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Published 6 January 2023
© Crown copyright 2023
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This publication is available at https://www.gov.uk/government/publications/adolescent-vaccination-programme-in-secondary-schools/adolescent-vaccination-programme-briefing-for-secondary-schools
Three vaccines are routinely offered to young people as part of a long-standing programme to protect them from serious preventable diseases. This year flu vaccination is also being offered to those in years 7 to 9 in school.
We are very grateful for the support of schools in hosting these vaccination sessions and in enabling communications to parents and young people to support the consent process. Delivering the programme through schools makes it more accessible to pupils, reduces inequality and results in higher uptake levels.
The 3 vaccines routinely offered to young people in secondary school are:
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.
Since the beginning of the coronavirus (COVID-19) pandemic there has been a fall in young people getting their routine vaccinations. Some of this reduction in uptake may be due to disruption in school attendance during the pandemic so it is essential that young people that missed out, as well as the newly eligible, are offered this important protection. This will help protect young people against serious illness at a time when we are seeing the return of vaccine preventable illnesses circulating amongst the unvaccinated following the end of restrictions that were bought in during the pandemic.
The school aged immunisation teams have been offering various catch-up opportunities to maximise vaccination uptake amongst 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 offered in years 8 and 9. In order to maximise opportunities to get young people vaccinated, it is important that there are robust processes in place for obtaining consent. 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.
This year flu vaccination will be offered to those in years 7, 8 and 9. There have been very low levels of flu activity in the last 2 years because of COVID-19 control measures and reduced contact between people but this has changed this winter because people are mixing more.
As there has been so little flu in the last 2 years there is also less immunity in the population to flu. We’re already seeing flu spreading in all age groups and the recent flu season in Australia saw a high number of children hospitalised. Flu vaccination plays an important part in the government’s wider winter planning to reduce illness from flu, and its potential impact on the NHS.
Benefits to schools include:
The flu vaccine is an annual vaccination programme offered this year to those in years 7, 8 and 9. 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.
The HPV vaccine is a 2 dose course offered to those in years 8 and 9 to protect against genital warts and HPV-related cancers such as cervical cancer, other genital cancers and cancers of the head and neck.
The MenACWY vaccine is offered to young people in year 9 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.
The 3 in 1 teenage booster is offered to young people in year 9 and boosts protection against tetanus, diphtheria and polio.
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 GP.
Flu vaccination needs to take place annually in autumn or winter.
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.
The pandemic has presented many challenges for the routine vaccination of adolescents such as school absences and closures because of COVID-19 and the competing demands of rolling out COVID-19 and flu vaccination to adolescents. There may also be some ‘vaccine fatigue’ amongst parents following multiple vaccine offers in close succession and confusion about what is being offered.
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. Even with relatively high vaccination rates in England this hides the fact that 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.
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, schools will be asked to:
Other practical considerations include:
The programme will be delivered by an NHS commissioned team which may include nurses, healthcare support workers, administrative staff, and other associated professionals who specialise in 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.
It is the responsibility of the immunisation team, not the school, to obtain the appropriate consent. A consent form and information leaflet provided by the school age immunisation service will be used to seek parental consent. 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.
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.
Schools have a key role to play in promoting uptake of the immunisation programme because of the relationship you 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.
In addition, the UK Health Security Agency (UKHSA) have developed a range of teacher resources on germs and bacteria designed to support learning about microbes, infection prevention and control, antibiotics and vaccination. These resources are available on e-Bug.
Please use all your communication channels to help promote uptake and share this guide 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.
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 the school age immunisation provider team is still on site, seek advice directly from them. If the school age immunisation provider team have 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.
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 are aged 50 years or older, 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 the other vaccines should discuss this with their GP practice.
Getting flu and other viral infections can increase the risk of invasive group A strep (iGAS) infection in the following weeks. There was an increase in iGAS infections during the 2009 to 2010 flu pandemic. The flu vaccine reduces the risk of having flu and group A strep infections at the same time therefore it reduces the chance of developing iGAS.
We strongly recommend children who are eligible get a flu vaccine – it’s the best way to protect them from serious illness. The flu vaccine for children has an excellent safety record, this includes the nasal spray given to school aged children and pre-schoolers, which has been given to millions of children in the UK and worldwide.
Young people are offered the following vaccines in secondary school as follows:
Immunisations for young people leaflet, your questions answered about the HPV, Td/IPV and MenACWY vaccinations given between school years 7 to 13, UKHSA
3-in-1 teenage booster (tetanus, diphtheria, polio), frequently asked questions, NHS.UK
Measles: Protect yourself, protect others’ leaflet, UKHSA
Measles: Don’t let your child catch it flyer, UKHSA. Translated versions are available.
MMR vaccine, NHS.UK
Protect yourself against meningitis and septicaemia: Have the MenACWY vaccine leaflet, UKHSA
Protect yourself against meningococcal meningitis and septicaemia poster, information for students in schools and sixth form colleges, UKHSA
MenACWY vaccine, NHS.UK
Protecting against HPV infection to help reduce your risk of cancer leaflet, UKHSA. Available in translated versions and British Sign Language.
Easy-read guide to the HPV vaccination leaflet, UKHSA
Don’t forget to have your HPV vaccination poster, UKHSA
HPV vaccine, NHS.UK
Protect yourself against flu leaflet, UKHSA. Available in translated versions, braille, audio and British Sign Language.
Five reasons to have the flu vaccine poster, UKHSA. Available in translated versions.
Children’s flu vaccine, NHS.UK
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