Tag: Vaccination

Protecting Against the “Quad-demic”: Influenza, Covid-19, Norovirus, and RSV

As the NHS braces for a challenging winter season, it is grappling with a “quad-demic” of health emergencies caused by influenza, Covid-19, norovirus, and respiratory syncytial virus (RSV). This confluence of viral threats poses a significant risk to public health in the UK as well as putting strain on healthcare resources, emphasising the importance of preventive measures to safeguard public health. Public health measures such a vaccination and good personal hygiene are pivotal in reducing the impact of these illnesses, particularly for vulnerable groups.

The Four Viruses: What Are They?

  • Influenza: A highly contagious respiratory infection that causes significant illness each winter. It can lead to severe complications, particularly in the elderly, young children, pregnant women, and those with chronic health conditions.
  • Covid-19: Though its most acute phase has passed, Covid-19 remains a concern, especially as new variants of SARS-CoV-2emerge. Severe illness continues to disproportionately affect older adults, those with underlying health conditions and people who are immunocompromised.
  • Norovirus: Known as the “winter vomiting bug,” norovirus is a leading cause of gastroenteritis. It can spread rapidly in closed environments like hospitals and care homes, causing outbreaks that pose a risk to health and which can disrupt health and care services.
  • Respiratory Syncytial Virus (RSV): A common virus that primarily affects young children and older adults. It can lead to bronchiolitis and pneumonia in severe cases, particularly among infants and the elderly.

The Role of Vaccination

Vaccination remains a cornerstone of prevention for influenza, Covid-19, and RSV. For those eligible, timely vaccination can significantly reduce the risk of severe illness, hospitalisation, and complications.

  • Who is eligible for vaccines?
    • Influenza Vaccine: Recommended annually for individuals over 65, pregnant women, children aged 2–10, frontline healthcare workers, and those with specific medical conditions.
    • Covid-19 Vaccine: Offered as part of booster campaigns, particularly for high-risk groups such as the elderly, those with weakened immune systems, and frontline healthcare workers.
    • RSV Vaccine: A relatively recent addition, now available for certain at-risk populations, including older adults and during pregnancy.

Vaccination campaigns are a critical public health tool, reducing the overall spread of these viruses and protecting vulnerable populations.

The Importance of Hygiene in Preventing Norovirus and Beyond

While vaccines are effective for influenza, Covid-19, and RSV, combating norovirus relies primarily on hygiene measures. Norovirus spreads easily through contaminated food, surfaces, and person-to-person contact. The following practices are crucial:

  1. Regular Handwashing: Wash hands thoroughly with soap and water, especially after using the toilet and before eating.
  2. Cleaning and Disinfection: Clean surfaces and commonly touched items with a bleach-based disinfectant to kill the virus.
  3. Proper Food Handling and Storage: Avoid preparing food for others if experiencing symptoms of gastroenteritis, such as vomiting or diarrhoea. Ensure food is stored correctly.
  4. Respiratory Hygiene: Although norovirus is not a respiratory virus, maintaining good respiratory etiquette, such as covering coughs and sneezes and disposing of tissues promptly, helps prevent other infections.

Why Prevention Matters

The intersection of these four viruses can lead to increased pressure on the NHS, with simultaneous outbreaks stretching resources and sometimes overwhelming healthcare services. By preventing illness, individuals not only protect their health but also contribute to easing the burden on the NHS.

Vaccination campaigns and hygiene education are crucial public health strategies. For eligible groups, staying up-to-date with vaccinations is essential, while everyone can benefit from reinforcing good hygiene practices. Together, these measures can help mitigate the impact of the “quad-demic” and support the resilience of our healthcare system during this challenging season.

Taking Action: A Collective Effort

In the face of this “quad-demic,” a proactive approach is essential. Whether through getting vaccinated, promoting hygiene, or supporting public health initiatives, we all have a role to play. By taking these steps, we can protect ourselves, our loved ones, and our communities while reducing the strain on healthcare resources.

This winter, prevention is the best medicine. Let’s work together to stay healthy and keep our NHS strong.

Why Vaccination During Pregnancy Matters

Pregnancy is a time filled with excitement, anticipation, and often, a touch of anxiety. Among the many decisions expectant parents make, one of the most crucial involves protecting the health of both the mother and the baby. Vaccination during pregnancy plays a vital role in this, yet uptake remains worryingly low in many regions.

