This site is intended for health professionals only

GPC warns over future additions to ‘crowded’ immunisation schedule

Exclusive The GPC has warned that any additions to the ‘crowded’ immunisation schedule need to be very carefully introduced to maximise uptake and minimise the workload on GP practices.

The warning comes after the Government’s proposed GP contract deal included two new immmunisations this year – rotavirus in the infant schedule and herpes zoster for the elderly.

There is also a large-scale programme to vaccinate all children aged two years and over against flu due to be introduced from 2014, with GPs taking charge of the under-fives and mopping up after a schools-based programme in the five to 17 age group.

Government advisers are also considering GP-based vaccination programmes for meningitis B, HPV vaccination in gay men and widening the pertussis boosters to adolescents and healthcare workers.

Dr Bill Beeby, who chairs the GPC’s clinical and prescribing subcommittee, said GPs will be able to manage the imminent changes, but warned the current schedule is already ‘about as crowded as it’s possible to be’.

He says: ‘It has been changed several times. So any new changes need to be talked over with the GPC, to discuss how we are going to introduce new vaccines.

‘There are always going to be complex [immunisation] routines and if they do introduce new vaccines, such as rotavirus, then it is going to be helpful if they introduce them at points when we are already doing something. flu va

‘It’s not too difficult to design a schedule that doesn’t involve multiple visits.’

The rotavirus vaccine programme will begin in September 2013, with the oral vaccine administered in infants aged two months or older. It does not require an additional visit and can be given with other childhood vaccines.

The herpes zoster vaccine programme is designed to prevent shingles, and will be conducted by GPs in all patients aged 70 to 79 years. Experts say that it can be given concomitantly with the seasonal flu vaccine to decrease the pressure on practices.

Related stories

Analysis: How immunisations are set to change

Case study: How to tackle low immunisation rates

Dr Beeby warned that while parents with young children usually follow GPs’ vaccination advice, they may struggle if repeated visits are required.

He says: ‘If the schedule becomes too complicated, there’s a risk that parents just won’t be able to keep up with it. The immunisation schedule needs to be kept sensible so that it is easy for parents to make sure their children become fully immunised.’

Others raised concerns that the NHS reforms – which give CCGs and Public Health England responsibility for vaccination programmes – will cause problems in rolling out any new programmes.

Dr John Middleton, vice-president of the UK Faculty of Public Health, warns the changes will make the immunisation system much more fragmented.

‘This is going to make it extremely hard to bring in new programmes,’ he says. ‘In fact, it’s going to be difficult enough to keep up levels with the existing immunisations that we have already got.’