planned. Child health record systems are not integrated with practice databases resulting in inaccurate mail-shots. There has been no obvious marketing of the vaccine and practitioners have been suspicious of the need for an additional vaccination (particularly on the back of the continuing lay-press led anti-vaccination lobby). Clinical computer software firms were not pre-warned about the additional vaccine and clinical systems have not been updated with the necessary Read Codes which inihibits the data entry requirements of any new vaccine dose. At a time of stress in primary care with inadequate practitioner numbers and daily demands for change, other things have to "give" in order to find time for additional work - money apart. Yes, I fully agree that catch-up campaigns CAN be successful. However the Department of Health needs to take Primary Care planning into consideration before instituting such campaigns - it also needs to consider the benefits and disadvantages of central vaccine supplies which introduce an additional and significant inefficiency into the system. Competing interests: None declared |
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J G Daniels, SpRPaediatrics Homerton Hospital, London E(
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A slip of paper from the district immunisation co-ordinator arrived on the same day as this weeks' BMJ. It stated that an appointment had been made for my son at the GPs, to receive "Additional HIB vaccine - Be wise - Immunise" The district immunisation coordinator and the Department of Health will have to do better than this if they want their current catch up campaign to be anything other than a failure. The current climate regarding vaccinations means that few parents will take their children for vaccinations unless they fully understand the need for them. Competing interests: None declared |
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Daniel B Hawcutt, SHO Community Paediatrics Radford Health Centre, Radford, Nottingham. NG7 3GW, Dr. Dilip Nathan, Consultant Community Paediatrician
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Editor The new Haemophilus Influenza B vaccination campaign targeting all children from ages six months to four years commenced on the 12th May 2003. It was highlighted in the editorial by Heath and Ramsey entitled Haemophilus influenzae type b vaccine—booster campaign(1) on 31st May. Prior to this information was disseminated by the Department of Health in a Document dated 10th April 2003(2). The recipients appropriately involved Public Health Officials, GP’s, Hospital A&E Department. Unfortunately the information was not cascaded to either Community or Hospital Paediatricians. The former group in particular are involved in advising parents and members of the Primary Health Care Team around immunisation issues. Our Community Paediatric Team only incidentally became aware of the programme when Practice Nurses questioned why we were not encouraging children within the target group. This is particularly important in areas of urban and rural deprivation with families with traditionally low immunisation uptake levels who may opportunistically seek advice for unrelated health issues from a different range of health professionals. These children invariably form a large part of Community Paediatric Practice. It is clearly difficult to ensure information delivery within a structure as vast as the NHS but was surprised at the omission of Paediatricians within an issue which involved children nationally. Dr. Dan Hawcutt
Dr. Dilip Nathan
1 BMJ 2003;326:1158-1159 2 Planned HIB Vaccination Catch up campaign – Further Information. Department of Health Document. 10th April 2003 Competing interests: None declared |
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Claire M Pillar, Website development officer North Cumbria Acute Hospitals NHS Trust
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At least in this small part of North Cumbria the Hib vaccine booster campaign appears to be working. We have received a leaflet with the appointment. However, as has been mentioned, as the vaccine is sent in instalments, children in one family are being vaccinated at different times. Rather a waste of postage to send separate appointment letters and a rather weighty leaflet. If you as a parent didn't receive the leaflet, you can find it at http://www.immunisation.org.uk/hib/ Competing interests: None declared |
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