Immunisation: General practice is key to successful vaccination campaigns

GPs and practice nurses are ideally placed to promote vaccinations and allay any concerns patients may have, which will help boost uptake and ultimately improve health for whole populations, says Public Health England's head of immunisations Dr Mary Ramsay.

Dr Mary Ramsay, head of immunisations, Public Health England
Dr Mary Ramsay, head of immunisations, Public Health England

Last week was European Immunisation Week - a campaign celebrating the successes of vaccines and highlighting the continued efforts needed to ensure that every person is protected from a range of serious but easily preventable diseases. 

Vaccines remain our best and most cost-effective line of defence for many diseases and save millions of lives every year. From the historic smallpox vaccine which eliminated the disease many years ago, to life-saving modern day vaccines such as the flu and HPV vaccine, that continue to keep us healthier for longer.  

Every day practice nurses and other practice staff play a huge part in ensuring the right people take up their offer of vaccination when they become eligible. They also face a year round challenge in ensuring that their local populations come in to receive their vaccinations when they become eligible. Every week that an eligible person delays their vaccination means that the cohort susceptible to a range of serious diseases, which the UK has managed to largely keep at bay for decades, grows.

Misconceptions about vaccines

Generally, vaccine uptake is high in the UK – much of this is down to the efforts of the staff working in general practice. However in recent years there have been small dips in some childhood vaccination programmes, despite the proven benefits. Some GPs may already have seen the first hand effects of local dips in vaccine coverage, with recent outbreaks of measles cropping up in pockets of the UK population with low MMR vaccination coverage.  

Misconceptions and myths about vaccines may stop people from getting protected, such as the myth that having multiple vaccinations at once overloads a child’s immune system. Other barriers, like not having enough appointments available at a convenient time, may be more important.

Frontline primary care workers are ideally placed to promote vaccinations to patients and allay any concerns they might have, as well as bust any myths which might be going around parent and baby groups or the school playground. 

This could be a gentle reminder during a routine checkup with a first time parent, or a friendly letter highlighting what vaccinations are available and encouraging parents to double check in their child’s Redbook to see whether or not they are up to date.

As all doctors and nurses know, as a result of childhood vaccination programmes, many deadly diseases are now rare in the UK including diphtheria, polio and tetanus to name just a few. The world is nearing the elimination of polio- but this is dependent on us keeping vaccination rates high.

Even if people miss out on vaccines at the allotted time, such as if a child is ill when they are due to come into the surgery; they should be encouraged to still catch up at a later date and their appointment should be booked back in straight away.

As frontline healthcare workers, we also benefit from the protection vaccines provide, such as the annual flu vaccine, which help to keep ourselves and the patients we treat. It’s important for us to practice what we preach and take the right steps to keep our patients, and ourselves, well.   

Boosting shingles vaccine uptake

GPs and practice nurses are well placed to communicate to all patients that vaccines are not just for children to give them the best start in life, but can provide important protection that will benefit them across the whole life course. Having vaccines as soon as they become eligible generally means less trips to the doctor throughout life. 

On the other end of the age spectrum, the shingles vaccine is offered to older adults aged 70 and 78, with the possibility of catching up until they turn 80, but unfortunately uptake is currently only around 45%.  

A recent analysis in the Lancet Journal of Public Health showed the shingles vaccine was 62% effective against shingles and between 70 to 88% effective against post-herpetic neuralgia (PHN).1

Considering that shingles affects around 50,000 older people every year, can cause severe pain with debilitating effects for months and causes about 50 deaths every year, increasing uptake could result in major improvements in older people’s quality of life. 

We all have a vital role to play in helping bust these myths and communicating how vaccinations are saving lives and communities from devastating diseases.  Ultimately, general practice staff can contribute most by making sure that the right people receive an invite when they turn eligible. 

Public Health England has recently launched e-learning resources aimed to equip anyone who delivers immunisations with the right, up to date tools so that they feel confident delivering all vaccinations and talking to patients about them.

1. Amirthalingam G et al. Evaluation of the effect of the herpes zoster vaccination programme 3 years after its introduction in England: a population-based study. The Lancet Public Health 2018 3: 2; e82-90.

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