Research and analysis

HPR volume 13 issue 21: news (21 June)

Updated 20 December 2019

Introduction of a universal HPV immunisation programme

Public Health England (PHE) and and NHS England / NHS Improvement have published operational information for health professionals on the forthcoming expansion of the human papillomavirus (HPV) vaccination programme into a universal programme [1].

The vaccine will be offered to boys, in addition to girls, as part of the routine school-aged schedule in England, from September 2019. This follows the government’s announcement in July 2018 to include HPV vaccination of boys, which was based on the advice of the Joint Committee of Vaccination and Immunisation (JCVI).

The same vaccine (Gardasil) as is currently used for girls will be offered routinely to all individuals in school year 8 (age 12 and 13 years, born from 1 September 2006 to 31 August 2007). For practical reasons, any individual who is eligible to be in school year 8, (regardless of their date of birth), should be offered HPV immunisation. This includes any individual who is eligible to be in, or is in school year 8. A second dose (separated by at least six months) will be offered either in the same school year or in the following year. A catch-up programme will not be offered for boys, but those eligible for the routine programme offered in school remain so until their 25th birthday.

A joint letter (from PHE, and NHS England and NHS Improvement) to directors of public health, service commissioners, heads of primary care and others responsible for implementing the programme includes, in annexes, summary clinical guidance. Further clinical guidance will shortly be available in an updated human papillomavirus chapter in the Green Book [2].

Communications materials to facilitate delivery of the strategy – for health professionals, parents and young people – will be available on the HPV Vaccination Programme collection webpage [3].

References

1. Bipartite letter (from PHE, and NHS England / NHS Improvement) to health professionals (20 June 2019). Introduction of a universal HPV immunisation programme.
2. Immunisation against infectious disease (the Green Book). Chapter 18a: human papillomavirus (HPV).
3. GOV.UK. HPV Vaccination Programme collection.

Mandatory HCAI reports quarterly trends: January to March 2019

PHE’s latest quarterly epidemiological commentary on trends in reports of Staphylococcus aureus (MRSA and MSSA) and Gram-negative bacteraemia, and of Clostridium difficile infections, mandatorily reported by NHS acute trusts in England up to January to March 2019, has been published on GOV.UK [1].

Some relevant facts are listed below.

Escherichia coli bacteraemia

Between July to September 2011 and January to March 2019, the count of cases and the incidence rate of all reported cases of E. coli bacteraemia increased by 23.7% – from 8,275 to 10,239 cases, and from 61.8 to 74.7 cases per 100,000 population.

Klebsiella spp. bacteraemia

Between April to June 2017 and January to March 2019, there was a 9.3% increase in the count of all cases – from 2,340 to 2,558 – and a 10.5% increase in the incidence rate of all reported Klebsiella spp. bacteraemia cases – from 16.9 to 18.7 cases per 100,000 population.

Pseudomonas aeruginosa bacteraemia

Between April to June 2017 and January to March 2019, there was a 4.7% decrease in the count, and a 3.7% decrease in the incidence rate, of all reported Pseudomonas aeruginosa bacteraemia cases – from 1,011 to 963, and from 7.3 to 7.0 cases per 100,000 population, respectively.

MRSA bacteraemia

The incidence rate of all reported cases of MRSA bacteraemia fell by 85% from 10.2 cases per 100,000 population April to June 2007 to 1.5 cases per 100,000 population in January to March 2014. The rate has subsequently decreased to 1.3 cases per 100,000 population between January to March 2014 and January to March 2019.

MSSA bacteraemia

The count of all reported cases of MSSA bacteraemia increased by 37.3% – from 2,199 to 3,020 – between January to March 2011 and January to March 2019. This was accompanied by a 31.1% increase in incidence rate – from 16.8 cases per 100,000 population to 22.0.

Clostridium difficile infection

Most of the decrease in the incidence rate of CDI occurred between April to June 2007 and January to March 2012: a 78% decrease in all-reported cases of CDI – from 16,864 to 3,711 cases – and an associated 79% reduction in incidence rate, from 131.6 cases per 100,000 population to 27.9. Subsequently, between January to March 2012 and January to March 2019, the count of all-reported cases decreased a further 29.6% – from 3,711 to 2,611 cases – and the incidence rate reduced by 31.8%, from 27.9 cases per 100,000 population to 19.0.

Reference

1. PHE (13 June 2019). Quarterly epidemiological commentary: mandatory MRSA, MSSA, Gram-negative bacteraemia, and C. difficile infection data (up to January to March 2019).

Infection reports in this issue of HPR

• Laboratory surveillance of Acinetobacter spp. bacteraemia in England, Wales and Northern Ireland: 2018