Immunisations

See: House of Commons Library Briefing Paper (Jan 2021) UK Vaccination Policy 

https://researchbriefings.files.parliament.uk/documents/CBP-9076/CBP-9076.pdf

Vaccines are a type of prescription-only medicine. Their purpose is to stimulate a person's immune system to produce antibodies that fight a specific disease, so that the person develops ‘immunological memory’. If the body is later exposed to the same natural infection, immunological memory enables the immune system to recognise and respond to it rapidly, thereby preventing or modifying the severity of the disease. Vaccines are a key part of preventative medicine and are described by the NHS as “the most effective way to prevent infectious diseases.”

See: Royal College of Nursing's Immunisation Clinical Topic https://www.rcn.org.uk/clinical-topics/public-health/immunisation

The World Health Organization (WHO) says: 'The 2 public health interventions that have had the greatest impact on the world’s health are clean water and vaccines.' Immunisation is a cost effective and critical element of preventive care around the world. The WHO estimate that it prevents between two and three million deaths each year. Vaccines work by making us produce antibodies to fight disease without infecting us with the disease. If the vaccinated person then comes into contact with the disease itself, their immune system will recognise it and immediately produce the antibodies they need to fight it.

NICE

All NICE products on immunisation https://www.nice.org.uk/guidance/health-protection/communicable-diseases/immunisation

NICE Pathway Immunisations for under 19s overview https://pathways.nice.org.uk/pathways/immunisations-for-under-19s

Clinical Knowledge Summaries (CKS) 

Immunizations - seasonal influenza https://cks.nice.org.uk/topics/immunizations-seasonal-influenza/

Immunizations - childhood https://cks.nice.org.uk/topics/immunizations-childhood/

Immunizations - pneumococcal https://cks.nice.org.uk/topics/immunizations-pneumococcal/

Immunizations - travel https://cks.nice.org.uk/topics/immunizations-travel/
 

Royal College of Nursing

Immunisation https://www.rcn.org.uk/clinical-topics/public-health/immunisation

COVID-19 and vaccination FAQs https://www.rcn.org.uk/get-help/rcn-advice/covid-19-and-vaccination

Royal College of Paediatrics and Child Health (RCPCH)

Immunisations https://stateofchildhealth.rcpch.ac.uk/evidence/prevention-of-ill-health/immunisations/

Vaccination in the UK - position statement https://www.rcpch.ac.uk/resources/vaccination-uk-position-statement

UK Health Security Agency

Collection: Vaccine uptake guidance and the latest coverage data https://www.gov.uk/government/collections/vaccine-uptake

Complete Immunisation schedule: www.gov.uk/government/collections/immunisation

Uncertain/Incomplete Immunisation schedule https://www.gov.uk/government/publications/vaccination-of-individuals-with-uncertain-or-incomplete-immunisation-status

Oxford vaccine group website https://vk.ovg.ox.ac.uk/vk/

Global schedules http://apps.who.int/immunization_monitoring/globalsummary

Compare the UK schedule with other countries https://www.gov.uk/government/publications/uk-and-international-immunisation-schedules-comparison-tool

 

Public Health England - Information for immunisation practitioners and other health professionals:

https://www.gov.uk/government/collections/immunisation

Provides training slide sets and ‘Information for Healthcare Practitioner’ documents for each vaccine programme which supplement the information provided in the online Green Book 

Immunisation against Infectious Disease - The Green Book:

https://www.gov.uk/government/collections/immunisation-against-infectious-disease-the-green-book

Monthly PHE publication – Vaccine Update https://www.gov.uk/government/collections/vaccine-update

BCG

How  to check for a SCID outcome result before giving a live vaccine.

https://www.gov.uk/government/publications/bcg-vaccination-and-scid-screening-patient-pathway

https://www.gov.uk/government/publications/rotavirus-vaccine-and-scid-newborn-screening-evaluation

PGDs

  1. Health Education England (HEE) PGD e-learning:

https://www.e-lfh.org.uk/programmes/patient-group-directions/

  1. PGDs for National Immunisation and Vaccine Programmes:

PGDs for national immunisation and vaccination programmes which are commissioned by NHS England can be found on the NHSE website for Kent, Surrey & Sussex: https://www.england.nhs.uk/south-east/our-work/info-professionals/pgd/kss/

  1. NICE Guidance - Competency framework:

For health professionals using Patient Group Directions. Implementing the NICE guidance on Patient Group Directions (MPG2): https://www.nice.org.uk/Guidance/MPG2/Resources

Immunisation Training for Registered Professionals

In order to ensure the ongoing delivery of a high quality, safe and effective immunisation programme that achieves high uptake, it is important that all practitioners involved in immunisation have a high level of knowledge and are confident in immunisation policy and procedures. To gain this, they need to receive comprehensive foundation training, regular updates, supervision and support.

