Adolescent vaccination programme: briefing for secondary schools 2023 to 2024

Question 1

Adolescent vaccination programme

Accepted Answer

Three vaccines are routinely offered to young people as part of a long-standing programme to protect them from serious preventable diseases:

the HPV vaccine, which helps protect against cancers caused by the human papillomavirus (HPV) virus
the MenACWY vaccine, which helps protect against meningococcal groups A, C, W and Y, which can cause meningitis and septicaemia
the 3 in 1 teenage booster, which protects against tetanus, diphtheria and polio

The measles, mumps and rubella (MMR) vaccine is also offered as a catch-up programme to young people if they have missed any doses when they were younger.

In the autumn term flu vaccination is also offered as part of the government’s wider winter planning to reduce transmission and illness from flu, and its potential impact on the NHS.

Since the beginning of the COVID-19 pandemic there has been a fall in the number of young people getting their routine vaccinations. Some of this reduction is due to disruption in school attendance during the pandemic so it is essential that young people who missed out, as well as the newly eligible, are offered this important protection. This will help protect young people and the wider community against serious illness at a time when we are seeing the return of vaccine-preventable illnesses circulating among the unvaccinated.

The school-aged immunisation teams have been offering catch-up opportunities to maximise vaccination uptake among those school-aged children who remain unvaccinated. These teams may contact schools to book additional catch-up visits or may be offering any missed vaccinations alongside other routine school-aged vaccinations. In order to maximise opportunities to get young people vaccinated, it is important that there are robust processes in place for identifying eligible children and obtaining consent via the appropriate routes.

The school-aged immunisation team will be sending consent forms to parents and will also allow young people to self-consent if they are deemed competent to do so. Some school-aged immunisations teams may use e-consent forms which will be sent to parents to complete. Schools play a vital role in ensuring that all eligible children in school have been identified and had the opportunity of an offer for the vaccine that they require.

Question 2

Benefits to schools

Accepted Answer

Vaccines:

help provide a healthy environment through the reduction of vaccine-preventable diseases in schools and in the wider community, including among the children’s immediate and extended family
reduce the likelihood of outbreaks in schools
protect children, which in turn reduces pupil and staff absenteeism rates

Question 3

Further information

Accepted Answer

Vaccines offered to young people

Flu vaccine

The flu vaccine is an annual vaccination programme which will be offered to those in years 7 to 11. It helps provide protection to those who receive it and reduces transmission of flu to the wider community.

For most young people, it is offered as a nasal spray. A small number of children cannot have the nasal spray because of pre-existing medical conditions or treatments and are offered protection through an injected vaccine instead.

The nasal vaccine contains highly processed porcine gelatine as an essential stabiliser. For those who may not accept the use of porcine gelatine in medicines, a flu vaccine injection is available. Parents should discuss their options with the school-aged immunisation team.

HPV vaccine

The HPV vaccine is offered to boys and girls in year 8 to protect against genital warts and HPV-related cancers such as cervical cancer, other genital cancers and cancers of the head and neck. Only one dose of HPV vaccine is now required to protect against HPV infection in this age group (unless individuals have specific health reasons which may mean they require 3 doses).

Children who have missed their HPV vaccine will be offered catch-up opportunities by the school-aged immunisation team and GP practices.

MenACWY vaccine

The MenACWY vaccine is offered to young people in year 9 or 10 and protects against meningitis (inflammation of the lining of the brain and spinal column) and septicaemia (blood poisoning) caused by meningococcal groups A, C, W and Y.

3 in 1 teenage booster

The 3 in 1 teenage booster is offered to young people in year 9 or 10 and boosts protection against tetanus, diphtheria and polio.

MMR vaccine status check

Ahead of vaccination sessions, the MMR vaccine status of the young person will be checked to see if any doses have been missed earlier in childhood. This vaccine is needed to provide protection against measles, mumps and rubella.

If a dose has been missed this will be given by the school-aged immunisation team if they are able to, or a referral made to the young person’s registered general practice.

Timing of vaccination

Flu vaccination needs to take place generally in the autumn term. This is to make sure that children are vaccinated before the flu virus circulates.

The other vaccines can be given at any time during the school year. Your school-aged immunisation service will let you know when the other vaccinations will be offered. In some instances, it may be that the flu vaccination is provided at the same time as other vaccines such as HPV.

Why vaccination dropped off during the pandemic

The pandemic presented many challenges for the routine vaccination of adolescents such as school absences and closures because of COVID-19. Since then, there may also be some ‘vaccine fatigue’ among parents following multiple vaccine offers in close succession and confusion about what is being offered, with uptake rates still not back to pre-pandemic levels.

Why it matters if some young people are not vaccinated

When a high percentage of the population is vaccinated, it is difficult for infectious diseases to spread, because there are not many people who can be infected. This is called ‘herd immunity’ and it gives protection to vulnerable people such as newborn babies, elderly people and those who are too sick to be vaccinated.

Herd immunity only works if most people in the population are vaccinated. Despite relatively high vaccination rates in England, rates are much lower in some parts of the country and in some communities. If a young person lives in an area where vaccine coverage is low and they are not vaccinated, it’s quite likely that many of the people they come into contact with will not be vaccinated either. If one of these people gets an infectious disease like measles, they can easily pass it on to the other unvaccinated people around them, and in some cases the disease can then spread very quickly through the population.

What schools need to do to support vaccination

Your school-aged immunisation service will try and keep disruption to a minimum and will only ask you to do the things that they cannot do themselves.

