Department of Health – Immunisation Update

November 2014

Michael BatchelorManager, ImmunisationHealth Protection Branch

Australian Childhood Immunisation Register (ACIR) coverage data Victoria, 30 September 2014

Age in months Total State

coverage

State

Indigenous

Total Australia

coverage

Vic Ranking

12 - <15 91.7% 88.6% 91.5% 3

24 - <27 93.3% 93.9% 92.8% 3

60 - <63 (5 years) 92.6% 92.2% 92.2% 3

72 - <75 (6 years) 94.1% 95.8% 93.5% 2

Provider split

GP 56%

Local council 42% Other 2%

From 31 December 2013, cohort

1 coverage assessment includes

Pneumococcal dose 3 for ‘fully

immunised’

Vic Aboriginal population coverage compared to total Vic population coverage 12>-15 months (2009-13)

Vic Aboriginal population coverage compared to total Vic population coverage 24>-27 months (2009-13)

Vic Aboriginal population coverage compared to total Vic population coverage 60>-63 months (2009-13)

Improving Childhood Coverage

State coverage for Cohort 1 in March 2014 fell below 90% for the first time since March 2000

Minister for Health sets a new childhood coverage target of 95%.

What is being done?•School entry immunisation status certificate (SEIC)

• Evaluation of barriers to presenting SEIC• Strategies with education sectors to improve presentation

•Working group forum – 2 October 2014• To identify barriers to increasing immunisation coverage in the Victorian

Childhood immunisation program.• Brainstormed issues, analysed and prioritised strategies to improve coverage

to Ministerial target of 95% for childhood coverage•Action Plan for the Minister

• AHA delivered final report October 2014

Findings covered : Data review & analysis, scan of school websites, interviews with key stakeholders, school staff, parents/guardians & immunisation providers. Synthesis and presentation of key findings.

Recommendations & conclusions:

• Wider promotion of effective key messages

• Development of a toolkit of resources for schools

• Audit tool & exclusion plan template

• Consider other options for transfer of information (schools accessing ACIR)

Report of ‘Barriers to presentation of SEIC’

2008-13 comparison of state-wide immunisation coverage: Childhood and adolescent programs

91%93%93%

76%

70%

78%

50%

55%

60%

65%

70%

75%

80%

85%

90%

95%

100%

2008 2009 2010 2011 2012 2013

Child Cohort 1Child Cohort 2Child Cohort 3Year 10 dTpa

Year 7 HPVYear 7 Varicella

~ 20% gap

The Victorian Regional Immunisation Initiatives

Resource Development

Development of consistent models of

practice

Education provision Capacity building

Goal

To increase immunisation participation and coverage rates amongst Victorian adolescents

Objectives

Raise awareness (providers, students, parents, teachers)

Build capacity amongst immunisation providers to enhance service delivery

Improve delivery of school-based immunisation program (providers, schools)

Improve access for hard-to-reach adolescent communities

3 changes to 2015 school vaccine program

1. Changes to the PHWA Regulations• Principals are authorised to release student/parent contact details to

councils

2. dTpa moving to Year 7 only from 2016; Year 7,8,9 &10 to be immunised in 2015• Letter to CEOs/MAV for support sent March & April 2014• Letter to education sectors for support sent March 2014• Emails to all councils with CEO letters attached May 2014• Upfront administrative bonus payment in July 2014

3. Cease Year 9 HPV boys • Time limited program for Year 9 (14-15 boys) ends 31 December 2014• No catch-up program in 2015

Communication to councils

•Factsheet: ‘Changes to the 2015 secondary school vaccine program’

AND

•School Implementation Kit

•emailed to all councils mid August 2014

•Instructions and training for collection of data from schools & upload to ImPS 30/31 October 2014

•Cc’d to Regions

Communication to schools

School Implementation Kit• CHO/PMA letter to principals

• Factsheet: ‘Three big changes to the vaccine program in 2015’

• Newsletter inserts

• Collection statement for parents

• emailed to all secondary schools 2 September 2014 (incl. home-school/distance ed.

• Instructions for data extraction / transfer late 2014

Immune Hero – School Extract Tool

Adolescent poster

VRHN: Needs analysis of immunisation in refugee and asylum seeker communities

Determine issues regarding access to vaccines, catch-up immunisation programs and service delivery for people of refugee background in Vic

• Final report July 2014 highlighted– public health significance due to pre and post arrival risk factors– eligibility and access to funded vaccine– service delivery and access to immunisation services

• Key recommendations– Secure funding for vaccines to comprehensively provide catch-up

schedule– Pilot improved service delivery models – local council program in ELS– Improve surveillance data for immunisation register and coverage for

refugee and asylum seeker populations– Improve/develop resources for community– Improve strategies for personal vaccine record use– Increase capacity of providers (guidelines, training, clinical practice)

• Next step… DH consideration and funding determined

1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 YTD

0

20

40

60

80

100

120

Notified cases of measles by year, Victoria, 1 Jan 1997 to 30 Sept 2014

Year of notification

Num

ber o

f noti

fied

case

s

Jan

97Ma

y 97

Sep

97Ja

n 98

May

98Se

p 98

Jan

99Ma

y 99

Sep

99Ja

n 00

May

00Se

p 00

Jan

01Ma

y 01

Sep

01Ja

n 02

May

02Se

p 02

Jan

03Ma

y 03

Sep

03Ja

n 04

May

04Se

p 04

Jan

05Ma

y 05

Sep

05Ja

n 06

May

06Se

p 06

Jan

07Ma

y 07

Sep

07Ja

n 08

May

08Se

p 08

Jan

09Ma

y 09

Sep

09Ja

n 10

May

10Se

p 10

Jan

11Ma

y 11

Sep

11Ja

n 12

May

12Se

p 12

Jan

13Ma

y 13

Sep

13Ja

n 14

May

14Se

p 14

0

200

400

600

800

1000

1200

Notified cases of pertussis by month and age group, Victoria, 1 January 1997 to 30 Sept 2014

25+18 to <2515 to <185 to <151 to <5<1

Month of notification

Num

ber o

f not

ified

cas

es

Other bits and pieces

• PBAC November 2014 meeting – considered submissions for Zostavax® (cohort of 70 year olds, with a proposed catch up for 71-79 year olds) and Infanrix® (booster dose of pertussis on the NIP for children aged 18 months of age). Outcomes made available on 19 December 2014

• NIP schedule to include annual trivalent influenza vaccine for all Aboriginal and Torres Strait Islander children aged 6 months to 5 years

• 2 strain changes to 2015 seasonal influenza vaccine – may lead to a late start

• New NPA on Essential Vaccines

• Review of HPV Register

• Review of Guidelines for immunisation education for nurses and midwives

29 November…..who knows

Questions?

Immunisation Section

T: 1300 882 008 M - F 9am – Noon and 2pm - 3pm

E: immunisation@health.vic.gov.au

W: www.health.vic.gov.au/immunisation