At 14:23 07/02/06 +0000, Paul Bivand wrote (in part):
>The NHS migrations estimates on NOMIS, which clearly only relate to
>children registered with a GP, show a substantial net outflow from the
>Westminster, kensington & chelsea area, predominantly within the first
>three years of life. - for the PCT area, a net outflow of 943 in 2004 as a
>whole for under 5s.
It clearly is a confusing situation. However, migration didn't really
ought to come into it, since the most obvious statistic to look at is the
proportion of those who reach their 5th birthday whilst living in the area
who have/have not had two MMR jabs - i.e. a statistic which comes with its
own denominator. Table 9a of the Immunisation report (the Table we're
really talking about here) certainly sounds as if it is meant to be that -
it is entitled "Percentage of children immunised by their 5th birthday...."
(and one would be inclined to presume that the children it relates to are
those who reach their 5th birthday within the area during the year in
question).
It is obviously of note that Table 9a indicates almost as pitifully low a
rate (13%) of children having had Diptheria, Tetanus and Polio boosters by
their 5th birthday. The problem, be it one of immunisations or data,
therefore relates to all 'booster' immunisations, rather than being
MMR-specific.
In passing, I presume that the large net outward migration from Westminster
of under 5's you mention must be a new and 'temporary', or perhaps even
'one-off', phenomenon - since if it were sustained, Westminster would soon
be at risk of running out of children!
>The lack of second vaccinations in Westminster may partly be due to these
>population shifts (and unrecorded ones) and amongst other things to the
>difficulty of GPs contacting mothers within the area ....
If, as you suggest, an appreciable proportion of the problem relates to
GP's having difficulty contacting mothers in the area, then if the figures
we are seeing are remotely true, this might suggest that the School medical
Service (or whatever it calls itself these days) ought to be playing a role
in identifying those who do not get their scheduled booster immunisations
at/around the time of school entry.
Kind Regards,
John
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