Vaccine update: issue 345, May 2024 (2024)

On the road again - conference season begins

Throughout the year the nursing and midwifery and publications teams attend professional events with our public and healthcare professionals resources stand.

These events provide us with an opportunity to promote the available resources that support all of the national immunisation programmes, and to hear from staff commissioning and delivering immunisation services across the country. We always welcome your questions and feedback as it helps us to understand better what training and public-facing materials best help you to encourage uptake of vaccinations. At some events we also have opportunities to deliver a presentation on an immunisation topic.

Recent events have included the National Immunisation Network (NIN) conference see below. Consultant Midwife Greta Hayward and immunisation advice nurse Kirsty Smith were pleased to attend the annual Royal College of Midwives conference in Liverpool in May see below.

Nurse Consultant David Green and Lead Immunisation Nurse Specialist Lesley McFarlane went to the Midlands Maternity and Midwifery Festival held in Birmingham on 14 May. Maternal immunisation programmes are a key focus at present. At all the events the stand was well attended by delegates allowing us to speak with lots of midwives and student midwives about the importance of vaccinations in pregnancy, with a focus on pertussis vaccine, following the news of 5 deaths in infants who had contracted pertussis in the first quarter of 2024. As trusted healthcare professionals, midwives and student midwives play a vital role in maternal immunisations and it was great to have the opportunity to speak with a wide range of midwives and students from different settings including community, hospitals and education.

UKHSA at The Royal College of Midwives

Midwife Consultant Greta Hayward and immunisation advice nurse Kirsty Smith were pleased to attend the annual Royal College of Midwives conference in Liverpool in May.

Kirsty spoke with a first-year student midwife who recognised the importance of speaking to pregnant women about maternal immunisations and she asked whether a pertussis vaccine was needed for each pregnancy. Kirsty explained it’s really important to vaccinate in every pregnancy, so that maternal antibodies are passed on to babies to protect them from whooping cough in the first few weeks of life, when they are most vulnerable. The answer to this question (and many others!) can be found in the vaccination against pertussis (whooping cough) for pregnant women guidance and the Green Book pertussis chapter 24.

The team also spoke with a student midwife who was passionate about immunisations following their own experience of a family member who had been very unwell with a vaccine-preventable disease. She really wanted to be able to provide pregnant women with the information they needed about maternal vaccination and she was pleased to see all of our leaflets and posters that she could take back to her clinical placement.

There was a lot of interest over the 2 days in the stand and resources available, in particular the ‘Whooping cough: vaccination in pregnancy programme’ resources which includes the ‘Whooping cough in pregnancy’ leaflet and poster. These can be ordered for free via the Health Publications website.

National Immunisation Network Conference 2024

On 24 and 25 April 2024, more than 320 people working in the field of immunisation from across the UK came together for the UK Health Security Agency’s (UKHSA) National Immunisation Network (NIN) Conference, which this year was held at Imperial College London.Held during World Immunisation Week each year, in line with our strategic priority to improve health outcomes through vaccines, the conference champions the advancement of public health through immunisation, from research and policy to commissioning and operational delivery of live-saving vaccines.

The theme for this year’s meeting was ‘protecting every generation’, acknowledging the positive impact and health benefit of vaccines across the life course.

Day 1 focused on science, modelling, and epidemiology. The day started with a session by our first international speaker, Dr Irene Rivero-Calle, who provided ‘hot off the press’ information on the evaluation of a respiratory syncytial virus (RSV) immunisation programme for infant protection in Galicia, Spain. Other sessions covered RSV, sexually transmitted infections (STIs), measles, and varicella. The day ended with a lively panel debate.

Day 2 built on the science and focussed on the operational delivery aspects of the immunisation programmes. The day started with sessions from 2 international speakers Dr Gareth Millward, from the University of Denmark, who provided ‘Historical reflections on British vaccination policy: a source for inspiration’. Followed by Dr Katie Atwell who joined via a Teams link from Perth, Australia and provided a very engaging session on ‘Incentives and penalties for vaccination’. Concluding with a heartfelt message that the universal aspects of the programmes delivered free via the NHS, and the voluntary basis for accepting the programmes, is something many other countries envy and look up to as a “bastion” of good practice.

Steve Russell and Caroline Temmink updated on the NHS England Vaccination Strategy and colleagues from NHS Scotland, Dr Clare Cameron and Dr Daniel Chandler, provided insight into the early evaluation of the service delivery and transformation project that has been implemented in Scotland over the past 4 years.

