MMR vaccination programme may run into next school year

Ninety-five percent of GPs have ordered additional MMR vaccines, but Public Health England has admitted that there may need to be a schools-based programme when children return after the summer holidays to meet its target.

The national MMR vaccination catch-up campaign, which launched in April, has resulted in GP practices ordering 200,000 total additional doses of MMR vaccine, Public Health England said, although overall uptake figures are not yet available.

But the figure falls far short of the doses needed to immunise the one million at-risk children targeted by Public Health England at the launch of the campaign and there may need to be a schools-based programme when children return to school in September, the original deadline for the programme.

Dr Mary Ramsay, head of immunisation at PHE, said: ‘We are encouraged by the high levels of engagement by GP practices seen to date. Health protection teams are continuing to work closely with our NHS partners to ensure we have accurate records of children who have missed vaccination, particularly in parts of the country where we are seeing more cases.

‘In July we will make a judgment about how well the programme is working through primary care and if it isn’t we will consider implementing a schools-based programme in September.’

The new public health body has estimated that there are approximately one third of a million 10-16 year olds (around 8%) who have had no vaccine, and they are the focus of the current campaign. However, it is also targeting a further third of a million in that age bracket who are in need of at least one further dose of MMR to give them full protection and a further estimated third of a million children above and below this age who need a further dose.

Commenting on the figures, Royal College of Paediatrics and Child Health immunisation specialist Professor David Elliman said: ‘It’s gratifying that ordering of 200,000 doses of the MMR vaccine has been done by GPs because it indicates enthusiasm, but there are caveats.’

‘The issue is the backlog. The target within the 10-16 year olds is a third of a million doses for children who’ve had nothing at all and a like number for children who’ve had one dose, so that’s still quite a way short even if all those 200,000 doses were used. And then there’s another third of a million we need to immunise outside that defined age group.’

He added that the reason for the haste, which is ‘appropriate’, was to ‘get the immunisation done before the beginning of the next school term so the timing is not brilliant because we’re coming up to major school holidays so people will be going away’.

‘From past experience for this age group, campaigns run through general practice have limited uptake, campaigns run through schools are better.’

Dr Tony Grewal, Londonwide LMCs medical director and a GP in Hillingdon, said GPs have ‘responded magnificently’.

He said: ‘If you look at the information we had before the campaign started, it looks as though in total there may be an average of 20 patients per GP – so the numbers are not unmanageable and practices can and will respond to in a short time scale if necessary. There still is time to identify, invite and immunise this 10-16 year old group before they go back to school.

‘Basically it’s down to general practice that has responded magnificently – as no other system could do, only general practice has the contacts and the list system that allows us to target these vulnerable children and no other system could have done it has general practice did.’

Under the programme, GPs receive £1.50 for each at-risk child on their list that they identify and call in for vaccination and £7.64 for each dose of MMR given to any unvaccinated patients aged 16 and over who present to the GP surgery requesting vaccination.

The service specification - agreed by the GPC and NHS Employers - involves practices identifying all children aged 10 to 16 years (born from 1997 to 2003) on their practice list who need at least one dose of MMR to fully protect them from measles, and then writing to their parents or guardians to offer them the vaccination.