Immunisation: it’s not just for kids
Jun 2017 - Medicine Today; 18(6): 25-33 - News
In this article by Dr Lucy Deng, Ryan Macdougall, A/Prof. Kristine Macartney published in Medicine Today June 2017; 18(6): 25-33 the authors focus on the important, and sometimes overlooked, area of adult vaccination.
In an ageing population with a high burden of vaccine-preventable diseases, vaccines are equally as important in adults as they are in children. Although there are many potential barriers to adult vaccination, these can be addressed, and every healthcare provider should routinely review the immunisation status of their adult patients as part of health promotion.
- Adults may require vaccines for multiple reasons, including incomplete childhood schedules, waning immunity, medical and lifestyle risk factors, occupation-related risks, travel and migration.
- The majority of undervaccinated people in Australia (those who are eligible for vaccines under the National Immunisation Program but do not receive them) are adults.
- Vaccines are one of the key components to healthy ageing, given the high burden of vaccine-preventable diseases in the older population.
- More vaccines are becoming available and are recommended for the adult population, including zoster vaccine for adults aged 70 to 79 years.
- Barriers to the delivery of adult vaccinations include cost, lack of documentation of doses previously received and public misconceptions about the need for vaccination in adulthood.
- The ‘HALO’ (Health, Age, Lifestyle, Occupation) principle can be applied when assessing vaccine requirements for adults.
- The Australian Immunisation Register, introduced in 2016, aims to capture all immunisations across the lifespan of a person.
2015 Annual Immunisation Coverage Report
May 2017 - News
The latest NCIRS national Annual Immunisation Coverage Report is now available along with a summary PDF document of key findings and accompanying PDF slideset document containing all tables and figures from the report. View the report here
May 2017 - News
The following fact sheets have been updated and are now available on our factsheets webpage
Influenza vaccines for Australians [PDF – 573kB]
Vaccines for Australian adults [PDF – 309kB]
Meningococcal vaccines for Australians [PDF – 741kB]
2017 Influenza vaccine safety confirmed by Australian-first vaccine safety surveillance system
May 2017 - News
AusVaxSafety introduces active safety surveillance of vaccines across the country to provide real-time monitoring, and boost confidence in immunisation
For immediate release May 19, 2017: New data released by the AusVaxSafety program have shown the 2017 Influenza vaccines to be safe, with no significant, unexpected or unusual reactions experienced by the close to 40,000 adults and children who have been vaccinated and participated in the program to date. It is now flu season and this system tells us the vaccines available this year are safe.
The results of a recent poll of Australian parents found that almost nine in ten parents (88 per cent) are unsure about the safety of the flu vaccine. (source: https://www.childhealthpoll.org.au/polls/flu-vaccination-perspectives-of-australian-parents/). Our data, straight from parents, whose children have been vaccinated, tells us the 2017 Influenza vaccines are safe.
For the first time in Australia, AusVaxSafety (www.ausvaxsafety.org.au), a ground-breaking national vaccine surveillance system, is now monitoring, in real-time, the effects of vaccines on Australians of all ages in over 150 ‘sentinel’ sites across the country. These include general practices (GPs), aboriginal medical services, immunisation clinics and hospital clinics. Led by the National Centre for Immunisation Research and Surveillance (NCIRS), this cutting-edge system actively monitors vaccine safety and aims to increase public confidence in immunisation.
The AusVaxSafety system utilises de-identified information provided directly by the people who receive the vaccines (or their parent or carer). The majority of responses are sought via an SMS sent from the patient’s immunisation clinic or GP using the automated SmartVax or Vaxtracker software at around 3 days after a vaccination. This form of active vaccine safety surveillance has not been implemented on this scale in Australia or internationally before.
The Deputy Director of NCIRS and paediatric infectious disease consultant, Associate Professor Kristine Macartney has said “Influenza is a serious disease in people of all ages and is the leading cause of hospitalisation due to a vaccine-preventable disease in Australian children under five years. The Australian government recommends everyone from six months old be vaccinated against influenza.”
“This robust vaccine safety surveillance mechanism is an active way of making sure vaccines perform as safely as we expect them to, and also serves as an early warning system for any unexpected outcomes. We are delighted to see such positive and encouraging feedback about AusVaxSafety. On average, we have a 70% response rate within three to four days of sending an SMS which is fantastic to see.” she added.
“Vaccine-preventable diseases can impact us all, resulting in numerous doctor's visits, hospitalisations and premature deaths. With AusVaxSafety now established, the community can feel confident that an active system is in place to monitor vaccines” said Karen Orr, Clinical Nurse Consultant specialising in immunisation and paediatrics at The Children’s Hospital Westmead in Sydney.
About AusVaxSafety: Funded by the Australian Government Department of Health, AusVaxSafety is a unique system that uses patient feedback to investigate vaccine safety. All adverse events can be reported, including those not necessarily caused by the vaccine. If any serious or unexpected adverse events arise, effective and rapid follow-up of the patient can occur, either via their own doctor or immunisation specialists.
