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Adult vaccinations

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Introduction

The overall aim of the routine immunisation schedule is to provide protection against the following vaccine-preventable infections1:

    • diphtheria
    • tetanus
    • pertussis (whooping cough)
    • Haemophilus influenzae type b (Hib)
    • polio
    • meningococcal serogroup C disease (MenC)
    • measles
    • mumps
    • rubella
    • pneumococcal disease (certain serotypes)
    • human papillomavirus types 16 and 18 (also 6 and 11)
    • rotavirus
    • influenza
    • shingles

Childhood vaccinations have been designed to provide early protection against infections that are most dangerous for the very young. Further vaccinations are offered at other points throughout life to provide protection against infections before eligible individuals reach an age when they become at increased risk from certain vaccine-preventable diseases.

Figure 1 shows the complete routine immunisation schedule for children, adults, selective immunisation programmes and additional vaccines for individuals with underlying medical conditions. 

Figure 1: Complete immunisation schedule

Imm schedule 2016
Source: PHE, Complete immunisation schedule 2016

Information on immunisation from the 'Green Book' recommends that five doses of diphtheria, tetanus and polio vaccines ensure long-term protection through adulthood. Selective vaccines against diseases including measles, mumps and rubella should be offered to young adults who have not received routine childhood immunisations. In addition, MenC should be considered in those under 25 years who are unvaccinated and for younger cohorts where the routine adolescent dose has been missed. Other vaccinations should be considered for any adult with underlying medical conditions and those at higher risk because of their lifestyle. These vaccinations include Hib, MenB, MenC, MenACWY, influenza, pneumococcal and hepatitis B. Older adults (65 years or older) should be routinely offered a single dose of pneumococcal polysaccharide vaccine, if they have not previously received it. Annual influenza vaccination should also be offered. Adults aged 70 years should also be offered shingles vaccine. People of any age who fall into certain risk groups may be offered vaccines to protect them from infectious diseases. The risk might be because of a medical condition, treatment, occupation or pregnancy.

Information on childhood immunisations can be found at Childhood immunisations (0-4 years) and Childhood immunisations (5 years and over). Further information on infectious diseases and other noncommunicable health threats is available in the Health Protection section.

Facts, figures and trends

Data published by the Public Health Outcomes Framework shows that in Blackpool:

    • The number of adults aged 65 and over who received the seasonal flu vaccination in 2015/16 was 24,818 (70.0%)

    • The number of 'at risk' individuals who received the seasonal flu vaccination in 2015/16 was 11,160 (44.2%)

    • The number of adults aged 65 and over who received PPV in 2014/15 was 24,829 (72.0%)

    • The number of adults aged 70 years who received the shingles vaccine in 2015/16 was 895 (53.4%)2.

Figure 2: Percent of adults immunised: 2015/16, Blackpool compared to England and the North West

Fig1-percent adults immunised 1516
Source: Public Health Outcomes Framework and Shingles immunisation programme 2015 to 2016: evaluation report

 Figure 3: Trend in percent of adults immunised, Blackpool compared to England and the North West

Fig2-Trend in adults immunised
Source: Public Health Outcomes Framework and Shingles immunisation programme 2015 to 2016: evaluation report

In Blackpool the proportion of adults vaccinated against flu, pneumococcal disease and shingles has followed the national trend over the last few years (Figure 3) though is consistently lower than the North West average. Flu vaccine uptake rates for those aged 65+ years in Blackpool have been close to the WHO target of 75% for a number of years, but have begun to fall slightly in the last couple of years. Take-up rates for other at risk groups have been persistently lower and are also falling.  11,160 (44.2%)of 'at risk' individuals were vaccinated in Blackpool in 2015/16 (Figure 4) which is in the second lowest 20% of all local authorities though 41.9% of pregnant women were given the flu vaccine3, this compares with 42.3% nationally.

Figure 4: Proportion of 'at risk' individuals immunised against flu, 2015/16 - Blackpool compared to upper tier local authorities in England

Fig3-percent at risk flu imms 1516
Source: Public Health Outcomes Framework

Frontline health care workers (HCW) involved in direct patient care are also encouraged to receive the seasonal influenza vaccination annually to protect themselves and their patients from influenza.

Nationally 50.6% of all frontline HCWs were reported to have received the 2015/16 seasonal influenza vaccine. Across Blackpool, 5,145 (78%) HCW involved in direct patient care received the flu vaccination in 2015/16. Figure 5 shows vaccination uptake by HCW group.

Figure 5: Proportion of health care workers (HCW) immunised against flu, 2015/16 - Blackpool compared to England

Fig5-HCW flu imm 1516
Source: PHE, Seasonal influenza vaccine uptake amongst frontline healthcare workers in England, Winter season 2016 to 2016

At risk groups

Current national policy advises that seasonal flu vaccine should be offered to:

      • All aged 65 years and older
      • Individuals aged 6 months or over in a clinical risk group
      • Those living in long stay residential care facilities
      • Those in receipt of a carer’s allowance or those who are the main carer of an elderly or disabled person
      • All pregnant women
      • Frontline health and social care workers

At risk groups who should also receive influenza vaccine include individuals with:

      • Diabetes
      • Chronic respiratory disease
      • Chronic heart disease
      • Chronic kidney disease
      • Chronic liver disease
      • Chronic neurological disease
      • Individuals who are immunosuppressed 

National and local guidance

'The Green Book' has the latest information on vaccines and vaccination procedures, for vaccine preventable infectious diseases in the UK

The PHE Annual Flu Plan: Winter 2016/17 sets out a coordinated and evidence-based approach to planning for, and responding to, the demands of influenza across England.

Recommendations

Practices should aim to deliver the nationally expected threshold of 75% for both over 65 years and under 65 years at risk. Adults with certain pre-conditions are recommended by the Joint Committee on Vaccination and Immunisation and the Department of Health (DH) to get the adult influenza immunisation to protect against illness.

 


[1]PHE, Immunisation againt infectious disease, the 'Green Book'

[2]PHE, Shingles immunisation programme 2015 to 2016: evaluation report

[3] PHE, Seasonal influenza vaccine uptake amongst GP Patients in England, 1 September 2015 to 31 January 2016