About Bristol Immunisation Group

The Bristol Immunisation Group Health Integration Team (BIG HIT) is a team of public and child health experts, scientists and health practitioners working together to improve the uptake of immunisations across Bristol.

The immunisation programme in the UK is expanding and changing. Bristol faces specific challenges in delivering the programme in an accessible, equitable way to the population who need it. Vaccine preventable diseases such as pertussis cause significant epidemics and our vaccination rates in some localities (particularly East and inner city) leave a door open to the return of measles which continues to threaten our population.

The introduction of two new universal childhood immunisations (rotavirus and influenza) and zoster vaccination for older adults, as well as significant changes in the timing of vaccines, places an increased demand on primary care and an increasing need to bolster the programme to ensure its future success.

Targeted immunisations to vulnerable groups are failing to reach the intended people, for example neonatal BCG. Adolescent immunisation taking place in GP practices is inadequate, and school-based immunisation relies on paperwork for parental consent and so fails to reach the young people most in need of protection.

BIG HIT will identify the areas of strength in the programme and identify the barriers to the effective and equitable delivery of immunisations across the city and wider area. This will entail strengthening our data, enabling parents to engage with the programme in an accessible manner, working with the media and schools, and educating and training healthcare professionals to deliver vaccines in a wider variety of settings.

Aims and objectives

The overall aim of BIG HIT is the development of an outstanding immunisation service: leading research on immunisation development and provision, responsive to vaccine preventable infectious disease outbreaks, flexible for future changes in the programme, using innovative technology to enable people to be better informed regarding their own (and their children’s) vaccinations.

BIG HIT aims to meet these challenges through three work streams:

  1. The use of information and technology to provide timely and accurate data
  2. Strengthening the provision of the universal immunisation programme including the development of a school-based immunisation service
  3. Spotlights on vulnerable areas of the programme

Who’s involved

The leading experts in immunisation in Bristol are involved in the team. The HIT is made up of:

  • HIT director: Adam Finn, Professor of Paediatrics at University of Bristol, Honorary Consultant in Paediatric Infectious diseases, Bristol Children’s Hospital, Director NIHR MCRN SW
  • HIT director: Julie Yates, NHS England Consultant in Public Health, Screening and Immunisation Lead for Bristol, North Somerset and South Gloucestershire
  • HIT director: Marion Roderick, University Hospital Bristol NHS Foundation Trust (UHBristol), Specialist Registrar Paediatric Immunology & Infectious Disease, Immunisation Hotline Coordinator
  • Alex Bentley, Professor of Anthropology and archaeology, University of Bristol, expertise in modelling and understanding collective behaviour in society
  • Karen Evans, Professional lead for Health Visitors and School Nurses, based at North Bristol Trust
  • Shona Arora, Public Health England Centre Director
  • Margaret Fletcher, Professor of Clinical Nursing, UWE & UHBristol
  • Jo Williams, Bristol City Council, Consultant in Child Public Health Bristol
  • Dr Sohail Bhatti, Interim Director of Public Health, Bristol City Council

How patients and the public are involved

The biggest challenge facing vaccine programmes this century is effective education and communication, because many of the vaccine preventable diseases have become rare and forgotten about. Seeking the views of children, young people, parents, and older adults will be key to the development of effective strategies to tackle this challenge and to understanding the roots of the inequalities that exist.

We will build on the existing patient and public involvement (PPI) work around vaccine research done by Bristol Children Vaccine Centre and NIHR Medicines for Children Research Network South West and ongoing PPI mapping work by the Respiratory Infections HIT (RuBICoN) and the Child Injury HIT (CIPIC) to ensure that BIG HIT has communication and engagement at its core.

Through existing PPI groups in partnership with health visitors and school nurses, we will develop communication interventions to tackle common misconceptions around immunisations.

Public and patient involvement will be monitored in order to ensure that opportunities for contributions are maximised.

Projects and activities

The team will undertake a number of projects based around the three work streams of technology and data, strengthening the provision of the immunisation programme and focusing on vulnerable areas in the programme.

These include:

  • Evaluate the adequacy and robustness of the child health database and other data sources, including developing a system to regularly validate data in this area
  • Evaluating and improving training for front line staff and immunisers
  • Assessing best practice in immunisation delivery and patient and public involvement
  • Develop, design and assess a school-based immunisation programme
  • Use data to identify and close gaps in the current programme, for example in demographic groups or GP practices
  • Evaluate the use of communications, including media and social media, in influencing uptake of immunisation and other health related education, and use this evidence to develop an effective communications programme


To find out more, please contact:

BIG at the HIT conference

BIG presented this poster (PDF) at the 2018 Bristol Health Partners Health Integration Team conference.

View the 2015 video