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Skirrow, Helen, Charlotte Flynn, Abigail Heller, Catherine Heffernan, Sandra Mounier-Jack, and Tracey Chantler. "Delivering routine immunisations in London during the COVID-19 pandemic: lessons for future vaccine delivery. A mixed-methods study." BJGP Open 5, no. 4 (May 18, 2021): BJGPO.2021.0021. http://dx.doi.org/10.3399/bjgpo.2021.0021.
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BackgroundGeneral practices in England have continued to care for patients throughout the COVID-19 pandemic by instigating major changes to service delivery. Immunisations have continued, although the number of vaccines delivered initially dropped in April 2020.AimTo evaluate how COVID-19 impacted the delivery of immunisations in London and identify innovative practices to inform future delivery, including for COVID-19 vaccines.Design & settingA mixed-methods study of immunisation delivery in London, UK.MethodAn online survey of London general practices was undertaken in May 2020 to produce a descriptive analysis of childhood immunisation delivery and identify innovative delivery models. Semi-structured interviews were conducted between August and November 2020 to explore innovative immunisation models, which were analysed thematically.ResultsSixty-eight per cent (n = 830) of London practices completed the survey and 97% reported having continued childhood immunisation delivery. Common delivery adaptations included spaced-out appointments, calling parents beforehand, and having only one parent attend. Forty-three practices were identified as having innovative models, such as delivering immunisations outside practice buildings or offering drive-through services. The thematic analysis of 14 semi-structured interviews found that, alongside adaptations to immunisation delivery within practices, existing local networks collaborated to establish new immunisation delivery models. Local population characteristics affected delivery and provide insights for large-scale vaccine deployment.ConclusionImmunisations continued during 2020 with practices adapting existing services. New delivery models were developed by building on existing local knowledge, experiences, and networks. Immunisation delivery during the pandemic, including for COVID-19 vaccines, should be tailored to local population needs by building on primary care immunisation expertise.
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Mori, Kazusa, Konosuke Otomaru, Toshihide Kato, Osamu Yokota, and Hiromichi Ohtsuka. "Field trial of antibody response to inactivated bacterial vaccine in young Holstein calves: influence of animal health status." Journal of Veterinary Research 66, no. 1 (March 1, 2022): 109–16. http://dx.doi.org/10.2478/jvetres-2022-0003.
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Abstract Introduction Bovine respiratory disease (BRD) is one of the primary causes of death in young calves. Vaccination against infection by the common bacteria causing BRD is possible; however, the physical condition of the young calves that enables antibody production when stimulated by early immunisation remains to be elucidated. Material and Methods Healthy young female Holstein calves on a commercial dairy farm were fed a colostrum replacer and administered primary and booster immunisations with an inactivated vaccine against the bacterial pneumonia agents Histophilus somni, Pasteurella multocida and Mannheimia haemolytica. At each immunisation, the body weight and height at the withers were measured and the body mass index (BMI) was calculated. Blood was sampled immediately before immunisation and 3 weeks following the booster. The calves were divided into positive and negative groups based on the antibody titre at the final blood sampling. Maternal antibody titres at the primary immunisation and BMI, nutritional status and oxidative stress at both immunisations were compared between the two groups. Results Antibody titre at the primary and BMI at both immunisations were significantly higher in the positive than in the negative group (P < 0.05). Additionally, serum gamma globulin was significantly higher in the positive group (P < 0.05), indicating a strong correlation between maternal antibody and serum gamma globulin levels. Conclusion Elevated maternal antibody titre and higher BMI are positive factors for successful early immunisation, for which suitable colostrum may also be fundamental in young calves administered inactivated vaccines.
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Goodyear-Smith, Felicity, Cameron Grant, Tracey Poole, Helen Petousis-Harris, Nikki Turner, Rafael Perera, and Anthony Harnden. "Early connections: effectiveness of a pre-call intervention to improve immunisation coverage and timeliness." Journal of Primary Health Care 4, no. 3 (2012): 189. http://dx.doi.org/10.1071/hc12189.
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INTRODUCTION: Children who have missed or delayed immunisations are at greater risk of vaccine-preventable diseases and getting their first scheduled dose on time strongly predicts subsequent complete immunisation. Developing a relationship with an infants parents and general practice staff soon after birth followed by a systematic approach can reduce the number of delayed first immunisations. AIM: To assess the effectiveness of a general practicebased pre-call intervention to improve immunisation timeliness. METHODS: Clustered controlled trial of general practices in a large urban district randomised to either delivery of pre-call intervention to all babies at aged four weeks or usual care. RESULTS: Immunisation timeliness for infants receiving the primary series of immunisations among their nominated Auckland general practices was higher than expected at 98% for the six week event. The intervention was statistically but not clinically significant. Coverage was significantly lower among infants with no nominated practice which reduced overall coverage rate for the district. DISCUSSION: Pre-call letters with telephone follow-up are simple interventions to introduce into the practice management system and can be easily implemented as usual standard of care. Early identification of newborn infants, primary care engagement and effective systems including tracking of infants not enrolled in general practices has the greatest potential to improve immunisation coverage rates even further. KEYWORDS: Randomized controlled trial; immunization; vaccination; general practice; intervention studies
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Ekhaguere, Osayame A., Rosena O. Oluwafemi, Bolaji Badejoko, Lawal O. Oyeneyin, Azeez Butali, Elizabeth D. Lowenthal, and Andrew P. Steenhoff. "Automated phone call and text reminders for childhood immunisations (PRIMM): a randomised controlled trial in Nigeria." BMJ Global Health 4, no. 2 (April 2019): e001232. http://dx.doi.org/10.1136/bmjgh-2018-001232.
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BackgroundSub-Saharan Africa has high under-5 mortality and low childhood immunisation rates. Vaccine-preventable diseases cause one-third of under-5 deaths. Text messaging reminders improve immunisation completion in urban but not rural settings in sub-Saharan Africa. Low adult literacy may account for this difference. The feasibility and impact of combined automated voice and text reminders on immunisation completion in rural sub-Saharan Africa is unknown.MethodsWe randomised parturient women at the Mother and Child Hospitals Ondo State, Nigeria, owning a mobile phone and planning for child immunisation at these study sites to receive automated call and text immunisation reminders or standard care. We assessed the completion of the third pentavalent vaccine (Penta-3) at 18 weeks of age, immunisation completion at 12 months and within 1 week of recommended dates. We assessed selected demographic characteristics associated with completing immunisations at 12 months using a generalised binomial linear model with ‘log’ link function. Feasibility was assessed as proportion of reminders received.ResultsEach group had 300 mother−baby dyads with similar demographic characteristics. At 18 weeks, 257 (86%) and 244 (81%) (risk ratio (RR) 1.05, 95% CI 0.98 to 1.13; p=0.15) in the intervention and control groups received Penta-3 vaccine. At 12 months, 220 (74%) and 196 (66%) (RR 1.12, 95% CI 1.01 to 1.25; p=0.04) in the intervention and control groups received the measles vaccine. Infants in the intervention group were more likely to receive Penta-3 (84% vs 78%, RR 1.09, 95% CI 1.01 to 1.17; p=0.04), measles (73% vs 65%, RR 1.13, 95% CI 1.02 to 1.26; p=0.02) and all scheduled immunisations collectively (57% vs 47%, RR 1.13, 95% CI 1.02 to 1.26; p=0.01) within 1 week of the recommended date. No demographic character predicted immunisation completion. In the intervention group, 92% and 86% reported receiving a verification reminder and at least one reminder during the study period, respectively.ConclusionPaired automated call and text reminders significantly improved immunisation completion and timeliness.Trial registration numberNCT02819895.
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Thomas, Susan, Natalie Allan, Paula Taylor, Carla McGrady, Kasia Bolsewicz, Fakhrul Islam, Patrick Cashman, David Durrheim, and Amy Creighton. "Combining First Nations Research Methods with a World Health Organization Guide to Understand Low Childhood Immunisation Coverage in Children in Tamworth, Australia." International Indigenous Policy Journal 12, no. 2 (July 20, 2021): 1–21. http://dx.doi.org/10.18584/iipj.2021.12.2.10959.
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In Australia, we used the World Health Organization’s Tailoring Immunization Programmes to identify areas of low immunisation coverage in First Nations children. The qualitative study was led by First Nations researchers using a strength-based approach. In 2019, Tamworth had 179 (23%) children who were overdue for immunisations. Yarning sessions were conducted with 50 parents and health providers. Themes that emerged from this research included: (a) Cultural safety in immunisation services provides a supportive place for families, (b) Service access could be improved by removing physical and cost barriers, (c) Positive stories promote immunisation confidence among parents, (d) Immunisation data can be used to increase coverage rates for First Nations children. Knowledge of these factors and their impact on families helps ensure services are flexible and culturally safe.
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Petousis-Harris, Helen, Cameron Grant, Felicity Goodyear-Smith, Nikki Turner, Deon York, Rhys Jones, and Joanna Stewart. "What contributes to delays? The primary care determinants of immunisation timeliness in New Zealand." Journal of Primary Health Care 4, no. 1 (2012): 12. http://dx.doi.org/10.1071/hc12012.
