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PHE London region CEV CYP Vaccination webinar

Covid 19 Vaccination for clinically extremely vulnerable children and young people webinar

Covid 19 Vaccination for clinically extremely vulnerable children and young people webinar

Welcome to the session! We are recording this session and are working out the best way to share it with you. Slides will be shared in a pdf shortly after the session. Whilst every care has been taken to ensure this is up to date the guidance does change so please make sure you check the NHS, Public Health England and Department for health and Social Care Websites. The Chat function will open up after the main presentations.

Chair’s Welcome and Housekeeping

Welcome to the session! What we need to share & how we want to continue the conversation. Parents and Carers are the experts on their own Children and Young People, together we can work to protect and support them.

Working with Parents, Carers and CYP Equity and Pragmatism

  • Emphasis is on explaining the offer to all Parents,Carers and CYP
  • Parents, Carers & CYP have the right to decline
  • Informed consent Balance of equity of the offerand personalised assessment of risk/impacts
  • Vaccinations work and continue to work acrossall ranges of needs/complexity
  • The approach/delivery will need to be planned and sensitivity for needs built in to the offer
  • Communicate early, communicate often - Partnership Approach

The Covid 19 response changes very quickly and the publication of new guidance from the Government or NHS changes quickly too.

We have tried to make the resource completely up to date 16th August 2021 but please do make sure you are checking the Gov or NHS websites regularly as changes in policy are introduced and new guidance are published.
We are aiming to give you an update on the changes to the Covid 19 vaccination programme for clinically extremely vulnerable children and young people and some ideas of how this might look in your local area. We want to ensure that you know that take up of the offer is Voluntary and that parent and carer informed choice and discussion with your local health providers is central to the programme. We are starting from the position that the Covid 19 Pandemic is a real and continuing health emergency and with confidence in the principles, processes and science behind both the Covid 19 vaccination programme and vaccination as a positive public health offer and will not be debating this or related areas.

Two Vaccine Journeys

  • Parents and Carer reflections on Covid 19 Vaccination
  • Reflections, Personalisation and Informed Consent
  • Fazilla Amide,  Learning Disability Family Carer Advisor, NHS England
  • Ros Luff, National Network of Parent and Carer Forums

Update 1 Wider Impacts of Covid 19 On Children and Young People with SEND

  • Report from the PHE London regional team June 2021
  • Looks at a wide range of priority areas for London’s Children
  • Aimed to give an early insight into the direct and indirect impacts from the pandemic
  • Alongside what we know suggestions for what we do about it
  • Specific section on CYP with SEND but transferrable lessons across all the areas considered SEND as a “Golden Thread”.

Update 1 Wider Impacts of Covid 19 On Children and Young People with SEND RCPH Research

Ladhani SN, Amin Chowdhury Z, Davies HG, et al. COVID 19 in children: analysis of the first pandemic peak in England. Arch Dis Child. 2020;105(12):1180 1185
Children represent less than 5% of COVID 19 cases and generally develop a mild and transient illness; severe disease, hospitalisation and deaths are rare in children .

COVID 19 research evidence summaries | RCPCH:  Clinically Extremely Vulnerable groups continue to be a concern. Deaths in children due to COVID 19 have been extremely rare: mortality seems to be consistent at around 0.01 0.1%.  Children with co morbidities, notably respiratory and complex neurodisability, appear more likely to suffer complications and need hospital +/ PICU admission, but not obviously more than would be expected from infection with other respiratory viruses. Emerging evidence and research is ongoing on impacts over time.

Update 1 Wider Impacts of Covid 19 On Children and Young People with SEND

Why is it Important? The challenges already faced by children and young people with special educational needs and disabilities (SEND) and the parents and carers who support them have been exacerbated
by the COVID 19 pandemic A small group of CYP with SEND, specifically those with complex respiratory and neurological disorders, are clinically extremely vulnerable and at greater risk of morbidity and mortality if they contract the virus. Children with SEND have been disproportionately impacted by the pandemic. The impacts on CYP and their families include:

  • Reduced access to healthcare
  • Reduced access to services and disruption of healthcare such as cancellation of routine rehabilitation appointments
  • Delays for new equipment such as leg gaiters to enable physical therapy at home
  • Reduced access to support
  • Social care failures to respond effectively, such as closure of day centres and an increased reliance on family and informal carers
  • Funding stopped for normal support services without any alternatives
  • Support stopped or reduced
  • Absence of trusted key workerstaff

