Vaccine Uptake in Children in Wales January to March 2009 COVER 90: Wales May 2009

Transcription

1 Vaccine Uptake in Children in Wales January to March 2009 COVER 90: Wales May 2009 Key points Uptake of the 5 in 1 vaccine, MenC and pneumococcal conjugate vaccines (PCV) at one year of age have all reached the 95% uptake target this quarter. Sixteen areas exceeded the target of 95%. Uptake of the first dose of MMR in two year old children increased to 89.6% this quarter, ranging by from 82.8% to 95.6%. One (Wrexham) has exceeded the 95% target. Uptake of the second MMR dose by five years of age increased again this quarter to 83.4% ranging by from 76.0 % to 89.4%. Uptake of pre-school 4 in 1 booster in five year old children increased this quarter to 88.3%, ranging by from 82.0% to 93.5%. Uptake of one dose of Human Papilloma Virus (HPV) vaccine in girls in the current school year 8 was 88% and uptake of two doses was 86%. Findings 1. These results are for children living in Wales in May 2009 and reaching their first, second, fifth, 15 th and 16 th birthdays during the quarter January to March Uptake of the HPV vaccine is reported here for girls in the current school Year 8 (reaching their 13 th birthday between 01/09/2008 and 31/08/2009). HPV vaccination protects girls against cervical cancer associated with HPV types 16 and 18. The routine HPV vaccination schedule consists of three doses, usually given to girls in school Year 8 at intervals of one to two months then six months. and hepatitis B immunisation uptake data is presented here for the first time. and hepatitis B are not part of the routine childhood schedule and are given selectively following risk assessment; further information on circumstances in which these should be given can be found in Immunisations Against Infectious Disease (The Green Book). 2. Uptake of all three doses of the combined 5 in 1 DTaP/IPV/Hib 1, scheduled at 2, 3 and 4 months of age was 96.0% this quarter; which represents an increase of 0.2% from the previous quarter. Uptake ranged by NHS Region from 95.8% to 96.3% and by Local Health Board () from 93.8% (Denbighshire) to 99.4% (Anglesey). Sixteen areas achieved the target 95% uptake (See: Figure 2 and Tables 1, 2). 3. National uptake of a completed two dose course of MenC 2 vaccine in children reaching their first birthday this quarter increased to 95.7% (from 95.6% last quarter). Uptake ranged by NHS Region from 95.5% to 96.1% and by from 93.4% (Torfaen) to 99.4% (Anglesey). Sixteen areas achieved an uptake in excess of the target 95% (See: Tables 1, 2). 4. Uptake of a complete two dose primary course of pneumococcal conjugate vaccination (PCV2 2 ) in children at one year of age was 95.8%, ranging by from 93.1% (Denbighshire) to 99.4% (Anglesey). Sixteen areas achieved the target 95% uptake (See: Tables 2). 1 DTaP/IPV/Hib vaccine protects against Diphtheria, Tetanus, Pertussis (Whooping Cough), Polio and Hib infection. 2 Men C vaccine protects against meningitis caused by meningococcus group C infection. PCV protects against pneumococcal meningitis, bacteraemia, pneumonia otitis media. Children reaching one year of age this quarter have been scheduled for the two dose course of pneumococcal conjugate vaccination (PCV) at two and four months of age and the two dose MenC primary course scheduled at three and four months of age. Children reaching 2 years of age this quarter should have been offered a routine dose of the Hib/ MenC at 12 months and PCV at 13 months.

