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Nurses urged to 'play their part' in MMR catch-up

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Nurses working in primary care and public health settings are being asked to be “watchful” for signs of measles in their patients and actively seek out those currently unprotected by the MMR vaccine.

A national catch-up programme to increase MMR vaccination uptake in children and teenagers was announced last week by Public Health England. Plans will be drawn up locally to reach unvaccinated young people through GP practices and schools.

In the meantime, primary care clinicians are being urged to actively identify young people that have not received MMR as well as offering it to unvaccinated patients when the visit for other reasons.

The catch-up programme aims to reach as many unvaccinated and partially vaccinated 10-16 year olds “as possible” in time for start of the next school year in September.

It follows a high-profile measles outbreak in Mid and West Wales, which has seen 942 cases since November. Nearly 600 cases have also occurred in England during the first three months of 2013 – mostly in the North West and North East. Almost 20% of cases have been admitted to hospital.

In a letter to GP practices last week, PHE head of immunisation Mary Ramsay said plans were “afoot” to develop tailored, targeted catch-up for individuals not adequately protected against measles, mumps and rubella. “Detailed local plans are still in development and will be communicated locally,” she said.

Dr Ramsey also urged clinicians to consider “who in your practice may not have had the MMR vaccine and take up any opportunities to offer this”.  “At this time, it is vitally important that the current measles situation is used to highlight the importance of the MMR vaccine,” she wrote.

Local screening and immunisation leads have written separately to school nurses and health visitors to “forewarn” them of the imminent catch-up campaign, which may “result in an increased demand for advice regarding MMR vaccination”.

In addition, PHE has published a “ready reckoner” to help public health professionals estimate current MMR coverage in their area.

Royal College of Nursing public health advisor Helen Donovan urged nursing staff to “play their part” and check children’s records to ensure they have had both doses of the vaccine.

She added: “We would also urge nurses to use opportunities when children come for their teenage booster vaccines or when coming for travel or other health advice to check their immunisation history.”

Professor Viv Bennett, director of nursing at the Department of Health and PHE, said nurses in public health and primary and community care were “key professionals” in responding to the current localised measles outbreaks being seen in England.

“The skills and knowledge of nurses working with primary care and schools will be vital in protecting local populations and managing the need for increased vaccination to prevent wider outbreaks,” she told Nursing Times.

PHE said its “best estimate” indicated that around one million MMR doses needed to be given – a third for unvaccinated 10-16 year olds, a third for the same age group that needed a second dose for full protection and a third for children of other ages.

Dr George Kassianos, immunisation lead for the Royal College of General Practitioners, noted that the MMR vaccine had an “excellent record in safety”.

“There is no scientific evidence that single vaccines provide any more of an advantage to children; and single vaccines can mean that children require six injections, two for each antigen, measles, mumps and rubella,” he said.

MMR coverage fell nationally to less than 80% in 2005 in the wake of the media-fuelled scare about the vaccine, based on discredited research suggesting a link with autism. As a result, measles became re-established in the UK in 2007 having previously been eliminated.

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