Evidence map›Paper›PMID 38671383›Full record

ArticleBMC public health2024

A new neonatal BCG vaccination pathway in England: a mixed methods evaluation of its implementation.

Koren Jones, Georgia Chisnall, Tim Crocker-Buque, David Elliman, Jeremy Horwood, Sandra Mounier-Jack, Colin Nj Campbell, Vanessa Saliba, Tracey Chantler

Open access · goldAbstract read
In one paragraph

Article in BMC public health, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed, 1 pooled it
1.0field-weighted citation impact, top 26% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 1 synthesis or guideline pooled it, 4 citations in OpenAlex.

  1. Pooled it
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors at 4 institutions in 1 country.

Koren Jones *UK Health Security Agency, London, England.
Georgia Chisnall *London School of Hygiene and Tropical Medicine, London, England. georgia.chisnall@lshtm.ac.uk.
Tim Crocker-BuqueLondon School of Hygiene and Tropical Medicine, London, England.
David EllimanGreat Ormond Street Hospital, London, England.
Jeremy HorwoodUniversity of Bristol, Bristol, England.
Sandra Mounier-JackLondon School of Hygiene and Tropical Medicine, London, England.
Colin Nj CampbellUK Health Security Agency, London, England.
Vanessa SalibaUK Health Security Agency, London, England.
Tracey ChantlerLondon School of Hygiene and Tropical Medicine, London, England.
London School of Hygiene & Tropical Medicine · GBUK Health Security Agency · GBGreat Ormond Street Hospital · GBUniversity of Bristol · GB

Funding

National Institute for Health and Care Research NIHR200929
6 · The paper itself

Abstract

introductionThe introduction of a national evaluation of newborn screening for Severe Combined Immunodeficiency (SCID) in England triggered a change to the selective Bacillus Calmette-Guerin (BCG) vaccination programme delivery pathway, as this live attenuated vaccine is contraindicated in infants with SCID. The neonatal BCG vaccination programme is a targeted programme for infants at increased risk of tuberculosis and used to be offered shortly after birth. Since September 2021 the BCG vaccine is given to eligible infants within 28 days of birth, when the SCID screening outcome is available. We explore the experiences of those implementing the new pathway, and how they made sense of, engaged with, and appraised the change.

methodsA mixed-methods evaluation was conducted between October 2022 and February 2023. This involved national online surveys with BCG commissioners and providers and qualitative semi-structured interviews with commissioners, providers, and Child Health Information System stakeholders in two urban areas. Survey data was analysed using descriptive statistics and interview data was analysed thematically. The data was triangulated using Normalization Process Theory as a guiding framework.

resultsSurvey respondents (n = 65) and qualitative interviewees (n = 16) revealed that making sense of the new pathway was an iterative process. Some expressed a desire for more direction on how to implement the new pathway. The perceived value of the change varied from positive, ambivalent, to concerned. Some felt well-prepared and that improvements to data capture, eligibility screening, and accountably brought by the change were valuable. Others were concerned about the feasibility of the 28-day target, reductions in vaccination coverage, increased resource burden, and the outcome of the SCID evaluation. New collaborations and communities of practice were required to facilitate the change. Three main challenges in implementing the pathway and meeting the 28-day vaccination target were identified: appointment non-attendance; appointment and data systems; and staffing and resourcing. Feedback mechanisms were informal and took place in tandem with implementation.

conclusionThe new NHS neonatal BCG service specification has created an effective structure for monitoring and managing the BCG vaccination programme, but further work is required to support delivery of the 28-day vaccination target and improve uptake rates.

Indexed as

BCG VaccineImmunization ProgramsEnglandHumansInfant, NewbornNeonatal ScreeningProgram EvaluationQualitative ResearchSevere Combined ImmunodeficiencySurveys and QuestionnairesTuberculosisBCG VaccineBacillus calmette-guerinEnglandEvaluationTuberculosisVaccine

Identifiers

PMID38671383
PMCPMC11046867
OpenAlexW4395668713

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.