2 5. Uptake of the first dose of MMR 3 in children reaching their second birthday (scheduled at 13 months of age) increased to 89.6% this quarter, ranging by from 82.8 (Conwy) to 95.6% (Wrexham) (see Tables 1, 3). One (Wrexham) achieved the target of 95% uptake, nine s have uptakes above 90%. 6. Uptake of the final dose of Pneumococcal Conjugate Vaccine (PCVf, scheduled at 13 months of age) by the second birthday was 88.6%. Uptake by ranged from 82.7% (Carmarthenshire) to 94.1% (Wrexham) (See: Tables 1, 3). 7. Uptake of the Hib/MenC (given at 12 months of age) in children reaching 2 years of age during this quarter was 92.7% ranging by from 87.0% (Conwy) to 97.2% (Wrexham) (See: Tables 1, 3). Three areas achieved uptakes in excess of 95%. 8. In children reaching five years of age this quarter, uptake of one dose of MMR increased to 92.0% and uptake of two doses increased to 83.4% (from 82.3% in the previous quarter). Uptake of two doses ranged by from 76.0% (Bridgend) to 89.4% (Merthyr Tydfil). 9. Uptake of the 4 in 1 DTaP/IPV 4 pre-school booster in children reaching their fifth birthday this quarter increased to 88.3% (from 87.7% last quarter), ranging by from 82.0% (Bridgend) to 93.5% (Anglesey) (Tables 1, 4). No s reached the 95% target, eight s had uptake in excess of 90% 10. Current uptake of the first dose of HPV vaccine in girls in the current school Year 8 (reaching their 13 th birthday during 01/09/08 and 31/08/09) is 87.6%, ranging by from 80.0% (Monmouthshire) to 96.1% (Blaenau Gwent) (Table 7). Uptake of the second dose of HPV vaccine stands at 85.7%, ranging by from 75.9% (Cardiff) to 94.2% (Blaenau Gwent). Immunisation sessions for the third dose are currently underway, provisional figures will be reported in the next COVER report. 11. Uptake of two doses of MMR in 16 year olds this quarter was 82.3%, ranging by from 74.0% (Monmouthshire) to 92.1% (Blaenau Gwent). Uptake of one dose of MMR in 16 year olds this quarter was 92.8%, ranging by from 87.8% (Monmouthshire) to 97.4% (Blaenau Gwent). Uptake of a full course (two doses of MMR) of immunisation against rubella in 16 year old girls this quarter was 83.4% and uptake of only 1 dose was 93.2%. 12. National uptake of the Td/IPV 5 teenage booster in children reaching 16 years of age was 59.3% (Table 6), ranging from by from 3.1% (Blaenau Gwent) to 79.4% (Denbighshire). Uptake in five s remains below 20% 13. Uptake of 6 immunisation is presented in Table 8. This data is based on notifications of recorded in the National Community Child Health Database (NCCHD). immunisation was received by 5.8%, 6.4%, 5.0% and 6.0% of children reaching their first, second, fifth and 16 th birthdays (respectively) during Jan Mar 09. Highest proportions children given by one and two years of age this quarter were seen in Cardiff and Newport s Uptake of hepatitis B immunisation is presented in Table 9. This data is based on notifications of hep B recorded in the National Community Child Health database. Completed three doses of the hepatitis B schedule were recorded for 42.6%, 60.9%, 68.6% and 47.3% of children reaching their first, second, fifth and 16 th birthdays (respectively) during Jan Mar MMR protects against measles, mumps and rubella infections. 4 DTaP/IPV (and dtap/ipv) vaccines boost protection against Diphtheria, Tetanus, Pertussis and Polio infection before school entry 5 Td/IPV boosts protection against Diphtheria, Tetanus and Polio infection before entering adulthood 6 protects against tuberculosis infection. 7 Numbers of eligible children for and hep B are not known

3 Comment Uptake of all routine in Wales by one year of age again exceed 95%, with the number of areas achieving the 95% target increasing to 16 this quarter from 11 one year ago. Uptake of the first and second doses of MMR by two and five years of age respectively have both increased this quarter and one has exceeded 95% uptake for uptake of one dose by two years of age this quarter. and hepatitis B immunisation data are presented in this report for the first time, data from the National Community Child Health Database suggest that approximately one in 20 of all children reaching their first, second, fifth and 16 th birthdays have been immunised with, increasing to around one in 10 in Swansea and Newport and one in five in Cardiff. The number of children reaching these birthdays who have started and completed hepatitis B doses one to three ranges from 43% to 69% at a national level. Local NHS Trust Child Health offices record all notifications of given, however since these are not part of the routine childhood schedule there may be a degree of under-notification associated with this data. It is anticipated that data quality will improve with use. Uptake figures for the first dose of HPV vaccine are very encouraging, with eight areas achieving an uptake in excess of 90%. Uptake of the second dose is also encouraging, although the majority of these would have been given during January to March 2009, data entry for these sessions would not have been completed by the reporting deadline for this report so this figure is likely to rise. Immunisation sessions for HPV dose 3 are currently underway. Report prepared by NPHS Vaccine Preventable Disease Programme and Communicable Disease Surveillance Centre. Data for this report was provided by Health Solutions Wales from the National Community Child Health Database (NCCHD). The data was sourced from Community Child Health databases maintained by local Child Health Office staff in Trusts throughout Wales based on regular returns from doctors and nurses who immunise or advise on immunisation. Uptake data presented throughout are for resident population, not for GP practice populations. The maps, graphs and Table 1 are best viewed in colour.