The National Minimum Standards and Core Curriculum for Immunisation Training for Registered Healthcare Practitioners (2018)

This document sets out a recommended minimum framework for training to meet the needs of all registered healthcare practitioners with a role in immunisation and includes a competency assessment tool.

https://www.gov.uk/government/publications/national-minimum-standards-and-core-curriculum-for-immunisation-training-for-registered-healthcare-practitioners

For practitioners new to Immunisations there is the option of virtual ‘face to face training’- see Eventbrite here or e-learning modules https://www.e-lfh.org.uk/ both training routes need to be followed up with a period of supervised practice and competency assessments. The competency assessment tool is provided on pages 24, 25 and 26 in the above document

The following modules and assessments are to be completed if using the e-learning route:

  1. National Immunisation and Policy Programme
  2. Immunology
  3. Vaccine preventable diseases
  4. Communicating with patients, patients and carers
  5. Legal aspects
  6. Vaccine Storage
  7. Vaccine administration

The below areas of knowledge are to be completed in the practice/PCN.

  1. Anaphylaxis and adverse reactions and BLS
  2. Documentation, record keeping and reporting
  3. Strategies for optimising immunisation uptake

How to use the competency assessment tool:

Healthcare practitioner: those administering immunisations should be assessed against all competencies, except where the practitioner is only required to use specific administration techniques, for example if they are only giving the intranasal influenza vaccine or intradermal Bacillus Calmette-Guérin (BCG) vaccine.

Healthcare practitioner: to complete the self-assessment column as part of the formative assessment. Work with your mentor discussing any areas that identified as ‘need to improve’.

The final assessment: your mentor assessing the practitioner must be a registered healthcare practitioner who is competent and experienced in delivering immunisation programmes. The mentor does not have to have a teaching qualification but does require the key skills in assessment.

Use of PGD e-learning:

https://www.e-lfh.org.uk/programmes/patient-group-directions/

Immunisation Training for Health Care Support Workers/Health Care Assistants

There is now greater recognition that HCAs can be a valuable addition to teams delivering vaccination programmes. The decision to involve HCAs in vaccine administration needs careful consideration and appropriate mechanisms in place for prescribing, delegation, accountability and supervision in order that vaccine administration is safe and effective. All immunisers must be confident, competent and well supported to ensure public confidence in vaccination is maintained. Delegation of immunisation must be both appropriate and in the best interests of the patient and the provider organisation.

The National Standards for HCA’s and Assistant practitioners (2015)

https://www.gov.uk/government/publications/immunisation-training-of-healthcare-support-workers-national-minimum-standards-and-core-curriculum

This document addresses the minimum standards of training for HCAs who administer influenza, shingles and pneumococcal vaccinations to adults, and intranasal influenza vaccine to children only.

The guidance states that only HCA’s who have achieved education and training to Level 3 or equivalent with at least 2yrs experience as an HCA can be considered for training in vaccine administration.

Page 9 outlines the core areas of knowledge for HCA’s. The training hub will provide Foundation Training for HCA’s- see Eventbrite here. All training needs to be followed up with a period of supervised practice and assessments of clinical competency in the practice.

Supervision

HCA’s involved in immunisation services must have an identified supervisor and ongoing supervision by a registered, appropriately trained, experienced and knowledgeable practitioner in immunisation.

Immunisation Information for Clinical Pharmacists

The National Minimum Standards and Core Curriculum for Immunisation Training for Registered Healthcare Practitioners document sets the standards and lists the essential topics which should be incorporated into immunisation training for registered healthcare practitioners. Pharmacists who will provide the a Vaccination Service must have completed practical training in vaccination that meets these requirements.  With regards to local providers of such training, practices may already be familiar with ones that their nurses attend.

NHS England and NHS Improvement has determined that pharmacists providing a Vaccination Service need to attend face-to-face training for both injection technique and basic life support (including administration of adrenaline) at least every three years. Injection Technique training is to be completed in the practice.

