Immunisations: information for health professionals and commissioners

Since the Health and Social Care Act 2012, NHS England has had responsibility for the routine commissioning of national screening and immunisation programmes under the terms of the Section 7a agreement. This Act introduced changed roles for commissioners of immunisations, the detail of which is outlined in the Immunisation & Screening National Delivery Framework & Local Operating Model.

In London, the NHS England London Public Health Immunisation Commissioning Team is responsible for the commissioning of the Section 7a immunisation programmes. The team works to improve the uptake and quality of commissioned vaccination services across London. These services are provided through general practice, vaccination teams who deliver immunisations to those aged 0-19, including school aged children and young people, pharmacies, maternity services, community-based providers, and outreach services.

There are a number of resources on the NHS Futures Platform’s Vaccinations and Screening workspace that you may find helpful. Please click on the webpage link to request access. We recommend that you also subscribe to the UKHSA Vaccine Update.

If you are an immunisation service provider and you would like to report a vaccine incident, please contact the Clinical Advice Response Service (ICARS) at london.immunisationqueriescars@nhs.net. For more information on the ICARS service, please see the ICARS at the bottom of this page.

For all other queries, including payments, please contact us on england.londonimms@nhs.net.

Useful Information for vaccinators

Guidance for healthcare professionals

• Please see the Complete routine immunisation schedule for a list of which vaccinations are due at which ages and also A visual guide to vaccines for the routine vaccination programme.
• If you have newly registered patients and are not sure about their vaccination status, please use the UKHSA algorithm for Vaccination of individuals with uncertain or incomplete immunisation. UKHSA also have a UK and international immunisation schedules comparison tool.
• For clinical queries, please use the Immunisation against infectious disease Green Book guidance or contact ICARS (details below).
• For an up to date list of the latest immunisation SNOMED codes to use, please see the latest Enhanced Services (ES), Vaccinations and Immunisations (V&I) and Core Contract (CC) components business rules and the Primary Care Refset Portalthat shows all the SNOMED CT concepts for all the services and extracts that form part of the General Practice Extraction Service (GPES).
• NICE has produced guidance on the Increasing vaccine uptake in the general population, including helpful visuals on:
  • identifying people eligible for vaccination and opportunistic vaccination
  • vaccinations for young children and older people: invitations, reminders and escalation of contact
  • vaccinations for pregnant women: invitations, reminders and escalation of contact
  • vaccinations for school-aged children and young people: invitations, reminders and escalation of contact.
• Please see the Future NHS Vaccination & Screening Workspace for up to date guidance, training and public-facing resources.

Training

• All vaccinators in primary care should have annual vaccination training updates in line with UKHSA standards. For training information, free immunisation promotional materials and general information on the Section 7a programmes, please see the UKHSA Immunisation homepage.
• The Health Publications website includes a range of patient facing materials, as well as the latest Primary care immunisation webinar series.
• You may also find useful resources on the elearning for healthcare (elfh) website, where you can register for an account to access the materials.

Targeted BCG and Hepatitis B programmes

Please see the UKHSA Guidance on the hepatitis B antenatal screening and selective neonatal immunisation pathway for further information on antenatal screening and selective neonatal immunisation services for pregnant women living with hepatitis B and their babies.

From the 1st of September 2024, there will be a new domiciliary service in London, providing the 4-week and 12-month dose of hepatitis B vaccines and Dried Blood Spot test at home by the new Children’s and Young People’s Community Immunisation Service (CYPCIS). This new hepatitis B home service is intended to improve uptake of vaccines and testing, and therefore reduce hepatitis B mother to child transmission within London. A domiciliary service will also reduce the burden for families to navigate the complex health system immediately after the birth of their baby. There may be instances where a GP practice chooses to offer the selective hepatitis B programme themselves, which includes doing a Dried Blood Spot test at 12 months alongside the 12-month dose. For any queries, please contact england.londonimms@nhs.net.

We update our London wide BCG Protocol regularly. For the latest version, please contact england.londonimms@nhs.net.

Shingles vaccine toolkit

The shingles vaccination programme provides a free vaccine that helps protect against shingles. It’s recommended for people at higher risk from shingles, including all adults turning 65, those aged 70 to 79 and those aged 50 and over with a severely weakened immune system.

We are pleased to present a shingles toolkit for GPs that provides practical information to help practices identify eligible patients and invite them for their vaccination. It provides updated information on the shingles programme changes that came in on 1 September 2023. The guide also offers information on conducting searches, working out eligibility, claiming payments and suggests ways in which GP practices can reach out to their patients.

Guidance for the collection of patient ethnicity data

London Region Immunisation Team are pleased to publish the following practical information to help practices in the collection of patient ethnicity data. All information provided is intended to support updating existing patient records and newly registered patients.

The GP information pack and posters, created in November 2022, include supportive information on the collection of patient ethnicity, benefits for the patient and systems, statutory responsibilities and supportive coding guidance and materials. Should General Practice teams have any additional queries about ethnicity coding or data please see page 14 in the GP information pack.

Season Flu Programme

London Region Immunisation Team is pleased to publish the following documents to support the delivery of the latest Seasonal Flu Programme

• National flu immunisation programme letter.
• General practice enhanced service specification: Seasonal influenza vaccination programme.
• General practice enhanced service specification: Childhood seasonal influenza vaccination programme.
• Community pharmacy seasonal influenza vaccination programme.
• Influenza Vaccination Programme: Enhanced service seasonal influenza vaccination collaboration agreement.