4 Figure 1. Percentage uptake of childhood in Wales, quarter to quarter Data are for: children reaching 1 year of age each quarter for diphtheria, pertussis, Hib, MenC and pneumococcal conjugate vaccine (PCV2), children reaching 2 years of age for MMR1 (first dose), and 5 years of age for MMR2 (second dose). Diphtheria Pertussis Hib MenC 100 MMR1 (2yrs) MMR2 (5yrs) PCV % uptake Figure 2. Uptake of 5 in 1 vaccine in Welsh Local Health Board areas in children reaching their 1 st birthday between 01/01/09 and 31/03/09 (See Table 1 for identifier codes).

5 Figure 3. Uptake of at least 1 dose of MMR immunisation in Welsh Local Health Board areas in children reaching their 2 nd birthday between 01/01/09 and 31/03/09 (See table 1 for identifier codes). Figure 4. Uptake of 4 in 1 vaccine in Welsh Local Health Board areas in children reaching their 5 th birthday between 01/01/09 and 31/03/09.

6 Table1. Summary table with uptake of selected in resident children reaching their 1st, 2nd, 5th and 16th birthday between 01/01/09 and 31/03/09. Age 1 year Age 2 years Age 5 years Age 16 years Map ref children 5 in 1* MenC children MMR1 PCVf Hib/MenC booster children MMR2 4 in 1 * children MMR1 MMR2 3 in 1 Teenage booster** (%) (%) (%) (%) (%) (%) (%) (%) (%) (%) 1 Blaenau Gwent Caerphilly Cardiff Merthyr Tydfil Monmouthshire Newport Rhondda Cynon Taff Torfaen Vale of Glamorgan South East Wales Bridgend Carmarthenshire Ceredigion Neath Port Talbot Pembrokeshire Powys Swansea Mid and West Wales Anglesey Conwy Denbighshire Flintshire Gwynedd Wrexham North Wales Unknown Total * Uptake of pertussis used as proxy. ** Uptake of diphtheria (reinforcing booster dose) used as proxy Children receiving the final dose of PCV.

7 Table 2. Vaccine uptake in children reaching their 1st birthday between 01/01/09 and 31/03/09 and resident on 14/05/2009. children D3 T3 P3 Po3 Hib3 MMR1 MenC PCV2* HibMenCb (%) (%) (%) (%) (%) (%) (%) (%) (%) Blaenau Gwent Caerphilly Cardiff Merthyr Tydfil Monmouthshire Newport Rhondda Cynon Taff Torfaen Vale of Glamorgan South East Wales Bridgend Carmarthenshire Ceredigion Neath Port Talbot Pembrokeshire Powys Swansea Mid and West Wales Anglesey Conwy Denbighshire Flintshire Gwynedd Wrexham North Wales Unknown Wales total * Full primary 2 dose course of pneumococcal conjugate vaccine

8 Table 3. Vaccine uptake in children reaching their 2nd birthday between 01/01/09 and 31/03/09 and resident on 14/05/2009. children D3 T3 P3 Po3 Hib3 MMR1 MenC* PCV2** PCVf*** Hib/MenCb (%) (%) (%) (%) (%) (%) (%) (%) (%) (%) Blaenau Gwent Caerphilly Cardiff Merthyr Tydfil Monmouthshire Newport Rhondda Cynon Taff Torfaen Vale of Glamorgan South East Wales Bridgend Carmarthenshire Ceredigion Neath Port Talbot Pembrokeshire Powys Swansea Mid and West Wales Anglesey Conwy Denbighshire Flintshire Gwynedd Wrexham North Wales Unknown Wales total * Reflects uptake of the completed primary course in this age group ** Full primary 2 dose course of pneumococcal conjugate vaccine *** Final (booster) dose of pneumococcal conjugate vaccine

9 Table 4. Vaccine uptake in children reaching their 5th birthday between 01/01/09 and 31/03/09 and resident on 14/05/2009. children D3 T3 P3 Po3 Hib3 MenC* MMR1 MMR2 D4 T4 ap Po4 (%) (%) (%) (%) (%) (%) (%) (%) (%) (%) (%) Blaenau Gwent Caerphilly Cardiff Merthyr Tydfil Monmouthshire Newport Rhondda Cynon Taff Torfaen Vale of Glamorgan South East Wales Bridgend Carmarthenshire Ceredigion Neath Port Talbot Pembrokeshire Powys Swansea Mid and West Wales Anglesey Conwy Denbighshire Flintshire Gwynedd Wrexham North Wales Unknown Wales total * refers to full completed courses of MenC (before the 2006 schedule change)