Education

  • CYP with education, health and care plans (EHCPs) had lower levels of attendance in schools than all pupils in autumn 2020
  • Education learning materials for CYP who were learning from home were inaccessible or inappropriate
  • Specialist resources and support that are available for CYP with SEND at school cannot be replicated at home
  • Social aspects of education were affected by the learning at home during lockdown
  • Delays to the ECHP process have had a detrimental effect on CYP’s education Inequalities
  • CYP with SEND are likely to live in socially disadvantaged households, so are less likely to have internetaccess and the ability to use digital materials

Inequalities

  • Two in five disabled children in the UK live in poverty, around 51,000 CYP in London
  • Families with disabled children are more likely be on lower incomes due the difficulty of combining workingand caring
  • 17% of families with disabled children go without food
  • 21% of families with disabled children go without heating
  • CYP with SEND often experience poorer health, social and education outcomes and challenges in terms of access to social, leisure, employment and training opportunities

Update 2 JCVI Statement on Covid 19 Vaccination

“That includes children aged 12 to 15 with severe neurodisabilities, Down’s syndrome, immunosuppression and multiple or severe learning disabilities. The JCVI also recommends that children and young people aged 12 to 17 who live with an immunosuppressed person should be offered the vaccine. This is to indirectly protect their immunosuppressed household contacts, who are at higher risk of serious disease from COVID 19 and may not generate a full immune response to vaccination. Under existing advice, young people aged 16 to 17 with underlying health conditions which put them at higher risk of serious COVID 19 should have already been offered vaccination. The JCVI is not currently advising routine vaccination of children outside of these groups, based on the current evidence.”
Read the JCVI statement on COVID 19 vaccination of children and young people aged 12 to 17 years (external site)

Update 2 Joint Committee on Vaccination and Immunisation Advice

Children under 16 years of age, even if they are clinically extremely vulnerable, are at low risk of serious illness and death from COVID 19 and are not routinely recommended for vaccination. However, the JCVI has advised that the following groups of children should be offered vaccination against COVID 19:

  • 12 to 15 year olds with the following health conditions:
  • severe neuro disabilities
  • Down’s syndrome
  • underlying conditions resulting in immunosuppression
  • those with profound and multiple learning disabilities, severe learning disabilities or who are on the learning disability register
  • 12 to 17 year olds who are healthy, but who live with individuals (adults or children) who are immunosuppressed

All 16 and 17 year olds who are either clinically extremely vulnerable or have underlying health conditions were included in Phase One of the vaccine deployment programme and should therefore already have been offered a COVID 19 vaccine.
The NHS will contact eligible children to invite them for vaccination. If a parent or guardian thinks that their child is eligible but has not been contacted by the end of August, they should contact their GP.

Update 2 JCVI Statement on Covid 19 Vaccination

Read the JCVI statement on COVID 19 vaccination of children and young people aged 12 to 17 (external site)

Update 2: CEV Vaccination Update overview of the advice and some details of delivery

Visit : Who can get the coronavirus (COVID 19) vaccine NHS (external site)
If your child is eligible for vaccination, you'll be contacted by a local NHS service such as their GP surgery to arrange their appointments. See How you will be contacted for your coronavirus (COVID 19) vaccination NHS (external site). 
Who can get a coronavirus (COVID 19) vaccine?

  • Some children aged 12 to 15
  • If you're aged 16 or 17
  • ALL People aged 18 and over they can book their appointments

Update 2: CEV Vaccination Update – overview of the advice and some details of delivery

JCVI advises that children and young people aged 12 years and over who are household contacts of persons (adults or children) who are immunosuppressed should be offered COVID- 19 vaccination on the understanding that the main benefits from vaccination are related to the potential for indirect protection of their household contact who is immunosuppressed.

Update 2: CEV Vaccination Update Overview

If your child is eligible for vaccination, you'll be contacted by a local NHS service such as their GP surgery to arrange their appointments. The NHS will contact eligible children to invite them for vaccination. If a parent or guardian thinks that their child is eligible but has not been contacted by the end of August, they should contact their GP.

