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Slide 11 - Successful immunisation programme There are stringent checks throughout the manufacturing process to assure the quality of the vaccine and safety of the vaccines. Manufacturers instructions in the Summary of Product Characteristics (SPC) ensure the continued safety and safety of vaccines through transport and storage to the administration of the vaccine. Maintaining the cold chain: Vaccines must be stored between +2º - +8ºC Storage below 0ºC causes freezing, deterioration of the vaccine and breakage of the container Vaccines should be checked against the order on receipt, checked for leakage other damage and Immediately placed under the required storage conditions Kept under required storage until administration Ordering and storage Practices should have in place safe and robust channels for ordering, receiving and storing vaccines: Specifically designated medicinal refrigerators (never domestic), ideally only for vaccines Maintained and protected power supplies, i.e. wired into mains or taped over socket Maximum/minimum thermometers within fridge Written documentation of regular temperature recording Local policies for disposal of contaminated waste and unusable vaccines Consent Department of Health information leaflets and fact sheets to enable individuals, their parents or carers to make an informed decision about immunisation. Information offered should include advice on: The vaccine(s) to be administered The diseases which will be prevented Adverse events & how to deal with them The benefit risk of vaccination compared with vaccine-preventable diseases Administration of vaccines Injection into the correct site Correct technique to ensure vaccine is properly deposited to maximise an immune response and minimise local reactions Reference: Getting to the point. Best practice in Vaccine Administration (2002). The Vaccine Taskforce, GlaxoSmithKline

Slide 12 - Public and professional knowledge In order to support the national childhood immunisation programme, twice-yearly tracking research, commissioned by the Department of Health has since 1991 provided information of parents with children under 3 on: Their knowledge of immunisations Their attitudes to immunisation Their experiences of immunisation services Since 1999, an annual survey of health professionals commissioned by the Department of Health supplements the twice-yearly tracking research. The purpose of this research is to: Assess the needs of GPs, health visitors and practice nurses Collect information on experiences and measure impact as part of the publicity surrounding the MMR immunisation among health professionals Measure awareness and evaluate the success of the materials produced, particularly the recent (2003) The information gathered from this research is used in developing resources to support the national childhood immunisation programmes.

Slide 13 - Information All information produced by NHS Immunisation Information about any of the national immunisation programmes is designed for individuals, their parents, and health professionals. The information is based on policy contained in the green book (Immunisation against Infectious Disease, 1996) and carefully checked for scientific accuracy. It is offered as a stepped approach, with leaflets forming the core information needed for individuals or their parents to make an informed decision on whether to immunise. This includes information on: The vaccines The diseases Schedules Adverse events and how to manage them The benefits and risks of the programme All NHS Immunisation information is pre-tested on: The population for whom a vaccine is intended and their parents where appropriate All social groups Minority ethnic communities Health professionals Pre-testing covers includes all aspects including: Design Language Content Comprehension Before any written information is published it is checked by the Plain English Campaign (Crystal Mark) and is translated into key languages. There is also a mechanism for translating into other languages where requested. Factsheets are written from a more detailed scientific perspective to provide health professionals and parents with properly referenced scientific evidence to support each programme. The website is divided into sections dealing in-depth with all aspects of the national immunisation programme for both children and adults. Programmes will also be supported by professional mailings to inform health professionals of important changes. They may also be supported by frequently asked questions (FAQs), posters, and videos and advertising campaigns. The press and public relations departments monitor and respond to specific issues of the programmes. All NHS Immunisation Information is available via local Health Promotion Units, or downlaoded from the website on http://www.immunisation.nhs.uk References: Immunisation against Infectious Disease (1996) Eds. Salisbury D, Begg N. HMSO, London http://www.immunisation.nhs.uk http://www.mmrthefacts.nhs.uk

Slide 14 - Professional responsibilities All health professionals have a responsibility to fully support immunisation programmes based on the currently available scientific evidence. We are all primarily members of the public, using the same sources of information as our client group. We read the same newspapers, listen to the same radio programmes and watch the same television programmes. But we have a professional responsibility not to be swayed by popular opinion or unsubstantiated suggestion, but to ensure that we have access to the resources that will provide scientific evidence from properly conducted studies to support the programme. We must be prepared to personally advocate and fully support the national childhood immunisation programme.

Slide 15 - Children’s rights As health professionals we have a duty to be properly trained in all aspects of immunisations: The reasons why we immunise The vaccines and the diseases they prevent Adverse reactions The benefits and risks of immunisation compared with the diseases Immunisation is a very safe procedure designed in particular to protect children and communities from potentially serious diseases and their complications. Childhood vaccination is one of the most cost-effective of all health interventions – saving more lives for the money invested than almost any other health interventions. In the UK we currently face a testing time, with confidence in MMR seriously damaged by junk science and media interference. A secondary effect of this has been a decrease of confidence in vaccination generally. Health professionals are increasingly concerned about litigation, but need to seriously consider not only their actions, but also more importantly their omissions if they fail to immunise. There is now a real risk of children being exposed to disease, in particular measles, and not immunising a potentially vulnerable child could have serious consequences, not just for the individual child but for the accountability of the individual health professional.

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