Systematic Literature Review of the Evidence for Effective National Immunisation Schedule Promotional Communications

Introduction: A systematic literature review examined the published evidence on the effectiveness of European promotional communications for national immunisation schedule (NIS) vaccinations. The review was commissioned by the European Centre for Disease Prevention and Control (ECDC) and conducted by the Institute for Social Marketing at the University of Stirling.The purpose of the review: ‘Immunisation hesitancy' has negatively impacted population uptake of routine immunisation. A substantial body of evaluated communication activity promoting nationally indicated routine immunisation has been published. This systematic review of the evidence aims to: collate and map the types of promotional communication that have been used; assess the quality of the evaluative research reporting on these promotional communications; and assess the applicability of this evidence to immunisation policy, strategy and practice priorities. The analysis and findings are intended to provide a current status report on the evidence, and evidence gaps for good practice in national immunisation promotional communications, thus supporting countries in their communication activities for the prevention and control of communicable diseases.Objectives of the review: The review aimed to answer the following research questions: Which audiences have been targeted by NIS promotional communications? Which communication methods and approaches have been used to promote or reinforce NIS vaccination uptake? What theoretical underpinnings are used to inform communication methods and approaches? Which settings and communication channels have been used to promote or reinforce NIS vaccination uptake? What is the evidence for effectiveness of communication initiatives in changing or reinforcing knowledge, attitudes or behaviour towards NIS? What is the evidence for impact of NIS communication initiatives to control communicable disease? What impact have campaign communications promoting NIS had on public acceptance and vaccine uptake rates

Characteristics of 5-year-olds who catch-up with MMR: findings from the UK Millennium Cohort Study

Objectives To examine predictors of partial and full measles, mumps and rubella (MMR) vaccination catch-up between 3 and 5 years. Design Secondary data analysis of the nationally representative Millennium Cohort Study (MCS). Setting Children born in the UK, 2000–2002. Participants 751 MCS children who were unimmunised against MMR at age 3, with immunisation information at age 5. Main outcome measures Catch-up status: unimmunised (received no MMR), partial catch-up (received one MMR) or full catch-up (received two MMRs). Results At age 5, 60.3% (n=440) children remained unvaccinated, 16.1% (n=127) had partially and 23.6% (n=184) had fully caught-up. Children from families who did not speak English at home were five times as likely to partially catch-up than children living in homes where only English was spoken (risk ratio 4.68 (95% CI 3.63 to 6.03)). Full catch-up was also significantly more likely in those did not speak English at home (adjusted risk ratio 1.90 (1.08 to 3.32)). In addition, those from Pakistan/Bangladesh (2.40 (1.38 to 4.18)) or ‘other’ ethnicities (such as Chinese) (1.88 (1.08 to 3.29)) were more likely to fully catch-up than White British. Those living in socially rented (1.86 (1.34 to 2.56)) or ‘Other’ (2.52 (1.23 to 5.18)) accommodations were more likely to fully catch-up than home owners, and families were more likely to catch-up if they lived outside London (1.95 (1.32 to 2.89)). Full catch-up was less likely if parents reported medical reasons (0.43 (0.25 to 0.74)), a conscious decision (0.33 (0.23 to 0.48)), or ‘other’ reasons (0.46 (0.29 to 0.73)) for not immunising at age 3 (compared with ‘practical’ reasons). Conclusions Parents who partially or fully catch-up with MMR experience practical barriers and tend to come from disadvantaged or ethnic minority groups. Families who continue to reject MMR tend to have more advantaged backgrounds and make a conscious decision to not immunise early on. Health professionals should consider these findings in light of the characteristics of their local populations

Surveillance of Hepatitis B in Malta : a four year trend

Surveillance systems include three fundamental elements of ongoing collection, analysis and feedback or dissemination of the data. A surveillance system for Hepatitis B was established in 1988 in order to improve prevention and control of transmission of this endemic disease. A disease register including data obtained mainly from notifications, laboratory reports and active case finding was established. This paper shows the findings from 1990 to 1993. The system shown cannot claim to be complete. However the findings suggest that some 14 clinically evident cases of Hepatitis B are confirmed each year. No rising trend has been seen. In anyone year a prevalence of 15.4 x 10-5 HBsAg positive results in persons who had previously not known that they were positive may be detected. Six month follow-up of these persons reveals that some 39 persons become chronic carriers each year. This has implications both for the targeted vaccination programme as well as for the individual’s chronic liver complications and treatment.peer-reviewe

