UPDATED: Polio vaccination for children aged 1 to 9


Please check this page regularly for polio booster vaccination programme updates

Last updated 04/11/2022

The Joint Committee on Vaccination and Immunisation (JCVI) has advised that a targeted inactivated polio vaccine (IPV) booster dose should be offered to children between the ages of one and nine in all London boroughs, following the discovery of type 2 poliovirus in sewage in north and east London.

Initial Invite letters and texts were distributed w/c 15 August. 

Reminders for uptake letter sent 4/11/2022

For some children this may be an extra dose of polio vaccine, on top of their routine vaccinations. In other children it may just bring them up to date. This will ensure a high level of protection from any risk of paralysis, though the risks to the general population are still assessed as low due to high vaccine coverage rates overall.

The IPV booster campaign algorithm poster summarises eligibility and which vaccines to use. This is available for download only.

General Practice team FAQ and resources

The polio vaccination programme is not ending on 28 September and those who have not taken up their offer still need to be encouraged to do so. We will continue to run community vaccination sites, and communications to support them, into October.

Three types of vaccine – all available free of charge through ImmForm

  • Hexavalent (six vaccines in one) for children aged 1 to less than 3 years 4 months
  • Boostrix to children aged 3 years 4 months up to 5 years
  • Revaxis to children aged 6 to 9 years

Vaccine can be co-administered with other vaccines including MMR and flu. 

Campaign algorithm poster attached, reflecting that a minimum of four weeks to be left between a previous dose of Polio vaccine and the proposed one

National PGDs have been published to support the delivery of the campaign; these can be accessed via the following links– hexavalent vaccine, Revaxis  and Boostrix IPV.   Practices and other providers must complete sections 2 and 7 before vaccination commences.

NHS NEL has also published template Patient Specific Directions (PSDs) (PSD general information, Boostrixhexavalent, Revaxis) to assist practices and vaccination sites to deliver the IPV booster campaign.  These PSDs allow delegation of the administration of the polio vaccine to a suitably trained person e.g.  registered professionals not authorised to work under the polio PGD or unregistered vaccinators.  Practices who chose to use PSDs should ensure that any registered professional or unregistered healthcare worker who is trained to assess patients or administer vaccinations under these PSDs should be familiar with each PSD template, supporting documents  and their responsibilities.

If partners wish to collaborate to deliver at scale, one practice can place an order on behalf of other practices and/or the GP Federation (the latter of whom do not have access to order childhood immunisations and vaccination via ImmForm)

£10.06 Item of Service payment for each dose administered

Additional funding available for the delivery of an outreach service where included in borough plans.

Call/recall to be done by Child Health Information Service (CHIS)

Recording invitations: Inviting children to have a booster or a catch-up polio containing vaccination during this campaign should be coded 864531000000105 (full coding lists attached).

This is also an opportunity to offer flu and MMR for children coming forwards who are not already immunised.

We are really keen that all practices participate in this programme. If you have any questions at all, please contact your primary care lead.

FAQ

"Q: Polio Vaccine - How can we order polio vaccine and can we arrange an urgent delivery?

A:Stocks are ordered via Immform https://portal.immform.phe.gov.uk. For urgent ordering query please contact Immform helpdesk Helpdesk@immform.org.uk/Tel: 0207 183 8580 (9am - 5pm)"

Q: Vaccine Transfer - Can we transfer vaccines between different sites?
A: For covid vaccines, a legal exemption applies to the transfer. This exemption is only applicable to Covid-19 vaccines and cannot be applied to other vaccines or medicines. Please refer to the latest vaccine transfer policy. https://www.england.nhs.uk/coronavirus/transfer-of-covid-19-vaccines-between-nhs-vaccination-sites/. For all other vaccines, supply from one legal entity to another is subject to regulatory control. An MHRA Wholesale Dealer License is normally required. 

Why are we talking about polio?

Following the discovery of poliovirus in sewage in north and east London, the Joint Committee on Vaccination and Immunisation (JCVI) has advised that a targeted inactivated polio containing vaccine (IPV) booster dose should be offered to children between the ages of one and nine in all London boroughs.

Why is this campaign being run and what is the purpose?