The Importance of Vaccination During Pregnancy

Vaccines offered during pregnancy, such as those against influenza, pertussis (whooping cough), COVID-19, and the newly added respiratory syncytial virus (RSV) vaccine in the UK, are designed to safeguard the health of mothers and their babies. For example:

  • Influenza vaccine: Protects against severe complications from flu, which can be more serious during pregnancy.
  • Pertussis vaccine: Provides critical early protection for babies against whooping cough until they are old enough to be vaccinated themselves.
  • COVID-19 vaccine: Reduces the risk of severe disease and complications from COVID-19 during pregnancy.

Despite the proven benefits, many pregnant women remain unvaccinated, leaving them and their babies vulnerable to preventable diseases.

Barriers to Uptake

Several factors contribute to low vaccination rates during pregnancy:

  1. Concerns About Safety: A common barrier is worry about the vaccine’s safety for the baby. While extensive research confirms the safety and effectiveness of these vaccines, misinformation – often spread online or through social networks – fuels hesitancy.
  2. Access Challenges: Some pregnant women face logistical hurdles, such as needing separate appointments for vaccination instead of being offered vaccines during routine antenatal visits.
  3. Socioeconomic and Demographic Disparities: Vaccination rates are often lower among women from ethnic minority backgrounds and those living in deprived areas. For instance, a study in London showed significantly lower COVID-19 vaccination rates among Black women and those in economically disadvantaged areas.

Overcoming the Barriers

Improving vaccine uptake requires a multi-pronged approach involving healthcare providers, public health campaigns, and structural changes. Here’s how:

  1. Empower Through Education: Healthcare professionals, including midwives, general practitioners, obstetricians and pharmacists, play a critical role in addressing concerns, countering misinformation, and sharing the benefits of vaccination. These conversations should focus on the risks of not vaccinating and provide clear, evidence-based information about vaccine safety.
  2. Enhance Accessibility: Offering vaccinations during routine antenatal visits and using reminder systems (text messages, emails, etc.) can make it easier for pregnant women to get vaccinated.
  3. Tailored Interventions: Targeted campaigns in communities with low vaccination rates can address specific barriers and build trust. Community leaders and trusted figures can help spread positive messages about vaccination.
  4. Efficient Record-Keeping: Ensuring up-to-date vaccination records prevents unnecessary reminders and allows healthcare providers to focus their efforts on those who are unvaccinated.
  5. Supportive Healthcare Settings: Designating a staff member in clinics or practices to lead vaccination efforts ensures a coordinated approach and provides a point of contact for women with questions.

A Shared Responsibility

Vaccination during pregnancy not only protects mothers but also provides early immunity for their babies, saving lives and preventing illness. Addressing vaccine hesitancy and improving access to vaccines requires a collective effort from healthcare providers, public health bodies, and the community.

As an expectant parent, you have the power to make informed decisions that protect your health and that of your baby. If you have questions or concerns about vaccines, talk to your healthcare provider. Together, we can create a safer, healthier future for you and your child.

For more information, visit the NHS vaccinations in pregnancy page.

Read also my recent article in the British Medical Journal.

Improving Migrant Healthcare: An Evaluation of of Health Catch-UP!

In today’s interconnected world, migration is a key feature of modern societies. The UK has become home to a significant number of migrants seeking new opportunities or fleeing difficult circumstances. Yet, this group often faces unique healthcare challenges, including the risk of undiagnosed infectious and non-communicable diseases and incomplete vaccination records. Addressing these issues is crucial not only for individual well-being but also for broader public health. In a recent article published in the journal BMC Medicine, we evaluated Health Catch-UP!, a digital tool designed to bridge these healthcare gaps.

Understanding the Need

Migrants when compared to local populations are more vulnerable to certain health conditions that are common in their countries of origin. These range from infectious diseases like hepatitis and latent tuberculosis (TB) to non-communicable conditions like diabetes and high cholesterol. Unfortunately, current healthcare services in the UK often overlook these needs, leading to underdiagnosed health issues and missed opportunities for early treatment and prevention.

What is Health Catch-UP!?

