Research and analysis

HPR volume 13 issue 14: news (26 and 29 April)

Updated 20 December 2019

Parental attitudes to vaccines survey 2018

Results of the latest PHE-commissioned survey of parental attitudes to the national childhood immunisation programme have confirmed that public confidence in the national programme remains very high and that self-reported vaccine coverage remains high for most childhood vaccines in the UK [1].

Surveys of parental attitudes to vaccination have been carried out annually since 1991 to inform development of the national programme. In 2018, the percentage of parents self-reporting that they had had all of their child’s vaccines done on time reached an all-time high of 91%, compared with 72% in 2010. Of those parents who did not vaccinate on time, most had postponed, rather than refused, vaccination, with the child going on to be vaccinated at a later date.

Health professionals remain parents’ most trusted source of advice on immunisation, while social media and the internet are the least trusted, according to the 2018 survey. A historically low proportion of parents (9% of respondents) had seen, read or heard about something that would make them doubt the value of vaccines, down from a third (33% of respondents) in 2002. Of those who had seen information to make them doubt having their child immunised, 35% had seen this on the internet and 14% mentioned social media as the main source.

Even though a clear majority of respondents were frequently undertaking online activity, three times as many parents cited leaflets rather than online sources as their main source of information, suggesting that provision of high quality and accessible print materials remain vital to the programme’s effective implementation.

The latest issue of PHE’s bulletin for immunisation practitioners, Vaccine Update, provides up-to-date information about the Value of Vaccines campaign currently running as part of the end-April, European and World Immunisation Weeks [2].

References

1. PHE offers support to UK vaccine heroes, PHE press release, 25 April.
2. PHE (April 2018). Vaccine Update issue 293.

Prenatal pertussis vaccine coverage report in summary

In April 2012 a national pertussis outbreak was declared in England. In response to the outbreak, a pertussis vaccination programme for pregnant women was introduced on 1 October 2012 with the aim of minimising disease, hospitalisation and deaths in young infants (through intra-uterine transfer of maternal antibodies) until they can be actively protected by the routine infant programme.

Pertussis activity was lower in 2018 than in any year since the outbreak peak in 2012. In the fourth quarter of that year pertussis vaccine coverage increased from 70.2% in October to 72.9% in December, averaging 71.7% across the quarter which was 1.9 percentage points lower than coverage for the same quarter in 2017. This drop could represent a genuine decrease or an increase in vaccination in maternity units. Ongoing research suggests that vaccines administered in maternity units are under-recorded in GP notes, resulting in more women being vaccinated but leading to an underestimate of vaccine coverage.

GPs, practice nurses, obstetricians and midwives should encourage pregnant women to receive the pertussis vaccine, ideally between weeks 20 and 32 of their pregnancy, to optimise protection for their babies from birth. Maternity units not offering pertussis vaccines to pregnant women should, nevertheless, continue to discuss its importance and direct them to their GP to receive the vaccine.

These are latest PHE recommendations following publication of the vaccine coverage data from the Pertussis Vaccination Programme for Pregnant Women covering the period October to December 2018 (and updating previous data for July to September) [1].

Reference

1. Pertussis vaccination programme for pregnant women update: vaccine coverage in England, October to December 2018, HPR 13(14) infection report.

Environmental causes of lung cancer in never-smokers

Evidence that lung cancer is under-recognised rather than uncommon among those who have never smoked is reviewed in a commentary article from respiratory medicine and public health experts published in the Journal of the RSM [1].

Lung cancer is, mistakenly, widely thought of as exclusively a ‘smokers’ disease’, the authors conclude, although lung cancer mortality among never-smokers is the eighth most significant cause of cancer mortality in the UK.

The article reviews the epidemiology and genomics literature, concluding that an estimated 6,000 never-smokers die each year from lung cancer in the UK (a greater number than die of cervical cancer, lymphoma, leukaemia or ovarian cancer) and that there is a need to raise awareness among clinicians and policymakers of environmental risk factors, including exposure to occupational carcinogens, air pollution, radon, and second-hand tobacco smoke.

The authors conclude that the historically strong, and correct, messaging on smoking and health has inadvertently contributed to a situation in which there is lack of knowledge of and research into lung cancer and that, as a result, never-smokers who develop lung cancer are disadvantaged.

Reference

1. Bhopal A, Michael D Peake MD, Gilligan D and Cosford P (26 April, 2019). Lung cancer in never-smokers: a hidden disease [Commentary], Journal of the Royal Society of Medicine (online).

Infection and vaccine coverage reports in this issue of HPR

Infection reports

• Laboratory confirmed cases of pertussis (England): fourth quarter and annual, 2018
• Laboratory reports of hepatitis A infections in England and Wales, October to December 2018

Vaccine coverage reports

• Cumulative shingles vaccine coverage report to end of March 2019: England
• Pertussis vaccination programme for pregnant women update: vaccine coverage in England, October to December 2018.