1-3 The Terrace
P.O Box 5013
Wellington
Date:
20 November 2015
Pages: 1 of 3
To:
General Practitioners, Practice Nurses, Practice Managers, Health Professionals
From:
Rayoni Keith, Manager, Immunisation
Subject:
Coverage Update, Immunisation during Pregnancy, HPV, Yellow Fever,
Measles, Survey – care for youth with mental health issues
Coverage update from Immunisation Champion Dr Pat Tuohy
As we head towards the end of another busy year, I want to thank you all for your ongoing
support for the immunisation programme. The work you have all done has contributed to
fewer children being admitted to hospital for vaccine-preventable diseases, particularly
rotavirus and invasive pneumococcal disease, in recent years. Immunisation rates have
held steady at 93 percent for eight month olds this month – there’s still time to see if we
can get that to 94% by 31 December. We’d like to get in early and wish a Merry Christmas
to everyone working towards this important goal.
Immunisation during pregnancy
The Ministry would like to remind practices that maternal immunisation against pertussis
and influenza is important and recommended by the Strategic Advisory Group of Experts
(SAGE) on Immunization, the United Kingdom Joint Committee on Vaccinations and
Immunisations and the United States Centers for Disease Control. Patients can be
reassured of the good safety profile for these vaccines.
If you know any of your patients are pregnant, please precall them for immunisation
against pertussis between 28 and 38 weeks’ gestation and influenza at any stage in
pregnancy but as early as possible during autumn and winter. Maintaining a Practice
Pregnancy Register is also useful for ensuring babies are enrolled within two weeks of
birth – see www.health.govt.nz/publication/enrolling-babies-birth for more information.
Information about maternal immunisation is included in the new resource “Let’s talk about
immunisation”, a guide for health professionals when talking about immunisation to
expectant and new parents. The resource is currently at print and will be distributed to
practices soon.
Human Papillomavirus Vaccine
General Practice Action Plan to Recall 14-year-old girls
Further to last month’s information about recalling 14-year-old girls who are not fully
immunised against HPV and precalling 12-year-old girls who have decided to have their
HPV vaccination with their GP provider, we have created a timeline to assist general
practices and school-based immunisation programme leads – please see the final page of
this update, or the Ministry’s website, for further details.
EMA review
The European Medicines Authority has recently released the results of its enquiry into
whether Gardasil is associated with Chronic Regional Pain Syndrome and Postural
Orthostatic Tachycardia Syndrome. It found "no evidence that the overall rates of these
syndromes in vaccinated girls were different from expected rates in these age groups,
even taking into account possible under reporting." The report is published online at:
www.ema.europa.eu/ema/index.jsp?curl=pages/news_and_events/news/2015/11/news_detail_002
429.jsp&mid=WC0b01ac058004d5c1 or search for “HPV review” at ema.europa.eu.
Safety
A recent current affairs programme aired concerns made by families regarding the safety
of HPV immunisation. We do not consider it fairly represented the science behind the
safety of the vaccine. The Ministry has published the following information on its website
that may help you address any questions parents may raise: www.health.govt.nz/newsmedia/news-items/hpv-vaccination-safety or search for “hpv safety” on health.govt.nz. IMAC
has also published responses to the programme at www.immune.org.nz .
Yellow Fever
Special authorisation is required to administer yellow fever vaccine to those travelling to atrisk areas. We have published a current list of all authorised Yellow Fever vaccination
centres on the Ministry website, alongside the usual forms to apply for or renew
vaccinating status, at www.health.govt.nz/our-work/diseases-and-conditions/yellow-fever
or search for “yellow fever” on health.govt.nz.
Measles – check your patients are protected before they travel
A number of countries overseas continue to have measles outbreaks, including many
places New Zealanders visit. New Zealand remains at risk of measles outbreaks if
travellers bring the infection back into the country.
With increased travel around the Christmas holidays, please take every opportunity to
ensure your patients are immunised with two doses of measles-containing vaccine. MMR
is funded for everyone born from January 1969 onwards who has not received two doses.
Those aged between 19 and 24 may have missed out on the school-based catch up
programme in 2001 when MMR dose two was changed from being offered at age 11 to
being offered at age 4.
Survey - care for youth (12 to 19 years) with mental health issues
Malatest International have been contracted by the Ministry of Health to evaluate the
Youth Primary Mental Health Service to see what difference it has made.
Please share your thoughts by:
•
Completing a short approximately five-minute survey at www.YPMH.malatest.net
•
Telephoning Malatest toll-free on 0800 002 577
Thank you for your help with this important project.
If you have any queries about anything in this update, please email
immunisation@moh.govt.nz.
Action Plan Timetable - Recalling Girls Age 14: Human Papillomavirus (HPV) Vaccines
Item
1
By Whom
General practice
teams
Action
Suggested Methods
Issue a 1st recall for all 14-year-old
girls who are unimmunised or
incompletely immunised for their HPV
vaccinations
1. Schedule a routine reminder to popup on each girl’s 14th birthday,
(Ensure you opt on to the NIR each
girl who does not have any HPV
immunisation history)
2
General practice
teams
School-based
immunisation
programme leads
By When
From October 2015ongoing process
and/or
2. Set up a monthly recall for all girls
who turned 14 years of age in the
previous month
Issue a 2nd recall if no response to
1st recall
Identify non-responders outstanding
from 1st recall and notify by text,
phone, email, or letter
3 months following 1st recall
Once notified by school-based
immunisation programme leads,
precall all girls who have nominated
you as their preferred provider for
HPV immunisation
Send precall by text, phone, email, or
letter
Within 1 month after notification from
school-based immunisation programme
leads
Issue a recall if no response to precall
Identify non-responders outstanding
from precall and notify by text, phone,
email, or letter
3 months following precall
Notify general practice teams of the
girls who have chosen to have their
HPV immunisation at their nominated
GP provider instead of at school
Flag girls who have indicated they will
have their HPV vaccination at general
practice and send notification to
nominated provider either by email or
letter.
Within 2 weeks following return of each
consent form (Preferably as it happens
rather than in large amounts)
If no response, leave alerts on PMS to
remind about non-responders
* Note: General practice teams should check the immunisation history for each girl they recall/precall to check their immunisation status (especially for HPV)
and complete other vaccinations as needed. If the girl is not on the NIR, she will need to be put on.