Regional Immunisation Initiatives:
Improving immunisation service for
Victoria's adolescents
Chelsea Taylor
Senior Project Officer and Policy Advisor,
Immunisation Section
August 2014
Regional Immunisation Initiatives
• December 2010 Minister approved a range of initiatives and
projects targeting immunisation service delivery including:
–
–
–
–
–
Enhanced adverse event surveillance
New immunisation service at Monash MC
Expanded service at RCH
Low coverage program through GPV
Low coverage HPV initiative through Cancer
Council
AND…
• Regional Immunisation Initiatives 2011-12 and 2012-13
• Address secondary school coverage in all regions
• Targeted Indigenous initiatives (identified regions)
2008-13 comparison of state-wide immunisation
coverage: Childhood and adolescent programs
100%
95%
93%
91%
90%
~ 20% gap
85%
Child Cohort 1
80%
78%
76%
75%
Child Cohort 2
Child Cohort 3
Year 10 dTpa
70%
70%
Year 7 HPV
Year 7 Varicella
65%
60%
55%
50%
2008
2009
2010
2011
2012
2013
Regional Secondary School Participation
• In 2010, every region had below 80% coverage for each
program
• In 2010, 5 out of 8 regions had ≤ 70% coverage for 1 or more
programs
• 7 out of 8 regions had a reduction in coverage between
2008, 09, 10 for 1 or more programs
• 6 out of 8 regions had a reduction in coverage by > 5%
between 2009-10 for 1 or more programs
Student participation by DH region and year
Secondary school Year 10 - dTpa
100%
95%
79.0%
79%
79%
81%
80%
76%
2011 Coverage
72%
2012 Coverage
69%
68%
70%
2010 Coverage
69.0%
72%
76.0%
78%
74%
80%
77%
77%
74%
72.0%
72%
72%
79%
79%
75.0%
76%
75%
76.0%
75%
76%
73%
80%
76.0%
74%
79%
75%
85%
78.0%
83%
90%
2013 Coverage
2010 State avg
2011 State avg
2012 State avg
2013 State avg
60.0%
65%
60%
55%
50%
Barwon
Eastern
Gippsland
Grampians
Hume
Loddon
Mallee
Northern
Western
Southern
Student participation by DH region and year
Secondary school Year 7 - HPV
100%
95%
90%
85%
78.0%
2009 Coverage
2013 Coverage
66%
68.0%
68%
66%
2008 State avg
63%
62%
66%
74%
71.0%
73%
73%
2012 Coverage
74%
73%
74%
77%
70%
69.0%
71%
74%
76%
78.0%
80%
79.0%
77.0%
73%
72%
76%
68%
69%
70%
69%
71.0%
75%
76%
73.0%
72%
72%
80%
2008 Coverage
65%
60%
55%
50%
Barwon
Eastern
Gippsland
Grampians
Hume
Loddon
Mallee
Northern
Western
In 2012 no data provided by Ararat (Grampians), Hobsons Bay (Western), Kingston (Southern) or Wyndham (Western)
councils indicating Yr 7 female enrolment number
2010-11 data not released from HPV Register and therefore not available
Southern
2009 State avg
2012 State avg
2013 State avg
Student participation by DH region and year
Secondary school Year 9 – HPV males
100%
95%
90%
85%
80%
2013 Coverage
75%
2013 State avg
66%
59%
Hume
Loddon
Mallee
58%
59%
60%
63%
64%
66%
65%
65%
63%
70%
55%
50%
Barwon
•
Eastern
Gippsland
Grampians
2013-2014 time-limited HPV program for Year 9 boys
Northern
Western
Southern
Student participation by DH region and year
Secondary school Year 7 & 9 HPV program 2013
100%
58%
64%
63%
61%
63%
69%
72%
76%
71%
61%
66%
61%
71%
73%
77%
64%
71%
72%
65%
70%
66%
69%
70%
76%
80%
77%
90%
60%
Female 7
50%
Male 7
Male 9
40%
30%
20%
10%
0%
Barwon
Eastern
Gippsland
Grampians
Hume
Loddon
North West
Southern
pi
ne
ur
r in
di
nd
i
a
at
ta
on
g
W
od
on
g
W
an
ga
r
To
w
St
ra
th
bo
gi
e
M
51.6%
66.7%
72.0%
73.5%
72%
83%
77.3%
80.8%
82%
81%
81.2%
79.0%
85%
80%
81%
82.1%
80%
81%
80%
78%
74.2%
76%
72.4%
71%
71.2%
67.5%
66%
64%
63.3%
65%
oi
ra
52.1%
81%
80.2%
80.4%
81.6%
85%
89%
90%
M
he
ll
ld
55%
itc
an
sf
ie
