Immunisation and vaccination

Childhood Immunisation and vaccination

Vaccines produce their protective effect by inducing active immunity and providing immunological memory. Immunological memory enables the immune system to recognise and respond rapidly to exposure to natural infection at a later date and thus to prevent or modify the disease.


There are two forms of immunity, acquired and innate. Acquired immunity can be from a vaccination or transferred across the placenta at birth, innate immunity is something that the individual is born with and includes physical barriers such as the skin and chemical barriers such as the digestive system.

From birth and in early infancy and childhood, people are exposed to countless numbers of foreign antigens and infectious agents in the everyday environment. Responding to these stimuli helps the immune system to develop and mature. Compared with exposure in the natural environment, vaccines provide specific stimulation to a small number of antigens.


The main aim of vaccinations is to protect the individual who receives the vaccination against specific diseases. In addition to the immunity gained by the individual, they are also less likely to be a source of infection to others therefore reducing the risk to unvaccinated individuals. This concept is called population or herd immunity. An example of one such programme is the whooping cough vaccination programme, babies under the age of two months are too young to be immunised but are at the greatest risk of dying if they contract whooping cough, however these babies are protected because their older siblings and children have been routinely immunised as part of the whooping cough programme.

It is possible to eliminate the presence of a disease if the vaccination coverage is high enough, for example diphtheria. 


However if high vaccination coverage were not maintained, it would be possible for the disease to return.

Vaccine uptake guidance can be found here - https://www.gov.uk/government/collections/vaccine-uptake

 

The Green Book or the ‘Immunisation against Infectious Diseases’ has the latest information on vaccines and vaccination procedures, for vaccine preventable infectious diseases in the UK, it can be found here - https://www.gov.uk/government/collections/immunisation-against-infectious-disease-the-green-book

Immunisations are commissioned by the National Health Service (NHS) England Local Area Team, from general practices and other providers. The role of local public health is to monitor and scrutinise the delivery of the vaccination programmes.


The childhood immunisation programme includes the following vaccines;

  • 5 in 1 vaccine – protects against diphtheria, tetanus, whooping cough, polio and Hib
  • Pneumococcal vaccine
  • Rotavirus vaccine
  • Meningitis B vaccine
  • Meningitis C vaccine
  • Hib/Meningitis C booster
  • MMR vaccine – protects against Measles, Mumps and Rubella
  • 4 in 1 pre-school booster (DTaP/IPV) – protects against protects against diphtheria, tetanus, whooping cough and polio

More information about these vaccines can be found on the NHS website by clicking here.


Currently, national coverage for most routine immunisations at 12 and 24 months fell slightly. National coverage of MMR at 24months decreased slightly following a year-on-year increase since 2007/08. Figures for most immunisations at 5 years showed a small increase. The exception was for coverage of DTaP/IPV which showed a slight decrease.


The national target for vaccinations is set at 95%.  Nationally this is only being met for the DTaP/IPV/Hib at 2 years and 5 years.  The rates are displayed in figure 1, in the table it shows Wokingham Borough has achieved the national target for DTaP/IPV/Hib at 2 years and 5 years.  The remaining vaccinations are below that national target.  This underperformance is replicated across, England, the South East and the Thames Valley.

 

Figure 1 – Vaccination rates for 1, 2 and 5 year immunisations for Wokingham Borough  compared with England, South East and the Thames Valley

vaccination figure 1
vaccination figure 2

What is this telling us?

 

Although the percentage of children receiving the vaccinations is high Wokingham Borough still has yet to achieve the national target for all but DTaP/IPV/Hib at 2 years and 5 years vaccination programmes. 

Further work needs to be carried out to promote the Diphtheria, Tetanus, Polio and Pertussis booster as well as the MMR vaccination in Wokingham Borough.

Keep up-to-date with your child’s vaccinations with this interactive planner provided by the NHS. To visit the tool on the NHS website click here.