Guidance

Rotavirus vaccine and SCID newborn screening evaluation: information for GPs and practice nurses

Published 20 September 2021

This information applies to all babies born on or after 1 September 2021 who will attend for their 8 week immunisation appointments from 27 October 2021.

Introduction of SCID newborn screening evaluation

From September 2021, an evaluation of newborn screening to identify Severe Combined Immunodeficiency (SCID) is being introduced for babies born in the regions served by screening laboratories in Newcastle, Manchester, Sheffield, Birmingham, Great Ormond Street Hospital and Guys and St Thomas Hospital. This will form part of the newborn screening test at 5 days.

SCID is a rare inherited condition that affects the immune system and can be passed on in families. Infants affected by SCID become unwell in the first few months of life as they have a much higher risk than usual of developing infection and of developing related complications from infection. Early treatment can reduce this risk and in many cases cure the illness.

SCID and vaccinations

It is important that babies with SCID are appropriately vaccinated. Most of the vaccines given as part of the routine childhood programme are inactivated and are safe for them to have.

However, there are 2 vaccines that are live vaccines and should not be given to babies with SCID. These are:

• Bacillus Calmette–Guérin (BCG) vaccine, previously given at birth, to protect against tuberculosis. This should now only be given when the baby has a known SCID screening outcome, usually around 28 days old

• rotavirus vaccine, usually given at 8 and 12 weeks to protect against diarrhoea and vomiting

SCID newborn screening evaluation

In the areas included in the evaluation, SCID will form part of the routine newborn screening test at 5 days old.

Practices should update their immunisation protocol to ensure that SCID results are available to be viewed by the immuniser at the 8 week immunisation appointment (or sooner), this should include babies moving in from out of area. This should also include SCID screening not offered.

Parents of babies investigated for SCID and GP practices will receive a direct communication from the immunology team to alert them that a child has a suspected or confirmed SCID diagnosis and this will include information on which vaccines should not be given.

Parents and caregivers should be reminded to bring the Red Book and the letter with the outcome of newborn bloodspot screening when they attend for their 8 week immunisation appointment.

Algorithm for checking SCID results

It is advised that practices use this algorithm in their local protocols.

Algorithm for the process of checking for SCID screening results at the routine 8 week appointment

1. For all infants born on or after 1 September 2021.

2. SCID screening results will be available to GPs and parents for all babies by 42 days of age, if not before. Babies in non-screening areas will be assigned a ‘SCID screening not offered’ result.

Ensure that when sent by Childhood Information System (CHIS), the outcome of the SCID screening is recorded in the GP record as soon as it is received and that it is made available to the practice nurse before or at the 8 week routine immunisation appointment.

An alert can be placed on the GP record if the result is SCID suspected or if a repeat test is required.

All eligible babies should have received their results within 28 days, if not available at this time, the screening laboratory or CHIS may be able to advise further.

3. Immunisers should make all reasonable effort to check the record for a SCID screening outcome before administering rotavirus vaccine.

This would involve checking with the parent or caregiver and checking for a record in the Red Book, GP record, parents newborn bloodspot screening outcome letter or CHIS record by contacting your local CHIS.

4. Remind parents and caregivers by letter and text message to bring the Red Book and the letter with the outcome of the newborn bloodspot screening when they are invited for their routine 8 week immunisation appointment.

5. If SCID suspected, or the result of a repeat test is awaited, BCG vaccine and rotavirus vaccine should be deferred until you have sight of a letter from an immunologist saying that SCID has been excluded. This deferral does not include inactivated vaccines which can be given.

If SCID is not suspected, or SCID screening is declined or not offered, rotavirus vaccine should be administered at 8 weeks and 12 weeks of age.

In the absence of an abnormal SCID screening result or if no result can be found, rotavirus vaccine should be administered at 8 weeks and 12 weeks of age.

Further information

Contact your Regional Public Health Commissioning team or your local screening and immunisation team for more information.

See the Rotavirus vaccination programme collection on GOV.UK.