Delivering the English immunisation programme – survey response dataset

An anonymised dataset containing results of an online survey completed by 278 health practitioners in 2016. The online survey sought to assess how the national immunisation programme (specifically Section 7a immunisation programmes) was being delivered across different regions of England. The dataset contains variables on the respondent’s professional background, individual and organisational responsibility for immunisation, levels of co-operation between partner organisations to manage and deliver the immunisation programme, and what is being done to monitor and improve the performance of immunisation services (e.g. quality and uptake).The survey forms part of a long-term analysis of how the national immunisation programme is managed and delivered in the post-April 2013 health system. It is was conducted by the ‘Health Protection Research Unit (HPRU) in Immunisation’, which includes researchers from the London School of Hygiene & Tropical Medicine (LSHTM) and Public Health England. The unit is funded by the National Institute of Health Research

Immunity in society: diverse solutions to common problems

Understanding how organisms fight infection has been a central focus of scientific research and medicine for the past couple of centuries, and a perennial object of trial and error by humans trying to mitigate the burden of disease. Vaccination success relies upon the exposure of susceptible individuals to pathogen constituents that do not cause (excessive) pathology and that elicit specific immune memory. Mass vaccination allows us to study how immunity operates at the group level; denser populations are more prone to transmitting disease between individuals, but once a critical proportion of the population becomes immune, “herd immunity” emerges. In social species, the combination of behavioural control of infection—e.g., segregation of sick individuals, disposal of the dead, quality assessment of food and water—and aggregation of immune individuals can protect non-immune members from disease. While immune specificity and memory are well understood to underpin immunisation in vertebrates, it has been somewhat surprising to find similar phenomena in invertebrates, which lack the vertebrate molecular mechanisms deemed necessary for immunisation. Indeed, reports showing alternative forms of immune memory are accumulating in invertebrates. In this issue of PLoS Biology, Konrad et al. present an example of fungus-specific immune responses in social ants that lead to the active immunisation of nestmates by infected individuals. These findings join others in showing how organisms evolved diverse mechanisms that fulfil common functions, namely the discrimination between pathogens, the transfer of immunity between related individuals, and the group-level benefits of immunisation

Healthy communities: immunisation rates for children in 2011-12

Immunisation helps protect individuals and the community generally against potentially serious diseases such as measles, polio, tetanus and whooping cough (pertussis). Although the great majority of children in Australia are immunised, it is important to maintain high immunisation rates to reduce the risk of outbreaks of these and other diseases recurring. Australian governments and experts endorse achieving high immunisation rates to protect individuals and those not immunised or too young to be immunised. States and territories are expected to maintain or improve their existing respective immunisation rates under the terms of the National Partnership Agreement on Essential Vaccines agreed in 2009. This report allows the public, clinicians and health managers to see for all children, and for Aboriginal and Torres Strait Islander children, the percentages fully immunised and how those percentages differ across the country. It reports these immunisation rates for each of the 61 geographic areas covered by the new network of Medicare Locals, which have been established to improve the responsiveness, coordination and integration of local health services. These data were sourced from the Australian Childhood Immunisation Register (ACIR). It is important to note that these data cover the period from July 2011 to June 2012. As Medicare Locals were still being set up during this time, this report establishes a baseline for comparisons that in future will help clinicians, health managers and others to assess whether improvements are occurring. Where possible, the results are broken down into geographic areas that are smaller than Medicare Local catchments – more than 300 statistical areas and more than 1500 postcodes. The report shows the percentages of children who were fully immunised at 1 year, 2 years and 5 years in each Medicare Local catchment, and in the smaller units of geography where applicable. Also reported are the numbers of children in each area who are not fully immunised. Key findings: The report’s findings can be considered in the context of three broad themes: The percentages of children fully immunised and variation between Medicare Local catchments, and between age groups The numbers of children who are not fully immunised in each Medicare Local catchment Lower immunisation rates among Aboriginal and Torres Strait Islander children

Beyond the ‘other’ as constitutive outside: : The politics of immunity in Roberto Esposito and Niklas Luhmann