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INTRODUCTION: Delay in receipt of the first vaccine dose in the primary series is one of the strongest and most consistent predictors of subsequent incomplete immunisation. AIM: To describe the on-time immunisation delivery of New Zealand infant scheduled vaccines by primary care practices and identify characteristics of practices, health professionals and patients associated with delays in receipt of infant immunisations. METHODS: Timeliness of immunisation delivery and factors associated with timely immunisation were examined in 124 randomly selected primary care practices in two large regions of New Zealand. RESULTS: A multiple regression model of demographic, practice, nurse, doctor and caregiver association explained 68% of the variance in immunisation timeliness between practices. Timeliness was higher in practices without staff shortages (ß-coefficient -0.0770, p= 0.01), where nurses believed parental apathy (ß-coefficient 0.0819, p=0.008) or physicians believed parental access (ß-coefficient 0.109, p=0.002) was a barrier, and lower in practices with Maori governance (ß-coefficient -0.0868, p=0.05), higher social deprivation (ß-coefficient -0.0643,<0.001) and where caregivers received immunisation-discouraging information (ß-coefficient -0.0643, p=0.04). DISCUSSION: Interventions supporting practice teams and providers in primary care settings could produce significant improvements in immunisation timeliness. KEYWORDS: Immunization; vaccination; immunization programs; primary health care; family practice
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Chakraborty, Arpita, Diwakar Mohan, Kerry Scott, Agrima Sahore, Neha Shah, Nayan Kumar, Osama Ummer, et al. "Does exposure to health information through mobile phones increase immunisation knowledge, completeness and timeliness in rural India?" BMJ Global Health 6, Suppl 5 (July 2021): e005489. http://dx.doi.org/10.1136/bmjgh-2021-005489.
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IntroductionImmunisation plays a vital role in reducing child mortality and morbidity against preventable diseases. As part of a randomised controlled trial in rural Madhya Pradesh, India to assess the impact of Kilkari, a maternal messaging programme, we explored determinants of parental immunisation knowledge and immunisation practice (completeness and timeliness) for children 0–12 months of age from four districts in Madhya Pradesh.MethodsData were drawn from a cross-sectional survey of women (n=4423) with access to a mobile phone and their spouses (n=3781). Parental knowledge about immunisation and their child’s receipt of vaccines, including timeliness and completeness, was assessed using self-reports and vaccination cards. Ordered logistic regressions were used to analyse the factors associated with parental immunisation knowledge. A Heckman two-stage probit model was used to analyse completeness and timeliness of immunisation after correcting for selection bias from being able to produce the immunisation card.ResultsOne-third (33%) of women and men knew the timing for the start of vaccinations, diseases linked to immunisations and the benefits of Vitamin-A. Less than half of children had received the basic package of 8 vaccines (47%) and the comprehensive package of 19 vaccines (44%). Wealth was the most significant determinant of men’s knowledge and of the child receiving complete and timely immunisation for both basic and comprehensive packages. Exposure to Kilkari content on immunisation was significantly associated with an increase in men’s knowledge (but not women’s) about child immunisation (OR: 1.23, 95% CI 1.02 to1.48) and an increase in the timeliness of the child receiving vaccination at birth (Probit coefficient: 0.08, 95% CI 0.08 to 0.24).ConclusionGaps in complete and timely immunisation for infants persist in rural India. Mobile messaging programmes, supported by mass media messages, may provide one important source for bolstering awareness, uptake and timeliness of immunisation services.Trial registration numberNCT03576157.
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Dathini, Hamina, Siti Khuzaimah Ahmad Sharoni, and Kever Teriyla Robert. "Parental Reminder Strategies and the Cost Implication for Improved Immunisation Outcomes: A Systematic Review and Meta-Analysis." Healthcare 10, no. 10 (October 11, 2022): 1996. http://dx.doi.org/10.3390/healthcare10101996.
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Getting children vaccinated amidst prevailing barriers to immunisation has been challenging in both developed and developing countries. To address these problems, studies on parental reminder strategies were conducted to improve immunisation outcomes in children. These led to the development of different parental reminder interventions. This review systematically reviews different parental interventions and their cost implication for improved immunisations. Five online databases; Medline Complete, the Cumulative Index for Nursing and Allied Health Literature [CINAHL], Academic search premier, SPORTDiscus, and Health Source Nursing/Academic were searched using search terms. A total of 24 articles that met the inclusion criteria were included in this review. Studies that provided sufficient information were included for meta-analysis using Comprehensive Meta-Analysis version three, while narrative synthesis was used for the other studies. Results indicate that a heterogeneous and low-quality certainty of evidence on parental voice calls (OR 4.752, 95% CI 1.846-12.231, p = 0.001) exists in improving immunisation coverage. Regarding immunisation timeliness, a high-quality certainty of evidence on Short Message Services (SMS)-delivered health education messages (OR 2.711 95% CI 1.387-5.299, p = 0.004) had more effect on timely immunisation uptake. The average cost of SMS-delivered parental reminder interventions for improved immunisation outcomes was USD 0.50. The study concludes that mobile technology is a promising, cost-effective strategy for improved immunisation outcomes.
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Bolsewicz, Katarzyna, Susan Thomas, Donna Moore, Colleen Gately, Andrew Dixon, Paul Cook, and Peter Lewis. "Using the Tailoring Immunization Programmes guide to improve child immunisation in Umina, New South Wales: we could still do better." Australian Journal of Primary Health 26, no. 4 (2020): 325. http://dx.doi.org/10.1071/py19247.
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In the Central Coast Local Health District of New South Wales, Australia, childhood immunisation (CI) rates are around 95%, but pockets of underimmunisation exist. Using the World Health Organization’s Tailoring Immunization Programmes, we identified areas of potential low vaccine coverage using Australian Immunisation Register (AIR) data (2016–18) and investigated factors that influence CI. Individual and group interviews with carers, community members and service providers (n=52 participants) were conducted. Data were analysed thematically and the themes presented to stakeholders for feedback before finalisation. During 2018, Umina had 218 children at least 1 month overdue for at least one vaccination. Five themes emerged: (1) broader socioeconomic factors may apply pressures that influence CI; (2) parents largely supported immunisation and knew of its benefits to their children and the community; (3) immunisation service providers are committed, experienced and collaborate with community partners; (4) there is potential to increase access to free immunisation services in Umina; and (5) AIR data and reminder systems could be better used to inform service delivery and prompt parents before immunisations are due. This study identified opportunities to improve CI coverage in Umina and new information useful in developing a tailored immunisation strategy. Awareness of the pressures socioeconomic factors may have on families could help plan and deliver supportive primary health care that includes equitable access to immunisation.
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Vusi, Dlamini Sabelo, Dlamini Xolisiwe, Simelane Tholie, Maphalala Gugu, Maseko Sibongile, Khumalo Lonkhululeko, Shabangu Philile, Dlamini Sihle Angel, and Hlophe Londiwe Dumsile. "Routine Child Immunization during the COVID-19 Global Pandemic in Eswatini: Challenges, Loss of Gains and Benefits." Research in Health Science 10, no. 2 (May 9, 2025): p66. https://doi.org/10.22158/rhs.v10n2p66.
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Introduction: Timely uptake of immunisations by all children at immunisation ages is key towards maintaining good health and protecting lives of the 80 million children worldwide. Disruptions of healthcare systems due to the impact and spread of coronavirus disease (SARS-CoV-2) created an issue of public health importance that required to be addressed in order to preserve gains in child survival statistics. Method: This analysis aimed at assessing the performance of child immunisation initiatives in Eswatini during COVID-19. Data on child immunisation before and during COVID-19 (i.e. before December, 2019 and for the year January to December 2020) was sourced from vaccination records kept by the Expanded Programme on Immunisation (EPI) and from the Health Management Information System (HMIS) of the Ministry of Health in Eswatini. Results: Most child immunization rates for different diseases in 2019, before COVID-19, were generally above the cumulative target. The only disease with cumulative immunisation rates below the cumulative target was MR2. The cumulative number of children unimmunised against MR1 shows an exponential increase in 2020 following implementations of strategies to reduce spread of COVID-19. Our study suggests that the implementation of routine immunisations between March 2019 and 2020 suffered logistical constraints such as: the supply of vaccines, delivery cold chain problems, staff shortage due to reallocation of nurses and doctors to work on COVID-19 and some testing positive to SARS-CoV-2 infection and having to go into quarantine and isolation. Discussion: Delayed or missed immunisations created a large cohort of children that became susceptible to infection due to lost herd immunity. Increased number of unimmunised children against MR1 and the other vaccine preventable childhood diseases while the country focused on reducing transmission of COVI-19 is likely to have created a large pool of susceptible children from which epidemics could arise. As such, the reported outbreaks of mumps, measles, etc, could be as a result of the large pool of unvaccinated children resultant from COVID-19 partial lockdown. Conclusion: Epidemics of some of these vaccine preventable childhood diseases could result in catastrophic consequences of unimaginable proportions and deaths among children. Therefore, efforts should always be made to ensure gains in routine child immunisations are never lost during epidemics such as COVID-19.
