Immunisations

Baby Vaccinations

Invitations for routine childhood vaccinations are sent to you by the health authority. On receipt please contact the surgery to make an appointment with the practice nurse.

Please note immunisations will only be administered if the red book (parent held record) is brought to the appointment. This book contains information on the child's full immunisation history and ensures that your child receives appropriate care.

If the child is brought to an immunisation appointment by some one other than a parent, the carer MUST bring a consent form signed by the parent, listing all the immunisations to be given and the appointment date.

A list of the immunisations and the stages are which they are given are to be found in the child's red book (parent held record).

Leaflets with more information about vaccinations can be obtained from the Health Visitors who are also happy to discuss any queries you may have. If your child receives vaccinations at any other surgery or clinic please inform the surgery so our records can be updated.

Hepatitis A

Vaccination is not routinely necessary in the UK. However vaccination is advised in the following circumstamces.

• Travelers to developing countries with high rates of hepatitis A infection. Check with the Nurse if this is recommended where you are going 
  
• Homosexuals
• Users of illegal drugs 
  
• People who work with hepatitis A virus in research settings

Hepatitis B

Vaccination against Hepatitis B is strongly advised for all people who have close or frequent contact with human blood and blood products, or with any source of hepatitis B viral infection. It is especially important for anyone at risk of needlestick and sharps injury, or physical violence.

Hospital workers such asl doctors, nurses, laboratory technicians, chiropodists, physiotherapists, speech therapists and staff who may contact used needles or contaminated clinical waste such as cleaning staff, laundry handlers and plumbers.

Vaccination should also be offered to staff working in institutions for the mentally handicapped, prison officers, blood transfusion service staff, fire, ambulance and other rescue service personnel. All these people could be at risk of infection in their work.

What is it?
Vaccination against hepatitis B is given as a course of three injections (into the upper arm) over a period of six months. Once completed, it provides very effective protection against infection especially in younger people. Some recipients may experience mild soreness and flu-like symptoms following the injections, but generally, they are well tolerated and produce very few ill effects. As with all medications, the vaccination is not normally given during pregnancy. The vaccine is prepared by synthetic techniques and does not contain live virus components.

How long does it last?
Anyone sustaining an injury where there is a risk of infection should be asked about their most recent immunisation. As with tetanus immunisation if there is any doubt as to the individual's level of protection, a blood test to check their immunity and possibly as booster vaccination may be advised. In addition, as a matter of routine, a test to check their antibody response is advisable following immunisation, and at 5 - 10 yearly intervals thereafter. Booster doses should be based on blood levels of protective antibodies.

HiB or Haemophilus Influenza Vaccine

HiB vaccine offers protection against the most but not all strains of this germ that may cause meningitis, acute epiglottitis, pneumonia, septic arthritis and cellulitis. Some forms of ear infections may still occur after vaccination.

The schedule now used is three doses of vaccine given at 2, 3 and 4 months.

Hib vaccine is offered to children up to 4 years of age; a single dose only is needed over one year old.

A combined DTP and Hib vaccine is available.

Holiday Vaccinations & Advice

The Practice nurses are happy to advise you on recommended health precautions for your foreign travel.

This may require vaccination according to the country or countries you are visiting and the time of year you are travelling.

The nurse has regularly updated information about the recommended vaccinations required for each part of the world and will be able to advise you if new or booster vaccinations are necessary after looking at your immunisation records. 

You should make sure you book an appointment at least a month in advance of your travel in case more than one vaccination has to planned after an interval to provide full protection.

Patients are warned that some specialised vaccinations are not provided as part of NHS services and maybe relatively expensive, requiring a private prescription to be paid by the patient.

Prescriptions to prevent malaria where necessary are also not provided under the NHS terms of service though in general are quite cheap and again these will be provided on a private prescription.

See a full list of our Travel Vaccination Charges.

Influenza

Influenza vaccine gives 70-80% protection against infection. In the elderly, protection against infection may be less, but immunisation has nonetheless been shown to reduce pneumonia, admissions to hospital and fatal outcomes as a result of infection with the Influenza virus. However influenza-like illnesses can be caused by many respiratory viruses and the influenza vaccine cannot prevent all of these.

Recommendations
The greatest problems from influenza occur among people with underlying disease, particularly long-standing lung or heart disease, and especially if they are also elderly. Influenza immunisation is offered to:

• Aged 65 and over 
  
• Asthma and Bronchitis 
  
• Heart disease 
  
• Kidney failure 
  
• Diabetes mellitus 
  
• Decreased immunity due to disease or treatment e.g. those taking oral steroids. 
  
• Residents of nursing homes, old people homes and other long-stay facilities where rapid spread is likely to follow introduction of infection.

Routine immunisation of fit children and adults, including health care and other key workers, is not recommended. These recommendations are unchanged from last year.

Dosage
Adults - a single injection. Children aged 3 - 12 years—injection repeated 4-6 weeks later if receiving influenza vaccine for the first time. Children aged 6 months-35 months—injection repeated 4-6 weeks later if receiving influenza vaccine for the first time.

The vaccines are prepared in hens' eggs and should not be given where there is severe allergy to egg products.

Side Effects
Influenza vaccine is usually well-tolerated apart from occasional soreness at the vaccination site. In rare instances it can, however, cause:

Fever, malaise and muscle pain beginning 6-12 hours after immunisation and lasting up to 48 hours. More rarely, immediate reactions such as allergic rashes and allergic asthma, most likely due to hypersensitivity to residual egg protein.

Influenza vaccine contains inactivated virus and cannot cause influenza.

