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Referrals for MMR immunisation in hospital

Emma Ainsworth1, Philip Debenham, Enitan D Carrol

  • 1Division of Child Health, School of Reproductive and Developmental Medicine, University of Liverpool, UK.

Archives of Disease in Childhood
|April 8, 2010
PubMed

Insights

Egg-allergic children can safely receive the measles, mumps, and rubella (MMR) vaccine without hospital referral. Unnecessary referrals delay vaccination, highlighting the need for updated guidelines to be widely shared.

Area of Science:

  • Pediatrics
  • Immunology
  • Public Health

Background:

  • Measles, mumps, and rubella (MMR) vaccine safety in egg-allergic children is a concern.
  • Existing guidelines (2000) from RCPCH and BSACI recommend hospital referral for MMR in certain cases.
  • Audit of hospital referrals for MMR vaccination in egg-allergic children.

Purpose of the Study:

  • To audit hospital referrals for MMR vaccination against established guidelines.
  • To assess the necessity and impact of hospital-based MMR vaccination for egg-allergic children.
  • To evaluate the safety and timeliness of MMR vaccination in this cohort.

Main Methods:

  • Retrospective audit of 110 children referred for MMR vaccination.
  • Hospitals included: Birmingham Heartlands Hospital (2002-2004) and Alder Hey Children's Hospital (2006-2009).
  • Referrals were assessed against 2000 RCPCH and BSACI guidelines.

Main Results:

  • 75% of referred children (82/110) did not meet referral criteria.
  • Only 12% of referred children (13/110) had severe egg allergy.
  • 81% of children experienced a >30-day delay in their first MMR dose.
  • All vaccinated children received MMR without significant adverse reactions.

Conclusions:

  • Hospital referral for MMR vaccination is often unnecessary for egg-allergic children.
  • Unnecessary referrals lead to significant delays in MMR vaccine administration.
  • Current BSACI guidelines promoting primary care vaccination for egg-allergic children require wider dissemination.

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