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Schley, Katharina, Jack C. Kowalik, Shannon M. Sullivan, Andrew Vyse, Carole Czudek, Eszter Tichy, and Jamie Findlow. "Assessing the Role of Infant and Toddler MenACWY Immunisation in the UK: Does the Adolescent MenACWY Programme Provide Sufficient Protection?" Vaccines 11, no. 5 (May 4, 2023): 940. http://dx.doi.org/10.3390/vaccines11050940.
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A combined Haemophilus influenzae type b (Hib)/meningococcal serogroup C (MenC) vaccine will soon be unavailable in the UK immunisation schedule due to discontinuation by the manufacturer. An interim statement by the Joint Committee on Vaccination and Immunisation (JCVI) advises stopping MenC immunisation at 12 months of age when this occurs. We undertook an analysis of the public health impact of various potential meningococcal vaccination strategies in the UK in the absence of the Hib/MenC vaccine. A static population-cohort model was developed evaluating the burden of IMD (using 2005–2015 epidemiological data) and related health outcomes (e.g., cases, cases with long-term sequelae, deaths), which allows for the comparison of any two meningococcal immunisation strategies. We compared potential strategies that included different combinations of infant and/or toddler MenACWY immunisations with the anticipated future situation in which a 12-month MenC vaccine is not used, but the MenACWY vaccine is routinely given in adolescents. The most effective strategy is combining MenACWY immunisation at 2, 4, and 12 months of age with the incumbent adolescent MenACWY immunisation programme, resulting in the prevention of an additional 269 IMD cases and 13 fatalities over the modelling period; of these cases, 87 would be associated with long-term sequelae. Among the different vaccination strategies, it was observed that those with multiple doses and earlier doses provided the greatest protection. Our study provides evidence suggesting that the removal of the MenC toddler immunisation from the UK schedule would potentially increase the risk of unnecessary IMD cases and have a detrimental public health impact if not replaced by an alternate infant and/or toddler programme. This analysis supports that infant and toddler MenACWY immunisation can provide maximal protection while complementing both infant/toddler MenB and adolescent MenACWY immunisation programmes in the UK.
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Ese, A. O., V. B. Brown, and O. A. Oluwatosin. "Mothers’ knowledge and utilization of non-routine childhood immunisation in Ibadan North Local Government Area, Oyo state, Nigeria." Nigerian Journal of Paediatrics 47, no. 2 (August 6, 2020): 96–102. http://dx.doi.org/10.4314/njp.v47i2.8.
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Background: Vaccinepreventable- diseases are major contributors to child mortality in Africa. In Nigeria, apart from the routine childhood vaccines that are provided free by the government, there are additional lifesaving non-routine vaccines like Rotavirus, Pneumococcal Conjugate (PCV), Varicella, Cerebrospinal meningitis, and Measles, Mumps, Rubella (MMR) vaccines. Until 2015 when PCV was included in the routine childhood immunisation, these five vaccines were optional and parents paid to immunize their children with them.Objective: To assess the level of knowledge and utilization of nonroutine immunisations among mothers.Methodology: A descriptive, cross -sectional study conducted in three infant welfare clinics purposively selected in Ibadan North Local Government Area, Oyo State, Nigeria. Participants were 110 mothers of children aged 6-24 months. A structured questionnaire was used for data collection and analysis done using SPSS version 20.0. Descriptive statistics were computed and Chi-square test was used for investigating association between categorical variables at 0.05 level of significance.Results: The findings revealed that 62 (56.4%) of the 110 mothers were aware of non-routine immunisation of which 23 (20.9%) had good knowledge about it. Only 23 (20.9%) of their children were immunized with all the nonroutine vaccines. High income, higher level of education and good knowledge level about non-routine immunisation of mothers were associated with the utilization of all non-routine immunisation among their children (p<0.01).Conclusion: Knowledge of mothers about non-routine immunisation was poor and uptake of the vaccines among their children low. Health education to improve mothers’ knowledge and utilization of non-routine immunisation by their children is recommended.
 Keywords: Vaccine-preventablediseases, Children, Optional, Immunisation, Awareness, Uptake, Ibadan, Nigeria
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Alfayadh, Naba M., Peter J. Gowdie, Jonathan D. Akikusa, Mee Lee Easton, and Jim P. Buttery. "Vaccinations Do Not Increase Arthritis Flares in Juvenile Idiopathic Arthritis: A Study of the Relationship between Routine Childhood Vaccinations on the Australian Immunisation Schedule and Arthritis Activity in Children with Juvenile Idiopathic Arthritis." International Journal of Rheumatology 2020 (August 4, 2020): 1–7. http://dx.doi.org/10.1155/2020/1078914.
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Background. Juvenile idiopathic arthritis (JIA) is a collective term for a group of inflammatory conditions of uncertain origin, which causes chronic arthritis in one or more joints. The clinical course of JIA is characterised by episodes of increased activity, termed flares. Vaccinations have previously been proposed as a “trigger” for some flares, although evidence supporting this is scant. Objective. To explore whether routine childhood vaccinations are associated with an increased risk of flares of arthritis activity in children with JIA. Methods. Patients aged below 6 years with a diagnosis of JIA were recruited from the Rheumatology Clinical Database at the Royal Children’s Hospital, Melbourne, Australia, from 1 January 2010 to 30 April 2016. Patient immunisation status was cross-checked with the Australian Childhood Immunisation Register (ACIR). The self-controlled case series methodology (Rowhani-Rahbar et al., 2012) was applied to determine whether the risk of arthritis flares in the three months following immunisation was greater than the baseline risk for each patient. Results. 138 patients were included in the study. 32 arthritis flares occurred in the 90 days following immunisation. The risk of arthritis flares during the 90 days following immunisation was reduced compared with patients’ baseline risk (RR 0.59 (95% CI 0.39-0.89, p=0.012)). Conclusion. Routine childhood immunisations were not associated with arthritis flare onset in patients with JIA. The risk of arthritis flares in the 90 days following vaccination was lower than the baseline risk. In the context of COVID19, vaccination will not increase interaction with the healthcare system beyond the immunisation encounter.
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Rajaonarifara, Elinambinina, Matthew H. Bonds, Ann C. Miller, Felana Angella Ihantamalala, Laura Cordier, Benedicte Razafinjato, Feno H. Rafenoarimalala, et al. "Impact of health system strengthening on delivery strategies to improve child immunisation coverage and inequalities in rural Madagascar." BMJ Global Health 7, no. 1 (January 2022): e006824. http://dx.doi.org/10.1136/bmjgh-2021-006824.
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BackgroundTo reach global immunisation goals, national programmes need to balance routine immunisation at health facilities with vaccination campaigns and other outreach activities (eg, vaccination weeks), which boost coverage at particular times and help reduce geographical inequalities. However, where routine immunisation is weak, an over-reliance on vaccination campaigns may lead to heterogeneous coverage. Here, we assessed the impact of a health system strengthening (HSS) intervention on the relative contribution of routine immunisation and outreach activities to reach immunisation goals in rural Madagascar.MethodsWe obtained data from health centres in Ifanadiana district on the monthly number of recommended vaccines (BCG, measles, diphtheria, tetanus and pertussis (DTP) and polio) delivered to children, during 2014–2018. We also analysed data from a district-representative cohort carried out every 2 years in over 1500 households in 2014–2018. We compared changes inside and outside the HSS catchment in the delivery of recommended vaccines, population-level vaccination coverage, geographical and economic inequalities in coverage, and timeliness of vaccination. The impact of HSS was quantified via mixed-effects logistic regressions.ResultsThe HSS intervention was associated with a significant increase in immunisation rates (OR between 1.22 for measles and 1.49 for DTP), which diminished over time. Outreach activities were associated with a doubling in immunisation rates, but their effect was smaller in the HSS catchment. Analysis of cohort data revealed that HSS was associated with higher vaccination coverage (OR between 1.18 per year of HSS for measles and 1.43 for BCG), a reduction in economic inequality, and a higher proportion of timely vaccinations. Yet, the lower contribution of outreach activities in the HSS catchment was associated with persistent inequalities in geographical coverage, which prevented achieving international coverage targets.ConclusionInvestment in stronger primary care systems can improve vaccination coverage, reduce inequalities and improve the timeliness of vaccination via increases in routine immunisations.
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Ames, Sophie, and Gill Kelly. "Exploring how the uptake of childhood immunisations can be improved in England: A systematic review." Practice Nursing 35, no. 12 (December 2, 2024): 412–26. https://doi.org/10.12968/pnur.2024.35.12.412.