Developed as a Clinical Decision Support System (CDSS), Health Catch-UP! is integrated into primary care practices to prompt healthcare providers to offer tailored screening and catch-up vaccinations for at-risk migrant patients. The tool works by collecting key demographic information (such as age, sex, and country of origin) and using this data to recommend relevant health checks and vaccinations according to current UK guidelines.

Key Findings from the Study

Our recent evaluation of Health Catch-UP! in two London-based primary care practices revealed several important insights:

Successful Data Collection: The tool enabled almost complete coding of essential patient demographics, which are often missing from standard records.

High Screening Uptake: Over 60% of the participating migrant patients were eligible for screening, with an impressive 87% choosing to undergo the tests.

New Diagnoses: Through the screening, 12 new health conditions were identified, showcasing the tool’s potential to detect previously unrecognized health issues.

Challenges with Vaccinations: Despite identifying gaps in vaccination coverage, the actual uptake of vaccines was low. This highlights the need for more patient engagement and support in this area.

Patient and Healthcare Staff Perspectives

The feedback from both patients and healthcare professionals was largely positive. Patients appreciated being offered comprehensive health checks, especially when these were explained clearly by their providers. Clinicians found the tool to be user-friendly and felt it integrated well with existing practices. However, they noted that certain questions, such as asking about the date of arrival in the UK, could make some patients uncomfortable. Clear communication was key to overcoming this challenge.

The Road Ahead

While Health Catch-UP! has shown promise in improving healthcare access and outcomes for migrants, there are hurdles to overcome. Low vaccination uptake suggests that more robust patient education and logistical support are needed. Additionally, financial and staffing resources will be critical for widespread implementation, particularly in high-migrant areas.

Conclusion

Health Catch-UP! is a step forward toward more inclusive and effective healthcare for migrants in the UK. By tailoring healthcare to the needs of this diverse group, we can ensure better health outcomes and a stronger, more equitable healthcare system for all.

Study Reveals Critical Gaps in Catch-Up Vaccinations Among UK Migrants

In our study published in the journal BMC Medicine, we report significant vulnerabilities to infectious diseases among UK migrants due to under-vaccination for diseases preventable through routine immunisations – such as measles, mumps, rubella, and polio. Our mixed-methods study, conducted between May 2021 and September 2022 across several London-based general practices, sheds light on the urgent need for improved healthcare strategies that ensure migrants receive necessary catch-up vaccinations.

Background

Migrants in the UK and Europe are often at increased risk of vaccine-preventable diseases (VPDs) due to incomplete childhood vaccinations and systemic marginalisation from health services. The COVID-19 pandemic further exacerbated these disparities, highlighting the critical gaps in vaccination coverage among adult and adolescent migrants. The study aimed to quantify these vaccination gaps and explore new strategies to improve vaccination uptake through better integration into primary care systems.

Study Insights

The “Vacc on Track” study involved 57 migrants from 18 countries, revealing a troubling landscape of under-vaccination:

  • 86% of the participants needed catch-up vaccinations for MMR.
  • 88% required catch-up for tetanus, diphtheria, and polio (Td/IPV).
  • Despite high referrals for catch-up vaccinations (93%), completion rates were dismally low, with only 12% completing the Td/IPV series and 64% completing the MMR.

Barriers and Facilitators

We identified numerous barriers to effective vaccination, including:

  • Lack of systematic approaches to catch-up vaccination upon migrants’ arrival.
  • Primary care staff’s limited awareness and implementation of vaccination guidelines.
  • Structural challenges such as limited appointment availability and follow-up.

Conversely, potential facilitators highlighted the importance of staff champions and community-based approaches to improve vaccination uptake. These insights suggest that primary care can play a pivotal role in reducing health inequalities by adopting more culturally competent and accessible vaccination strategies.

Conclusion

The study underscores a pressing public health issue: the need to better integrate catch-up vaccinations within primary care to protect vulnerable populations against VPDs. By strengthening existing pathways and enhancing staff training and resources, healthcare systems can make significant strides toward ensuring that all community members, regardless of their origin, are protected against preventable diseases.

