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Two new vaccines prompt overhaul of child schedule

Pneumococcal vaccination will be added to the childhood schedule as part of a major overhaul of the immunisation programme, the Department of Health has announced.

From June, infants will be given three doses of the pneumococcal vaccine in the first two years of life, contrary to recent media speculation that only two doses would be used.

The meningitis C schedule is also changing, with the four-month dose dropped and replaced with a new combination vaccine against Hib meningitis and meningitis C, to be given at 12 months.

Infants will receive the pneumococcal vaccine at two months ­ with the five-in-one and meningitis C vaccines ­ and at four months.

They will then get a pneumococcal vaccine booster at 13 months alongside MMR, with a catch-up programme until the age of two years.

Dr George Kassianos, RCGP immunisation spokesman and a GP in Bracknell, Berkshire, said the addition of pneumococcal vaccination to the schedule was urgently needed and would be welcomed by GPs.

'This is a great improvement in the UK's immunisation schedule. Too many of us have seen the devastating effects of pneumococcal infection,' he said. Trials suggest the vaccine could prevent 1,000 childhood cases of pneumococcal meningitis, scepticaemia and pneumonia and 27 deaths each year in the UK.

Dr Kassianos thought there could be concern that babies would now have three injections at their two-month visit.

'But we shouldn't worry about this. Giving two injections in one thigh is fine, as long as we allow at least 2.5cm between them.'

The GPC is negotiating payment for the new vaccines to reflect an increase in injections and visits. It is unclear whether there will be target pay for pneumococcal vaccination or a directed enhanced service.

Dr Kassianos added: 'UK GPs have shown they can deliver vaccines to target populations very quickly and efficiently. But it is essential we have continuity of vaccine supplies.'

Wyeth Pharmaceuticals, which makes the pneumococcal vaccine Prevenar, said: 'We take the supply of vaccines very seriously. We have made every effort to make sure there will be enough to meet plans.'

Professor Adam Finn, professor of paediatrics at the University of Bristol, said the introduction of pneumococcal vaccin- ation was long overdue.

He said although the vaccine was relatively expensive compared with other childhood vaccines ­ at a cost of £34.50 for each dose of Prevenar ­ its use would prevent 'a lot of expensive pneumococcal disease'.

He pointed out: 'Pneumococcal pneumonia and ear infections are reduced by vaccination ­ in addition to meningitis.'

Dr Kassianos said overhauling the schedule would improve the efficacy of meningitis C and Hib vaccination.

'Studies have shown improved immunogenicity with a longer gap between meningitis C vaccine doses. In addition, the new schedule adds a Hib booster at 12 months, which is very important.'

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