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A review of best practice in child immunisation was undertaken to help drive uptake Background Childhood immunisations protect communities against preventable and infectious diseases. Coverage for childhood immunisations in the UK is declining and coverage for the MMR vaccine stands at 85.5%, significantly below the target set by the Department of Health and Social Care to achieve herd immunity and prevent sustained disease transmission. Methods Three medical databases were searched using PICO, supported by the application of inclusion and exclusion criteria and critical appraisal. Results Reminder and recall activities are identified as a cost-effective method for improving childhood immunisation uptake but targeted, individualised and family-centred interventions should be utilised to promote access to childhood immunisations for underserved populations. Vaccination data should remain up to date and a child's vaccination status should be reviewed and meaningfully discussed at every healthcare contact and staff involved in immunisation should have access to appropriate education, training and support. Recommendations Understanding how to provide services and improve vaccine coverage for patients who frequently are not brought is identified as an opportunity for further research, as well as analysing the role of public health teams in identifying local inequalities and supporting GP practices to design and deliver bespoke interventions for their community. It is recommended that communication emphasises the safety and effectiveness of vaccines, while highlighting a child's susceptibility or risk to developing complications. Further research is needed to evaluate how best to communicate this to ensure that the information provided is clear and factual and comprehensible to all parents and carers.
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Henninger, Judith. "Human papillomavirus and papillomavirus vaccines: knowledge, attitudes and intentions of general practitioners and practice nurses in Christchurch." Journal of Primary Health Care 1, no. 4 (2009): 278. http://dx.doi.org/10.1071/hc09278.
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INTRODUCTION: General practitioners (GP) and practice nurses (PN) perform the majority of cervical screening in Christchurch and will have a key role in influencing uptake of human papillomavirus (HPV) immunisation. AIM: To assess and compare GP and PN knowledge about HPV disease, attitudes concerning adolescent sexual behaviour and intentions to recommend HPV immunisation. METHODS: A self-administered, anonymous questionnaire was distributed to GPs and PNs in Christchurch, New Zealand who attended peer-led small group meetings hosted by Pegasus Health Independent Provider Association in May 2008. RESULTS: Participation rate was 39%. Overall, 94% of respondents knew that HPV immunisation will not replace cervical cancer screening; 73% knew that HPV is the cause of cervical cancer; 48% knew that most HPV infections will clear without medical treatment; 20% correctly reported that anogenital warts are not cervical cancer precursors. More GPs reported comfort discussing sexual behaviour with adolescents than PNs (p < .008). While 95% of participants intend to recommend immunisation for 13–15-yearold girls, PNs were more likely than GPs to recommend HPV immunisation to older female adolescents and more often indicated that HPV vaccination may lead to risky sexual behaviour (p < .0001). DISCUSSION: This is the first New Zealand study to assess primary care knowledge and attitudes about HPV and HPV immunisations. The results are encouraging, provide a baseline for future research and may guide the development of training materials for GPs and PNs. KEYWORDS: Papillomavirus, human; papillomavirus vaccines; family physician; primary health care
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Harris, Rachel E., Lee Curtis, Vikas Hegde, Vikki Garrick, Lisa Gervais, Lawrence Armstrong, Caroline Delahunty, et al. "A Decade of Varicella Screening Within a Paediatric Inflammatory Bowel Disease Population." Journal of Crohn's and Colitis 14, no. 5 (December 31, 2019): 608–16. http://dx.doi.org/10.1093/ecco-jcc/jjz207.
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Abstract Introduction Increased risk of opportunistic infection—e.g., varicella zoster infection—secondary to therapies is a cause of morbidity in inflammatory bowel disease [IBD] patients. The UK vaccination schedule does not include varicella immunisation. We aimed to evaluate the varicella screening and immunisation programme in a paediatric IBD population. Methods Data regarding IBD diagnosis, varicella status, and consequent immunisations/treatment interventions were collected retrospectively from the records of patients diagnosed with IBD over a 10-year period [2009–2018]. Results In all, 520 IBD patients were diagnosed; 505/520 [97%] had varicella testing; 46/505 [9%] were naïve. Of 501 patients, 391[78%] were tested before or within 7 days of diagnosis; this increased in the second 5-year period compared with the first (229/268 [85%] versus 162/233 [70%]; p &lt;0.00001). Median diagnosis age of naïve patients was lower [8.3 years versus 12.8 years; p &lt;0.00001]. Where vaccination was feasible, 21/31 [68%] had two and 7/31 [23%] one immunisation. Prednisolone induction led to lower rates of vaccination (5/13 [39%] versus 23/33 [70%] for other induction therapies; p =0.02). Of 28 vaccinated patients, 5 [18%] had suspected breakthrough varicella; and 6/18 [33%] unimmunised patients required post-exposure prophylaxis or treatment for varicella. Immunisation was associated with a decrease in patients requiring post-exposure prophylaxis (0/28 [0%] versus 5/18 [28%]; p =0.0006) and varicella-related hospital admission (1/28 [4%] versus 4/18 [22%]; p =0.01). Conclusions High rates of varicella screening and immunisation within a PIBD population are possible, resulting in a reduction in hospital admissions for varicella treatment. Varicella immunisation may be of increasing importance within the PIBD population with the emergence of novel therapeutic strategies.
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Fekadu, Hailu, Wubegzier Mekonnen, Aynalem Adugna, Helmut Kloos, and Damen HaileMariam. "Inequities and trends of polio immunisation among children aged 12–23 months in Ethiopia: a multilevel analysis of Ethiopian demographic and health survey." BMJ Open 14, no. 3 (March 2024): e079570. http://dx.doi.org/10.1136/bmjopen-2023-079570.
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IntroductionDespite Ethiopia’s policy intention to provide recommended vaccination services to underprivileged populations, inequity in polio immunisation persists.ObjectiveThis study examined inequity and trends in polio immunisation and determinant factors among children aged 12–23 months in Ethiopia between 2000 and 2019.MethodsCross-sectional data from 2000, 2005, 2011, 2016 and 2019 Ethiopian demographic and health surveys were analysed with the updated version of the WHO’s Health Equity Assessment Toolkit software. Six standard equity measures: equity gaps, equity ratios, population attributable risk, population attributable fraction, slope index of inequality and relative index of inequality were used. Datasets were analysed and disaggregated by the five equality stratifiers: economic status, education, place of residence, sex of the child and regions. Multilevel logistic regression analysis was used to identify determinant factors.ResultsPolio immunisation coverage was increased from 34.5% (2000) to 60.0% (2019). The wealth index-related inequity, in coverage of polio immunisation between quintiles 5 and 1, was 20 percentage points for most surveys. The population attributable risk and population attributable fraction measure in 2011 indicate that the national polio immunisation coverage in that year could have been improved by nearly 36 and 81 percentage points, respectively, if absolute and relative wealth-driven inequity, respectively, had been avoided. The absolute difference between Addis Ababa and Afar Region was 74 percentage points in 2000 and 60 percentage points in 2019. In multilevel analysis result, individual-level factors like wealth index, maternal education antenatal care and place of delivery showed statistical significance.ConclusionAlthough polio immunisation coverage gradually increased over time, in the 20-year survey periods, still 40% of children remained unvaccinated. Inequities in coverage by wealth, educational status, urban–rural residence and administrative regions persisted. Increasing service coverage and improving equitable access to immunisations services may narrow the existing inequity gaps.
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Rimmer, J., C. Belk, V. J. Lund, A. Swift, and P. White. "Immunisations and antibiotics in patients with anterior skull base cerebrospinal fluid leaks." Journal of Laryngology & Otology 128, no. 7 (July 2014): 626–29. http://dx.doi.org/10.1017/s0022215114001431.
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AbstractObjective:There are no UK guidelines for the use of antibiotics and/or immunisations in patients with an active anterior skull base cerebrospinal fluid leak. This study aimed to define current UK practice in this area and inform appropriate guidelines for ENT surgeons.Method:A web-based survey of all members of the British Rhinological Society was carried out and the literature in this area was reviewed.Results:Of those who responded to the survey, 14 per cent routinely give prophylactic antibiotics to patients with cerebrospinal fluid leaks, and 34.9 per cent recommend immunisation against at least one organism, most commonly Streptococcus pneumoniae (86.7 per cent).Conclusion:There is no evidence to support the use of antibiotic prophylaxis in patients with a cerebrospinal fluid leak. We propose that all such patients are advised to seek immunisation against pneumococcus, meningococcus and haemophilus.
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Powelson, Jocelyn, Bvudzai Priscilla Magadzire, Abel Draiva, Donna Denno, Abdul Ibraimo, Bonifácia Beleza Lucas Benate, Lídia Carlos Jahar, et al. "Determinants of immunisation dropout among children under the age of 2 in Zambézia province, Mozambique: a community-based participatory research study using Photovoice." BMJ Open 12, no. 3 (March 2022): e057245. http://dx.doi.org/10.1136/bmjopen-2021-057245.
