Article Text

Download PDFPDF
Action on immunisation: no data, no action
  1. N S Crowcroft
  1. Dalla Lana School of Public Health and Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Ontario, Canada
  1. Correspondence to Natasha S Crowcroft, Surveillance and Epidemiology, Ontario Agency for Health Protection and Promotion, Dalla Lana School of Public Health and Department of Laboratory Medicine and Pathobiology, University of Toronto, 480 University Avenue, Suite 300, Toronto, Ontario M5G1V2, Canada; natasha.crowcroft{at}

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.

In the UK, the national immunisation programme is delivered free at point of care through the National Health Service (NHS) primary healthcare teams, led by general practitioners (GPs), and to a smaller and locally variable extent through child health clinics. Nearly all British children are vaccinated through the NHS, rather than privately. The UK national immunisation programme has been run by Child Health Systems which are in the process of being replaced as part of the National Programme for Information Technology (NPfIT) implemented by Connecting for Health, a Government agency. The Health Protection Agency (HPA) expressed concerns about the first system to be rolled out in August 2005. Since then, some of the problems which have resulted from the new systems have been well publicised, including the inability of systems to track children and calculate vaccination coverage.1 2 3 In London, two systems, the Child Health Interim Application (CHIA) and the Electronic Care record system (RiO) have been implemented without a call and recall function, with clear implications for patient safety. The opportunity was lost to improve immunisation in London, the worst place for this to have happened because London’s coverage is poor — and is the reason that the UK fails to meet its World Health Organization targets on immunisation.4 The city stands in contrast to other European capitals such as Paris, and to other cities in the UK which face similar challenges in having large mobile and deprived populations. London’s bad coverage has gone hand in hand with bad data, and bad data are toxic.5


Immunisation keeps us all healthy. Its global priority is shown by the excess of $1.7 billion given to childhood vaccines by Bill and Melinda Gates in 1999–2007, mainly to the World Health Organization and Global Alliance for Vaccines and Immunization …

View Full Text


  • Competing interests None.