UK: All child vaccine records to be checked

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All child vaccine records to be checked

All children should have their medical records checked when they start

school to see if they have had vaccinations for MMR and other illnesses,

under official guidance.

By , Medical Editor

Published: 7:15AM BST 23 Sep 2009

Where there are gaps, health visitors should contact parents to encourage

them them to ensure their children are given all the appropriate jabs, the

National Institute for Health and Clinical Excellence had said.

The checks should be made when a child joins nursery, playgroup or primary

school and records kept where parents have expressed concerns about

vaccination, the guidance said.

However campaign groups said parents will feel under pressure to have their

child vaccinated even if they have reservations.

It is the first time Nice has made recommendations about immunisation.

Uptake rates of the measles, mumps and rubella (MMR) vaccine has improved

following the scare in 1998 when Dr Wakefield linked the vaccine to

bowel and autism disorders, but levels still remain relatively low.

It has been estimated that 1.3 million children aged between two and 17 in

England are at risk of contracting measles because they have not been

vaccinated.

Children should have three doses of the five-in-one-jab which contains

vaccine against diphtheria, tetanus, polio, whooping cough and Hib, three

doses of pneumoccocal conjugate vaccine which protects against the bacterium

that can cause septicaemia, meningitis and pneumonia, three doses of

meningitis C vaccine and two doses of the measles, mumps and rubella vaccine

by the time they are aged five.

The guidance said: " The Healthy Child team, led by a health visitor working

with other practitioners, should check the immunisation record (including

the personal child health record) of each child aged up to 5 years.

" They should carry out this check when the child joins a day nursery,

nursery school, playgroup, Sure Start children’s centre or when they start

primary school. The check should be carried out in conjunction with

childcare or education staff and the parents. "

Jackie Fletcher, from the campaign group Jabs, said: " Parents will

definitely feel under pressure particularly because their choice is so

limited. Many parents would like to vaccinate their children but they cannot

have the single measles, mumps and rubella vaccines on the NHS.

" This will put extra pressure on parents that they could do without,

particularly because we do not have compulsory vaccination in this country. "

She said Jabs would support moves to improve record keeping where there are

reasons a child has not been vaccinated, including parental concerns but if

the note was used to put extra pressure on parents that would be a backward

step.

In some states in America children are not allowed to start school until

they have received all their immunisations.

A spokesman for Nice said: “The new Nice guidance recommends that

immunisation records of children and young people should be checked when

they join a new nursery, play group, school or college.

" If they are not up-to-date with their vaccinations, school nursing teams

should explain to parents why immunisation is important for children’s

health and provide information in an appropriate format.

" School nursing teams should also offer vaccinations to help them catch up,

or refer them to other immunisation services.”

Parents will still have a choice to vaccinate their child or not and there

is no recommendation to implement compulsory vaccinations, a spokesman for

Nice said.

Professor Law, Chair of the Public Health Interventions Advisory

Committee (PHIAC) at Nice and Professor of Public Health and Epidemiology,

University College London Institute of Child Health said: “Immunisation

plays a vital role in children’s health by providing protection against

common infections .

" These infections can have devastating effects and even cause death. This

new guidance, for those who have a role in immunisation, makes

recommendations which aim to increase the uptake in groups and settings

where immunisation levels are currently low.”

Dr Elliman Consultant Community Paediatrician, Great Ormond Street

Hospital NHS Trust and Haringey Teaching PCT said: “Although immunisation

rates are rising, there is still a way to go before all primary care trusts

have achieved the desired public health targets. "

Dr Ramsay Consultant Epidemiologist, Health Protection Agency Centre

for Infections said: “Immunisation saves lives and the aim of this guidance

is to ensure that children are given the best possible opportunity to

receive the protection they need.

" This could be achieved by ensuring that children are offered immunisation

at every possible opportunity by improving access by offering walk-in

vaccination clinics, mobile or outreach services which may include home

visits or vaccinations at children's centres and keeping track of their

immunisation history.”

The guidance said the youngest children from large families are among those

who may miss out on vital vaccinations, along with children in care, those

with physical or learning disabilities and children from non-English

speaking families.

This could be down to parents not wishing to have their children immunised

or other factors, such as failing to return to the GP for a follow-up jab.

Other recommendations include introducing outreach programmes and longer opening

hours in clinics so parents can access vaccines for their children more easily.