Progress Report Three

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Department of Health Meningococcal ACWY Immunisation Program

Progress Report Three

22 October 2018

Highlights

  • In a short timeframe (11 weeks), this is a good news story with the number of people vaccinated to date having exceeded expectations.
  • This has been achieved because of the cooperative effort, and commitment to protecting the health of Tasmanians - not only by General Practice, Local Government, Pharmacists, and the Tasmanian Government – but also by the children and their parents who have supported the program by presenting for immunisation.
  • Including the state-funded 15 to 19 year old meningococcal immunisation program, a total of 87 042 (66%) Tasmanians in the eligible cohort have been recorded on the Australian Immunisation Register (AIR) as immunised since 1 January 2017.
  • To 30 October 2018, PHS has distributed 90 685 doses of vaccine.
  • Overall state-wide, the proportion of the eligible cohort that has been immunised lies between 66% and 79%. It is important for us to maintain momentum.
  • In the area included in the Urgent Response to the community outbreak (Hobart’s northern suburbs); 82% of the eligible cohort have been immunised.
  • The proportion of the eligible cohort immunised varies by region and age group.
  • Seventy four percent of the eligible cohort have been immunised in the South,   61% in the North and 53% in the North West.
  • Across Tasmania the vaccination in each age group is as follows:
  • Age group

    Vaccination rate

    0-2

    74%

    2-4

    73%

    5-9

    68%

    10-14

    70%

    15

    94%

    16

    84%

    17

    67%

    18

    55%

    19

    39%

    20

    31%

  • Vaccine ordering and distribution was very high initially in the South and has started to plateau as a significant proportion of the eligible cohort have received vaccine. Distribution continues to be relatively strong to the North. In the North West, although slower initially, ordering and therefore demand is continuing strongly.

Targeted immunisation responses undertaken

South

Community outbreak area: Hobart’s northern suburbs

The Department of Health held four public immunisation clinics at the Derwent Entertainment Centre (4, 5, 18, 19 August 2018) delivering 7 458 immunisations (recorded on the AIR).

The Department of Health conducted a school-based program in Hobart’s northern suburbs. All 33 schools were visited and 1 637 children were vaccinated (12% of all students enrolled).

UTas residential college students

The Department of Health held a clinic in Hobart to immunise residential college students on Friday 12 October: 53 students were immunised. Public clinics in Launceston and Burnie were heavily promoted to UTas students in residential colleges in those cities.

Southern Midlands Council

The Department of Health supported the Environmental Health Officer to provide meningococcal ACWY vaccine to the four schools in the area: 100 children were immunised.

North

The Department of Health held a public immunisation clinic in Launceston (6 October 2018). Just under 700 people were vaccinated on the day (608 thus far reported on AIR).

Where to from here?

The immunisation program will continue into the new year. Specifically there will be an increased focus on supporting and improving coverage in the North West. At this stage of the program it becomes more difficult to translate the public’s knowledge and awareness of the program into action (receiving the vaccine).

Statewide

Continue the communications campaign, meetings with relevant stakeholders to gain on-the-ground insights, and provide support to general practice, pharmacists and councils. Although, uptake has been slower in the North and North West, data suggests demand is still strong and vaccine is being administered.

North West

The Department of Health will hold public immunisation clinics in Burnie (20 October) and Devonport (27 October).

In collaboration with the RACGP, local GPs with long wait lists for vaccine will be identified and in-kind support provided.

West Coast

The Department of Health is providing support to the Environmental Health Officers in the Burnie City Council to provide vaccine through a school-based program to schools on the West Coast. This is planned for early December.

Process notes:

  1. Data were extracted from the AIR on 17 October 2018 using five separate versions of the 11A report for different age groups.
  2. Year of service, age (at date of service) and age group fields were created. Locality data was mapped across to SA2 and SA3 according to ABS mapping.
  3. Data were imported into ACCESS and de-duplicated using the Surname, First name, DOB, Gender and Date of service fields. A second de duplication was then completed for remaining records with matching Surname, First name, DOB and Gender. Duplicates and removed from the dataset.
  4. SA2 data were used from the ABS as denominators for population level calculations. As five year age groups are used all 0-19 year age group population data were used and the 20-24 age group was divided by 5, with the resulting number added to the SA2 totals, as an estimate of the 20yo population.

Data

  • Data come from several sources, including the Australian Immunisation Register (AIR) and Public Health Services’ (PHS) records of the distribution of vaccine.
  • AIR is maintained by the Australian Government. It is a database of immunisation records submitted by healthcare providers. It is a relatively new system, and using it to monitor this Program necessitates downloads and local manipulations of raw data. The process of data being submitted to AIR and then downloaded, cleaned and analysed means there may be long delays between an immunisation encounter and the data being reportable. This process and incomplete or delayed reporting of immunisations, mean that the data represent an underestimate of current immunisation coverage.

Data Caveats:

  1. Limitations on AIR data:
    1. During the deduplication process, for consistency, priority is placed on the date of vaccination, with the most recent being included where a person has multiple quadrivalent meningococcal vaccinations recorded. If records have different locality or provider, only the information associated with the most recent record will be included.
    2. Addresses in the AIR may not be up to date and could be incorrectly recorded as elsewhere within the state or interstate. Those with an interstate address will not be included in this dataset.
  2. There were a small number of individuals that took their consent forms with them from the DEC clinics and were not entered into AIR. As such they are not part of this dataset.
  3. Some issues have been identified during uploading of school based program data into the AIR and as such, these data represent an underestimate of the total coverage during 2017/2018.
  4. Australian Bureau of Statistics population data cubes were used to calculate Tasmanian and Australian rates of disease. The latest data were used, which were 2016 estimated resident populations.