Continuous Quality Improvement in Childhood Immunisation

Essential – maintain routine immunisation

Immunisation is a safe and effective way to protect children from serious vaccine-preventable diseases. The Australian National Immunisation Program (NIP) provides free vaccines for all children in Australia against 14 diseases. A report from the Australian Institute of Health and Welfare indicated the vaccine-preventable disease burden rate reduced by 31 per cent between 2005 and 2015 due to more vaccines being included in the NIP Schedule.

According to the Department of Health and Aged Care, Australia’s national aspirational vaccine coverage target to achieve herd immunity is 95 per cent Herd Immunity is when enough people are vaccinated against a disease to prevent it from spreading. However, the national immunisation coverage rates were still under 95 per cent for all one to five years old as of June 2022. Hence, increasing and maintaining immunisation coverage rates in all age groups to 95 per cent is essential, making spreading disease from person to person more unlikely.

COVID-19 impact on routine childhood vaccinations

RCH National Child Health POLL from Royal Children’s Hospital Melbourne found one in five children had their routine vaccination doses delayed after the onset of the COVID-19 pandemic. About 43 per cent of children aged younger than five years were overdue for their routine childhood vaccinations.

Some reasons behind parents/caregivers delaying children’s routine immunisation might include:

• The fear of catching COVID-19 from healthcare facilities
• Routine childhood vaccination is considered the least priority during the COVID-19 pandemic by the parents
• Lockdown/Isolation due to COVID-19 infection within the household
• Limited immunisation services from medical providers

Delaying or missing vaccination is a pressing problem in Australia and even globally. Children are more likely to contract vaccine-preventable diseases. Consequently, they have lower herd immunity. This might place immunocompromised populations, neonates, and infants at higher risk of an outbreak.

How can general practices support and improve childhood immunisation uptake?

Identify children’s immunisation status regularly

• POLAR is a useful tool for general practice to identify children who are missing scheduled vaccines at a certain age in your practice. General practices can follow the POLAR Immunisation Walkthrough to identify patients aged one to two years old who may be missing their first dose of MMR (measles, mumps, and rubella) and Meningococcal ACWY.

Tips and tricks:

You can create a private bookmark to remember the filters applied, and it will enable you to track progress at any time. This private bookmark function is available in all POLAR reports. By creating your bookmark, one click from the bookmark list will enable you to bring up all the filters you have applied for the previously required patient cohort.

POLAR Walkthrough for private bookmarks

• The 10A report identifies patients due/overdue for immunisation. General practices can follow the walkthrough (Pages 9 to 17) to request this report from the Australian Immunisation Register (AIR).

Provide education to parents/caregivers and reduce their concerns about immunisation risks

• Increase awareness of the immunisation schedule by informing parents of the up-to-date National Immunisation Program Schedule (updated on October 2021), and advise them to download the Save The Date To Vaccine app.
• Provide resources for parents to take home such as Following Vaccination – what to expect and what to do. You can order this pad from the Department of Health.
• Advise of the facts a higher number of under-vaccinated children will decrease protection from communicable diseases and place other children and vulnerable people at risk.

Planning practice and patient outcome improvements

• General practices can participate in SWSPHN’s QIPC program which contributes to clinical quality improvement outcomes like childhood immunisation rates. Your assigned Health Systems Improvement Officer will support you in achieving better health outcomes for children and financial prospects.
• Implement reminder and recall systems to increase routine vaccination uptake and close the immunity gaps.
• Encourage clinicians to maintain up-to-date childhood immunisation knowledge. You can find out a lot of useful information from:
  Australian Immunisation Handbook
  Catch-up Calculator 
  NCIRS fact sheets 
  Public Health Unit 
  Childhood Immunisation HealthPathways – login detail: Username: select the region in which you practise (Bankstown, Fairfield, Highlands, Liverpool, Macarthur) and Password: network.