Population vaccination coverage: Meningococcal ACWY conjugate vaccine (MenACWY) (14 to 15 years) - WMCA

Local authority level vaccine coverage estimates for the school-based meningococcal ACWY adolescent vaccination programme for 14 to 15 year olds.

Rationale

The MenACWY vaccination was introduced into the national immunisation programme in autumn 2015 to respond to a rapid and accelerating increase in cases of invasive meningococcal group W (MenW) disease, which was declared a national incident. The MenACWY conjugate vaccine provides direct protection to the vaccinated cohort and, by reducing MenW carriage, will also provide indirect protection to unvaccinated children and adults. This follows advice from the Joint Committee on Vaccination and Immunisation (JCVI). It is routinely offered through schools in academic school Years 9 and 10 (rising 14 and rising 15 year olds). The indicator measures local authority level MenACWY vaccine coverage for students at the end of school Yr 10. Vaccination coverage is the best indicator of the level of protection a population will have against vaccine preventable communicable diseases. Coverage is closely correlated with levels of disease. Monitoring coverage identifies possible drops in immunity before levels of disease rise. Previous evidence shows that highlighting vaccination programmes encourages improvements in uptake levels. May also have relevance for NICE guidance PH21: Reducing differences in the uptake of immunisations (The guidance aims to increase immunisation uptake among those aged under 19 years from groups where uptake is low).

Definition of numerator

Total number of adolescents in LA responsible population whose 15th birthday falls within the time period who have ever received MenACWY vaccine.

Definition of denominator

Total number of adolescents attending school in LA plus adolescents resident in the LA not linked to any school whose 15th birthday falls within the time period.

Caveats

On 23 March 2020, all educational settings in England were advised to close by the UK Government as part of COVID-19 pandemic measures. Although the importance of maintaining good vaccine uptake was impressed, operational delivery of all school-aged immunisation programmes was paused for a short period of time as a consequence of school closures limiting access to venues for providers and children who were eligible for vaccination and to ensure that lockdown regulations were not breached.

The NHSEI central public health commissioning and operations team rapidly established an Immunisation Task and Finish Group, with regional NHSEI and UKHSA representation. The group was established to:

• assess the impact of COVID-19 on all immunisation programmes, including school-aged programmes
• develop technical guidance and a plan for restoration and recovery of school-aged programmes, once education settings were reopened

From 1 June 2020, some schools partially reopened for some year groups for a mini summer term. NHSEI published clinical guidance for healthcare professionals on maintaining immunisation programmes during COVID-19, and the Department of Education published further guidance which led to schools allowing vaccination sessions to resume on site.

NHSEI commissioned, school-aged immunisation providers were able to implement their restoration and recovery plans to commence catch-up during the summer of 2020. This included delivery of programmes in school and community settings following a robust risk assessment and in line with UK Government Public Health COVID-19 guidance.

In September 2020, schools across the UK reopened for general in-person attendance. During the 2020 to 2021 academic year, students were required to stay at home and learn remotely if they tested positive for COVID-19 or if they were a contact of a confirmed COVID-19 case, and so school attendance rates in England were lower than normal, especially in areas with very high COVID-19 incidence rates. In England, as part of a wider national lockdown in January 2021, schools were closed to all except children of keyworkers and vulnerable children. From early March 2021, primary schools reopened, with a phased reopening of secondary schools.

Although this led to some disruption of school-based elements of programme delivery in the 2020 to 2021 academic year, NHSEI Regional Public Health Commissioning teams worked with NHSEI commissioned school-aged immunisation providers to maintain the delivery of the routine programme and catch-up. As the routine programme is commissioned for a school-aged cohort rather than a school-based cohort, providers were able to build on existing arrangements such as community-based clinics in place for children not in mainstream education. A wide variety of local arrangements were established to ensure programme delivery continued effectively and safely in the school and community premises, during the term time and school breaks.