As in previous years, your school will be asked to:

work with the team to agree the best approach for implementing the programme in your school
nominate a named contact to liaise with the team
agree dates for the routine vaccination sessions or catch-up sessions as required
provide class lists with contact details to support the offer to eligible children
agree a process for providing parents or guardians with the invitation letter, information leaflet and consent form
encourage young people and their parents or guardians to look out for the consent form and return it by an agreed time
send reminders through your usual channels such as email or text distribution lists, parent newsletters, visual display screens, parent evenings
communicate these key public health programmes delivered in school on your website
let parents know which day vaccinations will take place
let young people know what will happen and answer any questions that they or their parents have on the logistics and date of vaccinations

Other practical considerations include:

providing a suitable location for the vaccination to take place such as the school hall or large classroom
ensuring the immunisation team can access the agreed space before the vaccinations are due to start, so they can set up

Who will give the vaccine to the children

The programme will be delivered by an NHS commissioned immunisation team which may include nurses, healthcare support workers, administrative staff, and other associated professionals who specialise in the delivery of school-aged vaccinations.

The team will administer the vaccination according to nationally set standards. Staff will have appropriate qualifications and training, including safeguarding training. All staff will be DBS cleared.

A consent form and information leaflet provided by the school-age immunisation service will be used to seek parental consent. It is the responsibility of the immunisation team, not the school, to obtain the appropriate consent. However, it is really important to have the support of schools to remind parents to complete and return their consent form in a timely manner.

Parents will also be provided with a contact number to call the vaccination team in case of any queries. Forms should be returned by the deadline agreed with the team. You may be asked to collect these forms from parents on behalf of the vaccination team or it may be done electronically.

Who decides whether a young person receives a vaccination

Parents or guardians with parental responsibility make this decision. It is therefore worth reminding parents of the importance of completing the consent form they are sent ahead of the scheduled vaccination sessions.

Some older children may be sufficiently mature to provide their own consent if their parents have not returned a consent form and they express a wish to have a vaccine on the day of the session. The immunisation team will speak to the young person and will be responsible for assessing the appropriateness of administering the vaccine. This will include making every effort to contact the parent to seek their verbal consent and/or an assessment of the individual child’s capacity to self-consent, where appropriate.

Parents of older children should be encouraged to speak to their children ahead of the time so that there is agreement on consent in advance of the vaccination session.

More ways the school could support the programme

Schools have an important role to play in promoting the uptake of the immunisation programme, because of the relationship they have with the parents and young people.

Vaccinations are included in the health education curriculum as part of the ‘health and prevention’ topic at primary and secondary school. It is also a statutory requirement that pupils should be taught the facts and science relating to allergies, immunisation and vaccination.

The UK Health Security Agency (UKHSA) has developed a range of teacher resources on germs and bacteria to support learning about microbes, infection prevention and control, antibiotics and vaccination. These resources are available on e-Bug.

There is also a lesson co-produced by young people and researchers from the University of Bristol and London School of Hygiene and Tropical Medicine available freely through the PSHE Association website.

Please use all your communication channels to help promote uptake and share this leaflet with staff in your school.

The General Data Protection Regulation (GDPR) became UK law in 2018. No change is needed to the ways in which young people’s personal information is used and shared by schools with the school-aged immunisation service for the purpose of providing vaccinations for this to be lawful under the UK Data Protection legislation.

If young people miss the vaccination session in school

Young people who missed their HPV, MenACWY or teenage booster vaccine remain eligible and the school-aged immunisation team will provide opportunities for catch-up either as an additional visit to schools or as a community clinic appointment. Parents will be written to by the immunisation team to inform them of these catch-up opportunities or they can also contact the team to make an appointment.

GP practices are also contracted to offer these vaccinations. Children from the age of 14 who have missed their HPV, MenACWY and 3 in 1 teenage booster vaccines can receive these at their GP practice.

With flu vaccine, any pupils who miss the session at school will be provided with further opportunities to get the vaccine (which may be at an alternative venue) – the school-aged immunisation service will be able to provide further details. For the small number of pupils who may be at increased risk from flu because of underlying health conditions, their parents have the option of requesting the vaccine from their GP practice if they prefer.

If a young person becomes unwell

If the school-age immunisation provider team is still on site, seek advice directly from them. If the school-age immunisation provider team has left the site, manage the situation according to existing policies for pupil sickness in school and contact the school-age immunisation provider team to ensure they are aware and can report any event related to the timing of administration of the vaccine.

Teachers and the flu vaccine

The nasal flu vaccine is not licensed for adults and teachers are not able to get a vaccine through the school-aged immunisation programme.

Some staff will be entitled to a free NHS flu injectable vaccine if they have certain medical conditions that put them at risk from flu or are pregnant.

Eligible staff should contact their GP practice or a participating pharmacy. See flu vaccine on NHS.UK for further information.

Schools may choose to provide flu vaccines for staff through an occupational health provider. Schools can also access this CCS framework for flu vaccine vouchers or on-site provision of flu vaccines at competitive rates.

Staff who are uncertain about their vaccination status for flu or other vaccines should discuss this with their GP practice.

Question 4

Table of vaccines offered in secondary school

Accepted Answer

Young people are offered the following vaccines in secondary school as follows:

Vaccine	School year offered	Diseases protected against
Flu vaccine	Annual vaccine offered to all in years 7 to 11	Protects against flu, which can lead to acute bronchitis and pneumonia
Human papillomavirus (HPV) vaccine	Year 8	Genital warts and HPV related cancers such as cervical cancer, some cancers of the head and neck and some genital cancers
MenACWY vaccine	Year 9 or 10	Meningococcal groups A, C, W and Y (which can cause meningitis and septicaemia)
3 in 1 teenage booster (Td/IPV)	Year 9 or 10	Tetanus, diphtheria and polio
MMR – for those that have not had 2 doses of MMR	Catch-up – offered opportunistically	Measles, mumps and rubella

Question 5

Resources

Accepted Answer