73.7%
74%
73.6%
73%
80%
M
M
69%
70%
67.8%
66%
75%
In
di
go
G
re
la
at
er
Sh
ep
pa
rto
n
70%
66%
85%
80.8%
99.8%
96.9%
100%
Be
na
l
Al
Hume Region
Secondary school Year 10 - dTpa
95%
2010 Coverage
2011 Coverage
2012 Coverage
60%
50%
2013 Coverage
2010 Region avg
2011 Region avg
2012 Region avg
2013 Region avg
Hume Region
Secondary school Year 7 - HPV
81%
84.0%
72.0%
77.0%
82.0%
82.0%
2008 Coverage
2009 Coverage
2012 Coverage
65.0%
79.0%
72.0%
78.0%
75.0%
78.0%
61.0%
64%
64%
63.0%
74.0%
73%
77.0%
82.0%
66%
74.0%
77.0%
76.0%
65.0%
70%
67.0%
72.0%
70.0%
66%
80%
77.0%
74.0%
71.0%
75.0%
76%
81.0%
83.0%
90%
84.0%
91.0%
100%
2013 Coverage
2008 Region avg
60%
2009 Region avg
2012 Region avg
2013 Region avg
50%
33.0%
40%
•
•
•
•
No data for 2012 reflects council not providing a Yr 7 female enrolment number
2010-11 data not released from HPV Register and therefore not available
Councils’ 2012 service provision by Wodonga Mobile Van
Councils* 2013 service included in Wodonga data
ob
i
le
Va
n
a
M
a
W
od
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oi
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di
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Be
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lla
at
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Sh
ep
pa
rto
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Al
pi
ne
30%
Hume Region
Secondary school Year 9 – HPV males
100%
68%
80%
76%
79%
90%
70%
55%
60%
60%
60%
2013 Coverage
50%
33%
40%
•
•
Councils* 2013 service included in Wodonga data
2013-2014 time-limited HPV program for Year 9 boys
a
W
od
on
g
*
at
ta
W
an
ga
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w
on
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In
di
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la
at
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Sh
ep
pa
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Be
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pi
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30%
2013 Region avg
3 changes to 2015 school vaccine program
1. Changes to the PHWA Regulations
•
Principals are authorised to release student/parent contact details to
councils
2. dTpa moving to Year 7 only from 2016; Year 7,8,9 &10 to be
immunised in 2015
•
Letter to CEOs/MAV for support sent March & April 2014
•
Letter to education sectors for support sent March 2014
•
Emails to all councils with CEO letters attached May 2014
•
Upfront administrative bonus payment in July 2014
3. Cease Year 9 HPV boys
•
Time limited program for Year 9 (14-15 boys) ends 31 December 2014
•
No catch-up program in 2015
The Victorian Regional Immunisation Initiatives
Goal
To increase immunisation participation and coverage rates
amongst Victorian adolescents
Objectives
Raise awareness (providers, students, parents, teachers)
Build capacity amongst immunisation providers to enhance service delivery
Improve delivery of school-based immunisation program (providers, schools)
Improve access for hard-to-reach adolescent communities
Development of
consistent models of
practice
Resource
Development
Education
provision
Capacity building
What we’re doing…Snapshot of strategies
Public Health & Wellbeing Amendment
(Immunisation Services) Regulations 2013
Local
Council
School
Students
Parents
Consent Card Distribution
Consent Card Return
•
Under previous arrangements, privacy legislation restricted schools’ ability
to release contact details parents to local council.
