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Why are we talking about polio?
Following the discovery of poliovirus in sewage in north and east London, the Joint Committee on Vaccination and Immunisation (JCVI) has advised that a targeted inactivated polio containing vaccine (IPV) booster dose should be offered to children between the ages of one and nine in all London boroughs.
Why is this campaign being run and what is the purpose?
There are signs the virus may be spreading in London and the number of children vaccinated in London is lower than it should be. Boosting immunity in children should help protect them and reduce the risk of the virus continuing to spread.
For some children this may be an extra dose of polio containing vaccine, on top of their routine vaccinations. In other children it may just bring them up to date. This will ensure a high level of protection from any risk of paralysis, though the risks to the general population are still assessed as low. However, the number of children vaccinated in London is lower than it should be. By vaccinating children, this will protect them in case of any future outbreaks. The booster programme is part of the incident response and is available to everyone in London, however routine polio vaccination is available to everyone in England.
What is the routine polio vaccination schedule?
The polio containing vaccine is free and given as part of combined jabs to babies, toddlers and teenagers. Children need all five doses of the vaccine to be fully protected against polio. The polio vaccine is given when a child is:
- 8, 12 and 16 weeks old as part of the 6-in-1 vaccine (DTaP/IPV/Hib/HepB)
- 3 years and 4 months old as part of the 4-in-1 (DTaP/IPV) pre-school booster
- 14 years old as part of the 3-in-1 (Td/IPV) teenage booster
What is being offered to children aged 1 to 9 in London?
In London, all children aged 1-9 years are being offered a dose of polio containing vaccine – whether it’s an extra dose if they are up to date with their routine vaccinations or to catch up. This is part of the incident response to ensure a high level of protection from paralysis and to help stop the virus spreading further. The booster dose will be offered to children in the areas where type 2 poliovirus has been detected in wastewater first and then offered to all London boroughs.
What information has gone out to parents?
A letter and text message was sent to parents of all children aged 1 to 9+365 days on 19 August 2022. The text message script is:
The NHS is inviting children aged 1 to 9 in your borough to receive a vaccine against polio. For some children this will be an additional booster dose if they are already up to date with their routine vaccinations, in others who are not up to date it will be a catch-up dose. Traces of poliovirus have been found in sewage in some London boroughs – the vaccine will boost your child’s protection. Polio can be very serious and in unvaccinated people can on rare occasions cause paralysis. You will be contacted by the NHS to book a vaccination appointment for your child. More info can be found here: https://www.gov.uk/government/publications/polio-booster-campaign-resources
And the letter is given at Appendix 1
Why are children that are up to date with their routine vaccinations being offered an additional dose in London? Are all 1-9 year olds being offered a polio booster?
Experts have advised that, as a precaution, all children aged one to nine years in London should be offered a dose of polio containing vaccine now to ensure that they are protected against polio and to stop any further spread of poliovirus in London. This is because children in this age range have not received the full programme of vaccination, so they are not yet fully protected against polio. By getting a dose now this will boost their protection against polio. In London, all children aged 1-9 years are being offered a dose of polio vaccine. This will either be a top up dose in children that are fully up to date with their routine vaccinations or a catch-up dose.
Is this an extra jab? Will children that need to catch up with their missed routine vaccination/s then get an additional dose on top of that?
We need to protect children against polio now. Bringing a child up to date now will achieve the same effect as the offer of an additional booster.
For children that are fully up to date with their routine vaccinations, this will be an additional polio vaccine to enhance their protection against polio whilst it is being detected in wastewater samples. If your child is not up to date with their routine vaccinations, they will be given a catch-up dose so it will not be an additional dose.
Is there anyone who does not need to get a polio dose now?
The only small group of children in London who don’t need a dose now are those who had a pre-school booster (at 3yrs 4m) in the last 12 months, but if they get an extra booster in error it won’t cause any harm.
Some of our patients do not live in London but are registered with us, are they eligible?
Yes, all children aged 1 to 9+364 days who are London residents or registered with a London GP practice are eligible to receive a polio containing vaccination.
What about older children and young people and adults – are they eligible for a vaccination?
The best way to prevent polio is to make sure everyone is up to date with vaccinations so anyone of any age may call to make an appointment and receive a polio containing vaccination on the NHS
Can patients get other vaccinations at the same time?
Yes – it is good practice to check the patient’s immunisation history and check the Redbook. You should speak with your Practice Immunisation Lead to develop a system that flags which other immunisations a patient is due and administer them at the same time.
We run a very busy practice and our appointment slots are allocated very quickly. What should we do if all appointment slots are taken?
Your practice may be part of a collaboration agreement where you can refer to other practices part of the agreement. Check with your GP, Practice Manager or Practice Immunisation Lead. You should allocate the earliest available appointment to anyone requesting one
Can I refer the patient to our extended access hub?
Can I refer the patient to a Vaccination Centre?
Where can I get details of other providers who are offering polio vaccinations near my practice?
We will notify you as soon as these are confirmed
Are the school aged vaccination services offering polio vaccinations and do they send us information?
At present they are not offering this service but we will notify you if this changes.
What do I do if a patient comes in for another reason and their record shows they’ve not had a polio vaccination or completed the schedule?
You should ask the practice nurse or GP to speak to the patient’s parent and offer a polio containing vaccination
Where do I get stock from?
Your practice will have an Immform account and the polio containing vaccinations are available to order free of charge
Is there a limit to what I can order and can I order more?
There are ordering limits in place on vaccine supplied by UKHSA to encourage regular ordering of smaller volumes and reduce wastage due to fridge or delivery failure. If your practice has the capacity to store and administer more than the weekly limit then they are advised to contact the ImmForm helpdesk with requests for additional allocation.
Requests for polio containing vaccine are dealt with as quickly as possible and you are encouraged to request additional allocation well in advance of order closing deadline where possible and to only order what is needed for booked clinics for the next 2 weeks.
What is our practice expected to do to support this campaign?
You should work with your practice Immunisation Lead and Local Immunisation Coordinator to develop a system where you:
- Invite children for a booster or catch up polio vaccination
- Use your existing practice call and recall system
- Use the correct SNOMED code
- Escalate any declines to your practice nurse, GP or Immunisation Lead
- Record reason for decline