Immunisation

Introduction

The Immunisation Program within the Divisions of General Practice continues to be greatly appreciated by General Practitioners, GP Nurses and other Immunisation Providers. The program has contributed to the health and wellbeing of the community by decreasing vaccine preventable disease, it has resulted in the Government having a successful population health strategy and it has been financially rewarding to General Practitioners. Due to this overwhelming accomplishment, funding for the Local Immunisation Coordinator positions is to continue for a further 3 years. This will enable the Divisions of General Practice to continue to support immunisation providers, in particular General Practitioners in all aspects of the provision of a quality immunisation service. Education and implementation of the new schedule on November 1st, continuos cold chain maintenance support, provision of resources and ongoing assistance with recall and reminder systems will ensure that immunisation rates will continue to improve within the Division.

The Adelaide Northern Division continues to work hard to attain good Immunisation coverage for children aged 0 – 7 years. As of the May 2005 quarter, the Division is ranked in 9th position in the State with an immunisation rate of 90.3%, and we are currently ranked 50 nationally. Over the past 2 years, the ANDGP has maintained between 90% and 92% coverage, but have not been able to achieve higher rates than that. I am sure that we can, it just means that we all need to work together to be diligent in offering opportunistic immunisations, reporting all encounters to the ACIR in a timely fashion and having a first-rate recall system in place. It is important to use the ACIR 020A (GPII Practice Reports) reports that come to your Practice each quarter to identify children overdue for immunisation so they can be recalled in to your practice as soon as possible to commence a catch-up program.

On a state level, South Australia continues to have immunisation coverage above the national average. Once again this is attributable to Divisions having a successful immunisation program and to the many hard working General Practitioners in the community. The success of Immunisation Programs are not only dependent on high coverage rates, they are also dependent on a quality service delivery system. Vaccines must be transported and stored correctly and vaccines must be given correctly. There is absolutely no point in vaccinating 500 children in the community if the vaccines are impotent because they have not been stored correctly or administered correctly.

The May quarter rates indicate that 90.3% of children aged 0 – 7 years living in the ANDGP catchment area was fully immunised. Of the 47 Practice registered with GPII, 26 had an increase in their practice percentage rate in the past 12 months, 19 had a decrease and 2 remained unchanged from the last quarter. Currently we have 41 practices with rates above 90%, 4 practices with rates between 85% - 90% and only 2 practices with rates below 85%.

Age Range	Children (No)	Children (%)	Children Fully Immunised	% Fully Immunised
0 to <4 months	701	3.8	662	94.4
4 to <12 months	1639	8.9	1366	83.3
12 to <18 months	1264	6.8	961	76.0
18 to <48 months	6691	36.2	6241	93.3
48 to <84 months	8186	44.3	7461	91.2
OVERALL	18481	100.0	16694	90.3

What a busy 12 months it has been, and I have to say, the next 12 months looks just as busy if not more so! Planning has begun for education sessions for the schedule change that is due to occur on 1st November 2005, when IPV combination vaccines and Varicella vaccine will become part of the funded schedule. It is advisable that usage of OPV and DTPa stock in your Practice is monitored closely and only small amounts are ordered as this change-over date creeps closer to reduce the amount of vaccine wastage.

Highlights

• The Local Immunisation Coordinator and the South Australian Immunisation Coordination Unit developed a consent resource folder to assist the public to make a valid consent and decrease the amount of time Providers require for an immunisation encounter. Funding was obtained from the South Australian Immunisation Coordination Unit to procure the services of a graphic designer to assist with this project. One folder has been sent to every Immunisation Provider site in South Australia while extra folders can be obtained free of charge through the Local Immunisation Coordinators in each Division of General Practice or the South Australian Immunisation Coordination Unit.
• A continual collaborative working relationship with other immunisation service providers such as Local Government, Child and Youth Health and the Royal District Nursing Society has been fundamental to ensure quality; affordable immunisation services are being provided. To ensure the Local Immunisation Coordinator is clinically competent, 38 hours of clinical practice has been completed at different public sites and a GP site this year.
• Immunisation Update sessions have been performed for Practice staff on a quarterly basis. These sessions have been well received as staff acknowledge that the field of Immunisation constantly changes and frequent updates are essential. In March 2005, the South Australian Immunisation Coordination Unit produce a basic immunisation workshop package titled “Immunisation – The Basics”. The workshop was designed for the Local Immunisation Coordinators to deliver to all persons interested or involved in any way in Immunisation. Attendees have included GP’s (not as many as we would like!!), nurses from public, private, Aged Care and hospital sites, Local Government EHO’s, ambulance officers, Practice Managers and Pharmacists. This full day workshop has been positively received as many of these attendees do not have any other immunisation education opportunities. The workshops will be evaluated toward the end of the year and changes made to the presentations as needed before being re-offered in 2006. The Adelaide Northern Division of General Practice Local Immunisation Coordinator has assisted other Immunisation Coordinators to deliver this workshop in Naracoorte, Mount Gambier, Murray Bridge, Minlaton and Port Augusta.
• The Immunisation Coordinator attended:
  • 9th National Immunisation/1st  Public Health Association Asia Pacific     Conference in Melbourne.
  • AGPAL Risky Business Conference in Adelaide.
  • South Australian Immunisation Network meeting in Berri.
  • Royal College of Nursing Conference in Wollongong.
  • Population Health Reform Seminar in Adelaide.
  • SADI Conference in Adelaide.
• Involvement in a successful multi-divisional CPD activity on Pneumococcal Disease and Vaccines. An Immunisation update in collaboration with the Northeast Division of General Practice was also offered to Pharmacists and Aged Care workers
• Completed the Hard to Reach Project titled “COINS Project” – Children Overdue for Immunisation in the Northern Suburbs. This project involved 5 postcode areas within the Division targeting children who were 4 months or more overdue for their 4 year old immunisations, but were otherwise fully immunised. A total of 835 children met the criteria for the project. 239 of these could not be contacted as address and phone contact details were not up to date. The final report for this project is now available.
• Immunisation Information has been delivered to the Public throughout the year at a variety of functions. The Local Immunisation Coordinator has given 2 information sessions to the Post Natal Mothers Group at Central Districts Private Hospital, 5 information/education sessions to TAFE college students (nursing and childcare), information booths at National Playgroup Expo, Health Smart Expo, Children’s and Babies Expo and the Playford Community Health Expo.
• A Flu and Pneumococcal Immunisation Program was held at Muna Paiendi. Overall 3 immunisation days were held where Flu, Pneumovax 23 and MMR vaccine was offered to all eligible ATSI persons. The Aboriginal Health workers would like this program to be offered each year.

Challenges and Direction

During the next 12 months support will be continue to be offered to assist practices to achieve higher immunisation rates. This can be achieved with assistance in managing the Overdue Children Report from the ACIR. During this time there will also be a new immunisation schedule released and the Local Immunisation Coordinator will be visiting Practices to support General Practitioners and their staff to implement these changes as smoothly as possible.

Ongoing education of Immunisation Providers will be of paramount importance as new information, policies and vaccines are released. A multi Divisional CME event is currently being planned for late September. The “Immunisation – The Basics” Workshops will continue to be presented in 2006 as well as quarterly Immunisation Update sessions. These sessions and the workshop is open to all staff who have an interest in keeping up to date with what is new in the immunisation field.

The Immunisation Coordinator will be attending the Royal College of Nursing Conference and the Australian Divisions of General Practice Conference to present the ‘Immunisation: What you need to know before you consent’ Resource Folder.