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Health Advice - immunisation ad vaccination. Central Hove SurgeryHealth Advice - Children's Immunisations

This advice is based upon advice from the 'UK Joint Committee for Vaccination and Immunisation' (JCVI). See also the 'Green Book' - 'Immunisation against Infectious Disease published by Her Majesty's Stationary Office (HMSO)' - ISBN 0 11 321815. (The new edition (2006) and chapter additions/updates are available via the Department of Health Website. Health Scotland also gives details on a very helpful website aimed at the general public which is easy to follow.

At birth
  • Tuberculosis (BCG) for those with infected or previously infected family members; all babies living in UK areas where the incidence of TB is 40/100,000 or greater, babies whose parents or grandparents were born in a country with a TB prevalence of 40/100,000 or higher. Immigrants from countries with a high prevalence of tuberculosis and their children and infants.
  • Hepatitis B for babies born to mothers who are chronic carriers of hepatitis B virus or to mothers who have had acute hepatitis B during pregnancy plus their close family members.

At 2 months

  • Diphtheria, tetanus, acellular pertussis, inactivated poliomyelitis and Haemophilus influenzae type b (DTaP/IPV/Hib).
  • Pneumococcal (PCV)

At 3 months

  • Diphtheria, tetanus, acellular pertussis, inactivated poliomyelitis and Haemophilus influenzae type b (DTaP/IPV/Hib).
  • Meningococcal serogroup C (MenC)

At 4 months

  • Diphtheria, tetanus, acellular pertussis, inactivated poliomyelitis and Haemophilus influenzae type b (DTaP/IPV/Hib).
  • Meningococcal serogroup C (MenC)
  • Pneumococcal (PCV)

At 12 months

  • Haemophilus influenzae type b (Hib) / Meningococcal serogroup C (MenC) combined.*

Around 13 months

  • Measles, mumps and rubella (MMR).*
  • Pneumococcal (PCV) *

* Note: The JCVI has concluded that it is acceptable to deliver MMR, PCV and Hib/Men C vaccines all at the same time. This follows evidence from a study that showed no additional adverse reactions when all three vaccines were administered simultaneously. The routine childhood schedule remains unchanged, however the new advice allows for flexibility and practitioners may choose to administer all three vaccines at 12 months or 13 months, or keep to the routine schedule (25/08/09).

Parents with concerns over the MMR vaccination are advised to visit the NHS Choices section on MMR Vaccincation designed to give you all the facts about Measles, Mumps and Rubella and vaccination, so you can  decide what is best for your child.

Between 3 years 4 - 6 months - before primary school entrance

  • Diphtheria, tetanus, acellular pertussis, inactivated poliomyelitis and Haemophilus influenzae type b. (DTaP/IPV and Hib)* 
  • Measles, mumps, rubella booster (MMR)
  • Hepatitis B booster, for children immunised in infancy who were born to hepatitis B infected-mothers .

* Note: On advice from the JCVI, a temporary change has been made to the pre-school booster vaccination, allowing a Hib booster campaign to run from Sep 2007 until Mar 2009. The campaign is to provide a Hib booster to a cohort of children born on or between 4 Apr 2003 and 3 Sep 2005 as this group will not have previously received one.

Between 10 and 14 years

  • On advice from the JCVI, the BCG programme in schools is being discontinued during 2005 after which time efforts will be focused in the UK on those in high risk categories such as contacts of known cases and immigrants plus their families from countries with a high prevalence of tuberculosis. See individual country records and the tuberculosis for advice on the risk for travellers.

Between 12 to 13 years (Girls only)

  • Human papillomavirus (HPV) vaccination was introduced in the UK from September 2008. Further information can be accessed via the Department of Health, 'Immunisation against Infectious Disease' (chapter addition 18a).

Between 13 to 18 years

  • Tetanus, low dose diphtheria and inactivated poliomyelitis boosters (Td/IPV).

Special considerations for adults

  • Varicella (chickenpox) is advised for non-immune adult health care workers, who work in general practice and in hospitals, and who have direct patient contact .
  • Hepatitis B is advised for those who may be exposed to blood or blood products through their occupation or life style such as health care workers, ambulance crews and those likely to take sexual risks or use intravenous drugs. Also for those living in households where a member(s) of the household is a hepatitis B virus carrier or attending/teaching in schools in countries where hepatitis B carrier rates are high.
  • Influenza  and/or pneumococcal vaccine is advised for those more likely to have complications such as those with chronic respiratory, heart, or renal disease; asthma; diabetes mellitus; after splenectomy (pneumococcal) or immunocompromise. Also for those over 65 years of age
  • Tetanus booster doses are not required for life in the UK following a full immunisation course i.e. a primary 3 dose course followed by 2 boosters, 5 in total. In the event of a high risk tetanus prone wound, human tetanus specific immunoglobulin should be given. Booster doses of tetanus may also be given at this time if the individual has an incomplete or unknown tetanus immunisation history.
    Travellers to areas where medical attention may not be accessible and whose last dose of tetanus was more than 10 years previously, a booster dose should be given prior to travelling, even if the individual has received 5 doses of vaccine previously. This is a precaution in case immunoglobulin is not available in the event of a tetanus prone wound.
  • Poliomyelitis after the 5 childhood doses boosters are advised 10 yearly for health care workers who may be exposed to infected patients and for those going to countries where poliomyelitis is still endemic.
  • Meningococcal type C vaccination is now recommended under the British Schedule up until the age of 24 years and a travel consultation may be an opportunity to consider this in relation to life in Britain. However it will NOT give any cover against the A and W135 strains prevalent in Africa when the quadrivalent polysaccharide vaccine is the type that is recommended.

For a guide to childhood immunisations and the diseases they prevent please visit the NHS Immunisation advice at www.nhs.uk/Planners/vaccinations

Dr Miriam Stoppard - immunisation Tips


 

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