Patient Group Directions (PGDs) for Vaccines

UKHSA develop and publish Patient Group Directions (PGDs) for vaccination service providers which NHS England (London Region) is required to authorize and publish.

As these are published, NHS England London Region will authorise them and then publish them on this website, and will replace any existing NHS England London Region PGDs. They will be identified as NHSE/UKHSA PGDs to differentiate them from those developed by NHS England London Region.

Not all vaccines included in the suite of individual vaccine PGDs may be commissioned from every service but these have been included for completeness.

The development and authorisation of these PGDs is supported by a PGD Policy.

The PGDs on this NHS England London Region’s webpage must only to be used by specified healthcare professionals in the London Region area working for providers that are either directly commissioned by NHS England London Region or who are administering vaccinations as part of a national immunisation programme.

Below are the current PGDs, if you have a query about older PGDs, please email england.londonimms@nhs.net.

Immunisation Clinical Advice & Response Service (ICARS)

• The aim of the London Immunisation Clinical Advice Response Service (ICARS) is to provide public health guidance to clinicians administering all vaccines commissioned under Section 7a including COVID-19 and Mpox, and to respond to clinical incidents as they arise in these programmes.
• ICARS operates Monday-Friday, 9am-5pm (excepting bank holidays) and endeavours to respond to enquiries within two working days.
• Please contact ICARS at immunisationqueriescars@nhs.net.
• ICARS is unable to provide advice to patients, please contact your GP or visit your local ICB website (which can be found below)
  • North West London Immunisations and vaccinations :: North West London ICS (nwlondonicb.nhs.uk)
  • North Central London Baby and Childhood Vaccinations – North Central London Integrated Care System (nclhealthandcare.org.uk)
  • North East London Vaccinations – NHS North East London (icb.nhs.uk)
  • South West London Vaccinations – NHS South West London Integrated Care Board (icb.nhs.uk)
  • South East London NHS South East London – Integrated Care Board (selondonics.org)

Incident reporting

• In the event of a clinical incident relating to COVID-19 or Section 7a vaccination programmes in London please complete an incident form Or email london.immunisationqueriescars@nhs.net
• Please see here Vaccine incident guidance: Responding to errors in vaccine storage, handling and administration (publishing.service.gov.uk) for more information about how to manage vaccine incidents.
• Examples of incidents include: the administration of expired vaccine, incorrect vaccine, incomplete dose of vaccine given, duplicate vaccine being given, administration of vaccines that have not been stored correctly, breaches in cold chain.

Clinical queries

• ICARS can also support with clinical queries relating to the S7a and COVID-19 vaccination programmes. Clinical queries could include, scheduling, eligibility, vaccine contraindications.
• If you can’t find the answer in the useful resources below please email immunisationqueriescars@nhs.net and we will endeavour to respond within two working days. Please do not send us any patient identifiable data.
• Please note ICARS cannot support with vaccinations queries or incidents outside of the routine immunisation programmes including advice on travel vaccination or vaccination for occupational health purposes. For advice on travel vaccination please visit https://travelhealthpro.org.uk

Useful Resources

• Collection of UKHSA immunisation resources and information: Immunisation – GOV.UK (gov.uk)
• Guidance for vaccination required in those with uncertain or incomplete immunisation histories: Vaccination of individuals with uncertain or incomplete immunisation – GOV.UK (gov.uk)
• The Green Book: Immunisation against infectious disease – GOV.UK (gov.uk)
• The UK immunisation schedule: Complete routine immunisation schedule – GOV.UK (gov.uk)
• Vaccine Incident Guidance: Vaccine incident guidance: Responding to errors in vaccine storage, handling and administration (publishing.service.gov.uk)
• Healthcare worker guidance for specific immunisation programmes:
  • Hexavalent combination vaccine: programme guidance – GOV.UK (gov.uk)
  • HPV vaccination: guidance for healthcare practitioners – GOV.UK (gov.uk)
  • Inactivated polio vaccine (IPV) catch-up: information for healthcare practitioners – GOV.UK (gov.uk)
  • MenACWY programme: information for healthcare professionals – GOV.UK (gov.uk)
  • Meningococcal B: vaccine information for healthcare professionals – GOV.UK (gov.uk)
  • Pertussis (whooping cough): information for healthcare professionals – GOV.UK (gov.uk)
  • Pneumococcal vaccination: guidance for health professionals – GOV.UK (gov.uk)
  • Rotavirus vaccination programme: advice for health professionals – GOV.UK (www.gov.uk)
  • Shingles vaccination: guidance for healthcare practitioners – GOV.UK (gov.uk)

Nationally published data

The UKHSA Vaccine uptake guidance and the latest coverage data holds all the published information on 0-5 imms, adolescent imms and adult imms:

• Cover of vaccination evaluated rapidly (COVER) programme
• MenB vaccine uptake
• COVID-19 vaccine monitoring reports
• Seasonal flu vaccine uptake: figures
• Shingles vaccine uptake
• Td/IPV adolescent vaccine uptake
• MenACWY vaccine uptake
• Pertussis vaccine uptake in pregnant women
• HPV vaccine uptake
• PPV vaccine uptake
• Rotavirus vaccine uptake
• Seasonal flu vaccine uptake: data collection guidance
• Adolescent vaccine coverage (HPV, MenACWY, Td/IPV)