Covid-19 was identified less than 6 months ago but the virus has spread rapidly across the world with the World Health Organization declaring coronavirus (Covid-19) disease to be a pandemic on 12 March 2020.
Along with most countries the UK has implemented strategies to minimise the spread of infection to mitigate the impact of the disease on the population as well as on the health and care system.
The UK and most European countries implemented public health advice to ‘stay at home’ and maintain a ‘social distance’ to help combat the disease.1 Health care services were realigned to facilitate management of patients with Covid-19 and many areas advised limiting routine access to health and care services to further help reduce the risk of transmission of the disease to otherwise healthy people.2
Vaccination is a prime example of something that needs to continue given the overall impact that vaccines have on preventing disease saving and lives.3 In March 2020, the European region of the World Health Organisation warned that even a short disruption to immunisation programmes during a pandemic could result in an increase in vaccine preventable diseases, further adding to the burden on health care .4 Experience demonstrates that even small declines in vaccine uptake leads to increases in cases of vaccine preventable diseases and deaths.
Between 2013 – 2019 we had already seen a small gradual decline in vaccine uptake.5 As a result of the concerted efforts of many and by no means least, those of nurses in primary care, there were some glimmers of optimism when coverage figures for the end of last year showed a slight increase in uptake.6 Across Europe, after major outbreaks of measles, there has more recently been a decrease in cases. However, there were still 13,200 cases in 2019 and 1,000 cases reported up to April 2020.7
While the UK advice has always been that childhood vaccination, should continue during the pandemic (8/9) the messages were not clear either for the primary care services or for parents who were also understandably concerned about the risk of infection if they attended their GP surgery. A rapid review of the data by Public Health England indicated there had been a significant drop in the uptake of childhood vaccination from the middle of March up to the beginning of April.10
The RCN published guidance to support the practicalities of maintaining vaccination services11 at the end of March 2020. This included guidance for services on managing the situation as well as the importance of promoting vaccination to parents. The Joint Committee for Vaccination and Immunisation (JCVI) also clearly recommended that the childhood programme should continue.12
The PHE data shows that since the early drop, uptake rates are now increasing but there is no room for complacency and efforts to ensure continued service provision as well as ensuring those infants who missed their vaccines in the early weeks of the pandemic must be a priority alongside providing reassurance to the public.
The national immunisation programme across the UK has always been highly regarded and successful in reducing the incidence of serious potentially life-threatening diseases. Nurses are recognised as being at the forefront of driving and delivering this but it is more important than ever that we do not take our foot off the pedal.
1. ECDC (2020) Coronavirus disease 2019 (COVID-19) in the EU/EEA and the UK – ninth update, 23 April 2020. Stockholm.
2. NHS E (March 2020) NEXT STEPS ON GENERAL PRACTICE RESPONSE TO COVID 19 19th March 2020
3. WHO Andre et al (2008): Vaccination greatly reduces disease, disability, death and inequity worldwide Bulletin of the World Health Organization
4. WHO (2020): Guidance on routine immunization services during COVID-19 pandemic in the WHO European Region (2020)
5. NHS Digital Childhood Vaccination Coverage Statistics – England 2018-19
6. PHE (2020) Quarterly vaccination coverage statistics for children aged up to five years in the UK (COVER programme): October to December 2019
7. ECDC April 2020 Measles continues to spread across the EU/EEA – No time for complacency
8. PHE (2020): Vaccine update: issue 306, March 2020
9. Public Health Wales (2020): Continuation of immunisation programmes during the COVID-19 pandemic: letter from CMO (WHC/2020/006)
10. McDonald H, Tessier E, White J, Woodruff M, Knowles C, Bates C, Parry J, Walker J, JA Scott, Smeeth L, Yarwood J, Ramsay M, Edelstein M (2020): Early impact of the COVID-19 pandemic and social distancing measures on routine childhood vaccinations in England, January to April 2020 Eurosurveillance Vol 25, (19), 14/May/2020
11. RCN 2020): RCN guidance on maintaining the National Immunisation schedule during COVID-19
12. JCVI April (2020): Statement from JCVI on immunisation prioritisation