1. Immunisation overview ST1 Sept 09 Dr Ulla Trend

2. The two public health interventions with the greatest impact are clean water and immunisation (World Health Organisation)

3. The “Green Book” 2006 ( Google “ Immunisation Green Book UK”)

4. Within the hospital Children Vulnerable adults Staff

5. Children 1 Universal programme starts at 2 months and continues till 15 years 7 points in schedule for boys, 10 for girls Should be recorded in the “Red Book” held by parents

6. Children 2 Targeted vaccines for those in need: Neonatal BCG Neonatal Hepatitis B Influenza Pnemococcus

7. Vulnerable adults 1 Influenza ( annual) Over 65 years Chronic respiratory disease Chronic heart disease Chronic renal disease Chronic liver disease Diabetes mellitus Immunosuppression

8. Vulnerable adults 2 Pneumococcus Over 65 years Asplenia / splenic dysfunction. N. B. This includes coeliac disease Chronic respiratory disease Chronic heart disease Chronic renal disease Chronic liver disease Diabetes mellitus Immunosuppression ( +few rarer indications)

9. Vulnerable adults 3 Hepatitis B Chronic renal failure Chronic liver disease Receiving regular blood/blood products Close family contacts of a case or individual with chronic Hepatitis B infection IVDU Frequent change of sexual partner,esp. MSM and male and female commercial sex workers Foster carers Prison inmates and staff People with learning difficulties living in residential care, and their carers Morticians/embalmers

10. Staff involved in direct patient care Routine immunisations up to date MMR (2 doses or immunity) BCG Hepatitis B Influenza Varicella – test if no definite history of disease