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Timeliness of childhood immunisation in Australia
Brynley P Hull1, Peter B McIntyre
1National Centre for Immunisation Research and Surveillance of Vaccine Preventable Diseases, Children's Hospital at Westmead and the University of Sydney, NSW, Australia. brynleyh@chw.edu.au
Insights
Timeliness of childhood vaccination in Australia has not improved despite rising coverage. Long delays in infant immunisation are more common in remote Indigenous communities, highlighting a need for targeted program improvements.
Area of Science:
- Public Health
- Immunisation
- Child Health
Background:
- Childhood vaccination timeliness is crucial for preventing diseases like pertussis, Haemophilus influenzae type b, and Streptococcus pneumoniae.
- Limited data exist on vaccination timeliness outside the United States.
Purpose of the Study:
- To examine trends and factors associated with infant vaccination timeliness in Australia.
- To utilize the Australian Childhood Immunisation Register (ACIR) for national-level analysis.
Main Methods:
- Defined age-appropriate immunisation as within 30 days of the recommended age.
- Analyzed data from the Australian Childhood Immunisation Register (ACIR).
Main Results:
- Vaccination delays increased for later doses, but long delays (>6 months) were infrequent (1-2%).
- Immunisation coverage improved over time, but timeliness did not.
- Long delays in remote Indigenous infants (5-12%) were observed, though overall coverage by age 2 was similar to non-Indigenous children.
Conclusions:
- Vaccination timeliness, not just coverage, should be a key program performance benchmark.
- Targeted improvements are needed for specific subgroups, particularly Indigenous children in remote areas, to prevent early-onset disease.
Abstract:
There are few data, especially outside the United States, examining the timeliness of childhood vaccination, although it is of key importance for diseases such as pertussis, and invasive disease due to Haemophilus influenzae type b and Streptococcus pneumoniae. The aim of this study was to use the unique resource of the Australian Childhood Immunisation Register (ACIR) to examine trends in and factors associated with timeliness of infant vaccination at the national level. As in previous studies, age-appropriate immunisation was defined as within 30 days of the recommended age. Vaccination delays became more common for later doses, given at an older age, but long delay (greater than 6 months) occurred in only 1-2%. Although immunisation coverage increased over time, timeliness did not improve. Among Indigenous infants, long delays occurred in 5-12% of those residing in very remote areas, but by 2 years of age, overall immunisation coverage was similar to non-Indigenous children. With immunisation coverage at the key indicator ages of 12 and 24 months now high in most industrialised countries including Australia, timeliness of vaccine doses should be the next benchmark to aim for in program performance, especially in specific sub-groups such as Indigenous children who stand to gain most from prevention of early onset disease.
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