•
Therefore local council reliant on information being communicated via
school to the student to the parent.
•
Unable to follow-up those students who didn’t return a card.
Public Health & Wellbeing Amendment
(Immunisation Services) Regulations 2013
Effective from 1 December 2013:
(1) …a Council may request the principal of a secondary school located within the municipal
district to disclose the following information about a student enrolled at the school –
a)
b)
c)
d)
e)
f)
The name of the student;
The student’s date of birth;
The student’s gender;
The class or group to which the student is attached;
The name of the parents or guardians of the student and their telephone
numbers, email addresses and postal addresses
The languages spoken at the student’s home
(2) On receiving a request under the subregulation (1), the principal may disclose information
held by the school.
– Results in:
» Councils ability to directly communicate information and follow-up with
parents/guardians
» Relieving schools of administrative burden; limited resources directed core
business of health promotion and program support
Accessible,
credible,
reliable,
engaging
information
regarding
adolescent
immunisation
One-stop shop
for schools,
students,
parents and
teachers
Immune Hero
School immunisation kit and agreement
1. Agreement
2. Guide
3. Ready Reference
•
Formalises agreement between
immunisation provider and
school principal
•
Outlines school-based
immunisation program process
and activities
•
Clarifies roles and responsibilities
of school and council staff
PREZI - School-based educational resource
•
Education sessions for school Community-(Teachers, Parent's, Students)
•
Facilitate meetings with councils & A/P’s to discuss SSI program and clarify
roles and responsibilities
•
Partnership with DEECD School Nursing Program
Targeting at-risk youth – headspace Project
headspace (National Youth Mental Health Foundation)
• Provide general health, mental health and counselling,
education, employment, alcohol and other drug
services for at-risk youth
• Increased focus on primary health care and
opportunistic service delivery
• Four pilot sites – Sunshine, Knox, Collingwood, Glenroy
• Promote opportunistic immunisation and catch-up
• Fortnightly nurse-led immunisation clinic
• Data collection to inform expanded policy/program
delivery
headspace Resources
headspace Resources
RII - Evaluation framework
Final Report May 2015
• Improve uptake of immunisation of Victorian young people
• Improve uptake of immunisation of Aboriginal children
Aims
Enablers
Strategies
• Identify barriers
• Regional engagement
• Resource development
• Guideline development
Implementation
Outcomes
• Strategies address ID’ed
barriers
• Consultation
• Appropriate, effective strategies
• Education
• Capacity building
• Improved systems
• Monitoring and assessment
• Improved immunisation
uptake
• Improved awareness
• State-wide
implementation of
improved strategies
VRHN: Needs analysis of immunisation in refugee
and asylum seeker communities
Determine issues regarding access to vaccines, catch-up immunisation
programs and service delivery for people of refugee background in Vic
• Final report May 2014 highlighted
– public health significance due to pre and post arrival risk factors
– eligibility and access to funded vaccine
– service delivery and access to immunisation services
• Key recommendations
– Secure funding for vaccines to comprehensively provide catch-up
schedule
– Pilot improved service delivery models – local council program in ELS
– Improve surveillance data for immunisation register and coverage for
refugee and asylum seeker populations
– Improve/develop resources for community
– Improve strategies for personal vaccine record use
– Increase capacity of providers (guidelines, training, clinical practice)
• Next step… DH consideration and funding determined
Questions…
Chelsea Taylor
Chelsea.l.taylor@health.vic.gov.au
03 9096 5561