This article re-conceptualises the ‘constitutive outside’ through Roberto Esposito’s theory of immunity to detach it from Laclau and Mouffe’s political antagonism. It identifies Esposito’s thought as an innovative epistemological perspective to dissolve post-ontological political theories of community from the intertwinement with a foundational self/other dialectic. Esposito shows how a community can sustain its relations through introversive immunisation against a primarily undefined outside. But it is argued that his theory of immunity slips back to a vitalist depth ontology which ultimately de-politicises the construction of the communal outside. This article draws on Niklas Luhmann’s immunity theory to resituate immunisation in the political production of social connectivity. Following Luhmann, politics relies on immunisation through contradictions to reproduce its functional role as a decision-making institution, but is at the same time constantly exposed to potential rupture through the political openness immunity introduces. Through Esposito and Luhmann, this article identifies the relationship between a social inside and its outside as open-ended and secondary to an introversive process of socio-political self-differentiation. It can involve, but does epistemologically necessitate, the construction of an external otherPeer reviewedFinal Accepted Versio

Parental Education and Child Health - Understanding the Pathways of Impact in Pakistan

This study investigates the relationship between parental schooling on the one hand, and child health outcomes (height and weight) and parental health-seeking behaviour (immunisation status of children), on the other. While establishing a correlational link between parental schooling and child health is relatively straightforward, confirming a causal relationship is more complex. Using unique data from Pakistan, we aim to understand the mechanisms through which parental schooling promotes better child health and health-seeking behaviour. The following ‘pathways’ are investigated: educated parents’ greater household income, exposure to media, literacy, labour market participation, health knowledge and the extent of maternal empowerment within the home. We find that while father's education is positively associated with the 'one-off' immunisation decision, mother's education is more critically associated with longer term health outcomes in OLS equations. Instrumental variable (IV) estimates suggest that father's health knowledge is most positively associated with immunisation decisions while mother's health knowledge and her empowerment within the home are the channels through which her education impacts her child's height and weight respectively.parental schooling, mother's health knowledge, father's health knowledge, media exposure, maternal empowerment, child health, immunisation, Pakistan

Midwives\u27 knowledge, attitudes and learning needs regarding antenatal vaccination

Objective: To determine the knowledge, attitudes and learning needs of midwives regarding antenatal vaccination. Design & Setting: A cross-sectional, paper-based survey of midwives employed at the only public tertiary maternity hospital in the Australian state of XX between November 2015 and July 2016. Participants: 252 midwives providing care in antepartum, intrapartum, and/or postpartum settings. Measurements: Self-reported responses to a 41-item survey. Findings: The vast majority of midwives supported influenza and pertussis vaccination for pregnant women, with 90.0% and 71.7% reporting they would recommend pertussis and influenza vaccine, respectively, to a pregnant friend or family member, and almost all stating that midwives should administer vaccines to pregnant patients (94.8%). Seven out of ten midwives (68.1%) responded correctly to all knowledge items regarding vaccines recommended during pregnancy; 52.8% demonstrated correct knowledge regarding vaccine administration despite only 36.6% having attended an education session on antenatal vaccination in the previous two years. Nearly all midwives (97.3%) expressed a need for more education on vaccine administration. The most commonly reported barrier to administering influenza (61.3%) and pertussis (59.0%) vaccination was having staff available with the certification required to administer vaccines. Key Conclusions: Midwives view antenatal vaccination as their responsibility and are interested and receptive to education. Implications for Practice: There is an unmet need and demand among midwives for professional development that would enable them to recommend and administer vaccines to pregnant women in accordance with national immunisation guidelines and integrate vaccination into routine antenatal care

Factors Affecting Childhood Immunisation in Bangladesh

This study has examined the coverage of childhood immunisation and tried to identify the factors affecting the acceptance of immunisation practice among children in Bangladesh using the data from Bangladesh Demographic and Health Survey (BDHS) 93-94. Results from multinomial logistic regression analysis indicate that education, occupation, household economic condition, mother’s age at birth, sex of child, mother’s TT immunisation acceptance, mother’s health facility visit, health worker’s visit to mothers, and contraceptive use are the independent variables that have statistically significant association with immunisation acceptance. The most important variable identified is the health worker’s visit to mothers.