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Childhood immunisations resources for professionals

This page contains useful information for those working in childhood immunisations in North West London. 
On this page you'll find contact numbers, links to the vaccine update and helpful links to further resources.

Latest updates from the North West London immunisations team

In this section you'll find the latest news and messages from the childhood immunisations team. 

Current areas of focus:

Measles and MMR  - quick overview

  • Just one person with measles can infect nine out of ten people who have not had the MMR vaccination.
  • Measles is more than just a rash, in some cases it can lead to meningitis and sepsis, causing real risk to life.
  • 1 in 4 cases of measles cases requires a hospital visit
  • Since the measles vaccine was introduced in the 1960s over 20 million cases have been avoided, saving over 4,500 lives.
  • Measles is completely preventable with the MMR vaccine. Two doses provide over 99% protection.

UKHSA resources on immunisation can be found here

 

Brief overview for primary care staff

  • Measles is highly infectious and can be severe in immunosuppressed patients and young infants. Measles in pregnancy increases the risk of miscarriage, stillbirth or preterm delivery.
     
  • The incubation period is typically around 10 to 12 days but can vary from 7 to 21 days. Patients are infectious four days before and after the onset of rash. R rate for measles is 15-20 (15 to 20 individuals infected from a single case in a totally susceptible population)
     
  • All staff working in primary care should have two documented MMR vaccinations or be IgG positive for measles. Staff who do not have immunity/ pregnant/ Immunocompromised should not be involved in the assessment or management of patients with suspected measles.
     
  • All children presenting to primary care with fever and coryzal symptoms should be triaged before being seen f2f. They should not be waiting in reception areas. Please do have hot and cold pathways if practically feasible within your surgeries. If this is not possible, children should be triaged and seen with  minimal waiting times within the surgery. Think about seeing the patient at the end of a session in a designated room where fallow time and cleaning can be undertaken

Ask about, and look for symptoms of measles:

  • Fever of 39ºC or more without taking paracetamol or ibuprofen, a rash which goes away with pressure and at least one of the following: cough, runny nose, and conjunctivitis.
     
  • A measles-like rash - red spots non-tchy, sometimes raised and joined together to form blotchy patches. The rash starts three to four days after the initial symptoms behind the ears, then the face, trunk of body and limbs.
     
  • Small white spots inside the cheeks and on the inner part of the lips –Koplik spots.
     
  •  Think about differential diagnosis -Scarlet fever/streptococcal infection,Kawasaki disease,Early meningococcal disease,Parvovirus B19,Rubella,Infectious mononucleosis (glandular fever),Herpes virus type 6 (roseola infantum) and safety net the patients appropriately.
     
  • Wear appropriate personal protective equipment (PPE). FFP3 is recommended by NHSE. FFP3 Fit testing has been arranged through mutual aid at various acute providers in NWL. Please see below for further details.
     
  • Seek immediate advice from secondary care services  if the patient has a measles-like rash and is in one of the following high-risk groups:
     
    • Younger than one year of age
    • Immunocompromised (regardless of immunisation status)
    • Pregnant
       
  • Immediately notify the local Health Protection Team (HPT):  They will advise on public health measures including contact tracing and  surveillance testing.
     
  •  The HPT will also advise on post-exposure prophylaxis. Healthy immunised patients deemed as low risk will need warn and inform l​​​​etter from the surgery or A&E.
     
  • Post exposure prophylaxis is recommended for Immunocompromised, Younger than one year of age and pregnant patients.
     
  • For immunocompromised patients, HPT will arrange administration of intravenous immunoglobulin through secondary care.
     
  • For pregnant women and infants under 9 months of age, HNIG (Human Normal Immunoglobulin) is recommended. HPT will liaise obstetric team for pregnant patients & local Paediatric team for infants under 9 months. Infants between 6-9 months of age who did not have a household exposure and infants over 9 months, will need MMR (to be done at the surgery).

 

  • Patients with measles need to exclude themselves from nursery/educational settings and work until four days after the onset of rash. Please do safety net patients regarding complications – pneumonia, otitis media, diarrhoea, encephalitis (rare), subacute sclerosing panencephalitis and other secondary bacterial infections.

 

  • Unimmunised household contacts might be advised to exclude themselves from school/work settings upto 20 days post exposure. Local public health teams and HPT will advise the patients themselves.
     