Children aged 12 to 15 can get vaccinated against COVID 19 if either: they live with someone who is more likely to get infections (such as someone who has HIV, has had a transplant or is having certain treatments for cancer, lupus or rheumatoid arthritis) or  they have a condition that means they're at high risk from COVID 19.
Conditions that mean your child may be at high risk and can get vaccinated are:

  • a severe problem with the brain or nerves, such as cerebral palsy
  • Down's syndrome severe or multiple learning disabilities (or they're on the learning disability register)
  • a condition that means they're more likely to get infections (such as some genetic conditions or types of cancer)

Clinical Extremely Vulnerable Groups

Which Children are Clinically Extremely Vulnerable?
Read COVID 19 guidance on clinically extremely vulnerable children and young people RCPCH: Royal College of Paediatrics and Child Health Report (external site)

Covid 19 Vaccine Side Effects

Coronavirus (COVID 19) vaccines side effects and safety
Millions of people have had a coronavirus (COVID 19) vaccine and the safety of the vaccines continues to be monitored. Reports of serious side effects are very rare.

Common side effects
Like all medicines, the COVID 19 vaccines can cause side effects, but not everyone gets them. Most side effects are mild and should not last longer than a week, such as:

  • a sore arm from the injection
  • feeling tired
  • a headache
  • feeling achy
  • feeling or being sick

You may also get a high temperature or feel hot or shivery 1 or 2 days after your vaccination. You can take painkillers such as paracetamol if you need to. If your symptoms get worse or you're worried, call 111. If you have a high temperature that lasts longer than 2 days, a new, continuous cough or a loss or change to your sense of smell or taste, you may have COVID 19. Stay at home and get a test. You cannot catch COVID 19 from the vaccine, but you may have caught it just before or after your vaccination.

The Hammersmith and Fulham Approach

NWL CYP Covid Vaccination Task & Finish group established as one of the specialist working groups reporting to the NWL Vaccination Board.
Eight borough based Task and Finish groups to ensure delivery model reflects local needs and landscape.
Multi agency involvement including:

  • Director of Public Health
  • Senior DCO
  • Asst Director SEND
  • Special School Heads
  • Parent Carer Forum
  • Disabled Children’s and Short Breaks teams
  • Children’s Community Nursing and School Nursing services
  • Commissioners, Community Aid Network and Communications
  • Primary Care
  • LA Covid lead and vaccination centre

Key Area:  Governance. Activity: Multi agency tasks and finish group reports to NWL CYP Covid Vaccinations group
Key Area: Identification of CYP. Activity: Used a range of means to identify eligible CYP:

  • Short breaks and social care caseloads, Special school pupil lists, Children’s Community, Nursing and School Nursing teams
  • GPs to undertake searches of clinical system, particularly for immunosuppressant conditions
  • Offer extended to 16 19 yr olds who have not been vaccinated and accompanying family members/carers

Key Area: Venue. Activity: 

  • Disabled Children’s Resource Centre for initial sessions during school holidays. Assurance and oversight from mass
  • vaccination centre
  • Special schools once term begins.
  • Access to the vaccination bus if required
  • Roving team for housebound/specific circumstances

Key Area: Staffing. Activity: 

  • Registered health professionals who are experienced vaccinators and have completed Level 2 Safeguarding and Paediatric Basic Life Support.
  • Staff from the short breaks service, OTs, Social Workers and EPs on site to support with waiting and recovery areas and distraction

Key Area: Booking. Activity: 

  • Booking via Eventbrite to manage flow
  • Free taxi or SEN transport available via H&F CAN if required

Key Area: Communication. Activity: 

  • Letter from Direct of Public Health emailed and posted to parents along with PHE leaflet and information about tonight’s webinar
  • Consent questions provided in advance
  • Phone calls from named staff to discuss letter, answer any questions and support with booking if required
  • Script/FAQ developed for staff for use during calls
  • DPH is recording a video for the Local Offer and Eventbrite site

Key Area: Support for individual young people. Activity: 

  • Skilled staff to support on the day
  • Activities for the recovery area
  • Individual desensitisation work if required once schools return following training by Adult LD team

Key Area: Sharing the learning & learning from others. Activity: 

  • Learning from the first vaccination events will inform further sessions and arrangements for second doses
  • Resources and learning shared via NWL CYP vaccination group
  • Learning from best practice elsewhere

Coronavirus Vaccines in London Local Programmes

For North Central London (external site)
For North East London (external site)
For North West London (external site)
For South East London (external site)
For South West London (external site)
For NHS England National System (external site)

27/08/2021, 12:13:21