Coverage Update from Immunisation Champion Dr Pat Tuohy

Coverage update from Immunisation Champion Dr Pat Tuohy

We need your help to solve a puzzle. At eight weeks of age, 84 percent of babies have had all their immunisations, but by six months, that has fallen to 80 percent. What’s happening with families over those four months? Do they think they’re covered if they’ve had the first immunisations? Are both parents back at work and finding it harder to get to an appointment? Is there something about their first experience that puts them off? If we solve that problem, we’ll have a much easier job of making sure babies are protected. We welcome any suggestions about how your practice keeps people coming back on time, and we’ll share the best with everyone in a later update.

On-time immunisation is particularly important for protecting young babies against whooping cough – around half of all babies under the age of 1 who catch whooping cough need hospital treatment, with the highest number of cases and hospitalisations among Māori and Pacific babies.

Latest reports show that we have 95 percent of babies fully immunised, but at age 12 months rather than 8 months, where the rate is about 93 percent. Our focus needs to be on getting the primary series complete on time, rather than using the three months’ leeway given by the target. More immunisations complete by six months means fewer immunisations to chase up later!

Measles

Four cases of measles have been reported in Waikato and Mid-Central DHBs during May. One person took part in a charity firefighter tower climb at Auckland’s Sky Tower, and stayed at the Sky City hotel over the weekend of May 22 to 24 while infectious. As there were a large number of people from many parts of the country potentially exposed during the weekend, public health units nationwide have been notified so they can take suitable steps.

Our key messages to the health sector at this time are:

1. Think measles. Notify any possible measles cases on suspicion to the local Medical Officer of Health.

2. Prevent spread. Take appropriate precautions to stop any spread of measles, including infection control measures in waiting rooms. People with possible measles symptoms are advised to phone ahead for advice. Triaging should be implemented when making appointments.

3. Offer immunisation. Please continue offering opportunistic MMR immunisation to anyone born from January 1969 onwards who does not have two documented doses of MMR vaccine. This is funded for children under 18 yearsand adults eligible for publicly funded health and disability services, therefore practices can claim the immunisation subsidy. Teenagers and young adults up to 30 years of ageare known to be those most likely to require another dose of MMR to be fully immunised.

Rotavirus vaccine

Medsafe has been monitoring adverse reactions to the rotavirus vaccine since it was added to the Schedule in 2014. While there has been no increase in intussusception, there have been a number of medicine administration errors, with 39 babies being given the first dose of the vaccine at 15 weeks of age or older (one at age 18 months), and two being given the third dose at eight months of age or older. The majority of errors occurred at five months of age, which suggests vaccinators incorrectly assumed that babies had previously received the first or second doses. Please check before giving rotavirus vaccine to babies 15 weeks of age or older that they have received previous doses, and do not administer at all to babies aged eight months or older.

The background rate of intussusception is 65 cases per 100,000, with a possible additional risk of between 1 and 6 in every 100,000 babies vaccinated. The majority of intussusception cases would have occurred regardless of vaccination, but intussusception should still be reported to CARM if it coincides with recent immunisation.

Influenza

Over 1.1 million doses of influenza vaccine have now been distributed. While influenza is present in the community, levels are still below the seasonal level, as at the week ending 31May. Thank you for your efforts in protecting our most vulnerable before winter hits.

Practices are reminded that Fluvax should not be given to children under 9 years of age. Influvac and Fluarix can both be used for children from 6 months of age.

Infanrix-IPV packaging change

GlaxoSmithKline have advised that while the New Zealand packaging for Infanrix-IPV has changed from green to orange, stocks of the green packaging are still in circulation. The Ministry will be updating the photo of Infanrix-IPV in its next reprint of the vaccine schedule card to reflect the new packaging.

Immunisation Record Stickers

The Ministry would like to remind practices that children with older WCTO books do not need a new Immunisation Record sticker to be placed in their book. The Immunisation Schedule has not significantly changed for children born before April 2014. References to PCV10 can be crossed out and replaced with PCV13 where necessary.

JABBED – love, fear and vaccines

The acclaimed Australian documentary JABBED – love, fear and vaccinesscreened on Sky’s Vibe channel on Sunday 24 May. The producers of the show have developed an information page for vaccinators here: While it is no longer available to view free online at SBS, Sky subscribers can view it for the next month here: and parts of it may be available on YouTube.

If you have any queries about anything in this update, please email