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Children overdue for immunisation: a question of coverage or reporting? An audit of the Australian Immunisation

Charlee Law1,2, Rhydwyn McGuire1, Mark J Ferson3,4

  • 1Communicable Diseases Branch, Health Protection NSW, New South Wales.

Australian and New Zealand Journal of Public Health
|April 9, 2019
PubMed

Insights

True childhood immunisation coverage in New South Wales (NSW) is higher than reported to the Australian Immunisation Register (AIR). Data errors and duplicate records contribute to underestimation, impacting public health insights.

Area of Science:

  • Public Health
  • Immunisation Policy
  • Data Accuracy

Background:

  • Vaccinations are reportable to the Australian Immunisation Register (AIR) in Australia.
  • New South Wales (NSW) conducted an audit following policy initiatives to assess true immunisation coverage.
  • The audit aimed to estimate coverage in NSW children at one year of age and identify under-reporting reasons.

Purpose of the Study:

  • To estimate the true immunisation coverage of one-year-old children in NSW.
  • To compare true coverage with Australian Immunisation Register (AIR) reported coverage.
  • To explore factors contributing to the under-reporting of vaccinations.

Main Methods:

  • A cross-sectional survey was conducted on a stratified random sample of 491 NSW children.
  • Children were aged 12-15 months and over 30 days overdue for immunisation according to AIR records.
  • Survey data were analysed using population weights to estimate true coverage.

Main Results:

  • Estimated true immunisation coverage in NSW was 96.2%, exceeding AIR reported coverage of 94.1%.
  • 34.9% of children reported as overdue on AIR were actually fully vaccinated.
  • Under-reporting was not significantly associated with socioeconomic status, rurality, or local coverage levels.

Conclusions:

  • Under-reporting continues to underestimate true childhood immunisation coverage in NSW, despite incentives.
  • Data errors during AIR uploading at the provider level and duplicate records were identified as causes.
  • Improving data transmission reliability and removing duplicates are crucial for accurate AIR coverage reporting.
Abstract

Keywords:
communicable diseasesimmunisationimmunisation scheduleinfantpublic health practice

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