Pertussis vaccine uptake in pregnant women varies significantly across the country and is affected by ethnicity, deprivation and parity. Variations should be addressed through service delivery models designed to reduce potential inequalities in infant protection.

Since 2016, the European Region has experienced large-scale measles outbreaks. Several measles outbreaks in England during 2017/18 specifically affected Romanian and Romanian Roma communities. In this qualitative interview study, we looked at the effectiveness of outbreak responses and efforts to promote vaccination uptake amongst these underserved communities in three English cities: Birmingham, Leeds and Liverpool. Semi-structured in-depth interviews were conducted with 33 providers involved in vaccination delivery and outbreak management in these cities. Interviews were analysed thematically and factors that influenced the effectiveness of responses were categorised into five themes: (1) the ability to identify the communities, (2) provider knowledge and understanding of the communities, (3) the co-ordination of response efforts and partnership working, (4) links to communities and approaches to community engagement and (5) resource constraints. We found that effective partnership working and community engagement were key to the prevention and management of vaccine-preventable disease outbreaks in the communities. Effective engagement was found to be compromised by cuts to public health spending and services for underserved communities. To increase uptake in under-vaccinated communities, local knowledge and engagement are vital to build trust and relationships. Local partners must work proactively to identify, understand and build connections with communities.

Protein antigen Research data Pneumococcal surface protein A (PspA) Protective aganist multiple pneumococcal serotypes in mice models of invasive disease pneumonia, and colonization. Vaccination of healthy volunteers with PspA generated antibodies aganist multiple strains that protected mice aganist invasive disease. Human studies in progess. Pneumolysins.Pneumolysoids Protection aganist Pneuminia and increased survival after intraperitoneal challenge. human studies in progress Neuraminidases (Nan) Protection aganist colonization and otitis media Pneumococcal surface protein C (PspC) Protection aganist colonization. Protection aganist sepsis Pneumococcal protective protein A (PppA) Protection aganist lung infection. Protective aganist nasopharyngeal colonization. Pneumococcal Histidine Trial Protein D Protective aganist animal models of invasive disease and pneumonia phase II trial reports awaited. IC4 antigens Protection aganist sepsis, pneumonia, nasopharyngeal carriage.

No abstract