Timing of influenza immunisation
Protective antibody levels may take up to 10-14 days to develop. Influenza activity is rarely significant before the middle of November, and therefore the ideal time for immunisation is October/early November. Immunity can be expected to last through the winter.

Meningitis C Vaccine

Routine immunisation with meningocococcal Group C conjugate vaccine was added to the national programme, from November 1999.

A newer more effective vaccine has recently become available. It is given as an injection into the fat or muscle.

Recommendations

• All children at 2,3 and 4 months with DTP/Hib/polio vaccination (3 doses) 
  
• Children aged 13 months with MMR (1 dose who have not previously received vaccine) 
  
• Children aged 15-17 (1 dose who have not previously received the vaccine) 
  
• First-year university/college students: (1 dose who have not received the vaccine through the schools programme) 
  
• Young Adults aged between 20-24 years 
  
• Splenectomy 
  
• Coeliac Disease 
  
• Sickle Cell Anaemia
  

If an individual received an older polysaccharide vaccine they should now receive the new vaccine, provided 3 years have elapsed.

Pnemococcal

Pneumococcal immunization consists of a single injection which is effective against 90% of pneumococcal strains that cause serious infection in the UK. Children under 2 years of age should be given a special form of the vaccine.

Immunisation is recommended in:

• Aged 65 and older 
  
• Post-splenectomy patients, though it is preferable to administer the vaccine some weeks before elective splenectomy 
  
• Coeliac Disease 
  
• Sickle cell disease 
  
• Diabetes 
  
• Immunocompromised and HIV-infected patients 
  
• Chronic liver disease and Alcoholism 
  
• Heart Failure 
  
• Kidney failure 
  
• Asthma and Chronic Bronchitis

Polio

The polio vaccine is a live vaccine, containing strains of the three polio viruses types I, II and III. It is given as drops by mouth, in three doses at the same time as the DTP vaccine - at 2, 3 and 4 months of age - with a booster dose of vaccine at school entry.

Once given the viruses become established in the intestine and stimulate the formation of antibodies both in the blood and the bowel lining. A course of three doses results in long-term immunity.

Adults don't need reinforcing doses unless they are at particular risk, for example travelling to high risk areas of the world or are health care workers with high exposure to polio cases.

Tetanus & Diptheria

The old single antigen tetanus vaccine has now been replaced by the combined tetanus/low dose diphtheria vaccine for adults and adolescents . 

It should be used for primary immunisation and for previously unimmunised adults and adolescents and where booster doses of tetanus are indicated to complete a full course of 5 doses of vaccine. 

It is no longer necessary to give boosters every ten years. 

A limited amount of single antigen tetanus vaccine is available for use in individuals who require a tetanus booster but have recently received single antigen low dose diphtheria vaccine, for example for the purposes of travel.

Tuberculosis

The BCG vaccine is a live attenuated given into the skin or intradermal injection. In the UK this vaccination is offered to all adolescents at around the age of 13 years, provided they have a negative Mantoux test.

The Mantoux test consists of a small injection into the upper arm which is examined or 'read' two to three days later.

A positive result is indicated by redness and induration (swelling) of at least 10 mm in diameter and the BCG is not necessary. If negative the BCG is given.

About 4 weeks after the BCG injection a local skin reaction is produced and there may be enlarged glands under the armpit in those who develop a strong immune response to the vaccine.

BCG vaccination is thought to give approximately 80% protection over 20 years.

Typhoid

The Department of Health currently recommends immunisation for all travellers to:

• Central and South-East America
  Middle East
  
• Some parts of South-East Europe
  India and Pakistan
  
• South - East Asia - including Bangladesh, Nepal, and the Pacific Islands
  
• China
  
• Africa
  

There are two forms of vaccination. By injection of an inactive vaccine though this is ineffective in children less than 18 months. By mouth as a live attenuated vaccine. It must not be given to children under six years.

The injectable form is given as a single dose and produces protection within 3 weeks in 95% of volunteers which persists in 90% for 3 years.

The oral vaccine is given orally in three doses on alternate days.It provides protection in two thirds of patients for 3 years. It is expensive, and is not licensed for children under 6 years.

Vaccinations in Pregnancy

Vaccines that may be given include:

• Cholera 
  
• Influenza 
  
• Tetanus/Diptheria
  

Vaccines that are NOT ADVISABLE except for a specific indication include:

• Polio 
  
• Typhoid 
  
• Smallpox 
  
• Yellow fever - in general pregnant women should not be given live vaccines. 'There may be exceptions, for example, the risk of yellow fever greatly outweighs the risk from vaccine. Ask your doctor for advice.

Vaccines that MUST NOT be given include:

• Rubella (women who are rubella NON-immune should be vaccinated after delivery) 
  
• Mumps 
  
• Measles 
  
• BCG (Tuberculosis)
  

Yellow Fever

Yellow Fever is transmitted by the bite of mosquitoes is confined to Africa and South America between 15 degrees north and 15 degrees south of the equator.Yellow fever has not been reported in Asia.

Yellow fever vaccination is a live, attenuated and freeze- dried preparation of the 17D strain of the virus, propagated in chick embryos.

The vaccine is an injection - and has to be given within one hour of it being prepared. For this reason it is only given at designated centres, which can be found listed in "Immunisation against infectious disease".

The vaccine is fully effective after 7-10 days and gives 95% protection which is probably life-long. However for the purpose of certification a booster is required every 10 years.

This vaccination is contraindicated for patients under the age of 9 monthsot those allergic to eggs. Vaccination in pregnancy is not advised unless the risks of contracting the illness outweight the dangers of vaccinattion.