PMU18 - UK EPIDEMIOLOGY AND CLINICAL BURDEN OF VACCINE-PREVENTABLE CHILDHOOD INFECTIOUS DISEASES: A SYSTEMATIC LITERATURE REVIEW

Abstract

Vaccines against diphtheria, tetanus, pertussis, hepatitis B (Hep B), poliomyelitis, and Haemophilus influenzae type b (Hib) are included in the current UK childhood vaccination schedule. Our aim was to provide an overview of recent data around the epidemiology and clinical burden of these diseases in the UK. Systematic searches for publications reporting incidence, prevalence, and risk factors were conducted in September 2017 using Embase, MEDLINE, Cochrane Library, four key conferences (2015-2017), additional sources/websites, and by hand-searching references of included publications. There was no restriction on intervention or comparator. Only English-language publications from 2012 onwards were included. Of the 11,451 publications identified, 38 (reporting on 37 studies) were included; 21 studies reported data on Hep B, eight on pertussis, five on H. influenzae, and one each on diphtheria, tetanus, and poliomyelitis. Incidence and prevalence of Hep B are low overall; those born overseas or of Asian ethnicity were at higher risk than the general population. People who inject drugs (psychoactive or image- and performance-enhancing) represent another risk group for Hep B. In 2012, there was a resurgence of pertussis primarily in very young infants; this was successfully addressed by a programme of maternal vaccination during pregnancy. Due to the effective control of Hib after two decades of routine vaccination, non-b serotypes now cause a large percentage of the remaining low H. influenzae morbidity and mortality in the UK; risk groups included expectant mothers, young infants, and adults with comorbidities or immunosuppression. The low number of studies and reported cases of diphtheria, tetanus and polio suggest that these diseases are well controlled. While the childhood vaccination schedule continues to be highly effective, certain population subgroups are at risk of vaccine-preventable hepatitis B and pertussis infections. This highlights the on-going importance of vaccination in conjunction with high population vaccine coverage rates.