Hospitals, General Practitioners, Aboriginal Medical Services, and immunisation clinics around the country are now able to install SmartVax and Vaxtracker which are free and use automated SMS technology to send patients or parents a brief survey following vaccination. The surveillance system also retrieves data from STARSS, a study evaluating the use of different follow-up methods.
Data is received on all vaccines given in the clinics; however, AusVaxSafety surveillance is currently focusing analysis on the following vaccines and age groups:
- Influenza vaccine in all ages during April-October
- Pertussis (whooping cough)-containing booster vaccines in children
- Zoster (shingles) vaccine in adults, particularly those aged 70-79 years
Analysis of all de-identified patient responses occurs frequently and is reviewed by AusVaxSafety vaccine experts, the Therapeutic Goods Administration (TGA) and the Department of Health each week. As well as the influenza vaccine showing a good profile, zoster and pertussis vaccines are tracking as expected, with a low rate of side effects.
For more information on AusVaxSafety, please visit www.ausvaxsafety.org.au
About NCIRS: The National Centre for Immunisation Research and Surveillance of Vaccine Preventable Diseases (NCIRS) is the leading organisation in Australia working in research to support evidence-based policy development for evaluation of the National Immunisation Program, and surveillance of vaccine preventable diseases, vaccine coverage and vaccine safety. This work is funded through agreements with the Australian Government Department of Health. www.ncirs.edu.au
Ms Leonie Leonard 02 9845 3364
(Public Relations Department Children's Hospital at Westmead
No Jab, No Pay and vaccine refusal in Australia: the jury is out
May 2017 - News
In a recent article in the Medical Journal of Australia, NCIRS experts have argued that, as Australian policies requiring documented receipt of all National Immunisation Program (NIP) vaccines to qualify for benefits (No Jab No Pay – federal) and to attend childcare or pre-school (No Jab No Play – state) are unique internationally, it is important to fully evaluate their impact.
Australian national childhood immunisation rates have remained at or over 90% for more than 15 years, and currently sit at 93%. Achieving an immunisation rate as close as possible to 100% is an important goal, and will maximise the benefits of vaccines to individuals and the community. However, parents actively refusing vaccines (refusers) are less numerous among the “last 7%” than families having difficulty accessing healthcare services, and it is important to realise even 100% child immunisation won’t prevent all cases, especially for whooping cough, write Professor Peter McIntyre and co-authors Dr Frank Beard and Associate Professor Julie Leask, of NCIRS and University of Sydney.
In the article titled 'No Jab, No Pay and vaccine refusal in Australia: the jury is out', Professor McIntyre and co-authors say "evaluation should focus on identifying differential effects on vaccine uptake, as well as any unintended adverse consequences" for children (such as children of vaccine-refusing parents) and parents affected by access or logistic issues. They go on to say the Victorian No Jab, No Play legislation, for example, requires full immunisation for attendance at childcare centres, unless the child has an approved medical exemption or is on a recognised catch-up schedule. The likely unintended adverse impacts of this highly restrictive Victorian legislation include reduced access to important early childhood education.
The authors argue that Australia’s vaccination rates are “relatively high and at least comparable with similar developed countries” and vaccine objection in 2013 was about 3% – the same as in 2001. They go on to say “Vaccine refusal is only one of a range of factors relevant to further improvements in vaccine coverage and disease control. The greatest yield is likely to come from first implementing measures already shown to be effective in improving accessibility and minimising logistic barriers to vaccination, and second, from well structured research and evaluation of new interventions [such as No Jab, No Pay, and No Jab, No Play] to overcome vaccine refusal and hesitancy.”
NSW Doctor Article - Advances in vaccination safety
May 2017 - News
Australia’s landmark system to monitor adverse reactions is increasing patients’ confidence in the safety of vaccines
Click here to read the article
AusVaxSafety, which actively monitors the safety of vaccines using SMS-feedback and email from recently vaccinated children and adults, is helping to ensure public confidence in taking up vaccination.
AusVaxSafety is a collaborative initiative led by the National Centre for Immunisation Research & Surveillance (NCIRS) and funded by the Australian Government Department of Health.
Currently established in 130 sentinel immunisation providers across all States and Territories, AusVaxSafety will expand to more than 200 sites in 2017. General practices, hospital and community-based clinics, and Aboriginal Medical Services are participant partners.
The idea for the monitoring system was sparked in 2010, after a number of children suffered fever and febrile convulsions after receiving one brand of the flu vaccine (Fluvax and Fluvax Junior). There have been no safety concerns with the use of other brands of flu vaccine in children.
Despite withdrawing that brand of vaccine, many parents lost confidence in the flu vaccination. Research conducted by Professor Christopher Blyth of the Telethon Kids Institute revealed that in WA, vaccine uptake was substantially reduced in the following two years.
These reactions prompted different groups across the country to develop a way to monitor adverse reactions to vaccinations, particularly in children.
Traditionally, it’s been left up to parents (or patients themselves) to report adverse reactions to a vaccination to their GP. This passive reporting system then relied on GPs to make a report to the Therapeutic Goods Administration (TGA).
In light of the events of 2010, several medical professionals identified the need for a more proactive reporting system that recorded how vaccination was performing across the population in real-time.