Sessions also covered maternal vaccinations and the Midlands measles outbreak response. The day ended with some thought-provoking presentations from PhD students from the London School of Hygiene and Tropical Medicine who provided insight into patient journeys, highlighting the impact of poor experience and system factors on vulnerable and underserved communities and identifying access as a key issue, often of greater significance than a perceived reluctance to have the vaccines, in several of these population groups.

Attendees included both UKHSA staff and other colleagues and stakeholders from across the health system. The conference was a fantastic opportunity to network with colleagues, and share experience and perspectives.

Project manager Pinar Erder led on organising this year’s conference alongside Suzanna McDonald, National Programme Lead for Influenza, and many other members of the Public Health Programmes Directorate contributed. It was a resounding success with fantastic feedback received and plans are already underway for the next NIN conference in 2025.

My first NIN conference

Zahrah is one of the newest members of the Immunisation Department, working in the immunisation publications team.

My first NIN conference was an amazing experience. As someone who is both new to UKHSA and to working in public health in general, it was great to see so many people come from all over as it really solidified how important our work is. Although I wasn’t able to attend as many of the presentations as I would’ve liked, the ones I did sit in on were incredibly engaging and helped better my understanding of what we do, and why we do it. In particular, the Bangladeshi and Nigerian case studies on day 2 of NIN were really insightful as they focused on the intersection of community and social work, and science.

The way the presentations were delivered across the 2 days made it easy for me, someone without a clinical background, to really absorb all the information without it feeling overwhelming, or like everyone was speaking a different language to me. I appreciated how accessible and inclusive it all felt.

Having attended the NIN conference, I now have a much better understanding and awareness of all the different immunisation programmes we have and the issues that healthcare professionals face in this area. I’m really looking forward NIN 2025 and seeing everyone again!

UKHSA at Nursing in Practice

On 23 May, immunisation advice nurses Kirsty and Helen attended the Nursing in Practice conference in Southampton with the immunisation publications stand. It was great to meet a broad range of professionals, including practice nurses, school-aged immunisation nurses, midwives, military nurses and nurses working in child and mental health services (CAMHS) and learning disability settings. While we talked about lots of different programmes across the range of ages, it was great to talk to school-aged immunisation nurses in particular about the success of the HPV programme and it’s impact on HPV-related cancers, recognising the hard work of the teams in implementing this. There are several postcards, leaflets, posters and stickers available for school-aged immunisations, which can be ordered at no cost through the health publications website so this was a great opportunity to go through some of these with visitors to the stand.

Kirsty said:

We received lots of feedback about the different resources available, including the benefits of the QR code translation links for the UK complete routine schedule.

Immunisation Queries

Check the information for healthcare practitioner guidance

When a new vaccine is introduced or a change is made to an existing vaccine programme, UKHSA produces ‘Information for Healthcare Practitioner’ guidance to answer the questions around scheduling, administration, inadvertent errors and so on that may arise for vaccinators. These can be found under the ‘Vaccine programmes’ section of the GOV.UK immunisation collection.

Examples of these include:

• HPV vaccination guidance for healthcare practitioners
• Shingles vaccination guidance for healthcare practitioners
• Hexavalent combination vaccine: information for healthcare practitioners

So next time you have a question about a vaccine, if it’s not covered in the Green Book chapter, we recommend you look in the ‘Information for Healthcare Practitioner’ guidance (if there is one for that vaccine) and see whether your question has been answered there.If an answer for your question cannot be found in these guidance documents, please email immunsation@ukhsa.gov.uk.

The selective neonatal hepatitis B immunisation pathway for babies born to hepatitis B positive mothers

Babies born to mothers who have screened positive for hepatitis B virus (HBV) in pregnancy, or whose mothers have acute hepatitis B infection in pregnancy, are offered an accelerated course of hepatitis B immunisation starting at birth and continuing as part of the routine childhood immunisation programme with hexavalent vaccine.The aim of the selective hepatitis B immunisation programme is to prevent babies acquiring HBV following exposure to their mothers’ blood and body fluids especially around the time of birth. As this is a post-exposure vaccination programme, timely administration of all doses of vaccine (±HBIG at birth) is vital in preventing the baby becoming persistently infected with HBV.

High risk infants should receive monovalent hepatitis B vaccine at birth and 4 weeks of age and then 3 doses of the hexavalent vaccine at 8, 12 and 16 weeks of age. They should receive a booster dose of monovalent hepatitis B vaccine at 12 months of age, at which time they should also have a blood test, preferably a dried bloodspot (DBS) test to check for chronic infection, that is, hepatitis B surface antigen (HBsAg).

