Increasing influenza immunisation uptake among children

Public Health England


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Plans for 2016–2017

  • In 2016–2017 all children aged two, three and four years old on 31 August 2016 are being offered flu vaccination, via their GP, as part of the programme to extend flu vaccination to children
  • GPs will continue to offer flu vaccination to children in at risk groups aged between 6 months and less than 18 years of age. Children of appropriate age for school Years 1, 2, and 3 are also being offered vaccination, primarily via school immunisation teams

Rationale for the programme

  • The programme will help to protect children against flu which can, although rarely, cause serious complications. By having the flu vaccination children are less likely to pass the virus on to friends and family, and the wider community
  • Evidence and best practice examples demonstrate that certain key strategies can improve vaccine uptake. This document provides a summary of those strategies that will help to increase flu vaccine uptake among children aged 2, 3, and 4 years

Pre-season preparation

  • All eligible patients should be vaccinated by the end of December before flu starts circulating. Advanced preparation is vital for a successful programme to achieve high vaccine uptake. Clinical judgement should be used to assess whether to vaccinate beyond December particularly if it is a late flu season

Staff responsibilities

  • Every practice should have a lead member of staff with responsibility for running the flu immunisation campaign
  • All staff should know who the lead person is
  • All staff should understand the reason for the programme and have access to PHE resources
  • Every member of the practice should know their role and responsibilities
  • Get all staff involved in promoting the vaccine message to parents
  • Hold regular meetings so that all staff know the practice plan and progress
  • Include health visitors, midwives, pharmacists and other healthcare professionals linked to your practice in your planning
  • Use NHS Employers website free resources to put your pictures on a poster (so all staff and parents know who can provide immunisation)

Practice goals

  • Set a higher goal than the previous season
  • Create computer searches to measure uptake and assess progress towards the goal
  • Calculate practice income depending on uptake—each extra 1% of uptake = £xxx income
  • Advertise the practice goal and have a ‘Blue Peter’ style ‘Totaliser' 

Identifying eligible children

  • The lead member of staff to identify eligible children
  • Check the accuracy of searches and coding to ensure all eligible children are identified
  • Make sure the correct flu vaccination codes are in your system and that staff are aware—don’t let hard work go unmeasured
  • Create IT system reminders so that opportunistic immunisation happens
  • Create a system for opportunistic identication of eligible children attending the practice for other clinics or with parents and siblings—use flags or sticky notes to alert staff. Don’t send a child away unimmunised

Invitation/contacting parents

  • Send a personalised invitation to eligible children—use the parent’s and child’s names, sign your name at the bottom
  • Phone calls can be more effective than letters; try text messages for reminders 
  • Ensure that staff phoning patients have a script but can also answer questions and address concerns
  • Plan phone calls after 4pm when more working parents might be available
  • Send letters if telephone contact is not possible
  • Set a date—invite every eligible child before the end of October
  • Be tenacious—make multiple contacts until child is immunised or an active refusal is received 

Clinics and appointments

  • Plan to have completed all routine immunisation activity by Christmas
  • Use time after Christmas to mop-up unimmunised children, particularly children in at risk groups. If clinically indicated vaccination can be given up to the end of March
  • Decide whether you will give timed appointments, run an open access clinic or invite parents to make appointments
  • Allow online booking for appointments
  • Consider family friendly clinic/appointment times such as after school 3.30pm–6.30pm, Saturday mornings, or October half term—consider health fairs or parties—incorporating flu vaccination with other vaccines, health checks, health visitor advice
  • Create a child friendly environment; including room for pushchairs 
  • Consider other clinics and busy waiting rooms 

Promote the vaccination offer to parents

  • Ensure every parent has a personalised invitation for their child
  • Display PHE child flu immunisation posters and leaflets in the reception and waiting rooms 
  • Create attractive displays in waiting rooms. Consider posters or banners outside the practice—on a notice board, walls or even on the roof
  • Place prominent information about the child flu immunisation programme on the practice website
  • Engage with the local primary school—ask if they can give leaflets to parents with pre-school age children and/or display posters on school/parent notice boards
  • Engage with local pre-school nurseries, children’s centres, libraries, toddler groups in your area. Ask staff to put up posters and issue leaflets to parents of 2–4 years old. Highlight the benefits of their children being immunised to these preschool groups and nurseries

During the season

  • Increasing resources in-season is difficult so comprehensive preparation and planning is critical. There are things you can do to help sustain efforts and uptake: 
    • review your uptake against your goals and financial plan; celebrate/promote success as the programme progresses
    • remain tenacious—re-run searches for eligible children
    • continue to offer vaccination, even once you have achieved your practice and campaign goals
    • keep staff engaged and enthused—consider incentives, promoting staff competition
    • ensure all practice staff have their flu jab—it is powerful to be able to say to patients 'I’ve had mine'

Post season

  • Review your campaign, measure and celebrate success—thank everyone involved
  • Share the review of your campaign with your stakeholders, patient focus group and partners who helped you achieve your goals
  • Capture lesson learnt and adapt next year’s plan—aim for higher uptake next year

References

full guidelines available from...
www.gov.uk/government/publications/flu-vaccine-best-practice-guide-for-gps

Public Health England. Increasing influenza immunisation uptake among children. Best Practice Guidance for General Practice. April 2016.
© Crown copyright 2016


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