10 Table 5. Vaccine uptake in children reaching their 15th birthday between 01/01/09 and 31/03/09 and resident on 14/05/2009 (with breakdown of MMR1 and MMR2 coverage by sex). children MMR1 MMR2 Teenage 3 in 1 booster* girls MMR1 (girls) MMR2 (girls) boys MMR1 (boys) MMR2 (boys) (%) (%) (%) (%) (%) (%) (%) Blaenau Gwent Caerphilly Cardiff Merthyr Tydfil Monmouthshire Newport Rhondda Cynon Taff Torfaen Vale of Glamorgan South East Wales Bridgend Carmarthenshire Ceredigion Neath Port Talbot Pembrokeshire Powys Swansea Mid and West Wales Anglesey Conwy Denbighshire Flintshire Gwynedd Wrexham North Wales Unknown Wales total * teenage booster doses of diphtheria, tetanus and polio (diphtheria used as proxy)

11 Table 6. Vaccine uptake in children reaching their 16th birthday between 01/01/09 and 31/03/09 and resident on 14/05/2009 (with breakdown of MMR1 and MMR2 coverage by sex). children MMR1 MMR2 Teenage 3 in 1 booster* girls MMR1 (girls) MMR2 (girls) boys MMR1 (boys) MMR2 (boys) (%) (%) (%) (%) (%) (%) (%) Blaenau Gwent Caerphilly Cardiff Merthyr Tydfil Monmouthshire Newport Rhondda Cynon Taff Torfaen Vale of Glamorgan South East Wales Bridgend Carmarthenshire Ceredigion Neath Port Talbot Pembrokeshire Powys Swansea Mid and West Wales Anglesey Conwy Denbighshire Flintshire Gwynedd Wrexham North Wales Unknown Wales total * teenage booster doses of diphtheria, tetanus and polio

12 Table 7. Uptake of HPV doses 1 and 2 in girls reaching their 13 th birthday between 01/01/09 and 31/03/09 (current school year 8) and resident in Wales on 14/05/09. girls HPV1 HPV2 HPV3* (%) (%) (%) Blaenau Gwent Caerphilly Cardiff Merthyr Tydfil Monmouthshire Newport Rhondda Cynon Taff Torfaen Vale of Glamorgan South East Wales Bridgend Carmarthenshire Ceredigion Neath Port Talbot Pembrokeshire Powys Swansea Mid and West Wales Anglesey Conwy Denbighshire Flintshire Gwynedd Wrexham North Wales Unknown Total * Immunisation sessions for dose 3 are currently underway, therefore this figure is an indicator of progess and is expected to increase in future reports.

13 Table 8. Uptake of immunisation in children reaching their 1 st, 2 nd, 5 th and 16 th birthdays between 01/01/09 and 31/03/09 and resident in Wales on 14/05/09. children 1yrs 2yrs 5yrs given (%) children given given (%) children given given given (%) children 16yrs given given (%) Blaenau Gwent Caerphilly Cardiff Merthyr Tydfil Monmouthshire Newport Rhondda Cynon Taff Torfaen Vale of Glamorgan South East Wales Bridgend Carmarthenshire Ceredigion Neath Port Talbot Pembrokeshire Powys Swansea Mid and West Wales Anglesey Conwy Denbighshire Flintshire Gwynedd Wrexham North Wales Unknown Wales Total Data reflects given and recorded on the National Community Child Health Database (following notification to local Child Health Administration offices). is not a routinely scheduled immunisation, data may be subject to under-reporting.

14 Table 9. Uptake of hepatitis B immunisation in children reaching their 1 st, 2 nd, 5 th and 16 th birthdays during 01/01/09 to 31/03/09 and resident in Wales in 14/05/09, and percentage who are recorded as completing doses 1 to 3. children dose 1 1yr dose 2 dose 3 Completed 3 doses (%) children dose 1 2yr dose 2 dose 3 Completed 3 doses (%) children dose 1 5yr dose 2 dose 3 Completed 3 doses (%) children Blaenau Gwent Caerphilly Cardiff Merthyr Tydfil Monmouthshire Newport Rhondda Cynon Taff Torfaen Vale of Glamorgan South East Wales Bridgend Carmarthenshire Ceredigion Neath Port Talbot Pembrokeshire Powys Swansea Mid and West Wales Anglesey Conwy Denbighshire Flintshire Gwynedd Wrexham North Wales Unknown Wales Total Data reflects given and recorded on the National Community Child Health Database (following notification to local Child Health Administration offices). Hepatitis B is not a routinely scheduled immunisation, data may be subject to under-reporting. dose 1 16yr dose 2 dose 3 Completed 3 doses (%)