‘Hepatitis B: antenatal screening and selective neonatal immunisation pathway’ gives further detail about the pathway.

Ordering monovalent hepatitis B vaccine

The monovalent vaccine is not available to order on ImmForm and needs to be procured from the manufacturer, if you order before 4pm the vaccine should arrive the next day. The 2 licensed monovalent preparations are:

Engerix B: 10 micrograms / 0.5ml (GSK)

• Available from: AAH Pharmaceuticals
• Telephone: 0344 561 8899
• To place an order & live online chat function: www.vaccines.co.uk
• General information: www.aah.co.uk

HBVaxPRO Paediatric® 5 micrograms / 0.5 ml (Merck Sharp and Dohme Limited (MSD))

• Available from: Alliance Healthcare
• Customer services via telephone: 0330 100 0448
• Online at: www.myahportal.co.uk

Hepatitis B dried blood spot testing for infants

A free national dried blood spot (DBS) testing service for babies at 12 months of age is offered by UKHSA to improve ease and uptake of testing, particularly in primary care. The DBS test has been validated for detecting hepatitis B surface antigen (HBsAg) which is the marker for infection.

The DBS test uses a single-use safety lancet to prick the heel of the infant allowing healthcare professionals to obtain several drops of blood, which is then applied to a filter paper with speed and little discomfort. Simple standard infection control precautions prevent any risk of cross-infection and allowing the blood to air dry onto the filter paper renders it safe for posting to the laboratory at UKHSA Colindale.

Screening and immunisation teams who feel this free of charge service could help to increase the uptake of testing of at-risk infants at 12 months of age are encouraged to express their interest in joining the service by emailing the hepatitis B at-risk infants surveillance team at UKHSA Colindale at hepatitisbbabies@ukhsa.gov.uk.

Further information about the service and resources to support health professionals in carrying out DBS testing can be found on UKHSA’s dedicated website pages on Hepatitis B dried blood spot (DBS) testing for infants.

Vaccine supply

Influenza vaccines for the 2024/25 season

Information on all influenza vaccines that will be marketed in the UK for the 2024/25 season are available on GOV.UK.

The impact of changes to opening hours on routine vaccine deliveries

Please consider temporary changes to opening times when placing ImmForm orders. If you are aware of a scheduled site closure, please refrain from placing an order for that date. In case of a one-off closure, consider rescheduling your order for the week before or after. This approach will contribute to improved overall efficiencies and enhance delivery performance for the benefit of all customers.

It is not possible to accommodate one-off changes to delivery days. Customers should report long-term changes to the days and times when they can accept deliveries, such as routine training days and closures, by contacting Movianto UK Customer Care by:

• email: MoviantoUK.NHSCC@movianto.com
• phone: 01234 587207

This should not be used to report short-term changes due to absence or holidays.

DTaP/IPV/Hib/HepB vaccine ordering

Supplies of DTaP/IPV/Hib/HepB vaccines Infanrix hexa® and Vaxelis® are available for the routine infant primary immunisations programme. Orders for Infanrix hexa® remain unrestricted.

Customers in England and Wales may order up to 20 packs of Vaxelis® per ImmForm account per week – this will vary for customers taking part in the Oxford Vaccine Group trial. Customers in Scotland should refer to their local ordering restrictions. Providers should not order more than 2 weeks’ worth of stock to minimise wastage due to fridge failures. For assistance, please contact the ImmForm Helpdesk at helpdesk@immform.org.uk.

Registering for a new or updating your existing ImmForm vaccine ordering account

When you register for or update an existing ImmForm account, UKHSA as a wholesaler of vaccines needs to verify the requesting customer. Please ensure you have your professional regulatory body registration number or wholesaler dealer licence and an organisation code which can be verified when requesting updates or requesting a new vaccine ordering account. For more information please see the ImmForm Helpsheet: how to register.

The EU Falsified Medicines Directive and Delegated Regulation as applicable toUKHSA-supplied vaccines for the national immunisation programme

TheEU Falsified Medicines Directive (FMD) and Delegated Regulationimpose legal obligations on the EU medicines supply chain to prevent entry of falsified medicinal products into the supply chain. The Delegated Regulation was implemented in all EU member states on 9 February 2019. Following the UK’s departure from the EU, the Delegated Regulation ceased to apply in Great Britain from 31 December 2020, but continues to apply in Northern Ireland.

