The rapid development and roll out of vaccines to protect us from COVID-19 brings renewed hope in protection from this global pandemic. School and public health nurses have been and remain at the forefront of delivering the childhood immunisation programme. COVID-19 has sadly seen many of these immunisations delayed, and the negative impact of this in reduced uptake is now being seen (Public Health England, 2021).
Undeterred, the nursing workforce, with its usual determination and doggedness, is using each and every opportunity to offer immunisations, through extended evening/weekend hours ‘catch-up’ sessions, ‘drive-thru’ sites and, opportunistically, at each and every contact. One school nurse reported during the recent SAPHNA webinar that some immunisations have taken place in risk-assessed gardens. Of course, in lockdown, there are many barriers and, indeed, with many children at home, this brings a host of restrictions.
During their annual leave, in spare time and aft er working hours, many nurses have stepped up to support the mass COVID-19 immunisation programme and, with decades of experience, are hailed as a great asset to this tremendous effort.
‘…school and public health nurses are using this as an opportunity to reflect and build on best practice.’
In times such as these, it would be easy to become despondent, particularly aft er working so hard to achieve a world-leading uptake status for childhood immunisations; however, that is not the case. Instead, school and public health nurses are using this as an opportunity to reflect and build on best practice, with over 200 having accessed the recent SAPHNA webinar to share, learn, celebrate, support and, subsequently, develop their own community of practice.
‘…school and public health nursing services will offer a blended approach [to immunisation], including risk-assessed face-to-face community venues, postal contact and doorstep visits’
During COVID-19, there has been a rapid introduction and expansion of intelligent electronic systems, including ‘e-consent’, vaccine notifications (School Screener, 2020), online school nursing text support services, and website health education and promotion (Health for Teens, 2020; ChatHealth, 2020), making services safer, smoother and more efficient. Access to others, such as the Child Protection Information System, is helping to target and thus protect many of the most vulnerable (NHS Digital, 2020).
However, it is important to note here that, although many technological advances have been positively implemented, SAPHNA is also aware of the inequality of digital poverty, which can, by definition, further exclude some children, young people and families from accessing their essential childhood immunisations. Therefore, school and public health nursing services will offer a blended approach, including risk-assessed face-to-face community venues, postal contact and doorstep visits as required, while also using critical key relationships with schools, families and partner agencies.
The current commissioning arrangements for childhood immunisations result in a variety of providers, with individual strengths (Department of Health and Social Care, 2018).
Regardless of provider, the key to optimum uptake is communication and co-operation between NHS England and local authorities. Some excellent developments on this have been seen during COVID-19, which need to be harnessed and solidified. Sadly, much of this comes down to funding. Perhaps as the government pledges to ‘Build Back Better’ (2020) and with Public Health England's refresh of the Healthy Child Programme, including commissioning guidance, this will be acknowledged, strengthened and invested in. There is a huge, but not insurmountable, task ahead in ensuring that children and young people have their immunisations. These may come to include the COVID-19 vaccination, depending on a decision from the Joint Committee on Vaccination and Immunisation.
If there is any workforce that can pull this off, with appropriate investment, it is school and public health nursing.