1. GP PLT: Community Paediatrics
18th September 2012

2. Public Health Update: Flu Vaccination in Children
Dr Caroline Hird
Locum Consultant in Public Health

3. Latest vaccination rates
Routine childhood vaccinations
Q1 Highest rates ever
Flu vaccination in high risk children
17.6% in 6 months – 2 years
35.9% in 2 – 16 years
Flu vaccination in pregnant women
23.1%
The Quarter 1 childhood immunisation data was published at the end of August This shows a continuing and sustained improvement in the uptake of childhood immunisations in Nottingham City. We receive information on 18 measure points at age 1, 2 and 5 years of age, across the 10 different vaccines. 16/18 of these measure points are up when compared to Q4 data by between 0.1% & 3.4% The 2 declines are by 0.6% & 0.7%. This information will be shared with practices individually as well as including it in the Immunisation Bulletin that is will be issued to practices this autumn.
In the city the uptake for all pregnant women last year was 23.1% down from 34.4% the year before/
For at risk – 52.7% - up from 51.2%
Not at risk – 20.8% down from 38.6%
Target for all at risk is 70%

4. High risk groups Chronic respiratory disease
Asthma requiring steroids or previous admissions (including inhaled steriods)
Cystic fibrosis
Children who have previously been admitted to hospital for lower respiratory tract disease
Nine high risk groups but list is not exhaustive, clinical judgement to take into account the risk of influenza exacerbating any underlying illness as well as the risk of serious illness from influenza itself
Copd: including chronic bronchitis and emphysema, bronchiectasis, cystic fibrosis, interstitial lung fibrosis, pneumoconiosis and bronchopulmonary dysplasia

5. High risk groups Chronic heart disease Chronic neurological disease
Congenital heart disease
Chronic neurological disease
Conditions in which respiratory function may be compromised due to neurological disease
Consider on individual basis clinical needs of patients with cerebral palsy

6. High risk groups Chronic kidney disease Chronic liver disease Diabetes
Immune suppression
Pregnancy
List is not exhaustive, clinical judgement to take into account the risk of influenza exacerbating any underlying illness as well as the risk of serious illness from influenza itself
Age 6 months onwards.

7. Vaccines 2012/13 All inactivated except intranasal (Fluenz®)
2 doses 4 weeks apart if <9 years and no previous vaccination
Enzira® - not under 9’s
Viroflu® and Inflexal® – not under 5’s
– an A/California/7/2009 (H1N1)pdm09-like virus;
– an A/Victoria/361/2011 (H3N2)-like virus;
– a B/Wisconsin/1/2010-like virus.

8. What to do Identify children in risk groups
Inform of need to vaccinate
Staff member responsible for FU?

9. Future National children’s flu vaccination programme Details awaited
From 2014
Using intranasal vaccine, live attenuated
Who will deliver vaccine has not been agreed
Children transmit virus to susceptible population and act as reservior