  • Please continue to invite unvaccinated children and adults for their MMR vaccination

 

Additional information and links:

    1. Timeline of the symptoms https://www.grepmed.com/images/5861/signs-peds-kopliks-diagnosis-timelin
    2. National measles guidelines https://assets.publishing.service.gov.uk/media/6616573be49ee0998d3ea70a/National_measles_guidelines_April2024.pdf
    3. Measles guidance for primary, community care, emergency departments and hospital https://www.england.nhs.uk/long-read/measles-guidance-for-primary-community-care-emergency-departments-and-hospital/
    4. PPE : Refer to the National infection prevention and control manual (NIPCM) sections 1.4, 2.4 and appendices 5b and 6 for further information of the use of PPE. NHS England’s Infection Prevention and Control guidance on PPE is available online

 

  • Target Groups:
    • Routine Programme: Adults turning 75 years old on or after 1 September 2024 until their 80th birthday
    • One – Off Catch-up Campaign:
      • For those already aged 75 to 79 years old on 1 September 2024 with the aim of completing the majority by 31st August 2025. 
      • Adults who turn 80 years of age between 2nd September 2024 and 31st August 2025 (i.e. within the 1st year of this programme) remain eligible up to and including 31st August 2025.
      • As many as possible should be vaccinated during September and October prior to the expected RSV season.
  • All pregnant women from 28 weeks’ gestation delivered by maternity service and primary care who will be commissioned through the GP contract as a component of Essential Services, to offer and provide RSV vaccination in pregnancy on an opportunistic or on request basis.

Guidance:

Document and training slide set for health care professionals:

Maternal vaccination leaflet and poster for sharing and the links to the GOV.UK page and the health publications page where pre-order is open:

Older adult leaflet and poster for sharing and the links to the GOV.UK page and the health publications page where pre-order is open:

FutureNHS

We encourage all primary care colleagues to stay informed and prepared for the rollout. Further RSV resources are available on: https://future.nhs.uk/LincsVaccinationProgrammes/view?objectId=53599728

If you do not already have access, you may need to sign up using your NHS Mail account.

Integrated Care Boards (ICBs) are currently awaiting further guidance from NHS England (NHSE) regarding the planning and implementation details.

If you require further information, please contact nhsnwl.immunisations@nhs.net

Thank you for your continued support.

NHS NWL Immunisation and Vaccination team  

 

Contacting the NHS North West London immunisation team

To contact the immunisations team, send an email to: 
nhsnwl.immunisations@nhs.net

Health visiting - please use the links below:

Brent,
Ealing,
Hammersmith and Fulham,
Kensington & Chelsea and
Westminster 
Hillingdon
Hounslow

School nursing

Brent,
Ealing,
Hammersmith & Fulham 
Hounslow
HIllingdon 
Kensington & Chelsea and
Westminster

In NW London we have two providers for our school age immunisation services (SAIS).

 

Brent, Ealing, Hillingdon, Hammersmith & Fulham, Kensington and Chelsea, Westminster

The child immunisation service is provided by Central and North West London NHS Trust.

More information can be found on their website here

 

Harrow and Hounslow

The service is provided by Central London Community Healthcare NHS Trust.

More information can be found on their website here.

 

Training:
If you are a health professional working in immunisations and would like to be kept-up-to-date on immunisations and vaccination services in London, please contact ENGLAND.londonimms@nhs.net who have a number of resources on NHS Futures Platform that can be shared with you. You can also subscribe to the vaccine update newsletter here - https://www.gov.uk/government/collections/vaccine-update

Call and recall system:
Parent invite and reminder systems (call/recall) are the most effective way to improve uptake of childhood immunisations. NHS England have developed best practice guidance to help London based general practices. A Good Practice Immunisation Invite Reminder Poster is also available.

Vaccine clinical queries and incidents:
If you are an immunisation service provider and you would like to report a vaccine incident, please contact NHSE at england.londonscreening-incidents@nhs.net.
Link to UKHSA Vaccine Incident Reporting page Vaccine incident guidance: responding to vaccine errors - GOV.UK (www.gov.uk)

Urgent on-call / TB issues contact NWL HPT on 0203 326 1658 (email: NWLHPT.oncall@ukhsa.gov.uk / phe.nwl@nhs.net) quoting a HPZ reference if you have one.

Clinical immunisation queries : london.immunisationqueriescars@nhs.net
Reporting of a vaccine incident : england.londonscreening-incidents@nhs.net
Suspected outbreaks of a Vaccine-Preventable Disease (VPD) : phe.nwl@nhs.net

Other queries
For all other queries, including payments, please contact NHSE at ENGLAND.londonimms@nhs.net

 

Vaccine Update

Get the latest edition of the UKHSA Vaccine Update 

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