Analysis of yellow fever vaccination practice in England

Prior to initiation of a program of registration, training, standards, and audit for yellow fever vaccination centers (YFVCs) in England, the National Travel Health Network and Centre (NaTHNaC) assessed the current practice and resource needs of these centers.

A questionnaire was sent to all YFVCs on the English Department of Health (DH) database in November 2004. It surveyed type of practice, administration of travel vaccines, training and duties of staff, vaccine storage and record keeping, access to travel health information, and resource and training needs.

The questionnaire was completed by 69% (2,933 of 4,242) of YFVCs on the DH database. Nearly all (94%) YFVCs were part of general practice; centers were widely distributed throughout England. A median number of 35 doses of yellow fever vaccine (YFV) were given every year, with 75% of centers giving less than one dose per week. Nurses administered YFV more frequently than physicians (96% of nurses vs 49% of physicians, p < 0.0001). More nurses in YFVCs had received travel health training compared with physicians (95% vs 57%, p < 0.0001). Study days run by pharmaceutical companies were the most frequent source of training. Most YFVCs properly refrigerated vaccine and maintained vaccination records. Of the centers that reported using Internet resources for every patient, the Travax (Health Protection Scotland) (64%) and DH (England) (48%) Web sites were most frequently accessed. YFVCs cited training opportunities, information for travelers, and specific travel medicine advice as resources that would be most helpful to them.

The NaTHNaC program of registration, training, standards, and audit should help to meet important needs in practice settings and contribute to an improvement in travel health.