Immunisation Program Evaluations
Program evaluation is essential in order to understand the successes and challenges with program implementation and the impact of vaccination programs on disease burden.
Since 2006, NCIRS has been contracted by the Australian Government Department of Health to evaluate the introduction of vaccines onto the National Immunisation Program. The scope and timeline involved varies with each vaccination program, though each evaluation includes the following main components:
Process evaluations are undertaken to understand how a program was conducted. Evaluating the process of program planning, implementation and delivery provides contextual information to assist in interpreting the other components of the evaluation (see below). National vaccination program process evaluations mainly consist of semi-structured interviews with key stakeholders and review of key policy, operational and promotion/communication documents in order 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.
Data collection systems
A description and assessment of the surveillance systems used to monitor and evaluate the disease burden, coverage, seroepidemiology and vaccine safety. These may include the National Notifiable Diseases Surveillance System, the National Hospital Morbidity Database, the Adverse Drug Reaction System database, Australian Childhood Immunisation Register and national serosurveillance data.
Estimating the uptake of vaccine in targeted age group(s).
Identification of changes in population seroepidemiology through the Australian national serosurvey program. Inclusion of this in national immunisation program evaluations may vary depending on the disease.
A description and assessment of the adverse events following immunisation for a particular vaccine.
This section evaluates the direct effect of the vaccination program on disease. Core components are:
- Calculation of vaccine effectiveness and identification of vaccine failures.
- An assessment of the changes in disease notification, hospitalisation and mortality rates.
- Identification of the changes in the epidemiology of the 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 expert groups, 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 peak body, Primary Health Networks, state/territory health departments and others.
National Immunisation Program evaluations conducted by NCIRS
- Evaluation of the National Measles Control Campaign, 1998 – completed in 2000 [Report] [Related paper]
- Evaluation of the Young Adult Measles, Mumps and Rubella (MMR) Campaign, 2001 – completed in 2003 [Related paper]
- Evaluation of the National Indigenous Pneumococcal and Influenza Immunisation (NIPII) Program – completed in 2004
- Evaluation of the National Q fever Management Program, 2001–2003 – completed in 2004 [Related paper]
- Evaluation of the Meningococcal C Program, 2003–2006 (Parts 1 and 2) – completed in 2007
- Evaluation of the Adolescent Pertussis Immunisation Program – completed in 2009 [Related paper]
- Evaluation of the National Older Australians Adult Pneumococcal Immunisation Program – completed in 2009
- Evaluation of the National Childhood Pneumococcal Immunisation Program – completed in 2009
- Evaluation of the National Rotavirus Vaccination Program – completed in 2010 [Related paper]
- Evaluation of the National Varicella Vaccination Program – completed in 2011 [Related paper] [Related paper]
- Review of school-based vaccination in Australia – completed in 2011 [Related paper]
- Evaluation of the National HPV Vaccination Program – completed in 2014 [Final report]
- Evaluation of the introduction of 13vPCV on the National Immunisation Program – completed in 2015
- Evaluation of the 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]
- Evaluation of the introduction of measles-mumps-rubella-varicella (MMRV) vaccine on the National Immunisation Program – in progress
- Evaluation of the introduction of the Haemophilus influenzae type b-meningococcal C (HibMenC) vaccine on the National Immunisation Program – in progress
- Evaluation of the Influenza Immunisation Program for Aboriginal and Torres Strait Islander Children aged 6 months to <5 years – in progress
Other Immunisation Program evaluations conducted by NCIRS
- Evaluation of the implementation of the 13-valent pneumococcal vaccine supplementary dose program on the New South Wales North Coast – completed in 2012 [Related paper]
- Evaluation of the effectiveness of the New South Wales pertussis vaccine ‘cocooning’ strategy – completed in 2013 [Related paper]
- Evaluation of the New South Wales Aboriginal Immunisation Healthcare Worker Program – completed in 2015 [Final report]
- Evaluation of BCG vaccination programs in Australia – in progress