Haemophilus influenzae type b vaccine—booster campaign
BMJ 2003; 326 doi: https://doi.org/10.1136/bmj.326.7400.1158 (Published 29 May 2003) Cite this as: BMJ 2003;326:1158All rapid responses
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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
Community Paediatric SHO
Dr. Dilip Nathan
Consultant Paediatrician
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
Competing interests: No competing interests
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
Competing interests: No competing interests
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
Competing interests: No competing interests
Booster campaign information reaching some parents
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
Competing interests: No competing interests