G431(P) An audit of vaccination adherence and acceptability of opportunistic vaccination in inpatient paediatrics

Aims Childhood immunisation constitutes an effective public health intervention to prevent serious infection, yet several areas of the UK fail to achieve the WHO target of 95% vaccination coverage.1–3 One strategy to improve the uptake of vaccination involves healthcare professionals identifying children in need of further immunisation and offering opportunistic vaccination.4–5 We aimed to assess local vaccination adherence rates and parent attitudes towards opportunistic vaccination. This aimed to determine the feasibility of implementing a process to identify and opportunistically vaccinate children during their inpatient stay. Methods A questionnaire was designed and administered by a doctor to parents/guardians of paediatric inpatients aged five years and under at a district general hospital over a four-week period. Parents/guardians who spoke no English were excluded. Vaccination adherence was assessed by discussion with parents and counterchecked using the personal child health record (red book). Acceptability of opportunistic vaccination during inpatient stay or by the GP was asked using ‘yes’, ‘no’ or ‘not sure’ questions. Results 50 eligible families participated. 42/50 (84.0%) participants reported the child’s vaccines were up to date (UTD), significantly below the WHO target (p=0.024). Of these, 14/50 (28.0%) were verified by the red book. Verification was not possible in 29/50 (58.0%) as the red book was missing. Rates for individual vaccines were (table 1): 2/42 (4.76%) patients were identified as missing an immunisation (BCG) by checking the red book, despite parents reporting the child was UTD. 47/50 (94.0%) participants considered it acceptable to have catch-up vaccines in hospital prior to discharge. 3/50 (6.00%) reported ‘not sure’ due to limited spoken English. 48/50 (96.0%) participants considered GP-led vaccination acceptable. Conclusions The audit has determined that overall vaccination adherence is significantly below the WHO target of 95% within our population and that some families were unaware that their child was not UTD with their vaccinations. Children in our population would therefore benefit from identification and opportunistic vaccination offered during an inpatient stay, which is a strategy deemed acceptable by most families. References . Maciosek MV, Coffield AB, Edwards NM, Flottemesch TJ, Goodman MJ, Solberg LI. Priorities among effective clinical preventive services: Results of a systematic review and analysis. Am J Prev Med2006;31:52–61. . WHO, UNICEF and World Bank. State of the world’s vaccines and immunisation (3rd ed.) 2009. World Health Organisation: Geneva. . Public Health England. Quarterly vaccination coverage statistics for children aged up to five years in the UK (COVER programme): January to March 2017. Public Health England. Health Protection Report: Number 23, 2017. . Roland D, Ellis C, Blair ME. Assisting healthcare professionals in understanding drivers and barriers to improving pre-school immunisation uptake. Community Pract2013;86:28–31. . Williams N, Woodward H, Majeed A, Saxena S. Primary care strategies to improve childhood immunisation uptake in developed countries: Systematic review. JRSM Short Rep2011;2:81.