An Opportunity Not To Be Missed: Vaccination as an Entry Point for Hygiene Promotion and Diarrhoeal Disease Reduction in Nepal

This report aims to ascertain whether or not vaccination programmes offer a useful entry point for hygiene promotion and to define options for piloting and scaling up of a hygiene promotion intervention in Nepal

Primary health care for Aboriginal and Torres Strait Islander children

This final report presents the findings from each of the phases of the Engaging Stakeholders in Identifying Priority Evidence-Practice Gaps and Strategies for Improvement in Primary Health Care (ESP) Project. This report is designed for people working in a range of roles including national and jurisdictional policy makers, managers, community-controlled organisations and government health authorities, peak bodies, clinical leaders, researchers, primary health care staff and continuous quality improvement (CQI) practitioners who may have an interest in the interpretation and use of aggregated CQI data to drive decision making. Stakeholders across services and systems that deliver Aboriginal and Torres Strait Islander primary health care (PHC) engaged in a process to analyse and interpret national continuous quality improvement (CQI) data from 132 health centres. We used a consensus process to identify priority evidence-practice gaps in child health care, based on these data. Stakeholders drew on their knowledge and experience working in Aboriginal and Torres Strait Islander PHC to identify barriers and enablers to addressing the priority evidence- practice gaps, and to suggest strategies to overcome barriers and strengthen enablers to addressing the priority evidence-practice gaps. Important messages emerge from these findings

The health and development of children born to older mothers in the United Kingdom: observational study using longitudinal cohort data

Objective: To assess relations between children’s health and development and maternal age. Design: Observational study of longitudinal cohorts. Setting: Millennium Cohort Study (a random sample of UK children) and the National Evaluation of Sure Start study (a random sample of children in deprived areas in England), 2001 to 2007. Participants: 31 257 children at age 9 months, 24 781 children at age 3 years, and 22 504 at age 5 years. Main outcome measures: Childhood unintentional injuries and hospital admissions (aged 9 months, 3 years, and 5 years), immunisations (aged 9 months and 3 years), body mass index, language development, and difficulties with social development (aged 3 and 5 years). Results: Associations were independent of personal and family characteristics and parity. The risk of children having unintentional injuries requiring medical attention or being admitted to hospital both declined with increasing maternal age. For example, at three years the risk of unintentional injuries declined from 36.6% for mothers aged 20 to 28.6% for mothers aged 40 and hospital admissions declined, respectively, from 27.1% to 21.6%. Immunisation rates at nine months increased with maternal age from 94.6% for mothers aged 20 to 98.1% for mothers aged 40. At three years, immunisation rates reached a maximum, at 81.3% for mothers aged 27, being lower for younger and older mothers. This was linked to rates for the combined measles, mumps, and rubella immunisation because excluding these resulted in no significant relation with maternal age. An increase in overweight children at ages 3 and 5 years associated with increasing maternal age was eliminated once maternal body mass index was included as a covariate. Language development was associated with improvements with increasing maternal age, with scores for children of mothers aged 20 being lower than those of children of mothers aged 40 by 0.21 to 0.22 standard deviations at ages 3 and 4 years. There were fewer social and emotional difficulties associated with increasing maternal age. Children of teenage mothers had more difficulties than children of mothers aged 40 (difference 0.28 SD at age 3 and 0.16 SD at age 5). Conclusion: Increasing maternal age was associated with improved health and development for children up to 5 years of age

A positive approach to parents with concerns about vaccination for the family physician

Provides an approach for primary care physicians to enable effective communication with parents who have different levels of concerns about vaccinations and awareness of currently available resources that may be used to support discussions. Summary Background Vaccine hesitancy is becoming increasingly recognised as an issue in Australia and globally, as concerns about vaccine and their safety predominate over concerns about the risk of vaccine-preventable diseases. Discussion Clear and flexible communication strategies for healthcare providers to undertake effective discussions with vaccinehesitant parents or clear referral pathways are the key to addressing concerns about vaccination in both primary and secondary care

The rise of pertussis in Malta in 2011 : a case for adolescent and adult pertussis booster vaccination

Notwithstanding the high rates of pertussis infant vaccination coverage in developed countries, Bortedella pertussis infections are manifesting a changing epidemiological pattern of disease. Of notable concern is the rise of pertussis in adolescents and adults. This changing picture is largely attributable to waning immunity after natural infection or vaccination. The belief that pertussis is chiefly a childhood disease is a common misconception. A significant rise of pertussis cases in Malta in older age groups was recorded in 2011. The addition of an adolescent and/or an adult booster dose against pertussis should be strongly considered.peer-reviewe