Program evaluation is essential to understand the success and challenge associated with the implementation of a vaccination program and the impact of the program on disease burden.

Since 2006, NCIRS has been contracted by the Australian Government Department of Health to evaluate the introduction of vaccines on the National Immunisation Program (NIP). Although scope and timeline varies with each vaccination program, each evaluation includes the following main components:

  • Process evaluation

  • Impact evaluation

  • Vaccination coverage

  • Seroepidemiology

  • Vaccine safety

  • Disease burden

Process evaluation

Process evaluation is done to understand how a program was conducted. Evaluating the process of program planning, implementation and delivery provides contextual information to help interpret other components of the evaluation. NIP process evaluations use tools such as semi-structured interviews with key stakeholders, online surveys of immunisation providers, computer-assisted telephone interviews of consumers and review of key policy, operational and promotion/communication documents to:

  • describe how the program was planned and delivered, including communication strategies

  • identify the strengths and challenges of the implementation approaches taken.

  • develop ideas to enhance the implementation of future national vaccination programs.

Impact evaluation

Impact evaluation involves description and assessment of relevant data on disease burden, vaccine coverage, seroepidemiology and vaccine safety. This may include data from the National Notifiable Diseases Surveillance System, National Hospital Morbidity Database, the Adverse Events Management Database, Australian Immunisation Register, Australian Coordinating Registry (for deaths) and national serosurveillance data. 

Vaccination coverage

This involves estimation of the uptake of vaccine in targeted age groups.

Seroepidemiology

This involves identification of changes in population seroepidemiology through the Australian national serosurvey program. Inclusion of seroepidemiology in NIP evaluations varies depending on the disease.

Vaccine safety

This involves description and assessment of adverse events following immunisation for a particular vaccine.

Disease burden

This involves evaluation of the impact of the vaccination program on disease. Core components include:

  • calculation of vaccine effectiveness and identification of vaccine failures

  • assessment of changes in disease notification, hospitalisation and mortality rates

  • identification of changes in the epidemiology of a disease over time, including overall incidence, age-specific and regional-specific incidence, as well as serotype/serogroup-specific and Indigenous-specific incidence, if appropriate.

Program evaluation cannot be conducted by NCIRS in isolation. It requires extensive collaboration and consultation with a broad range of stakeholders, including the Australian Government Department of Health, Communicable Diseases Network Australia, National Immunisation Committee,  Australian Government Department of Human Services, Australian Institute of Health and Welfare, Therapeutic Goods Administration, the National Aboriginal Community Controlled Health Organisation, Primary Health Networks, state/territory health departments and others.

NIP evaluations conducted by NCIRS

Haemophilus influenzae type b

  • Introduction of the Haemophilus influenzae type b-meningococcal C (Hib-MenC) vaccine on the National Immunisation Program – completed in 2016

Hepatitis A

  • Hepatitis A immunisation program for Aboriginal and Torres Strait Islander Children in the Northern Territory, Queensland, South Australia and Western Australia – completed in 2015 [Final report] [Related paper]

Human papillomavirus (HPV)

  • National HPV Vaccination Program – completed in 2014 [Final report]

Influenza

  • Influenza immunisation program for Aboriginal and Torres Strait Islander children aged 6 months to <5 years – completed in 2018 [Final report]

    Measles

    • National Measles Control Campaign, 1998 – completed in 2000 [Report] [Related paper]

    • Young Adult Measles, Mumps and Rubella (MMR) Campaign, 2001 – completed in 2003 [Related paper]

    • Introduction of measles-mumps-rubella-varicella (MMRV) vaccine on the National Immunisation Program – completed in 2016

    Meningococcal 

    • Meningococcal C Program, 2003–2006 (Parts 1 and 2) – completed in 2007

    Pertussis

    •  Adolescent Pertussis Immunisation Program – completed in 2009 [Related paper]

    Pneumococcal

    • National Indigenous Pneumococcal and Influenza Immunisation (NIPII) Program – completed in 2004

    • National Older Australians Adult Pneumococcal Immunisation Program – [Final report]

    • National Childhood Pneumococcal Immunisation Program – completed in 2009

    • Introduction of 13vPCV on the National Immunisation Program – completed in 2015

      Q fever

      • National Q Fever Management Program, 2001–2003 – completed in 2004 [Related paper]

      Rotavirus

      School-based vaccination

      • Review of school-based vaccination in Australia – completed in 2011 [Related paper]

      Varicella-Zoster

      • National Shingles Vaccination Program: process and early impact evaluation – completed in 2018

      • National Varicella Vaccination Program – completed in 2011 [Related paper] [Related paper]

      Other immunisation program evaluations conducted by NCIRS

      • Implementation of the 13-valent pneumococcal vaccine supplementary dose program on the New South Wales North Coast – completed in 2012 [Related paper]

      • Effectiveness of the New South Wales pertussis vaccine ‘cocooning’ strategy – completed in 2013 [Related paper]

      • New South Wales Aboriginal Immunisation Healthcare Worker Program – Stage 1 – completed in 2015 [Final report]

      • BCG vaccination programs in Australia – completed in 2016 [Final report]

      • New South Wales Aboriginal Immunisation Health Care Worker Program – Stage 2 – completed in 2017 [Final report]

      • NSW Meningococcal W Response Program– completed in 2018 

       

      Last updated December 2018