Moving Forward

our findings emphasise the need for further research and larger trials to refine and implement effective strategies that ensure equitable healthcare access. As the UK continues to navigate the challenges posed by migration and health disparities, such studies are essential for informing policy and practice, aiming for a healthier, more inclusive society. This research not only highlights the gaps but also charts a course for future action, aiming to transform insights into impactful health interventions.

Bridging the Gap: Enhancing Catch-Up Vaccination Strategies for Migrant Populations in the UK

Among the many public health challenges facing the UK, the issue of equitable access to vaccinations stands out, particularly for adult migrants who might have missed critical immunisations due to disrupted healthcare services in their countries of origin or during the migration process. Our recent in-depth study published in Vaccine provides valuable insights into the experiences and perspectives of adult migrants regarding catch-up vaccinations and outlines strategies to improve their immunization coverage.

The study focused on adult migrants in the UK, including refugees, asylum seekers, undocumented migrants, and those without recourse to public funds. It used in-depth interviews to gather data on migrants’ experiences with and attitudes towards vaccination since arriving in the UK. Despite the UK having guidelines for offering catch-up vaccinations, the study revealed a significant lack of awareness and implementation at the primary care level.

One of the critical findings was that most participants were not routinely offered catch-up vaccinations nor asked about their vaccination history upon arrival. This oversight persists despite existing guidelines that advocate for such measures to prevent the spread of vaccine-preventable diseases (VPDs). Participants expressed a general positivity towards vaccinations when informed about them, although some hesitancy rooted in fears of side effects and distrust in the healthcare system due to past negative experiences.

The barriers to vaccination highlighted by the study include logistical challenges like language barriers, financial constraints, and a fundamental lack of trust in the healthcare system—often exacerbated by migrants’ fears of data sharing with immigration authorities. Moreover, the intense focus on COVID-19 vaccinations has overshadowed the need for routine and catch-up vaccinations, leading to what some describe as vaccination fatigue.

To address these challenges, our study proposes several strategies:

Enhanced Training and Incentives for Healthcare Providers: There’s a pressing need for training healthcare professionals about the importance of checking vaccination histories and actively offering catch-up vaccinations. Financial incentives might also encourage primary care providers to prioritize this activity.

Community Engagement and Tailored Communication: Building trust within migrant communities is crucial. This can be achieved by involving community leaders in health promotion activities and ensuring that vaccination campaigns are sensitive to cultural and individual needs.

Flexible Healthcare Services: Offering vaccinations in community settings and outside of standard clinic hours can make access to immunization more convenient for migrants who might struggle with traditional healthcare settings due to work or family commitments.

Implementing these strategies requires a multi-faceted approach, combining policy enforcement with grassroots initiatives to create an inclusive healthcare environment that recognizes the unique needs and challenges faced by migrants.

This comprehensive approach not only aims to protect vulnerable populations but also contributes to the broader public health goal of eliminating VPDs as a threat, ensuring that no community, especially not the migrant population, is left behind in our collective healthcare efforts. As the UK moves forward, it is crucial to integrate these strategies into routine healthcare practices to improve vaccination uptake and protect public health.

Increasing measles, mumps, and rubella (MMR) vaccine uptake in primary care

Measles cases in the UK have increased recently; putting at risk the health of children who are unvaccinated.[1] What can primary care teams do to boost measles (MMR) vaccine uptake? I discuss some actions that general practices can take in a recent comment in the British Medical Journal.

Implementing an effective vaccination programme within a general practice requires a multifaceted approach; combining clear leadership, comprehensive staff training, patient education, and meticulous record-keeping. The collective effort of the entire practice team is essential for its success. Assigning a dedicated team member to lead the vaccination programme ensures focused oversight. It is crucial that all staff are well-informed about the vaccination programme, including eligibility criteria and the benefits of vaccination for individuals, families, the NHS, and society. This knowledge can be enhanced through free online training.[2]

Developing a set of Frequently Asked Questions based on official sources like NHS England and the UKHSA, and training staff in effective communication strategies, are key steps in addressing patient concerns and misinformation. Accuracy of medical records is essential, especially in urban areas with high population mobility, to avoid unnecessary vaccination reminders. Regular audits and updating vaccine status during patient registration can help maintain record accuracy.[3]

Effective patient communication about the MMR vaccine’s benefits requires using multiple channels, including text messages, emails, and social media, as well as during consultations, to ensure impact. Practices should also consider the cultural and linguistic diversity of their patients, using appropriate materials and partnering with community organisations to enhance outreach.

