This investigation sets out the system for providing vaccinations to pre-school children in England. It is prompted by public concerns about the levels of uptake of pre‑school vaccinations | National Audit Office
Health professionals consider that vaccinations are a crucial tool in protecting the health of individuals and that of the wider population, particularly for people with existing health problems who are more vulnerable to infectious diseases and for those who cannot receive vaccinations themselves. For vaccinations to be most effective, the World Health Organization (WHO) recommends that enough people need to be vaccinated to stop disease spreading across the population. This is called ‘herd immunity’.
There are seven types of vaccines (which protect against 13 diseases) routinely provided to children by the National Health Service (NHS) before they go to school aged five. In 2017‑18, the Department of Health & Social Care (the Department) set NHS England a performance standard of 95% uptake for pre-school vaccinations (except flu). There has been a general fall in uptake of pre-school vaccinations in England since 2012-13 and, in many cases, uptake of these vaccinations
is below the Department’s performance standard.
This report sets out:
the current levels of vaccination uptake and cases of disease across England
Public Health England (PHE)’s and NHS England’s understanding of the problem
PHE’s and NHS England’s response to the problem.
The report uses the MMR vaccination, the 4-in-1 booster and the Hib/MenC booster to highlight many of the challenges that exist in the system for pre‑school vaccinations and illustrate in more detail how uptake of vaccinations is falling.
Guidance for early years childcare settings on the nasal spray flu vaccination for preschool children. | Public Health England
This guidance has been produced for the early years sector to assist staff and childminders and answers the most frequently asked questions regarding the nasal spray flu vaccination being offered to children in this age group.
It is not intended for parents and children as they have their own dedicated leaflet.
Objective: To investigate recruitment and retention, data collection methods and the acceptability of a ‘within-consultation’ complex intervention designed to reduce antibiotic prescribing.
Conclusion: Differential recruitment may explain the paradoxical antibiotic prescribing rates. Future cluster level studies should consider designs which remove the need for individual consent postrandomisation and embed the intervention within electronic primary care records.
Adams, D.J. et al. The Journal of Pediatrics | Published online: 7 April 2017
Objective: To characterize the medication and other exposures associated with pediatric community-associated Clostridium difficile infections (CA-CDIs).
Conclusions: CA-CDI is associated with medications regularly prescribed in pediatric practice, along with exposure to outpatient healthcare clinics and family members with CDI. Our findings provide additional support for the judicious use of these medications and for efforts to limit spread of CDI in ambulatory healthcare settings and households.
Zingg, W. et al. The Lancet Infectious Diseases. Published online: 12 January 2017
Background: In 2011–12, the European Centre for Disease Prevention and Control (ECDC) held the first Europe-wide point-prevalence survey of health-care-associated infections in acute care hospitals. We analysed paediatric data from this survey, aiming to calculate the prevalence and type of health-care-associated infections in children and adolescents in Europe and to determine risk factors for infection in this population.
Findings: We analysed data for 17 273 children and adolescents from 29 countries. 770 health-care-associated infections were reported in 726 children and adolescents, corresponding to a prevalence of 4·2% (95% CI 3·7–4·8). Bloodstream infections were the most common type of infection (343 [45%] infections), followed by lower respiratory tract infections (171 [22%]), gastrointestinal infections (64 [8%]), eye, ear, nose, and throat infections (55 [7%]), urinary tract infections (37 [5%]), and surgical-site infections (34 [4%]). The prevalence of infections was highest in paediatric intensive care units (15·5%, 95% CI 11·6–20·3) and neonatal intensive care units (10·7%, 9·0–12·7). Independent risk factors for infection were age younger than 12 months, fatal disease (via ultimately and rapidly fatal McCabe scores), prolonged length of stay, and the use of invasive medical devices. 392 microorganisms were reported for 342 health-care-associated infections, with Enterobacteriaceae being the most frequently found (113 [15%]).
Sepsis awareness campaign will help parents and carers of young children recognise the symptoms of sepsis.
A nationwide campaign has been launched to help parents spot the symptoms of sepsis to protect young children and save lives.The campaign is principally aimed at parents and carers of young children aged 0 to 4.
The campaign, delivered by Public Health England and the UK Sepsis Trust, follows a number of measures already taken by the NHS to improve early recognition and timely treatment of sepsis. This includes a national scheme to make sure at-risk patients are screened for sepsis as quickly as possible and receive timely treatment on admission to hospital.
Leaflets and posters are being sent to GP surgeries and hospitals across the country. These materials, developed with experts, will urge parents to call 999 or take their child to A&E if they display any of the following signs:
looks mottled, bluish or pale
is very lethargic or difficult to wake
feels abnormally cold to touch
is breathing very fast
has a rash that does not fade when you press it
has a fit or convulsion
The UK Sepsis Trust estimates that there are more than 120,000 cases of sepsis and around 37,000 deaths each year in England.