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BMJ Open. 2012; 2(5): e001303.
Published online Sep 10, 2012. doi:  10.1136/bmjopen-2012-001303
PMCID: PMC3467615
BCG vaccination in England since 2005: a survey of policy and practice
Daniel Pilger,1 Patrick Nguipdop-Djomo,1 Ibrahim Abubakar,2,3 David Elliman,4 Laura C Rodrigues,1 John M Watson,3 Vera Eastman,5 and Punam Mangtani1
1Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK
2Institute of Epidemiology & Health, Faculty of Population Health Sciences, University College of London, London UK
3Department of Respiratory Diseases, Health Protection Services, London, England
4Whittington Health, London, UK
5Columbia University, New York, New York, USA
Correspondence to Dr Punam Mangtani; punam.mangtani/at/lshtm.ac.uk
Received April 18, 2012; Accepted July 3, 2012.
Abstract
Objective
Assess the current BCG vaccination policies and delivery pathways for immunisation in Primary Care Trusts (PCTs) in England since the 2005 change in recommendations.
Design
A survey of key informants across PCTs using a standardised, structured questionnaire.
Setting
152 PCTs in England.
Results
Complete questionnaires were returned from 127 (84%) PCTs. Sixteen (27%) PCTs reported universal infant vaccination and 111 (73%) had selective infant vaccination. Selective vaccination outside infancy was also reported from 94 (74%) PCTs. PCTs with selective infant policy most frequently vaccinated on postnatal wards (51/102, 50%), whereas PCTs with universal infant vaccination most frequently vaccinated in community clinics (9/13, 69%; p=0.011). To identify and flag up eligible infants in PCTs with targeted infant immunisation, those who mostly vaccinate on postnatal wards depend on midwives and maternity records, whereas those who vaccinate primarily in the community rely more often on various healthcare professionals.
Conclusions
Targeted infant vaccination has been implemented in most PCTs across the UK. PCTs with selective infant vaccination provide BCG vaccine via a greater variety of healthcare professionals than those with universal infant vaccination policies. Data on vaccine coverage would help evaluate the effectiveness of delivery. Interruptions of delivery noted here emphasise the importance of not just an agreed, standardised, local pathway, but also a named person in charge.
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