Accessible clinics are also essential. Vaccination should be offered during routine appointments and through additional channels like mobile clinics or community centres. Monitoring vaccine uptake and actively following up unvaccinated patients through reminders can significantly improve vaccination rates.[4]

For patients vaccinated outside the practice, it is important to verify and record their vaccination status. Motivating staff with incentives to meet vaccination targets and collaborating with community groups can further improve vaccine uptake.

References

1. Bedford H, Elliman D. Measles rates are rising again. BMJ 2024; 384 :q259 doi:10.1136/bmj.q259

2. NHS England Immunisation e-learning programme. https://www.e-lfh.org.uk/programmes/immunisation/

3. Carter J, Mehrotra A, Knights F, Deal A, Crawshaw AF, Farah Y, Goldsmith LP, Wurie F, Ciftci Y, Majeed A, Hargreaves S. “We don’t routinely check vaccination background in adults”: a national qualitative study of barriers and facilitators to vaccine delivery and uptake in adult migrants through UK primary care. BMJ Open. 2022 Oct 10;12(10):e062894. doi: 10.1136/bmjopen-2022-062894.

4. Williams N, Woodward H, Majeed A, Saxena S. Primary care strategies to improve childhood immunisation uptake in developed countries: systematic review. JRSM Short Rep. 2011 Oct;2(10):81. doi: 10.1258/shorts.2011.011112.

Improving measles (MMR) vaccine uptake in primary care

The UKHSA has warned that the UK is seeing a surge in measles cases; putting at risk the health of children and others who are unvaccinated. What can primary care teams do to boost measles vaccine uptake in their patients and help bring the number of measles cases down?

In this post, I list some of the key steps in implementing measles (MMR) vaccination in your practice and raising vaccine uptake. This guidance can also be used by primary care providers in other countries.

1. Give one member of the practice team responsibility for leading the vaccination programme, supported by the wider practice team.

2. Ensure that all staff are informed about the programme; including who is eligible; and the benefits of vaccination for the individual patient, their family, the NHS and society. There are many free online programmes on vaccination and addressing vaccine hesitancy for health professionals. Ensure that vaccination is discussed regularly at team meetings to review progress and address challenges.

3. Prepare FAQs to common questions from patients. These are usually available on government websites such as those published by NHS England and the UKHSA. Ensure staff know where to look for these FAQs, which are essential in countering misinformation about MMR vaccination. Specific training is available in effective communication strategies to address vaccine hesitancy and misinformation during patient interactions.

4. Ensure medical records are as accurate as possible so that patients are not called for vaccination inappropriately. This is particularly important in large urban areas where population mobility is high and vaccine records may not always be up to date. Regular audits of medical records can help identify gaps in the recording of vaccine status.

5. A key time to record vaccine status and offer MMR vaccination is when patients register with a practice. Ensure that vaccine records are entered on the medical record correctly (including vaccines given overseas) and offer MMR vaccine to patients who are unvaccinated or unsure of their vaccine status.

6. Prime patients with information about MMR vaccination, including who is eligible; and the benefits of vaccination for the individual, their family and society.

7. Use multi-channel communication to inform patients. Consider using a variety of media to inform patients as well as direct contact through text messages, phone calls, emails and letters: posters, leaflets, social media, and the practice’s website. Different people prefer different methods of communication. Partnering with local schools, colleges and universities can also help in contacting patients.

8. Be culturally sensitive, particularly if your practice is located in a diverse area. Use materials that are linguistically and culturally appropriate to cater to diverse populations, especially those who may not be fluent in English or are from different cultural backgrounds. Collaborations with community organisations and voluntary groups can help practices to better reach and communicate with diverse groups of patients; including those least likely to be vaccinated.

9. Provide accessible clinics for MMR vaccination and also offer opportunistic vaccination to patients when they attend appointments at the practice for other reasons. To make it easier for working adults, consider extending clinic hours for vaccinations. Some areas may also offer mobile clinics or clinics in community centres that can further improve access to vaccination.

10. Monitor uptake in each target group. Contact those who have not come forwards for vaccination by text, email or telephone. Discuss the need for vaccination with patients in clinics. Implementing an automated system for sending reminders for upcoming vaccination appointments can be efficient and lead to increased attendance.

11. Some patients will receive MMR vaccines elsewhere in the NHS or overseas. Details of vaccinations at NHS sites should be sent to the practice automatically but this may not always be the case. Contact patients to check their vaccination status by text or email and enter vaccinations on their medical record if given elsewhere. This will improve the data the NHS uses to monitor vaccine uptake and also ensures that patients are not sent unnecessary reminders.

12. Incentivise staff to achieve targets; and work with the patient participation group and other local community groups to increase awareness of the benefits of vaccination and improve vaccine uptake.

13. Develop a way for patients to provide feedback about their vaccination experience. This could be a short survey sent by email or available at the clinic. The feedback can provide valuable insights for improving the programme in the future. Also consider a post-campaign evaluation to understand what worked well and what didn’t. This information can be also help for planning future campaigns.

14.The same principles can be applied to maximise uptake of other vaccination programmes delivered by the practice for both children and adults.

Boosting Vaccine Uptake in Pregnancy: What Works and What Doesn’t

Pregnancy is a time of anticipation and preparation. But it’s also a time when expectant mothers must be vigilant about their health — not just for themselves but for their unborn children as well. Vaccinations against COVID-19, influenza, and pertussis are vital during this period, yet many pregnant women hesitate to get these lifesaving shots. Let’s delve into recent research that sheds light on effective strategies to increase vaccine uptake among pregnant women.

Our study published in the Journal of Travel Medicine reviewed studies from January 2012 to December 2022, following the gold-standard PRISMA guidelines, to identify interventions that successfully increase vaccine uptake in pregnant women. The meta-analysis focused on three key diseases: COVID-19, influenza, and pertussis — all of which pose significant risks to both mother and child.

Key Findings

Out of 2,681 articles, 39 studies were relevant, comprising over 168,000 participants from nine different countries. Interestingly, while 15 of these were randomized controlled trials, the quality of evidence was strong in only 18% of the studies. Here’s what we found:

– For influenza, interventions modestly increased vaccine uptake, but the overall effect was small.

– For pertussis, the data showed no clear benefit from the interventions.

– There were no randomized controlled trials available for COVID-19 vaccine interventions during pregnancy.

The ‘Three Ps’ Approach

The interventions that were examined fell into three categories — patient, provider, and policy-level strategies.

Patient-Level: The most effective strategies at this level involved healthcare professionals giving clear recommendations, supplemented by text reminders and written information. Personalized face-to-face discussions that addressed concerns, debunked myths, and emphasized benefits were particularly effective.

Provider-Level: Educating healthcare professionals about the vaccines’ safety and importance, along with reminders to offer them as part of routine care, made a significant difference.

Policy-Level: Financial incentives, mandatory recording of vaccination data, and ensuring vaccines are readily available were key policy interventions that showed promise.

Conclusions

Our study indicates that while there’s some success in increasing influenza vaccinations, the overall impact of interventions is modest. Pertussis vaccine interventions didn’t show a clear benefit, and data on COVID-19 interventions is lacking.

What’s clear is the pivotal role of healthcare providers in educating and encouraging pregnant women to get vaccinated. There’s also untapped potential in mobile health technologies that could further promote vaccination during pregnancy.

The takeaway message is that a concerted effort combining clear communication, education, and policy support is essential to protect both mothers and their babies from vaccine-preventable diseases. As the medical community continues to explore and implement these interventions, the hope is to see a significant rise in vaccine uptake, ensuring safer pregnancies and healthier babies.

The Next Steps

For healthcare providers, the message is to continue the dialogue with expectant mothers, ensuring they have all the information they need to make informed decisions about vaccinations. For policymakers, the challenge is to create an environment where vaccinations are not just available but are actively and consistently promoted as part of prenatal care. And for expectant mothers, our study underscores the importance of discussing vaccinations with healthcare providers to ensure the healthiest possible start for their children.

Closing Thoughts

Vaccinations during pregnancy aren’t just a personal choice; they’re a public health priority. Our study provides a roadmap for increasing vaccine uptake — a mission that, if successful, could mean the difference between life and death for the most vulnerable among us.