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ObjectiveImmunisations are highly impactful, cost-effective public health interventions. However, substantial gaps in complete vaccination coverage persist. We aimed to describe caregivers’ immunisation experiences and identify determinants of vaccine dropout.DesignWe used a community-based participatory research approach employing Photovoice, SMS (short messaging service) exchanges and in-depth interviews. A team-based approach was used for thematic analysis. The Increasing Vaccination Model guided the analysis and identification of vaccination facilitators and barriers.SettingThis study was conducted in Zambézia province, Mozambique, in Namarroi and Gilé districts, where roughly 19% of children under 2 start but do not complete the recommended vaccination schedule.ParticipantsParticipants were identified through health facility vaccination records and included caregivers of children aged 25–34 months who were fully vaccinated (n=10) and partially vaccinated (n=22). We also collected data from 12 health workers responsible for delivering immunisations at the selected health facilities.ResultsFour main patterns of barriers leading to dropout emerged: (1) social norms and limited family support place the immunisation burden on mothers; (2) perceived poor quality of health services reduces caregivers’ trust in vaccination services; (3) concern about side effects causes vaccine hesitancy; and (4) caregivers hesitate to seek and advocate for vaccination due to power imbalances with health workers. COVID-19 created additional barriers related to social distancing, mask requirements, supply chain challenges and disrupted outreach services. For most caregivers, dropout becomes increasingly likely with compounding barriers. Caregivers of fully-vaccinated children noted facilitators, including accompaniment to health facilities or assistance caring for other children, which enabled them to complete vaccination.ConclusionsOvercoming immunisation barriers requires strengthening health systems, including improving logistics to avert vaccine stockouts and building health worker capacity, including empathic communication with caregivers. Consistent and reliable immunisation outreach services could address access challenges and improve immunisation uptake, particularly in distant communities.
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Suresh, Aneena. "Awareness of Immunisation Health Care Providers on Adverse Events Following Immunisation: A Multicentre Study." Journal of Communicable Diseases 54, no. 1 (March 31, 2022): 1–9. http://dx.doi.org/10.24321/0019.5138.202241.
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Introduction:Adverse events following immunisation (AEFI) are often under-reported in India due to limited awareness among immunisation health care providers negatively affecting the immunisation programme of the country. This study assesses the knowledge, attitude and reporting practices (KAP) of AEFI among immunisation healthcare providers (IHPs) of private hospitals and clinics in South India.Methods: Using a semi-structured questionnaire, 58 IHPs were interviewed. The mean age was found to be 14.5 ± 7.2 years. Few IHPs had good knowledge (34.5%) while 91.4% had a good attitude, but it didn’t influence their good reporting practices (25.9%). The overall KAP score was the highest for physicians (50%), followed by pharmacists (43.8%) and nurses (37.8%).Results: Barriers to effective reporting were lack of knowledge about AEFI surveillance, filling an AEFI reporting form, time constraints and unfamiliarity with electronic reporting.Conclusion: KAP of immunisation health care providers isn’t satisfactory. In recent years, the rate of serious AEFIs has decreased to a greater extent. This also decreased the IHPs’ awareness of AEFI reporting as they don’t need to frequently report. Improving the perception of AEFI and active participation in reporting by IHPs can strengthen the nation’s AEFI surveillance system.
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Martin, Jeannett. "Immunisation." Nursing Standard 14, no. 30 (April 12, 2000): 47–52. http://dx.doi.org/10.7748/ns2000.04.14.30.47.c2812.
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DAVIES, M. K. "Immunisation." Archives of Disease in Childhood 82, no. 4 (April 1, 2000): 282. http://dx.doi.org/10.1136/adc.82.4.282.
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Kamalappanawar, Mr Ramesh, Dr Bimla rani, and Dr Susheel Kumar V. Ronad. "IMMUNISATION." RESEARCH RESERVOIR 8, no. 2 (December 15, 2022): 82–85. https://doi.org/10.47211/trr.2022.v08i02.017.
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Immunisation is the most cost–effective public health intervention. The vaccine prevents illness and death for millions of individuals every year. Children below five years of age are vulnerable and liable to get various diseases and disabilities which may lead to high mortality. I Immunisation is often a prerequisite for enrolment in school or daycare, it's important to keep your children up to date on their vaccines. There are some very rare and very mild side effects that can be the result of vaccinations. These side effects completely depend on the Immunisation you got, and how your specific body will react to it. The benefit of immunisation is that your child has the best possible protection against dangerous diseases.
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McQuaid, Fiona, Rachel Mulholland, Yuma Sangpang Rai, Utkarsh Agrawal, Helen Bedford, J. Claire Cameron, Cheryl Gibbons, et al. "Uptake of infant and preschool immunisations in Scotland and England during the COVID-19 pandemic: An observational study of routinely collected data." PLOS Medicine 19, no. 2 (February 22, 2022): e1003916. http://dx.doi.org/10.1371/journal.pmed.1003916.
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Background In 2020, the SARS-CoV-2 (COVID-19) pandemic and lockdown control measures threatened to disrupt routine childhood immunisation programmes with early reports suggesting uptake would fall. In response, public health bodies in Scotland and England collected national data for childhood immunisations on a weekly or monthly basis to allow for rapid analysis of trends. The aim of this study was to use these data to assess the impact of different phases of the pandemic on infant and preschool immunisation uptake rates. Methods and findings We conducted an observational study using routinely collected data for the year prior to the pandemic (2019) and immediately before (22 January to March 2020), during (23 March to 26 July), and after (27 July to 4 October) the first UK “lockdown”. Data were obtained for Scotland from the Public Health Scotland “COVID19 wider impacts on the health care system” dashboard and for England from ImmForm. Five vaccinations delivered at different ages were evaluated; 3 doses of “6-in-1” diphtheria, tetanus, pertussis, polio, Haemophilus influenzae type b, and hepatitis B vaccine (DTaP/IPV/Hib/HepB) and 2 doses of measles, mumps, and rubella (MMR) vaccine. This represented 439,754 invitations to be vaccinated in Scotland and 4.1 million for England. Uptake during the 2020 periods was compared to the previous year (2019) using binary logistic regression analysis. For Scotland, uptake within 4 weeks of a child becoming eligible by age was analysed along with geographical region and indices of deprivation. For Scotland and England, we assessed whether immunisations were up-to-date at approximately 6 months (all doses 6-in-1) and 16 to 18 months (first MMR) of age. We found that uptake within 4 weeks of eligibility in Scotland for all the 5 vaccines was higher during lockdown than in 2019. Differences ranged from 1.3% for first dose 6-in-1 vaccine (95.3 versus 94%, odds ratio [OR] compared to 2019 1.28, 95% confidence intervals [CIs] 1.18 to 1.39) to 14.3% for second MMR dose (66.1 versus 51.8%, OR compared to 2019 1.8, 95% CI 1.74 to 1.87). Significant increases in uptake were seen across all deprivation levels. In England, fewer children due to receive their immunisations during the lockdown period were up to date at 6 months (6-in-1) or 18 months (first dose MMR). The fall in percentage uptake ranged from 0.5% for first 6-in-1 (95.8 versus 96.3%, OR compared to 2019 0.89, 95% CI 0.86– to 0.91) to 2.1% for third 6-in-1 (86.6 versus 88.7%, OR compared to 2019 0.82, 95% CI 0.81 to 0.83). The use of routinely collected data used in this study was a limiting factor as detailed information on potential confounding factors were not available and we were unable to eliminate the possibility of seasonal trends in immunisation uptake. Conclusions In this study, we observed that the national lockdown in Scotland was associated with an increase in timely childhood immunisation uptake; however, in England, uptake fell slightly. Reasons for the improved uptake in Scotland may include active measures taken to promote immunisation at local and national levels during this period and should be explored further. Promoting immunisation uptake and addressing potential vaccine hesitancy is particularly important given the ongoing pandemic and COVID-19 vaccination campaigns.
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Ames, Sophie, and Gill Kelly. "Exploring how the uptake of childhood immunisations can be improved in England: A systematic review." British Journal of Child Health 5, no. 1 (February 2, 2024): 29–44. http://dx.doi.org/10.12968/chhe.2024.5.1.29.
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Background: Childhood immunisations protect communities against preventable and infectious diseases. Coverage for childhood immunisations in the UK is declining and coverage for the MMR vaccine stands at 85.5%, significantly below the target set by the Department of Health and Social Care to achieve herd immunity and prevent sustained disease transmission. Methods: Three medical databases were searched using PICO, supported by the application of inclusion and exclusion criteria and critical appraisal. Results: Reminder and recall activities are identified as a cost-effective method for improving childhood immunisation uptake but targeted, individualised and family-centred interventions should be utilised to promote access to childhood immunisations for underserved populations. Vaccination data should remain up to date and a child's vaccination status should be reviewed and meaningfully discussed at every healthcare contact and staff involved in immunisation should have access to appropriate education, training and support. Recommendations: Understanding how to provide services and improve vaccine coverage for patients who frequently are not brought is identified as an opportunity for further research, as well as analysing the role of public health teams in identifying local inequalities and supporting GP practices to design and deliver bespoke interventions for their community. It is recommended that communication emphasises the safety and effectiveness of vaccines, while highlighting a child's susceptibility or risk to developing complications. Further research is needed to evaluate how best to communicate this to ensure that the information provided is clear and factual and comprehensible to all parents and carers.
