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GPs set to run new pre-school Hib booster campaign

Government advisers are recommending GPs conduct a pre-school Hib booster catch-up campaign after warning significant numbers of children are being left unprotected.

The Joint Committee on Vaccination and Immunisation has advised a Hib booster dose be given in children too old to have routinely received the Hib/ MenC booster, normally given at the age of 12 months.

GP leaders welcomed the recommendations, which will now be considered by the Department of Health, but warned funding would be required to reimburse practices for the work.

The advisory committee assessed evidence that more cases of Hib disease than had been expected were occurring in children aged three to four years. The age group is too young to have had sufficient doses to protect fully against the disease following the 2003 campaign.

The committee warned: 'The number of cases in the age groups targeted has fallen but a strong herd immunity effect has not been observed in older children.' A pre-school booster would prevent 50 cases of Hib and two deaths a year, the committee estimated.

It advised vaccination despite an assessment of cost-effectiveness above the usual £30,000 per quality adjusted life-year threshold.

Dr Anthony Harnden, a GP in Wheatley, Oxfordshire, and member of the JCVI, told Pulse it was important the department acted quickly upon the recommendations to maximise the benefits of a catch-up campaign in about 300,000 children. 'There's a cohort who were too old to receive the jab and have missed out through no fault of their own or general practice. I would imagine immunisation would be done in general practice.'

He added: 'The longer the debate goes on the more likely it is they would have missed the age and be too old. There's a pressing need for us to make a decision because these children are getting older now.'

Dr Richard Vautrey, GPC negotiator and a GP in Leeds, said GPs would need support to offer another childhood vaccination. 'The key question is where it will operate. I assume it would operate as part of the routine programme,' he said. There's a need for financial resources to cope with the workload. It's not different to other catch-ups in the past where one-off payments have been made to GPs.'

GPs were paid £7.51 per vaccine for the recent pneumo-coccal catch-up campaign. Dr George Kassianos, immunisation spokesperson for the RCGP, said: 'We welcome this and look forward to the implementation of this recommendation.'

Who will get the vaccine Who will get the vaccine

• Before September 2006, Hib and MenC vaccines were given to babies at two, three and four months with booster at one
• A catch-up campaign was launched in 2003 to vaccinate children aged six months to four years in April
• Evidence suggests levels of herd immunity in older children are lower than expected following the 2003 catch-up campaign
• The new JCVI recommendation is for an additional booster dose of Hib vaccine in children who are too old to have routinely received the Hib/MenC booster, potentially preventing 50 cases of Hib disease and two deaths

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