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In addition, unprotected individuals travelling to countries where infectious diseases remain prevalent may be at risk of acquiring infection and subsequently importing it into the UK, and are vulnerable to infection acquired from unprotected family members visiting the UK from such countries. Low uptake of immunisations makes individuals living in these ethnically dense areas more vulnerable to disease.
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Individuals from some BAME backgrounds live in areas with high concentrations of individuals from their own ethnic group, 13–15 particularly in cities. 4–12 While herd immunity will benefit the general population, where subpopulations live apart from the general population they may not be protected if they remain unimmunised. While overall coverage of immunisations in the UK is very good, 2, 3 there is evidence that uptake of some immunisations is lower among individuals from some Black and Asian Minority Ethnic (BAME) backgrounds.
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High uptake is crucial to the success of the programme, providing direct protection to vaccinated individuals and, if a sufficiently high proportion of the population is immunised, indirect protection to the unimmunised through herd immunity. 1 Additional vaccines (such as BCG) are offered selectively from birth to high-risk individuals. In the UK, the routine childhood programme offers immunisation against 17 diseases, starting when the infant is 2 months old.