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Amaechi, Uchenna A., Chukwudi A. Nnaji, and Charles S. WIysonge. "Immunisation Agenda 2030: prioritising sustainable immunisation financing." Lancet 402, no. 10410 (October 2023): 1325. http://dx.doi.org/10.1016/s0140-6736(23)01167-4.
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Reynolds, Gary, Mareta Timo, Anjileena Dev, Tracey Poole, and Nikki Turner. "Effective general practice: audit and feedback for the primary series of immunisations." Journal of Primary Health Care 6, no. 1 (2014): 40. http://dx.doi.org/10.1071/hc14040.
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INTRODUCTION: General practice immunisation audits do not always match the national rates recorded on the New Zealand (NZ) National Immunisation Register (NIR). AIM: To complete audits at one general practice for infants requiring the primary series of immunisations (6-week, 3-month and 5-month vaccines) over a 12-month period and compare findings with the NIR audit. METHODS: A manual and electronic practice management system (PMS) audit were compared with identical NIR audit parameters for completion of the 5-month vaccination from 1 February 2011 to 1 February 2012. All three results were then combined with further sub-audits of the total practice newborn population to produce a multifaceted audit, identifying further eligible patients. The NIR database query tool was used to corroborate data on partially immunised and unimmunised patients identified. RESULTS: All three initial audits produced different results for vaccinated and eligible patients: NIR 31/36; PMS audit 39/43; manual audit 41/48. The multifaceted audit identified 48 eligible infants. All 48 (100%) started their primary series 95.8% (46 of 48) fully immunised; 4.2% (2 of 48) partially immunised, missing only one injection. None were unimmunised, contrary to initial audits. Lower levels of timeliness of delivery were confirmed for this practice, with 52.1% (25 of 48) immunised on time. DISCUSSION: Results show 9.7% higher levels of immunisation than reported by NIR statistics for this practice (95.8% vs 86.1%), above current NZ government and World Health Organization targets. The multifaceted audit produced the best estimate of eligible patients and identified deficiencies in vaccine delivery. KEYWORDS: Children; general practice; immunisation schedule; medical audit; New Zealand
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Pal, Moneeta, Felicity Goodyear-Smith, and Daniel Exeter. "Factors contributing to high immunisation coverage among New Zealand Asians." Journal of Primary Health Care 6, no. 4 (2014): 304. http://dx.doi.org/10.1071/hc14304.
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INTRODUCTION: While New Zealand (NZ) immunisation coverage has improved steadily over the years, there is inequity between ethnic groups, with rates lower in Maori and Pacific people and highest in Asian people. This qualitative study aimed to identify attitudes and behaviours of NZ Asian parents of children under the age of five years that might contribute to their seeking immunisation for their children. METHODS: In-depth, semi-structured interviews were conducted to explore attitudes, values, experiences, knowledge, behaviour and perceived barriers regarding childhood immunisation. Transcripts were analysed using a general inductive approach. FINDINGS: Key themes identified were a general positive attitude towards immunisation, being well-informed and aware of the value of immunisation, accepting governmental encouragement to use immunisation services, and perceiving minimal barriers to immunisation services access. CONCLUSION: The findings of this study suggest that high immunisation coverage rates among NZ Asians may be primarily due to parental attitudes, rather than the quality and accessibility of immunisation services in NZ. KEYWORDS: Asian continental ancestry group; child; culture; ethnic groups; immunisation; qualitative research
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Nandini, Nurhasmadiar. "Upaya Edukasi Kader Kesehatan dan Ibu Hamil untuk Peningkatan Cakupan Imunisasi Dasar Lengkap di Kecamatan Pamotan Kabupaten Rembang." Journal of Community Development 1, no. 2 (March 22, 2021): 66–70. http://dx.doi.org/10.47134/comdev.v1i2.11.
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Immunisation is one of the health programs which considered cost-effective and able to prevent millions of deaths and disability which caused by diseases which could be prevented by immunisation. For the past years, the coverage of Basic Complete Immunisation has been increasing in several areas in Central Java. However, there were still some community groups that believed immunisation was harmful for their children and they did not allow their children to be vaccinated. This condition could cause a new case of diseases which usually can be prevented by immunisation, such as Polio, Diphtheria, Tetanus, Hepatitis, and many more. Therefore, this program held to refresh the cadres knowledge about immunisation also provide more knowledge for pregnant mother about immunisation so they agree to let their children vaccinated after they born until they complete the basic immunisation. This community service heldin January – February 2020 in Sendangagung Village, Pamotan, Rembang District. The participants were health cadres and pregnant woman in Sendangagung Village, Pamotan, Rembang District. This event started with a mini pre-test, explanation about immunisation, and discussion. Participants stated that this event increase and refresh their knowledge about immunisation. Moreover, participants also get a booklet about the immunisation so the health cadres might use this booklet as their education media to educate other pregnant women and toddler’s parents about immunisation.
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Moore, Anthony M., Sandra Burgess, Hailey Shaw, Carolyn Banks, Irene Passaris, and Charles Guest. "Achieving high immunisation rates amongst children in the Australian Capital Territory: a collaborative effort." Australian Health Review 35, no. 1 (2011): 104. http://dx.doi.org/10.1071/ah10769.
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Background. In September 2008 the ACT achieved the highest childhood coverage rates in Australia with rates of 93.5% (12–15-month age cohort), 94.9% (24–27-month age cohort) and 90.58% (60–63-month age cohort). Purpose. To analyse the key contributing factors and policy initiatives that have likely to have led to high childhood immunisation rates in the ACT. Methods. Data used in this report were sourced from the Australian Childhood Immunisation Register (ACIR) held at Medicare Australia, General Practice Immunisation Incentives (GPII) ‘calculation’ data held at ACT Division of General Practice and internal immunisation databases held at Health Protection Service. Outcomes. Although the reasons for the high coverage rates seen in children are multi factorial (including national and consumer factors), key reasons locally in the ACT include: (a) the implementation of an ACT-wide immunisation strategy; (b) proactive follow up of children overdue for immunisation; (c) more sustainable provision of immunisation services across both public and private health providers; and (d) a centralised vaccine delivery service and ‘cold chain’ monitoring system. Conclusions. Although nationwide immunisation policy has been successful in increasing childhood coverage rates across all Australian jurisdictions, it is important to also acknowledge local factors that have likely to have contributed to the successful implementation of the Immunise Australia Program at the coal face. What is known about the topic? Childhood immunisation rates have risen significantly in Australia since the mid 1990s following a plethora of initiatives at both a national and state and territory level. This article examines in depth the various factors over the past decade that have likely to have contributed to the high childhood immunisation rates currently seen in the Australian Capital Territory What does this paper add? The ACT changed its strategic thinking towards immunisation provision in 2004 with an increased focus on immunisation delivery in general practice. Immunisation coverage rates improved in the ACT between 2005 and 2008 with general practice increasing their contribution to immunisation provision from 35 to 57% during this time period. This was despite of a drop in full-time equivalent general practices (GPs) in the ACT between 2003 and 2008. At face value the initial decision to increase immunisation provision through general practice in the face of a dwindling GP workforce appeared counter intuitive. What this article illustrates is the importance of having the right mix and proportion of providers delivering immunisation (public clinics v. general practice) as well as having well resourced support systems for vaccine delivery, provider education and data analysis. More importantly this paper illustrates that any disruption in any component of immunisation provision is likely to have a negative effect on coverage rates (examples provided in the article). What are the implications for practitioners? Achieving high immunisation in the ACT has been a collaborative effort by a range of immunisation stakeholders. These groups have formed strong partnerships to raise awareness of the value of immunisation and the importance of receiving vaccinations at the correct time. It is this collective effort across the health portfolio that is likely to have contributed to the ACT achieving high immunisation coverage rates amongst children. It is important for immunisation practitioners to retain strong professional networks with clear delineation of roles in order to maintain high immunisation rates. Such networks must also be adequately prepared for challenges on the horizon (i.e. change in government policy, loss of personnel, change in consumer attitudes towards immunisation, etc.) that may pose a threat towards high immunisation rates.
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Hanshila, Vudaga, Shaik Khadeer, and Syeda Sumera. "Determination of immunisation status of children between 2-5 years of age who attending to teaching institute with concern to both national immunization schedule and optional vaccines." International Journal of Contemporary Pediatrics 11, no. 6 (May 27, 2024): 707–11. http://dx.doi.org/10.18203/2349-3291.ijcp20241352.
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Background: In order to know the causes for non-immunisation, search for societal reasons for primary immunisation along with evaluating coverage. Aim of this current study is to determine the immunisation status of children between 2-5 years of age who are attending teaching health care centre with concern to both National Immunisation Schedule and Optional vaccines. Methods: Study analysed the children's immunisation status, factors affecting their immunisation coverage, and reasons for partial or incomplete immunisation. The information was obtained from the parents using a questionnaire. Information such as socio-demographic variables, immunisation status, causes of their partial immunisation and lack of immunisation. The "vaccination card and the recall" approach was used to determine the recipient's immunisation status. Results: Study found that 70.4% of children had received all recommended vaccinations. Lack of information and ignorance are significant contributors to under-immunization. Other statistically significant contributing factors for the low immunisation coverage include female gender, rural background, low socioeconomic status, born at home, lower mother age, and being from a joint household. BCG vaccination coverage was higher than pentavalent vaccine coverage, probably because of multiple doses needed. Only 77% of kids received vitamin A solution. Conclusions: Paediatrician should mention the next vaccination date and dose at each appointment in order to lower the vaccination dropouts. Parents should be informed regarding the date of vaccination of their child through SMS message, calls, and social media groups.