Please also note that if the pharmacists will be vaccinating under the PGD produced by PHE, then they will need to demonstrate competency in working under a PGD.  Health Education England (HEE) have a PGD online training package – Patient Group Directions (an e-learning resource for those considering, developing, authorising and using Patient Group Directions) https://www.e-lfh.org.uk/programmes/patient-group-directions/

Flu Immunisation Training

Public Health England South East Screening & Immunisation information

Updates to the Flu Immunisation e-learning programme for the 2021/22 flu season

The Flu Immunisation e-learning resource is designed to provide all healthcare practitioners involved in delivering the national flu immunisation programme with the knowledge they need to confidently promote high uptake of flu vaccination and administer the flu vaccines to those who need them.

The Flu Immunisation programme is available to access on the elfh hub, ESR and via AICC links. For more information about the programme, including details on how to access, visit: www.e-lfh.org.uk/programmes/flu-immunisation/.

Flu_immunisation_training_recommendations_appendix_A.pdf

Guidance on immunisation training during the COVID-19 pandemic

During the global COVID-19 pandemic it is imperative that vaccine uptake remains high and that vaccines continue to be delivered safely by a well-trained and confident workforce. The response to the pandemic has disrupted the provision of face to face, classroom-based immunisation training so PHE have provided guidance during the pandemic. https://www.gov.uk/government/publications/immunisation-training-guidance-during-the-covid-19-pandemic/guidance-on-immunisation-training-during-the-covid-19-pandemic

New immunisers who undertake online foundation immunisation training during the pandemic should be given the opportunity to attend face to face training if they wish to once this is available.

The Training Hub are arranging virtual foundation and update courses so please keep an eye on Eventbrite here for dates.

Maintaining knowledge and competency (Annual Updates)

It is recommended that all immunisers have annual updates (Page 16 of the guidance outline what is required to be covered). This can be carried out through completing the relevant e-learning modules https://www.e-lfh.org.uk/ , completing the assessment and downloading the certificate.

On line Resources

Flu 2021/22

  1. E-Lfh Flu Programme https://www.e-lfh.org.uk/programmes/flu-immunisation/
  2. The National Flu Immunisation Programme Plan 2020-21 update letter https://www.gov.uk/government/publications/national-flu-immunisation-programme-plan
  1. Public Health England Annual Flu Programme. Many useful resources including patient information leaflets. New resources are added regularly: https://www.gov.uk/government/collections/annual-flu-programme#2020-to-2021-flu-season

 Immunisations in general:

e-Lfh https://www.e-lfh.org.uk/programmes/immunisation/

 e-Lfh COVID-19 Vaccination https://www.e-lfh.org.uk/programmes/covid-19-vaccination/

Royal College of Paediatrics and Child Health (RCPCH)  Vaccines in practice - online learning https://www.rcpch.ac.uk/resources/vaccines-practice-online-learning

RCGP Learning COVID-19 vaccination programme https://elearning.rcgp.org.uk/mod/page/view.php?id=11513#COVID-19

Any immunisation queries contact the Screening and Immunisation team by email

phe.screening-immsssat@nhs.net

Imms Schedule Document

Routine Childhood Imms Schedule Document

Outreach Library & Knowledge Services https://future.nhs.uk/surreyheartlands/view?objectID=26431600 can identify, collate, and summarise evidence for you, to inform your clinical practice, patient pathways and professional development.

Public Health England

Child and Maternal Health - Vaccinations and immunisations https://fingertips.phe.org.uk/profile/child-health-profiles/supporting-information/vaccs-imms

A visual guide to vaccines for the routine vaccination programme https://www.gov.uk/government/publications/a-visual-guide-to-vaccines-poster

Guidance - Immunisations: applying All Our Health (2020) https://www.gov.uk/government/publications/immunisations-applying-all-our-health/immunisations-applying-all-our-health

NHS Digital
Series/Collection: Childhood Vaccination Coverage Statistics https://digital.nhs.uk/data-and-information/publications/statistical/nhs-immunisation-statistics

House of Commons Library Briefing Paper (Jan 2021) UK Vaccination Policy 

https://researchbriefings.files.parliament.uk/documents/CBP-9076/CBP-9076.pdf

Joint Committee on Vaccination and Immunisation (JCVI) https://www.gov.uk/government/groups/joint-committee-on-vaccination-and-immunisation