Dr Alan Leeb, a GP in Western Australia, set up a system called SmartVax that uses text messaging and clinical data extracted from existing medical practice management software to actively contact patients who have received a vaccination, to enquire whether they had experienced any adverse reactions.
Meanwhile Professor Mike Gold set up another active monitoring system in South Australia, and a similar system called Vaxtracker was established in NSW by Professor David Durrheim.
Recognising the value in monitoring vaccine safety, the Australian Government called for tenders to conduct surveillance of influenza vaccination in children aged under five for the next three years.
NCIRS won the tender. Now, using SmartVax as the main data collection tool in general practice, AusVaxSafety receives and analyses de-identified data from all States and Territories and reports this to the Department of Health and TGA. AusVaxSafety currently monitors the safety of influenza vaccine in all ages (during the influenza season), pertussis vaccines in toddlers and young children, and zoster vaccine in adults.
SmartVax is a software program, designed to actively monitor the safety of all vaccines given in general practice and vaccination clinics via SMS and smartphone technology. When a practice uses SmartVax, an automated text message is sent to patients three days after their vaccination asking whether they experienced a reaction. Patients who respond ‘yes’ are sent a question about the severity of the reaction, and a survey. Many States and Territories offer specialist vaccine adverse events clinics for patients who experience a reaction. Patients who experience a significant reaction can be referred by their GP to specialist vaccine adverse events clinics. For more information, contact the NSW Immunisation Specialist Service (NSWISS) on 1800 679 477.
SmartVax is completely free for practices. It is fully automated, and integrates with existing patient management systems. To get your practice involved, contact SmartVax via the website or by emailing firstname.lastname@example.org.
According to the NCIRS, “Patients respond extremely well to SmartVax and participation rates are high. As well as informing national vaccine safety monitoring, the use of SmartVax in practices helps GPs with their duty of care following vaccination.”
NCIRS provides reports regularly to the Department of Health, TGA and vaccine safety experts and clinicians throughout Australia. Any safety concerns are reviewed by the NCIRS Expert Leadership Group, and there are mechanisms in place to follow-up safety concerns through more detailed data analysis and clinical follow-up of patients.
Dealing with requests for vaccination exemption
May 2017 - News
There are few valid reasons to sign an Immunisation Medical Exemption form. It is important that general practitioners (GPs) understand what these are, and how to manage common vaccine concerns that may contribute to exemption requests.
'To sign or not to sign: dealing with requests for vaccination exemption' written by Dr Frank Beard and Dr Nicholas Wood of NCIRS and published in Medicine Today (April 2017) is a guide for GPs on what the true medical contraindications are and what constitutes adequate evidence of natural immunity. It is also offers practice points on how to recognise and manage common concerns, including those about adverse events after vaccination, that may contribute to parents’ requests for completion of exemption forms.
Updated NCIRS meningococcal disease fact sheet
Apr 2017 - News
Thanks to all those who attended the Controlling Meningococcal Disease in 2017 symposium last Friday (7 April 2017). It was fantastic to be able to hear from so many leading clinicians, researchers and public health authorities about meningococcal disease and vaccination programs in Australia, New Zealand and the United Kingdom.
Following our meningococcal symposium, we've updated our meningococcal disease fact sheet, Meningococcal vaccines for Australians: Information for immunisation providers.
The full list of NCIRS fact sheets can be viewed on our fact sheets page.
Congratulations to NCIRS Public Health Physician, Dr Anastasia Phillips, recipient of the 2016 Australasian Faculty of Public Health Medicine (AFPHM) Sue Morey Medal
Apr 2017 - News
NCIRS would like to congratulate Dr Anastasia Phillips, recipient of the 2016 Australasian Faculty of Public Health Medicine (AFPHM) Sue Morey Medal. The AFPHM Sue Morey Medal is awarded to the trainee who has achieved the highest mark in the AFPHM Oral Examination.
Dr Phillips completed the AFPHM Public Health Medicine Advanced Training Program in 2016 while working at NCIRS. She continues to work at the Centre, predominantly in vaccine safety surveillance, and is a PhD Candidate with the University of Sydney. Dr Phillips also holds an academic appointment as Clinical Associate Lecturer with the School of Public Health, University of Sydney.
Is there a test your child can take before getting vaccinated, as Pauline Hanson said?
Mar 2017 - News
In this article published in The Conversation, Associate Professor Kristine Macartney (NCIRS), Associate Professor Nicholas Wood (NCIRS) and Associate Professor Julie Leask (University of Sydney) address the comments made by Senator Hanson in a recent interview on Insiders. Senator Hanson commented that people should have a test to see if they have a reaction to a vaccine before they are vaccinated. These experts in infectious diseases and immunisation state "Immunisation programs prevent millions of deaths worldwide each year. Vaccine safety monitoring – what experts call vaccine pharmacovigilance – as well as many other checks and balances before and after vaccines registration, ensure that vaccines have a minimal risk of causing harm. There is no blood test to see if vaccines shouldn’t be given. In fact, the best 'test' for deciding if a vaccine is appropriate is taking a good old medical history."
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