Unmet Needs
Adult immunisation uptake and coverage data indicates there is unmet need within the borough resulting in an increased risk of vaccine preventable disease. Some examples are discussed below.
Flu is usually self-limiting, and symptoms can be managed with self-care. However, for some people flu can be far more dangerous. Those in at-risk groups are more likely to experience complications from flu resulting in hospitalisation or death. At risk groups include people with respiratory conditions, diabetes, heart conditions, being very overweight, chronic kidney disease, liver disease, neurological conditions, learning disability, a weakened immune system or spleen problems. In England, those aged six months to 64 years of age with a clinical at-risk condition are 11 times more likely to die from flu than members of the general population. However, the risk varies by condition; for example, the risk of death from flu is highest among people with chronic liver disease, immunosuppression, chronic neurological disease, chronic renal disease, and diabetes. Pregnant women are also at increased risk from flu death.
The most effective way of managing influenza is by preventing it, with vaccination being the most successful means of protection. In North Tyneside for 2021/22 flu season 12,701 individuals in clinical at-risk groups did not get their flu vaccination. Unpublished data indicates that uptake varies between clinical at-risk groups. In the same flu season 1,252 pregnant women did not get their flu vaccination. Unpublished data and local intelligence could provide helpful guidance on focused areas for the borough.
The pneumococcal vaccine protects against serious and potentially fatal pneumococcal infections. It is also known as the pneumonia vaccine. Pneumococcal infections are caused by the bacterium Streptococcus pneumoniae and can lead to pneumonia, blood poisoning (sepsis) and meningitis. At their worst, they can cause permanent brain damage, or even kill10 . Data indicates that 12,460 individuals 65 and over registered with a GP in North Tyneside are eligible for the PPV vaccine but have not received it. PPV coverage increases as the individual ages therefore the number of individuals outstanding the vaccine is expected to be higher for those in younger age groups. There is no numerator and denominator available for those in at risk groups.
Shingles can be very painful and uncomfortable. Some people are left with pain lasting for years after the initial rash has healed. Shingles can also be fatal for around 1 in 1,000 over-70s who develop it. The shingles vaccine is expected to reduce the risk of getting shingles. If individuals do go on to have the disease, their symptoms may be milder and the illness shorter. Cumulative Shingles Coverage in 70-year-olds within North Tyneside indicates that 71.1% of individuals are not vaccinated.
Whooping cough (pertussis) rates have risen sharply in recent years and babies who are too young to start their vaccinations are at greatest risk. Young babies with whooping cough are often very unwell and most will be admitted to hospital because of their illness. When whooping cough is particularly severe, they can die. Getting vaccinated while pregnant is highly effective in protecting the baby from developing whooping cough in the first few weeks of their life. Within North Tyneside we are achieving higher coverage than the regional and national average however their remains 15% of pregnant women unvaccinated.
In 2018, a report by the Royal Society of Public Health undertook a survey to identify barriers to vaccination across the life course. The report stated that accessibility and convenience of vaccination services can be important determinants of vaccine uptake, and this may be particularly true for those who are not explicitly anti-vaccination, but perhaps are more questioning, as reassurance from a healthcare professional (usually a nurse) is the most effective way of encouraging them to vaccinate. Based on that survey, the most common barriers to getting vaccinated were:
- timing of appointments (49%)
- availability of appointments (46%)
- childcare duties (29%)