1. Giving MMR alongside teenage vaccines in schools Barbara Morgan Senior Nurse Quality Assurance School Nursing
Firstly I would like to thank Simon and the team in Public Health Wales and VPDP for allowing me to use their tables in my presentation, sorry if I repeat some of what Simon has just said but I am repeating it with regards to figures for uptake in Hywel Dda University Health Board. .

2. Back ground
Hywel Dda includes 3 local authority areas which is a mix of rural with some urban areas.
Hywel Dda University Health Board area, covering a quarter of the landmass of Wales (5,781 square km), is the second most sparsely populated HB area after Powys. Within Hywel Dda University HB, Carmarthenshire accounts for 41 per cent of the land area
There are approximately 44,000 school aged children 5-16 years old
In 211 primary schools and 26 secondary schools, 3 special schools and 3 private schools.
A teams of 55 staff , skill mix of Band 6, Band 5 and Band 3 all working part time term time only

3. Why do we bother! Page Title Source: Public Health Wales
Tables show all Wales levels of uptake of MMR 1 & 2 and then the levels by individual HB, Hywel Dda is second lowest for MMR 1 despite the work that went into the catch-up programme in local outbreak of measles.
Source: Public Health Wales

4. Why do we bother! Source: Public Health Wales
These tables speak for themselves, any increase identified is worth the slight increases in effort.
Source: Public Health Wales

5. Why do we bother! Public health role prevention of further outbreaks
Prudent health care
We’re already in schools immunising

6. Risks and challenges
Professional concerns increase in vaccine errors pupils will not be compliant parents will not consent for 3 vaccines for fear of overload
Pilot carried out in a small secondary school
Pilot carried out in one secondary school which was successful so rolled out to the remaining schools.,
Initially only targeted pupils that had originally had MMR1, now routinely offered to all pupils with none or incomplete MMR status

7. School Sessions
Named nurse for school checks consent forms, separates pupils needing 3
One nurse does either 2 or 3 injections at a time MenACWY & MMR same arm 2.5cm apart dT/IPV in the other arm

9. Immunisation incidents recorded , only 1 incident is recorded as vaccine error should actually be recorded as a consent issue and was regarding fluenz.

10. Source: Public Health Wales

11. Source: Public Health Wales

12. Session in school 2018
Video clip of an immunisation session carried out in Coedcae School, Llanelli
Teenage booster, MenACWY and MMR

13. A Whole Team Approach All nurses now deliver vaccines in this manner
No new concerns have ever emerged
School nurses now looking proactively at immunisation history for any opportunity to complete immunisations.
This is a snap shot of a session in school, this is being shown to evidence how simple and easy it is to administer 3 vaccines to one pupil and to show how well it is received by pupils.

14. Thank you for listening