26 | Nursing in Practice | Spring 2023
CLINICAL
Immunisation proposals and
measures affecting children
The latest clinical guidance in general practice and community nursing nursingin practicelearning . co . uk
1.5 CPD HOURS
The JCVI has advised changes to the childhood immunisation schedule . Here we consider the proposals :
• Children could be offered an additional vaccine appointment at 18 months with a Hib-containing multivalent vaccine ( such as the DTaP / IPV / Hib / HepB , which is also given earlier in infancy ).
• The second MMR dose , currently routinely given at the age of three years and four months , is expected to be
brought forward to 18 months
• A MenC dose at 12 months no longer required
• These changes are expected after supplies of Hib / MenC vaccine ( Menitorix , to be discontinued ) are used
• The routine HPV programme could become a one-dose schedule ( except for special cohorts )
Immunisation programmes are constantly evolving in response to the epidemiology of vaccine-preventable disease prevalent in the population and available vaccines . In the UK , the advice for these changes is provided by the independent Joint Committee on Vaccination and Immunisation ( JCVI ). 1
It is important for immunisers to ensure they remain up to date with these developments , and know where and how to access the most recent information on the current vaccine programme .
This article highlights finalised advice for the proposed changes to the UK childhood immunisation schedule – the childhood part of the complete schedule – as detailed in the JCVI statement of 30 November 2022 . 2 The proposed changes come in response to the discontinuation of the vaccine product Menitorix , which includes the Haemophilus influenzae type b ( Hib ) and meningococcal C ( MenC ) vaccines . The JCVI has issued separate advice that the HPV ( human papilloma virus ) vaccine schedule become a single dose , following evidence of the efficacy of one dose to maintain protection . 3
This article will highlight the key aspects of the JCVI ’ s updated advice .
Background The World Health Organization ( WHO ) recognises that immunisation is a key component of primary care and a fundamental human right ; evidence demonstrates that vaccines have saved the lives of millions and continue to do so . 4 Vaccines are available for more than 20 different diseases and the UK is fortunate to have an extensive range available for the population . The routine immunisation schedule includes vaccines for 16 different diseases that impact our population . 5
Our immunisation programme is constantly evolving , based on the evidence of the burden of vaccinepreventable diseases , the impact of immunisation , the epidemiology of the diseases in the UK and the availability and evidence of the safety and efficacy of vaccines . The UK programme is informed by advice from the JCVI , which was initially established in 1963 , following on from the previous advisory board for polio immunisation . This robust history allowing rigorous scrutiny of the UK ’ s vaccination programmes over many decades offers reassurance for immunisers , parents and the public alike . It is essential , however , that immunisers stay informed and know where and how to access
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