Alliance quality and standards manager Melanie Pilcher explains why vaccines are so important for young children. This article originally appeared in our Under 5 magazine.
“One of the greatest breakthroughs in modern medicine” – that’s how the NHS Choices website describes vaccination. The practice has brought an end to incurable diseases including smallpox, which was officially eradicated in 1980, and polio, which has seen a 99% reduction in the number of cases reported worldwide. Despite this, recent years have seen a trend for parents opting out of vaccinating their children. If this continues, we could be only a few steps away from seeing some of these deadly diseases return.
Although claims that the measles, mumps and rubella (MMR) vaccine can cause autism have been completely discredited, concerns amongst parents about its safety continue to impact on use of the vaccine. Children should have two doses of the MMR before they start school, but while take-up rates on the first dose have recently hit the 95% target, only 87.6% are currently having both before they reach the age of five. This is significant when you consider that outbreaks of a disease become more likely if coverage falls below 90-95%.
The World Health Organisation recently reported that the “interruption of endemic transmission of measles has been achieved” in the UK – which in other words means that the disease is no longer able to spread here. However, last year, Public Health England issued a warning after 20 cases of measles were confirmed in south-east England.
Meanwhile, confirmed cases of pertussis, or whooping cough, another disease preventable with a vaccination, have risen in recent years. According to the University of Oxford’s Vaccine Knowledge Project, there were more than 6,000 confirmed cases in 2016 – up from less than 500 in 2002.
What does this mean for early years practitioners?
When children first start attending an early years setting, they will be introduced to a new group of young children from a range of different backgrounds. These children will spend time together for a significant proportion of each day. Young children have a relatively low state of immunity as they will have had only limited exposure to specific germs. This can make them more susceptible to infections and makes common childhood illnesses an inevitable part of life in an early years setting.
Despite your best efforts to maintain good hygiene practice and uphold procedures for outbreaks of illness, there will be times when children have to be temporarily excluded when poorly. You will need to take steps to manage outbreaks of common childhood illnesses. Settings should also make plans for what to do in the case of an outbreak of a serious disease.
Keeping good records
It is best practice for early years providers to maintain a record of the vaccinations that children have had and to keep this information in their personal file, along with other important information – including any specific health needs. This record should be updated as further vaccinations are given.
It is important to remember that there will always be some children who will not be protected for some diseases. This could include:
- children who cannot be immunised for medical reasons
- children who are too young to be immunised
- children who missed appointments, or were too ill when they were due to be vaccinated
- children whose parents have decided against vaccination
For a few children, it might also be the case that a vaccination didn’t work for them, so even those who have been vaccinated will not always be protected.
It would be wrong for any early years provider to routinely refuse to offer a place to a child who has not been vaccinated. That said, parents should always be encouraged to have their child immunised to protect both their health and that of the other children in the setting. Any parent who is concerned about having their child immunised should be encouraged to talk to their health visitor or GP. The most important thing for you is to know the vaccination status of every child in the setting. This will be important information should there be an incident of a serious disease.
Most of the illnesses routinely vaccinated against are known as ‘notifiable diseases’. This means that doctors or GPs who are presented with a case of one of these serious diseases, such as measles or diphtheria, are required by law to notify government authorities. This is so that they can monitor and intervene as appropriate in order to prevent an epidemic.
Responding to such an outbreak may involve Public Health England’s local health protection team. The actions they take might include alerting the general public, organising a vaccination programme or simply providing information and advice.
If a child attending your setting is diagnosed with a ‘notifiable disease’ then we highly recommend that you report this to Ofsted. This is not the same as notifying a disease to the government, which is the responsibility of registered medical practitioners. If you are concerned about a child attending your setting who has been diagnosed with one of these diseases, you can also contact your local health protection team for further advice.
Notifiable diseases include: