Research and analysis

HPR volume 10 issue 4: news (29 January)

Updated 16 December 2016

1. Cessation of rubella susceptibility screening in pregnancy in England

Rubella (German measles) susceptibility screening in pregnancy in England will cease from 1 April 2016, taking account of the conclusions of recent screening policy reviews carried out by the UK National Screening Committee [1].

The NSC reviews found that screening for rubella susceptibility during pregnancy no longer met the criteria for a screening programme and should be discontinued because:

• rubella infection levels in the UK are so low they are defined as eliminated by the World Health Organization
• rubella infection in pregnancy is very rare
• immunisation with the measles, mumps and rubella (MMR) vaccine before they become pregnant is a more effective means of protecting women against rubella in pregnancy
• the screening test used can potentially give inaccurate results and cause unnecessary stress among women.

Cessation of screening has been made possible by high uptake rates of MMR vaccine in children in England, which are close to the WHO’s target of 95%, resulting in rubella infection being now very uncommon in the country. In 2014 and 2015, 91.5% of children aged up to two years had received at least one MMR vaccination; and 94.5% had received at least one dose of MMR by five years [1].

1.1 References

1. Rubella susceptibility screening in pregnancy to end in England, PHE press release, 27 January 2016.

2. NSC (October 2015). “Criteria for appraising the viability, effectiveness and appropriateness of a screening programme”.

2. Shingles vaccine coverage and hepatitis disease reports in this issue of HPR

A report on vaccine coverage achieved during the first quarter of the third year of the herpes zoster (shingles) immunisation programme in England is published in the routine reports section of this issue of HPR [1]. The report presents provisional cumulative coverage data for each of the two relevant age cohorts – the 70-year-old “routine” cohort and the 78-year-old “catch-up” cohort – by NHS England Area Team, but not by CCG due to incompleteness of data.

There was 37.8% coverage for the 70-year-old routine cohort, and 38.2% coverage for the 78-year-old catch-up cohort. Compared with November 2014, coverage decreased by 2% for the routine cohort and by 0.4% for the catch-up cohort.

Although it is noted that the data are provisional and need to be interpreted with caution, they indicate the importance of GPs continuing to offer the vaccine to eligible patients in order to prevent the significant burden of disease associated with shingles among older adults in England.

Further provisional cumulative coverage data will be published on a quarterly basis, with the finalised annual coverage data due to be published in autumn 2016.

Further information on shingles vaccine eligibility is available in “Immunisation against infectious disease” (the Green Book) [2].

Also in this issue, a third quarter 2015 infection report on laboratory-confirmed hepatitis A virus and hepatitis C reports in England and Wales [3].

2.1 References

1. Shingles vaccine coverage report, England, September 2015 to November 2015, HPR 10(4): immunisation, 29 January 2016.
2. PHE/DH (October 2015). Immunisation against infectious disease (chapter 28a): Shingles (herpes zoster).
3. Laboratory reports of hepatitis A and C (England and Wales): July-September 2015, HPR 10(4): immunisation, 29 January 2016.