There are signs the virus may be spreading in London and the number of children vaccinated in London is lower than it should be. Boosting immunity in children should help protect them and reduce the risk of the virus continuing to spread.

For some children this may be an extra dose of polio containing vaccine, on top of their routine vaccinations. In other children it may just bring them up to date. This will ensure a high level of protection from any risk of paralysis, though the risks to the general population are still assessed as low. However, the number of children vaccinated in London is lower than it should be.  By vaccinating children, this will protect them in case of any future outbreaks.  The booster programme is part of the incident response and is available to everyone in London, however routine polio vaccination is available to everyone in England.

What is the routine polio vaccination schedule?

The polio containing vaccine is free and given as part of combined jabs to babies, toddlers and teenagers. Children need all five doses of the vaccine to be fully protected against polio. The polio vaccine is given when a child is:

  • 8, 12 and 16 weeks old as part of the 6-in-1 vaccine (DTaP/IPV/Hib/HepB)
  • 3 years and 4 months old as part of the 4-in-1 (DTaP/IPV) pre-school booster
  • 14 years old as part of the 3-in-1 (Td/IPV) teenage booster

What is being offered to children aged 1 to 9 in London?

In London, all children aged 1-9 years are being offered a dose of polio containing vaccine - whether it’s an extra dose if they are up to date with their routine vaccinations or to catch up. This is part of the incident response to ensure a high level of protection from paralysis and to help stop the virus spreading further. The booster dose will be offered to children in the areas where type 2 poliovirus has been detected in wastewater first and then offered to all London boroughs.

What information has gone out to parents?

A letter and text message were sent to parents of all children aged 1 to 9+364 days on 19 August 2022.  The text message script is:

The NHS is inviting children aged 1 to 9 in your borough to receive a vaccine against polio. For some children this will be an additional booster dose if they are already up to date with their routine vaccinations, in others who are not up to date it will be a catch-up dose. Traces of poliovirus have been found in sewage in some London boroughs - the vaccine will boost your child’s protection. Polio can be very serious and in unvaccinated people can on rare occasions cause paralysis. You will be contacted by the NHS to book a vaccination appointment for your child. More info can be found here:

And the letter is given at Appendix 1

Why are children that are up to date with their routine vaccinations being offered an additional dose in London? Are all 1 - 9 year olds being offered a polio booster?

Experts have advised that, as a precaution, all children aged one to nine years in London should be offered a dose of polio containing vaccine now to ensure that they are protected against polio and to stop any further spread of poliovirus in London.  This is because children in this age range have not received the full programme of vaccination, so they are not yet fully protected against polio. By getting a dose now this will boost their protection against polio. In London, all children aged 1-9 years are being offered a dose of polio vaccine. This will either be a top up dose in children that are fully up to date with their routine vaccinations or a catch-up dose.

Is this an extra jab? Will children that need to catch up with their missed routine vaccination/s then get an additional dose on top of that? 

We need to protect children against polio now. Bringing a child up to date now will achieve the same effect as the offer of an additional booster.

For children that are fully up to date with their routine vaccinations, this will be an additional polio vaccine to enhance their protection against polio whilst it is being detected in wastewater samples. If your child is not up to date with their routine vaccinations, they will be given a catch-up dose so it will not be an additional dose.

What is the risk of not having the polio booster vaccine?

Since February 2022, we have found a type 2 polio virus in sewage samples taken from north London. This suggests that the virus is now spreading between people. This has probably happened because vaccine uptake for the infant and toddler vaccinations in London is lower than it should be.

Polio is an infection caused by a virus that attacks the nervous system – it can cause permanent paralysis of muscles. Before the polio vaccine was introduced, there were as many as 8,000 cases of polio in the UK in epidemic years. Because of the success of the polio vaccination programme, there have been no cases of natural polio infection in the UK for over 30 years (the last case was in 1984) and polio was eradicated from the whole of Europe in 2003.

The polio virus found in London should not pose any risk to those who are fully vaccinated. However, whilst it is spreading, there is a small chance that those who have not been fully vaccinated, or those who cannot respond well to vaccines, could be at risk of catching polio. The good news is that we have picked this virus up early and we want to act now to protect as many children as we can.

