Vaccines in practice - 2011

Should vaccines go through NICE?
Catherine Heffernan
pp 1-3
In 2007, a press release was issued by the Health Protection Agency (HPA) stating that vaccinating 12-year-old girls against human papillomavirus (HPV) would meet National Institute for Health and Clinical Excellence (NICE) criteria for cost-effectiveness. The HPA’s Centre for Infection had modelled a base scenario of 80% coverage in 12-year-old girls, estimating it to be at a likely cost to the NHS of £23,000 per quality-adjusted life-year (QALY). This was less than the £30,000 per QALY threshold set by NICE.
Comment: Measles and MMR – again
Peter M English
pp 3-3
We have been saying for years that vaccination uptake levels do not appear to be as high as is needed to prevent measles from reemerging in the UK. Vaccination uptake rates need to exceed 95% for two doses of measles, mumps and rubella vaccine (MMR) to maintain herd immunity and yet we have consistently failed to achieve this level.
Immunisation of healthcare workers – a national perspective
Conall Watson
pp 4-4
Dan Bowen and colleagues at Birmingham Children’s Hospital have demonstrated that high levels of staff immunisation against seasonal influenza – over 90% – can be achieved at a hospital trust though a combination of belief, leadership, planning, communication and a real commitment to making vaccination as accessible as possible to healthcare workers (HCWs). Their performance lays down a clear challenge to others across England – where uptake in HCWs averages 34.7%.
Achieving high HCW immunisation levels without a mandatory campaign
Dan Bowen, Michelle McLoughlin and Helen Carter
pp 5-7
‘Immunisation is more highly valued by a public persuaded of its benefits, not coerced.’ It is agreed that influenza poses a risk to the vulnerable. Healthcare workers (HCWs) have a duty of care to protect vulnerable adults and children under their care.
Immunisation programmes in Singapore
Si Min Chan
pp 8-9
In 2010, Singapore had an estimated total population of 5.1 million, comprising 3.8 million citizens and permanent residents, and 1.3 million foreigners. The ethnic distribution consists of 74% Chinese, 13% Malay and 9% Indian. There were 37,978 live births in 2010. Singapore has a National Childhood Immunisation Programme (NCIP) that offers vaccination against tuberculosis (TB); hepatitis B (HBV); pneumococcus; diphtheria, pertussis and tetanus (DPT); poliomyelitis; and measles, mumps and rubella (MMR). The pneumococcal vaccine was integrated into the NCIP in November 2009 and the 7-valent, 10- valent, 13-valent conjugate vaccines and 23-valent polysaccharide vaccine are available. Before 2009, pneumococcal vaccine elective immunisation was estimated to cover about 20% of infants. Only diphtheria and measles vaccinations are compulsory by law.
Vaccinations and international travel
Hilary Simons and David R Hill
pp 10-11
Most health hazards encountered by the international traveller are not prevented by vaccination and while the risk of contracting a vaccine-preventable disease during travel is low (usually one case or less per 1,000 overseas visits), the risk can be higher for those with underlying medical conditions, and those visiting friends and relatives, attending mass gatherings or undertaking hazardous activities. The potential for exposure should be assessed on an individual basis as part of a comprehensive pre-travel risk assessment. Vaccination offers the traveller protection against some travel-related illnesses, and is an important public health measure against the international spread of infectious disease.