Chickenpox vaccination in the UK

The Joint Committee on Vaccination and Immunisation (JCVI) recommending the inclusion of the chickenpox (varicella) vaccine in the UK’s childhood immunisation schedule is a significant step for public health. This decision aligns the UK with many other countries that have already integrated the chickenpox (varicella) vaccine into their routine childhood immunisation programmes.

The implementation of the chickenpox vaccine on a national scale offers several benefits:

1. Reduction in cases: Widespread vaccination among children has the potential over time to significantly reduce the incidence of chickenpox, a highly contagious disease, among children and the wider community.

2. Prevention of complications: While chickenpox is often mild, it can lead to serious complications such as secondary bacterial infections, pneumonia and encephalitis; and can be particularly severe in immunocompromised individuals. Vaccination will help reduce the risk of these complications.

3. Healthcare burden: By reducing the number of chickenpox cases, the NHS can lower the associated healthcare burden, saving resources, GP consultations, urgent care capacity and hospital beds for other important healthcare needs.

4. Economic impact: Fewer chickenpox cases mean less time off from school for children and work for parents, positively affecting the economy and individual productivity, as well as educational outcomes for children and quality of life for families.

5. Herd immunity: Vaccination contributes to herd immunity, protecting those who are not  vaccinated or at higher risk of complications from chickenpox.

6. Health equity: Bringing the UK’s vaccination programme in line with other countries ensures that children in the UK benefit from the same level of healthcare protection.

The JCVI’s recommendation is based on evidence of the vaccine’s safety and effectiveness, making it a positive addition to the UK’s public health strategy. This decision underscores a commitment to safeguarding children’s health and reducing the impact of preventable diseases through immunisation once the governments in the UK and devolved nations accept the decision and start to implement the recommended vaccination programme.

Digital Tools for Enhancing Infectious Disease Screening in Migrants

The European Centre for Disease Control (ECDC) has highlighted a stark reality: migrants in Europe are disproportionately affected by undiagnosed infections, including tuberculosis, blood-borne viruses, and parasitic infections. Many migrants also fall into the category of being under-immunised. The call to action is clear — innovative strategies must be developed to deliver integrated multi-disease screening within primary care settings. Despite this call, the United Kingdom’s response remains fragmented. Our recent in-depth qualitative study published in the Journal of Migration and Health delves into the current practices, barriers, and potential solutions to this pressing public health issue.

Primary healthcare professionals from across the UK participated in two phases of this qualitative study through semi-structured telephone interviews. The first phase focused on clinical staff, including general practitioners, nurses, healthcare assistants, and pharmacists. The second phase targeted administrative staff, such as practice managers and receptionists. Through these interviews, a complex picture emerged, revealing a primary care system capable of effective screening but hamstrung by inconsistency and lack of standardized approaches. Many practices lack a systematic screening process, resulting in migrant patients not consistently receiving care based on established NICE/ECDC/UKHSA guidelines.

The barriers to effective infectious disease screening are multifaceted, stemming from patient, staff, and systemic levels. Clinicians and administrative staff pinpointed the stumbling blocks: overly complex care pathways, a lack of financial and expert support, and the need for significant administrative and clinical time investments. Solutions proposed by respondents include appointing infectious disease champions among patients and staff, providing targeted training and specialist support, simplifying care pathways, and introducing financial incentives.

Enter Health Catch-UP!., a collaboratively developed digital clinical decision-making tool designed to support multi-infection screening for migrant patients. The primary care professionals involved in the study responded enthusiastically to this digital innovation. They recognized its potential to systematize data integration and support clinical decision-making, thereby increasing knowledge, reducing missed screening opportunities, and normalizing infectious disease screening for migrants in primary care.

The conclusion is unequivocal: current implementation of infectious disease screening in migrant populations within UK primary care is suboptimal. Yet, there is hope. Digital tools like Health Catch-UP! could revolutionize disease detection and the effective implementation of screening guidance. However, for such digital innovations to succeed, they must be robustly tested and adequately resourced. It’s not just about having the right tools but also ensuring the entire healthcare system is aligned to support their deployment. With the right commitment, we can ensure that migrants receive the care they need and deserve, safeguarding both their individual health as well as public health in the UK.