Catherine Heffernan
Public Health England, UK
Title: Perspectives of vaccinators on the factors affecting uptake of MenACWY vaccine amongst school leavers in London
Biography
Biography: Catherine Heffernan
Abstract
Statement of the Problem: Uptake of MenACWY amongst school leavers (18 years old) is suboptimal in London (9.9% compared to 17.4% nationally in 2015/16). There are studies looking at acceptability of MenACWY amongst adolescents (mostly younger adolescents as they receive the vaccination in schools) but very few studies look at how vaccination service provision may affect uptake of adolescent vaccination. This study identifies service delivery barriers and elicits insights from general practice staff on their interaction with this cohort. The purpose was to inform the NHSE (London) public health commissioning team’s strategy to improve MenACWY vaccination uptake in London.
Methodology & Theoretical Orientation: Qualitative semi-structured interviews study. Purposive sampling of practice nurses from three general practices from each of the three London clinical commissioning group areas (Barnet, Camden and Newham) with the largest numbers of 18-20 year old registered patients. Participants were recruited through their practice managers. A thematic analysis approach was used.
Findings: A total of ten interviews were conducted between June and August 2017. Five themes were identified: nurses unsupported by practice systems; difficulty getting school leavers into the practice; confused messaging; reliance on parental responsibility for health and; perception of complacency amongst adolescents.
Conclusion & Significance: Little is known about the service factors that impede uptake of adolescent vaccinations. This study shows that existing programmatic mechanisms for delivering the MenACWY catch-up programme were not adequate. The number of adolescent vaccinations offered has increased in the UK in the last five years and is likely to continue. General practice staff needs more systematic guidance on their role and how they can support vaccine decision-making in later adolescence.