Information for customers in Northern Ireland

FMD-barcoded packs of routine immunisation programme vaccines that are centrally supplied byUKHSAcontinue to be supplied with activeFMDserialisation, and should be decommissioned by end users in Northern Ireland. Customers in Northern Ireland who access centrally supplied vaccines are encouraged to review local guidance on implementation of the EU FMD.

MMR vaccine ordering

In order to rebalance central supplies of both measles, mumps, and rubella (MMR vaccines), please consider ordering M-M-RvaxPRO® as your first choice, which is available to all customers without restriction. Customers in England and Wales who require Priorix®, for example because you serve communities that do not accept vaccines containing porcine gelatine, may order up to 15 packs of Priorix® per ImmForm account per week. For assistance with ordering more than 15 packs of Priorix®, please email your request to the ImmForm Helpdesk at helpdesk@immform.org.uk. Customers in Scotland should refer to their local ordering restrictions.

Non routine vaccine supply

Hepatitis A vaccine

Adult:

• GSK: supply of Havrix AdultPFSsingles and packs of 10 are currently available
• Sanofi: AvaximPFSsingles and packs of 10 are currently available
• MSD: VAQTA Adult is available

Paediatric:

• GSK: supply of Havrix Paediatric singles and packs of 10 are currently available
• MSD: VAQTA Paediatric is available
• Sanofi: Avaxim Junior singles are currently available

Hepatitis B vaccine

Adult:

• GSK: Engerix BPFSsingles and packs of 10 are currently available
• GSK: supply of Fendrix is currently available
• MSD: HBVAXPRO 10 micrograms is available
• MSD: HBVAXPRO 40 micrograms is available
• Valneva: PreHevbri is available

Paediatric:

• GSK: supply of Engerix B Paediatric singles is currently available
• MSD: HBVAXPRO 5 micrograms is available

Combined hepatitis A and B vaccine

• GSK: Twinrix Adult singles and packs of 10 are available
• GSK: Twinrix Paediatric is currently available
• GSK: Ambirix is available

Combined hepatitis A and Typhoid vaccine

Sanofi: Viatim is now a discontinued product and no longer available for sale.

Typhoid vaccine

• Sanofi: Typhim singles and packs of 10 are available
• Patientric: Vivotif is available

Rabies vaccine

• Valneva; Rabipur is out of stock until 24 July 2024
• Sanofi: Verorab is available to order with restriction of 30 doses per customer per month

Pneumococcal polysaccharide vaccine (PPV)

MSD: supply of Pneumovax 23 (PPV23)PFSis available.

Pneumococcal polysaccharide conjugate vaccine (PCV)

• Pfizer: Prevenar 13 is currently available.
• MSD: Vaxneuvance is currently available

Varicella zoster vaccine

• GSK: VARILRIX is currently available
• MSD: VARIVAX is available
• MSD: ZOSTAVAX is now a discontinued product

Diphtheria, tetanus, poliomyelitis (inactivated) vaccine

Sanofi: Revaxis is available.

Diphtheria, tetanus, pertussis (acellular) and (inactivated) vaccine

• GSK: supply of Boostrix-IPVis currently available
• Sanofi: Repevax is currently available

MMR

• MSD:MMRVaxpro is currently available
• GSK: Priorix is currently available

Meningitis ACWY vaccine

• GSK: Menveo is currently available
• Pfizer: Nimenrix is currently available
• Sanofi: MenQuadfi is available

Yellow fever

Sanofi : Stamaril is available.

Human papillomavirus (HPV) vaccine

• MSD: GARDASIL has been discontinued
• MSD: Gardasil 9 is currently available
• GSK: Cervarix has been discontinued

Cholera vaccine

• Valneva: Dukoral is available but subject to order caps of 10 packs/per customer/per week
• Patientric: Vaxchora is available

Japanese encephalitis vaccine

Valneva: Ixiaro is available

Meningococcal group B vaccine

GSK: Bexsero is currently available

Diphtheria, tetanus, pertussis, hib vaccine and poliomyelitis

GSK: InfanrixIPV+Hib is currently available

Hib + meningococcal group c combined vaccine

GSK: Menitorix is currently available

Live attenuated rotavirus vaccine

GSK: Rotarix is currently available

Herpes zoster vaccine

GSK: Shingrix is currently available

Diphtheria, tetanus and pertussis

Sanofi: ADACEL is available to order without restrictions