Children overdue for immunisation: a question of coverage or reporting? An audit of the Australian Immunisation Register.

OBJECTIVE: Vaccinations in Australia are reportable to the Australian Immunisation Register (AIR). Following major immunisation policy initiatives, the New South Wales (NSW) Public Health Network undertook an audit to estimate true immunisation coverage of NSW children at one year of age, and explore reasons associated with under-reporting. METHODS: Cross-sectional survey examining AIR immunisation records of a stratified random sample of 491 NSW children aged 12≤15 months at 30 September 2017 who were >30 days overdue for immunisation. Survey data were analysed using population weights. RESULTS: Estimated true coverage of fully vaccinated one-year-old children in NSW is 96.2% (CI:95.9-96.4), 2.1% higher than AIR reported coverage of 94.1%. Of the children reported as overdue on AIR, 34.9% (CI:30.9-38.9) were actually fully vaccinated. No significant association was found between under-reporting and socioeconomic status, rurality or reported local coverage level. Data errors in AIR uploading (at provider level) and duplicate records contributed to incorrect AIR coverage recording. CONCLUSIONS: Despite incentives to record childhood vaccinations on AIR, under-reporting continues to be an important contributor to underestimation of true coverage in NSW. Implications for public health: More reliable transmission of encounters to AIR at provider level and removal of duplicates would improve accuracy of reported coverage.

Adapting to Sydney's local government boundaries changes: a population health perspective.

The territory of a Local Health District (LHD) comprises multiple local government areas (LGAs). The recent amalgamation of several LGAs in metropolitan Sydney has resulted in two new LGAs being expanded across multiple LHDs, resulting in nonconcordance of boundaries. Here, we discuss the implications for planning health activities and service delivery, and ways to address them.

Responding to a measles outbreak in a Pacific island community in western Sydney: community interviews led to church-based immunization clinics.

INTRODUCTION: There are large Pacific island communities in western and south-western Sydney, New South Wales, Australia. In 2011 and 2012, measles outbreaks disproportionally affected children and youth within these communities. The objectives of this study were to explore barriers to immunization in a Pacific island community from the perspectives of community members and health professionals and to conduct a pilot programme whereby immunization catch-up clinics were held in a Samoan church in western Sydney. METHODS: Interviews were conducted with Pacific island community members (n = 12) and health professionals connected with the Pacific island community (n = 7) in 2013. A partnership with a local Samoan church was established to provide an accessible venue for immunization catch-up clinics. RESULTS: Among the community members there were high levels of belief in the importance of immunization and a positive view regarding the protection offered by immunization. A key barrier reported by community members was being busy and therefore having limited time to get children immunized. The important role of the church within the community was emphasized in the interviews, and as a result, two immunization catch-up clinics were held in a Samoan church in western Sydney. The age range of attendees was 7-33 years. A total of 31 measles, mumps and rubella doses and 19 meningococcal C doses were given during the two clinics. DISCUSSION: The outcomes of the interviews and the subsequent clinics highlighted the potential of churches as a venue for providing public health interventions such as catch-up immunization.