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Tilley, Elspeth, Niki Murray, Bronwyn Watson, and Margie Comrie. "New Views on a ‘Stuck’ Issue: Communicating about Childhood Immunisation in Aotearoa New Zealand." Media International Australia 152, no. 1 (August 2014): 40–56. http://dx.doi.org/10.1177/1329878x1415200106.
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This article explores attitudes towards immunisation and immunisation communication materials among parents and caregivers currently facing immunisation decisions in Aotearoa New Zealand. The research aimed to discover, from an open-ended qualitative investigation, new ways to conceptualise and explain immunisation decision-making, and identify participants' own views on approaches worth trialling as ways to increase immunisation rates. The research used communication artefacts as talking points, and an action research process to modify these to reflect participants' design suggestions, but was primarily exploratory. It started a broad conversation with participants about their decision-making influences rather than being designed to test any particular attributes of the immunisation communication process. From a qualitative analysis of transcripts of focus-group and in-depth interviews with 107 immunisation decision-makers, themes were drawn. Applying an emic process enabled identification of participants' own ideas that have now broadened the range of possible approaches currently being considered for immunisation communication in Aotearoa New Zealand. Given that immunisation decline is a problem internationally, these participant-driven ideas may also be worth testing in other contexts.
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Jackson, Cath, Lisa Dyson, Helen Bedford, Francine M. Cheater, Louise Condon, Annie Crocker, Carol Emslie, et al. "UNderstanding uptake of Immunisations in TravellIng aNd Gypsy communities (UNITING): a qualitative interview study." Health Technology Assessment 20, no. 72 (September 2016): 1–176. http://dx.doi.org/10.3310/hta20720.
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BackgroundGypsies, Travellers and Roma (referred to as Travellers) are less likely to access health services, including immunisation. To improve immunisation rates, we need to understand what helps and hinders individuals in these communities in taking up immunisations.Aims(1) Investigate the barriers to and facilitators of acceptability and uptake of immunisations among six Traveller communities across four UK cities; and (2) identify possible interventions to increase uptake of immunisations in these Traveller communities that could be tested in a subsequent feasibility study.MethodsThree-phase qualitative study underpinned by the social ecological model. Phase 1: interviews with 174 Travellers from six communities: Romanian Roma (Bristol); English Gypsy/Irish Traveller (Bristol); English Gypsy (York); Romanian/Slovakian Roma (Glasgow); Scottish Showpeople (Glasgow); and Irish Traveller (London). Focus on childhood and adult vaccines. Phase 2: interviews with 39 service providers. Data were analysed using the framework approach. Interventions were identified using a modified intervention mapping approach. Phase 3: 51 Travellers and 25 service providers attended workshops and produced a prioritised list of potentially acceptable and feasible interventions.ResultsThere were many common accounts of barriers and facilitators across communities, particularly across the English-speaking communities. Scottish Showpeople were the most similar to the general population. Roma communities experienced additional barriers of language and being in a new country. Men, women and service providers described similar barriers and facilitators. There was widespread acceptance of childhood and adult immunisation, with current parents perceived as more positive than their elders. A minority of English-speaking Travellers worried about multiple/combined childhood vaccines, adult flu and whooping cough. Cultural concerns about vaccines offered during pregnancy and about human papillomavirus were most evident in the Bristol English Gypsy/Irish Traveller community. Language, literacy, discrimination, poor school attendance, poverty and housing were identified by Travellers and service providers as barriers for some. Trustful relationships with health professionals were important and continuity of care was valued. A few English-speaking Travellers described problems of booking and attending for immunisation. Service providers tailored their approach to Travellers, particularly the Roma. Funding cuts, NHS reforms and poor monitoring challenged their work. Five ‘top-priority’ interventions were agreed across communities and service providers to improve the immunisation among Travellers who are housed or settled on an authorised site: (1) cultural competence training for health professionals and frontline staff; (2) identification of Travellers in health records to tailor support and monitor uptake; (3) provision of a named frontline person in general practitioner practices to provide respectful and supportive service; (4) flexible and diverse systems for booking appointments, recall and reminders; and (5) protected funding for health visitors specialising in Traveller health, including immunisation.LimitationsNo Travellers living on the roadside or on unofficial encampments were interviewed. We should exert caution in generalising to these groups.Future workTo include development, implementation and evaluation of a national policy plan (and practice guidance plan) to promote the uptake of immunisation among Traveller communities.Study registrationCurrent Controlled Trials ISRCTN20019630 and UK Clinical Research Network Portfolio number 15182.FundingThis project was funded by the National Institute for Health Research (NIHR) Health Technology Assessment programme and will be published in full inHealth Technology Assessment; Vol. 20, No. 72. See the NIHR Journals Library website for further project information.
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Kerr, Jessica. "Immunisation and the Law: Slippery Slope to a Healthy Society." Victoria University of Wellington Law Review 37, no. 1 (May 1, 2006): 93. http://dx.doi.org/10.26686/vuwlr.v37i1.5562.
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The immunisation of children against communicable diseases is a crucial public health intervention. Yet the understandable prioritisation of parental autonomy within New Zealand immunisation policy has contributed to consistently unsatisfactory coverage rates, in both absolute and comparative terms. If our immunisation law could be strengthened to eliminate ‘passive’ non-immunisation without fatally undermining parental choice, the goals of ‘population immunity’ might be achievable. Of the three reform options explored by this paper, two are rejected as unworkable. The first, a universal mandatory immunisation requirement, might be justifiable in principle but would encounter prohibitive public opposition. The second, an ‘informed choice’ requirement limited to beneficiaries, is unprincipled and potentially ineffective. The recommended option is more moderate and equitable. Creating a presumption in favour of immunisation at the point of school-entry would shift the legal focus from ‘informed consent’ to United States-style ‘informed refusal’. The degree of effort required to invoke a statutory exemption to immunisation would depend upon the extent to which policy-makers were satisfied that only parents implacably and legitimately opposed to immunisation were invoking it. Barring a dramatic increase in the size of the anti-immunisation lobby, it is suggested that an informed refusal requirement could successfully eliminate passive non-immunisation, thereby potentially achieving population immunity while substantially preserving parental autonomy.
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Siga Tage, Petrus Kanisius, and Herliana Monika Azi Djogo. "Barriers felt by nurses related to childhood basic immunisation in East Nusa Tenggara: A phenomenological study." Jurnal Keperawatan Padjadjaran 10, no. 3 (December 31, 2022): 180–88. http://dx.doi.org/10.24198/jkp.v10i3.2164.
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Background: Immunisation barriers can increase morbidity and mortality associated with vaccine-preventable diseases. Understanding barriers to childhood vaccination is critical to informing effective interventions to maximise coverage. Purpose: This study aims to explore the experiences of nurses involved in immunisation related to the obstacles they experience in immunisation activities. Methods: This research is qualitative research with a phenomenological approach. Nurse participants who manage immunisation activities at the public health centre were recruited using a purposive sampling technique. In-depth interviews were conducted with 15 nurses who work in immunisation activities. Inclusion criteria are nurses who directly provide immunisation services and have managed the immunisation program for more than one year. Exclusion criteria were nurses who were on leave. The study was conducted from August to September 2022, and face-to-face interviews were conducted. Interview transcripts were analysed using the thematic analysis method. Results: Three major themes were generated in this study, namely: 1) barriers to immunisation governance systems, 2) barriers to vaccine recipients, and 3) policy barriers. Conclusions: Interventions to overcome barriers to immunisation need to be carried out comprehensively at various levels, such as promoting the benefits of vaccines for the community, strengthening the capacity of officers' competence, reducing political bias, and funding supporting facilities for immunisation programs.
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Kodriati, Nurul, Putri Eka Mulyana Wahab, and Bunga Bilbina Rizkika. "Pengaruh persepsi pentingnya imunisasi terhadap pelaksanaan imunisasi balita selama pandemi Covid-19." Jurnal Cakrawala Promkes 5, no. 1 (September 23, 2022): 1–7. http://dx.doi.org/10.12928/promkes.v5i1.6466.
