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2017 Immunisation Coverage and 2018 AIR Data Transfer Study Reports

Two new reports released by the National Centre for Immunisation Research and Surveillance (NCIRS) shine a bright new light on immunisation coverage in Australia.

Detailed analysis in the NCIRS 2017 Immunisation Coverage Report shows that vaccine coverage in Australia is climbing to new highs. The proportion of children fully immunised in Australia reached 94.5% at 60 months of age and 93.8% at 12 months of age in December 2017.

The proportion of Aboriginal and Torres Strait Islander children fully immunised also reached the highest ever recorded levels of 96.9% at 60 months of age and 93.2% at 12 months of age. Levels of on-time vaccination – within 30 days of recommended age – increased for all children in 2017, although delayed vaccination remained higher among Aboriginal and Torres Strait Islander children.

NCIRS also found that in 2017 more than 20,000 adolescents aged 10–19 years caught up on their second dose of measles-mumps-rubella (MMR) vaccine. A much higher proportion of overdue Aboriginal and Torres Strait Islander adolescents got this dose than non-Indigenous adolescents (20.3% versus 6.4%). “This catch-up vaccination activity is very important. While Australia has eliminated local measles transmission, outbreaks related to infected overseas travellers continue and we need high coverage to prevent these spreading,” said Dr Frank Beard, Public Health Physician at NCIRS. “Many of these catch-up doses given are likely a result of the Australian government’s No Jab No Pay policy, and associated efforts to support vaccination delivery at the coalface”.

Summary data released by Health Minister The Hon. Greg Hunt earlier this year confirmed that this upward trend has continued into 2018.

A second important report – the NCIRS Australian Immunisation Register (AIR) Data Transfer Study Report – is the first since 2001 to systematically audit the accuracy of children’s immunisation records held on the AIR at a national level. “Accuracy of data in this world-class register is important for many reasons, including that it is the source of information for immunisation requirements linked to Australian government family assistance payments and childcare subsidy and enrolment.” Dr Beard said.

The report found that 86% of 905 children, randomly selected from the AIR as overdue for specific vaccines at 1, 2 and 5 years of age, were truly overdue and needed catch-up doses. However, 14% of children listed as overdue were actually up-to-date, with the AIR record being incorrect. The most common reason for errors was found to be failure of transfer of vaccination information from practice management software to the AIR, due to either human or systems error. “Our study findings suggest that true vaccine coverage levels in Australia could actually be close to or even higher than the 95% national target,” Dr Beard said.

The proportion of inaccurate records varied from 3% in Victoria to 29% in New South Wales. “The higher accuracy of data in Victoria could be due to the strict No Jab No Play legislative requirements for enrolment in childcare in that state,” added Dr Beard. “It is important that such policies be evaluated to better understand their full impact.”

“While our study shows that information in the AIR is largely accurate, it is important to reduce inaccuracies as much as possible,” said Professor Kristine Macartney, Director of NCIRS and senior author on the report. “Considerable work continues to go into improving functionality of the AIR for users and to ensure accuracy of the data, but ultimately the AIR is only as accurate and complete as the information submitted by immunisation providers. We’ve worked collaboratively in this report to unpick where further work is needed to guide system improvements in data entry and transfer from practice management software, and to enhance support to immunisation providers.”