Boosting immunity in children aged 1 to 9 years now by offering them an extra dose of polio vaccine should help ensure they have very high levels of protection from paralysis and reduce the risk of them spreading the virus to others. It’s important all children aged 1 to 9 – even if up to date with their vaccinations – take up this vaccine when offered to further strengthen their protection against the poliovirus.

Is there anyone who does not need to get a polio dose now?

The only small group of children in London who don't need a dose now are those who had a pre-school booster (at 3yrs 4m) in the last 12 months, but if they get an extra booster in error it won't cause any harm. 

Some of our patients do not live in London but are registered with us, are they eligible?

Yes, all children aged 1 to 9+364 days who are London residents or registered with a London GP practice are eligible to receive a polio containing vaccination.

What about older children and young people and adults – are they eligible for a vaccination?

The best way to prevent polio is to make sure everyone is up to date with vaccinations so anyone of any age may call to make an appointment and receive a polio containing vaccination on the NHS.

Can patients get other vaccinations at the same time?

Yes – it is good practice to check the patient’s immunisation history and check the Redbook.  You should speak with your Practice Immunisation Lead to develop a system that flags which other immunisations a patient is due and administer them at the same time.

We run a very busy practice and our appointment slots are allocated very quickly. What should we do if all appointment slots are taken?

Your practice may be part of a collaboration agreement where you can refer to other practices.  Check with your GP, Practice Manager or Practice Immunisation Lead.  You should allocate the earliest available appointment to anyone requesting one.

Can I refer the patient to our extended access hub?

Yes

Can I refer the patient to a Vaccination Centre?

Yes

Where can I get details of other providers who are offering polio vaccinations near my practice?

The details and locations of other providers who are offering Polio vaccinations are provided in the link below:

Extra polio vaccine dose for children (London only) - NHS (www.nhs.uk)

Are the school aged vaccination services offering polio vaccinations and do they send us information?

SAIS Providers are contributing to the programme with staff capacity and clinics. All information of children vaccinated at non-GP sites will go through CarePlus/CHIS. The data and tech team are working through a solution to send data from CHIS to GP practices to update the patient record.

What do I do if a patient comes in for another reason and their record shows they’ve not had a polio vaccination or completed the schedule?

You should ask the practice nurse or GP to speak to the patient’s parent and offer a polio containing vaccination.

Where do I get stock from?

Your practice will have an Immform account and the polio containing vaccinations are available to order free of charge.

Is there a limit to what I can order and can I order more?

There are ordering limits in place on vaccine supplied by UKHSA to encourage regular ordering of smaller volumes and reduce wastage due to fridge or delivery failure. If your practice has the capacity to store and administer more than the weekly limit, then they are advised to contact the ImmForm helpdesk with requests for additional allocation.

Requests for polio containing vaccine are dealt with as quickly as possible and you are encouraged to request additional allocation well in advance of order closing deadline where possible and to only order what is needed for booked clinics for the next 2 weeks.

What is our practice expected to do to support this campaign?

You should work with your practice Immunisation Lead and Local Immunisation Coordinator to develop a system where you:

  • Invite children for a booster or catch up polio vaccination
  • Use your existing practice call and recall system
  • Use the correct SNOMED code (see Appendix 2)
  • Escalate any declines to your practice nurse, GP or Immunisation Lead
  • Record reason for decline

What do I do if a person attends the practice for a polio vaccination but is not registered with the practice?

Where possible the practice should register the person and arrange an appointment with the relevant clinician so they can be brought up to date with any outstanding vaccinations.

Do the polio containing vaccines contain porcine gelatine?

the IPV vaccines deployed in the routine programme and being used for the IPV booster campaign do not contain any porcine gelatine.

Does the campaign have an end date?

The IPV booster campaign in London is still very much underway as we continue to work together to achieve as high uptake as possible in the eligible cohort. The national polio incident management team will be reviewing the evidence on vaccine uptake and findings from the sewage surveillance and considering any further public health action as needed. NHSE London has advised that the campaign is continuing for a number of weeks with no end date currently set

The initial guidance only covered those who were at least 1yo as of 31st August 2022. As the campaign appears to be ongoing, do new 1yos become eligible (once they are >12m from their 6-in-1 jabs)?