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The Covid-19 pandemic has had a significant impact on health services, including basic immunisation for under five children. The goal of this study is to identify whether parents’ perception about the importance of immunisation for their children associate with immunisation of children during the Covid-19 pandemic. From June 2022 to June 2023, an online survey was conducted to parents of children under the age of five. Purposive sample with a 5% margin of error and a 95% confidence level resulting at least 370 minimal samples were required in this study. The logistic regression method was used to examine several factors associated with children’s immunisation during the Covid-19 pandemic including demographic factors, perception about the importance of immunisation, and access related factors. During the 2020 to 2022, 10.9% of respondents did not implement immunisation, and 0.8% stated that immunisation is not necessary for their children. During the Covid-19 pandemic, parents who believe immunisation is necessary were 10 times more likely to immunise their children under the age of five (95% CI: 5.9 - 20.5). The findings of this study suggest that community education and understanding should be maintained in order to ensure the parents understand the importance of immunisation and further to increase immunisation coverage.
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Syawqi, Rahmat, Finny Fitry Yani, Asrawati, and Rinang Mariko. "Catch-up immunisation for children in earthquake-affected areas of West Pasaman, Indonesia." E3S Web of Conferences 604 (2025): 05003. https://doi.org/10.1051/e3sconf/202560405003.
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Children are a particularly vulnerable population when exposed to natural disasters and experience increased problems related to physical health, mental health and post-disaster learning. The conditions of displacement during a disaster will cause an increased risk of morbidity to mortality of infectious diseases and even potential outbreaks. The success of immunisation efforts at the scene of a disaster is a successful effort to reduce the mortality rate due to Immunisation Preventable Diseases. However, in emergency or disaster situations, there can be significant disruption or reduction in routine immunisation services, delays or temporary suspension of immunisation programmes. Immunisation achievements in West Pasaman Regency, especially in Kenagarian Kajai, still have not reached the target of forming herd immunity. The Covid 19 pandemic is one of the causes of low immunisation achievements and the earthquake could further reduce it. Efforts to achieve immunisation targets must also be made in a disaster situation, one of which is in the form of an immunisation catch-up program. We collaborated with various parties in Kenagarian Kajai, West Pasaman to conduct catch up immunisation through posyandu as an effort to ensure children in disaster locations still have the opportunity to get immunised according to the recommended immunisation schedule.
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Syifa Faikhatul Ilmi and Efri Diah Utami. "Influence Of Health Behaviour Factors On Basic Immunisation In Indonesia 2022." Saintika Medika 20, no. 2 (December 31, 2024): 138–52. https://doi.org/10.22219/sm.vol20.smumm2.35004.
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Background: The coverage of complete basic immunisation in Indonesia from 2020 to 2022 never reached the target of the 2020-2024 National Medium-Term Development Plan despite various efforts made by the government. As a result, there are many cases of infectious diseases in children. Therefore, this study aims to determine the overview of the coverage of complete basic immunisation in Indonesia in 2022 and the effect of antenatal care visits, doctor ratio, and ownership of immunisation documents on the coverage of complete basic immunisation in Indonesia in 2022. Methods: This study uses data from the Central Bureau of Statistics publication and the Ministry of Health publication. The analysis method used in this study is multiple linear regression analysis. Results: Antenatal care visits and the ratio of doctors have a positive and insignificant effect on the coverage of complete basic immunisation in Indonesia in 2022 while ownership of immunisation documents has a significant positive effect. Conclusion: The variable of ownership of immunisation documents is the most influential variable on the coverage of complete basic immunisation. This variable will increase the coverage of complete basic immunisation by 1.377 percent every 1 percent increase in the percentage of ownership of immunisation documents.
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Zirimenya, Ludoviko, Gyaviira Nkurunungi, Jacent Nassuuna, Agnes Natukunda, Alex Mutebe, Gloria Oduru, Grace Kabami, et al. "Impact of BCG revaccination on the response to unrelated vaccines in a Ugandan adolescent birth cohort: randomised controlled trial protocol C for the ‘POPulation differences in VACcine responses’ (POPVAC) programme." BMJ Open 11, no. 2 (December 2020): e040430. http://dx.doi.org/10.1136/bmjopen-2020-040430.
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Introduction There is evidence that BCG immunisation may protect against unrelated infectious illnesses. This has led to the postulation that administering BCG before unrelated vaccines may enhance responses to these vaccines. This might also model effects of BCG on unrelated infections. Methods and analysis To test this hypothesis, we have designed a randomised controlled trial of BCG versus no BCG immunisation to determine the effect of BCG on subsequent unrelated vaccines, among 300 adolescents (aged 13–17 years) from a Ugandan birth cohort. Our schedule will comprise three main immunisation days (week 0, week 4 and week 28): BCG (or no BCG) revaccination at week 0; yellow fever (YF-17D), oral typhoid (Ty21a) and human papillomavirus (HPV) prime at week 4; and HPV boost and tetanus/diphtheria (Td) boost at week 28. Primary outcomes are anti-YF-17D neutralising antibody titres,Salmonella typhilipopolysaccharide-specific IgG concentration, IgG specific for L1-proteins of HPV-16/HPV-18 and tetanus and diphtheria toxoid-specific IgG concentration, all assessed at 4 weeks after immunisation with YF, Ty21a, HPV and Td, respectively. Secondary analyses will determine effects on correlates of protective immunity (where recognised correlates exist), on vaccine response waning and on whether there are differential effects on priming versus boosting immunisations. We will also conduct exploratory immunology assays among subsets of participants to further characterise effects of BCG revaccination on vaccine responses. Further analyses will assess which life course exposures influence vaccine responses in adolescence. Ethics and dissemination Ethics approval has been obtained from relevant Ugandan and UK ethics committees. Results will be shared with Uganda Ministry of Health, relevant district councils, community leaders and study participants. Further dissemination will be done through conference proceedings and publications. Trial registration number NCT10482904.
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Guevarra, Maria Victoria C., Leena Gupta, Timothy C. Heath, and Margaret A. Burgess. "A Statewide Survey of General Practitioners in NSW, Australia, about Immunisation and Strategies to Increase Childhood Immunisation Rates." Asia Pacific Journal of Public Health 11, no. 1 (January 1999): 20–25. http://dx.doi.org/10.1177/101053959901100105.
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A statewide survey was conducted to ascertain GPs' views in New South Wales (NSW), Australia, about the potential usefulness of strategies to increase immunisation rates and to facilitate providing childhood immunisation in their practice. The survey also explored the usefulness of information sources about immunisation. From September 1997-January 1998, a cross-sectional study using a four page self-administered questionnaire was undertaken. Four hundred GPs practising in NSW, Australia were randomly selected and 343 were eligible to participate. Of these, 281 returned a completed questionnaire (82% response rate). Ninety-one percent and 88% of GPs, respectively, agreed that television campaigns or registering children with the national Australian Childhood Immunisation Register (ACIR) w ere likely to increase immunisation rates. Sixty-two percent of respondents considered that the media created unwarranted parental concern about immunisation. GPs most commonly rated availability of an ACIR list of children overdue for immunisation, better parent educational material and better access to vaccines as strategies which would make immunisation easier. Sixty percent of respondents felt that increased GP payments would be successful in increasing immunisation rates. Only 51% indicated that they had used the “Australian Immunisation Procedures Handbook 6th edition” (a national clinical practice guideline) in the previous month. This study identified GP support for many initiatives aimed at increasing immunisation rates in Australia although GPs were sceptical about the benefits of some programmes. Studies to monitor the impact of GP incentives on immunisation rates in populations and individual practices are underway. These will be useful in determining whether GPs' opinions found in our study correlate with practice in this regard.
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&NA;. "Maternal immunisation." Inpharma Weekly &NA;, no. 1178 (March 1999): 4. http://dx.doi.org/10.2165/00128413-199911780-00004.
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Bedford, Helen. "Childhood Immunisation." Paediatric Nursing 8, no. 1 (February 1996): 28–29. http://dx.doi.org/10.7748/paed.8.1.28.s20.
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McCarthy, Helen. "Childhood immunisation." Nursing Standard 15, no. 44 (July 18, 2001): 39–44. http://dx.doi.org/10.7748/ns2001.07.15.44.39.c3058.
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Hall, Robert. "Influenza immunisation." Australian Prescriber 25, no. 1 (February 1, 2002): 5–7. http://dx.doi.org/10.18773/austprescr.2002.004.
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Bickle, Ken, and Peter Collignon. "H1N1 immunisation." Australian Prescriber 33, no. 3 (June 1, 2010): 64–67. http://dx.doi.org/10.18773/austprescr.2010.029.
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Rowles, Greg, and Peter Collignon. "H1N1 immunisation." Australian Prescriber 33, no. 3 (June 1, 2010): 64–67. http://dx.doi.org/10.18773/austprescr.2010.030.
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Cook, Rosemary. "Paediatric immunisation." Nursing Standard 8, no. 14 (December 15, 1993): 23–28. http://dx.doi.org/10.7748/ns.8.14.23.s31.
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Kempson, Sharon. "Travel immunisation." Nursing Standard 25, no. 1 (September 8, 2010): 59–60. http://dx.doi.org/10.7748/ns.25.1.59.s57.
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Duclos, Philippe, and Charles-Antoine Hofmann. "Immunisation Safety." Drug Safety 24, no. 15 (2001): 1105–12. http://dx.doi.org/10.2165/00002018-200124150-00002.
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