Written Question · S4W-20791 · Session 4
What it has done to (a) ensure and (b) monitor the delivery by midwives of (i) pertussis vaccine during pregnancy and (ii) MMR vaccine imme…
The question
To ask the Scottish Government what it has done to (a) ensure and (b) monitor the delivery by midwives of (i) pertussis vaccine during pregnancy and (ii) MMR vaccine immediately after pregnancy.
The answer
Midwives are recognised as a key group in promoting the benefits of pertussis vaccination and rubella screening.
The pertussis immunisation programme for pregnant women was introduced in October 2012 in response to a UK wide outbreak of pertussis. The programme aims to provide passive immunity to young infants in the first few weeks of life before they are old enough to start their immunisation schedule at eight weeks of age. Most pregnant women are vaccinated against pertussis in their GP practice.
Prior to the introduction of the programme, training materials were produced by NHS Education for Scotland for registered healthcare professionals and midwives and a revised version will be issued in May this year.
A leaflet explaining the benefits of vaccination is also provided to pregnant women by NHS Health Scotland.
A point of delivery audit was undertaken in the main maternity units in Scotland in January 2013, which estimated that uptake of the vaccine was high at 78.1%. HPS is currently working on a mechanism to obtain regular uptake data via general practices for the routine monitoring of this programme.
HPS monitors the incidence of pertussis and this includes collecting a dataset on all laboratory confirmed cases under one year of age, including whether the mother was vaccinated during pregnancy.
The number of laboratory confirmed cases in infants < 1 year, declined by over 85% from 140 cases in 2010 to 19 in 2013.
MMR vaccine is offered to women immediately after pregnancy if they have been identified as not immune to rubella during screening tests in pregnancy. Screening for rubella antibodies is one of the routine tests offered to all pregnant women at their first appointment with their midwife at around two to three months pregnant. Information about Rubella immunity is also included in the pregnancy screening guide which is issued to every pregnant woman in Scotland.
The MMR vaccine is the only licensed rubella vaccine in the UK. It is a live vaccine and should not be given to pregnant women. So although screening for rubella immunity happens during pregnancy, MMR vaccine can only be given after delivery and offers protection for future pregnancies.
Rubella screening services are commissioned by each NHS board and at this time there is no national system where screening and vaccination are recorded. However, a number of initiatives have been developed to monitor pregnancy and newborn screening programmes at the local (NHS board) level.
Clinical standards for pregnancy and newborn screening were developed by NHS Quality Improvement Scotland in 2005.
NHS National Services Division (who commission screening services in Scotland) developed quality indicators for pregnancy and newborn screening in 2011. These indicators included an indicator for uptake of MMR in rubella susceptible women within five days after delivery. NHS boards provided preliminary data against these indicators in 2011-2012 but the data was not robust enough to be reported.
NHS Healthcare Improvement Scotland published a series of indicators for pregnancy and newborn screening in 2013. There is no specific indicator for uptake of MMR. This can be found at:
http://www.healthcareimprovementscotland.org/our_work/reproductive,_maternal__child/programme_resources/pns_indicators.aspx
Rubella screening for pregnant women is a routine and well established part of pregnancy and newborn screening.
The pertussis immunisation programme for pregnant women was introduced in October 2012 in response to a UK wide outbreak of pertussis. The programme aims to provide passive immunity to young infants in the first few weeks of life before they are old enough to start their immunisation schedule at eight weeks of age. Most pregnant women are vaccinated against pertussis in their GP practice.
Prior to the introduction of the programme, training materials were produced by NHS Education for Scotland for registered healthcare professionals and midwives and a revised version will be issued in May this year.
A leaflet explaining the benefits of vaccination is also provided to pregnant women by NHS Health Scotland.
A point of delivery audit was undertaken in the main maternity units in Scotland in January 2013, which estimated that uptake of the vaccine was high at 78.1%. HPS is currently working on a mechanism to obtain regular uptake data via general practices for the routine monitoring of this programme.
HPS monitors the incidence of pertussis and this includes collecting a dataset on all laboratory confirmed cases under one year of age, including whether the mother was vaccinated during pregnancy.
The number of laboratory confirmed cases in infants < 1 year, declined by over 85% from 140 cases in 2010 to 19 in 2013.
MMR vaccine is offered to women immediately after pregnancy if they have been identified as not immune to rubella during screening tests in pregnancy. Screening for rubella antibodies is one of the routine tests offered to all pregnant women at their first appointment with their midwife at around two to three months pregnant. Information about Rubella immunity is also included in the pregnancy screening guide which is issued to every pregnant woman in Scotland.
The MMR vaccine is the only licensed rubella vaccine in the UK. It is a live vaccine and should not be given to pregnant women. So although screening for rubella immunity happens during pregnancy, MMR vaccine can only be given after delivery and offers protection for future pregnancies.
Rubella screening services are commissioned by each NHS board and at this time there is no national system where screening and vaccination are recorded. However, a number of initiatives have been developed to monitor pregnancy and newborn screening programmes at the local (NHS board) level.
Clinical standards for pregnancy and newborn screening were developed by NHS Quality Improvement Scotland in 2005.
NHS National Services Division (who commission screening services in Scotland) developed quality indicators for pregnancy and newborn screening in 2011. These indicators included an indicator for uptake of MMR in rubella susceptible women within five days after delivery. NHS boards provided preliminary data against these indicators in 2011-2012 but the data was not robust enough to be reported.
NHS Healthcare Improvement Scotland published a series of indicators for pregnancy and newborn screening in 2013. There is no specific indicator for uptake of MMR. This can be found at:
http://www.healthcareimprovementscotland.org/our_work/reproductive,_maternal__child/programme_resources/pns_indicators.aspx
Rubella screening for pregnant women is a routine and well established part of pregnancy and newborn screening.
In the Official Report
No contribution in the Official Report cites S4W-20791 by reference.