Related Experiment Videos
Control of epidemic group A meningococcal disease in Auckland
Insights
Group A meningococcal vaccination in Auckland infants in 1987 effectively controlled an epidemic. High vaccination coverage was achieved through community health worker involvement, particularly in South Auckland.
Area of Science:
- Public Health
- Epidemiology
- Vaccinology
Background:
- Group A meningococcal disease outbreaks pose significant risks to young children.
- Infants under two years old represent a high-risk group with historically low routine vaccination coverage.
- Effective vaccine delivery strategies are crucial for controlling epidemic infectious diseases.
Purpose of the Study:
- To evaluate the delivery mechanisms of the group A meningococcal vaccine to infants under two years old in Auckland during a 1987 epidemic.
- To assess the impact of vaccination on controlling the group A meningococcal disease outbreak.
- To identify factors facilitating vaccine delivery in different regions of Auckland.
Main Methods:
- A retrospective audit of signed consent forms was used to determine vaccine delivery sources for children under two.
- Telephone surveys identified the primary healthcare providers for children presenting with meningococcal disease.
- Vaccination coverage rates were analyzed based on age group and geographical area within Auckland.
Main Results:
- The 1987 vaccination campaign likely abated the group A meningococcal epidemic, achieving 90% coverage in the target population (3 months-13 years).
- In South Auckland, the Plunket Society, supported by the Department of Health and community health workers, delivered 92% of vaccines to children under two.
- Vaccine delivery by general practitioners varied regionally, with higher uptake in North-West and Central Auckland, especially after addressing concerns about side effects. Coverage for the first dose in children under two was 89% in South Auckland.
- A significant proportion (1 in 4) of children with meningococcal disease lacked an identifiable general practitioner.
Conclusions:
- Vaccination programs targeting serious pediatric illnesses are highly cost-effective.
- Optimal vaccine delivery strategies can differ geographically, necessitating tailored approaches.
- Community involvement, including dedicated health workers for Maori and Pacific Island communities, was instrumental in the campaign's success.
Aim:
To study group A meningococcal vaccine delivery to infants less than 2 years of age in Auckland in 1987 to control epidemic disease.
Methods:
Mechanisms of vaccine delivery and its facilitation are described. A detailed audit of delivery of vaccine to children less than two years using signed consent forms determined delivery source. This was the age group at highest risk, and poorly covered by routine childhood vaccines. Primary health care source of children presenting with disease was determined by telephone.
Results:
The epidemic of group A meningococcal disease in the winters of 1985 and 1986 abated most likely due to the vaccination of high risk children (3 months-13 years) in 1987. 90% of the target population were vaccinated. In south Auckland the majority (92%) of vaccine doses for children less than two years of age was delivered by the Plunket Society with Department of Health backing aided by community health workers. By contrast delivery by, general practitioners was greater in north-west and central Auckland (approximately 25%, of dose 1), especially after the publicity over possible side effects (approximately 50% of dose 2). Coverage for dose 1 of children < 2 years was similar (89%) in south Auckland. Of children presenting with meningococcal disease 1 in 4 did not have an identifiable general practitioner.
Conclusions:
Vaccines to prevent serious paediatric illness are known to be highly cost effective. The best method of delivery of vaccinations may vary from area to area. Major community involvement including community health workers for the Maori and Pacific Island communities may have facilitated the dissemination of information in this campaign.