The future of the immunisation schedule: recommendations of a workshop

The Ministry of Health convened a workshop in June 1998 on the future of the immunisation schedule. Your comments are invited on the recommendations of the workshop. PRINCIPLES BEHIND THE SCHEDULE: Improve on-time immunisation coverage as the priority. Reaching the last 20% will cost at least as much as the first 80% and is vital to achieve the aims of the immunisation programme (disease elimination and improved control). Obtain regular secure coverage data, derived from a tracking system that ensures children are followed up. Assess compliance with early childhood centre immunisation checks at entry and improve if necessary. Establish an expert committee to advise on the immunisation schedule and policies. Keep the schedule as simple as possible. Accept that vaccines are not generic and future schedule recommendations may be vaccine-specific. Involve providers in the process of change.

Move the second dose of measles-mumps-rubella vaccine from age 11 years to around five years. Consider moving the third visit from five to four months to achieve earlier protection against pertussis. Consider adding a fifth dose of pertussis vaccine. Change to acellular pertussis vaccine, once suitable vaccines are available. Change to inactivated polio vaccine, once suitable vaccines are available. Consider omitting the fourth dose of polio vaccine. Consider introducing an adult immunisation schedule with fewer adult tetanus-diphtheria boosters.