Abstract
Why did you do this work?In May 2024, the local NHS England screening and immunisation team provided financial support for a ten-month pilot catch-up MMR (measles, mumps, and rubella) vaccination programme for eligible1 children and young people (CYP) at a specialist children’s hospital. This was in response to the ongoing measles outbreak in the UK,2 and low local uptake of MMR1 and MMR2.3 Activity so far is reported here.

What did you do?The team includes Consultants in Paediatric Infectious Diseases and Public Health Medicine (4h/week each), an Advanced Nurse Practitioner, and a project officer (8h/week each). There are weekly virtual Vaccination Multi-Disciplinary Team meetings (VMDT) and fortnightly Vaccination Ward Rounds (VWR).

Eligible CYP are identified from weekly inpatient lists, initially with a stay > 30 days, expanding to those with a stay > 7 days in mid-July 2024.

Vaccination data are obtained from sources including Child Health Information Services (CHIS). CYP missing at least one MMR are discussed at the VMDT and seen on the VWR. Any other missed vaccines (routine or condition-specific) are incorporated into management plans.

What did you find?In the first four months of the pilot, the team ‘screened’ the notes of 395 CYP for eligibility, checked the vaccination status of 340, contributed to the management of 42, and administered 10 vaccines to nine CYP. Vaccines were administered by the vaccination team or the clinical team caring for the CYP. If the CYP had left the hospital, the vaccine team liaised with community colleagues. It was often initially difficult to confirm vaccination status, but this was improved via direct access to CHIS for the local region.

A small number (five) of absolute contraindications to administration of MMR were encountered (e.g. immune suppression). Relative contraindications were more common but usually time-bound (e.g. undergoing cardiac surgery), so incorporated into management plans.

Four parents/carers refused the offer of vaccination, and two children died after screening and before being offered an intervention.

What does it mean?It is possible to offer an in-patient MMR vaccination catch-up programme to often complex CYP. Easy access to accurate vaccination data remains an issue. A small number of parents/carers refused vaccination.

Activity will now expand to include low-volume but high-risk (e.g. with immune modulation) and high-volume but low-risk (e.g. attending for constipation) outpatients. Learning from the pilot is being shared with other specialist settings looking to develop similar services.