Sneak peak at great immunisation rates

Sneak peak at great immunisation rates for 2 year olds particularly among

Two Waikato primary health organisations worked tirelessly to immunise eligible two-year-olds and their 100 per cent strike rate helped the Waikato District Health Board achieve its immunisation health target and get an "outstanding" mark from the Health Ministry.

The latest health target results are not out until later this week but there is every reason now to celebrate the huge improvements in Maori and Pacific Island immunisation rates in the final quarter ended 30 June, said planning and funding general manager Brett Paradine.

The work in primary care saw an increase in Maori two-year-old immunisation rates from 68 per cent in June 2009, to 84 per cent in June 2010 - just a fraction away from the national overall target.

Similarly, Pacific immunisation rates for two-year-olds increased by 13 per cent up from 80 per cent in June 2009 to 93 per cent coverage.
Across all two-year-olds, Waikato DHB improved from 75.7 per cent to 85.6 per cent.

"We had agreed a target of 81 per cent and exceeded it. Our goal now is to get to 90 per cent by the end of the year," he said.

"Achieving coverage is high on the agenda for all key providers."

North Waikato and Toiora PHOs had excellent results, he said.

Toiora PHO chief executive Tureiti Moxon said the result was a concerted effort by its nine GP practices.

"With focus and sheer determination the nursing staff and community health workers worked tirelessly to immunise our babies.

"Immunisation Outreach nurses were also utilised to follow up whanau in their homes and Radius Medical took the bold step of encouraging whanau participation with their $10 incentive.

"These results could only be achieved through the commitment of our GP practices to improve the health of our babies," said Mrs Moxon.
Waikato DHB medical officer of health Felicity Dumble said it was very much a team effort by all health providers.

"The excellent work in primary care, by the National Immunisation Register, non-government organisations and the Immunisation Advisory Council has undoubtedly contributed to Waikato achieving its target and reducing immunisation inequalities for Maori and Pacific youngsters," said Dr Dumble.
"Achieving these targets really requires a team effort involving parents, the vaccinators and multiple other health professionals including educators, midwives, community workers and GPs."

Dr Dumble said achieving increased coverage among Maori and Pacific was very encouraging.

"Unfortunately the impact of these diseases is greater among Maori. It is important that vaccination services are acceptable and accessible, particularly for those most vulnerable in our community."

"Getting your children vaccinated on time is very important," said Dr Dumble.
"The aim of vaccination is to give children immunity while they are most vulnerable and before they encounter these diseases. A six-week old baby is tiny and fragile and that is the very reason they need to have their vaccines.
"Pertussis or whooping cough is annoying for an adult but potentially lethal for a wee baby. They need to start their vaccinations at six weeks to ensure they are developing their own antibodies as soon as possible. Even if a mother has antibodies to a disease and passes them on to her infant, any protection gained that way wears off over a few months."

The Waikato region's immunisation stakeholders are already working towards achieving the 90 per cent target by June 2011.

"When coverage reaches 95 per cent we can prevent outbreaks in our population. The vaccine preventable diseases are still out there and a potential threat," said Dr Dumble.

Waikato DHB Child Health project manager Kay Montgomery said behind the scenes strategic planning aided the increase in coverage and would continue to do so.
Waikato DHB's hospital and health services provider arm, Health Waikato, initiated the 'Going Home' project last year.

"'Going Home' follows the information flow as the infant enters the delivery suite at Waikato Hospital and exits either the delivery suite or ward 54 and back to the medical centre, ultimately engaging the infant for their six week immunisation," said Mrs Montgomery.

"We developed an electronic discharge form for when the infant is discharged from secondary care, and in receipt of the discharge summary, all PHOs now have a protocol which initiates a letter to parents and welcomes them to the practice, and advises them they are enrolled."

The medical centres then send a letter out about four weeks later with an invite to attend six-week immunisations.

"This provides a streamlined system for more than 3000 newborn infants back to primary care per year," said Mrs Montgomery.

Waikato DHB key messages:

Waikato children do matter. Love them, protect them, immunise them.
The 10 key tasks agreed to by all health providers were:
1. know who and where children are - track and count them
2. become an NIR expert
3. routine pre calls for all immunisations
4. timely recalls for overdue immunisations
5. share immunisation coverage across all practices/PHOs
6. improve access to immunisations - no appointments for example
7. opportunistically immunise where possible
8. promote immunisations whenever you see a child
9. promote immunisation through antenatal and well child services
10. use opportunistic immunisation services efficiently.

We reached the target by:
* improving data integrity and data mapping in general practice to National Immunisation Register (more than 2000 missing immunisation events in one quarter were recorded through this work by the NIR)
* keeping Plunket educating about immunisations at every visit
* having a mobile service which targets low coverage communities and hard to reach children and vaccinates in the van and at home
* establishing a hospital based immunisation service where inpatients, out patients and ED presentations are immunised if overdue
* outreach immunisation services delivered to Pacific and Maori families
* performance management and incentive payments to general practice for achieving targets.
ends