No, the eligible cohort was defined at the start of the campaign. Babies turning 1 after 31 August are not eligible for the IPV booster campaign. However, as per standard protocol, they need to be recalled for any missed or incomplete doses. The vaccine strategy will continue to be reviewed on the basis of the latest evidence from the polio incident investigation and response.

The initial guidance stated that those who were fully up to date and <12m since their 4-in-1 pre-school booster would not require a catch-up booster and would next receive a polio vaccine at their 14yo 3-in-1 booster. As the campaign appears to be ongoing, what do we do about kids who were <12m post 1-in-4 at the start of the campaign, but are now >12m post 4-in-1?

As above, the eligible cohort was defined at the start of the campaign (so by 31 August), any updates will be communicated as appropriate.

Recording Polio Vaccinations Given By Other Providers

Practices will be paid a fee of £1.50 for each patient record entered/uploaded to the clinical IT system (e.g. EMIS, TPP, Vision) for vaccinations given by other providers as part of the mass polio campaign

The payments only apply to vaccinations given as part of the mass vaccination campaign. It is anticipated that most vaccinations will have been given by other providers between August to October 2022. Polio campaign data received after October and until the end of the campaign must also be entered within 5 working days for the payment to be valid

Data received must be uploaded within 5 working days of the data being received from System C

The payment scheme has a cap of 100,000 vaccinations across London, data entry for vaccinations over this volume will not be eligible for the incentive, further communications will be shared if this number of records is reached

Please read he attached FAQs ‘Recording Polio Vaccinations Given Outside GP Practice’ for information on uploading records. 

 

 

This document includes FAQ, SNOMED code recommendations., Polio vaccination sites, how to order the vaccine and more.

Polio vaccine transfer

Training available 

ELFT training is available at this link.

Co-administration 

We have received enquiries about co-administration of the current polio vaccines with  MMR vaccines; in principle this is possible and is encouraged.

The Greenbook’s  Chapter 26 on Polio under Administration  states that: “IPV-containing vaccines can be given at the same time as other vaccines such as MMR, MenC and hepatitis B. The vaccines should be given at a separate site, preferably in a different limb. If given in the same limb, they should be given at least 2.5cm apart (American Academy of Pediatrics, 2003). The site at which each vaccine was given should be noted in the patient’s records.” 

Please refer to Greenbook for the most up-to-date information.

Green book chapter 26 polio

The government has also published an algorithm for IPV booster campaign which you might find helpful

Inactivated polio vaccine booster information for healthcare professionals

Cold Chain

Colleagues involved in the vaccination programme are kindly reminded to ensure appropriate cold storage of the vaccines and how to escalate temperature breaches for the polio vaccines: Cold Chain Storage for Polio Vaccines

Key messages

  • Children aged 1 to 9 years old in London are being offered a dose of polio vaccine.
  • For some children this may be an extra dose on top of their routine vaccinations. In other children it may bring them up to date with their routine vaccinations.
  • There are signs the virus may be spreading in London and the number of children vaccinated in London is lower than it should be. Boosting immunity in children should help protect them and reduce the risk of the virus continuing to spread.
  • If your child is eligible for an extra dose, the NHS will contact you to ask you to book an appointment for the vaccine

Communication materials 

Translated materials 

This leaflet includes information on polio, vaccination and the booster campaign.

Paper copies of the English version of this leaflet are available free to order or download.

This leaflet is being translated into the languages and alternative formats below and most are currently available to download, translations will be added as they become available. Please place orders for any paper copies you require and these will be dispatched as soon as they are available.

Albanian, Arabic, Bengali, Bulgarian, Chinese (simplified), Chinese (traditional,Cantonese), Estonian, Farsi, French, Greek, Gujarati, 

Hindi, Italian, Latvian, Lithuanian, Panjabi, Pashto, Polish, Portuguese, Romanian, Romany, 

Russian, Somali, Spanish, Tagalog, Tigrinya, Turkish, Twi, Ukrainian, Urdu, Yiddish and Yoruba.

Alternative formats:

Braille version of this leaflet is available to order.

An English large print version is available to order.