Questions and answers - Immunisation Coverage

Immunisation
Immunisation Coverage Questions and Answers

1. What does the immunisation coverage data show?

2. Why does national immunisation coverage increase from 6 months to 12 months, and then decrease at 18 months?

3. Why has the Ministry of Health published the immunisation coverage data?

4. When will the immunisation coverage data be updated?

5. Who will access and use the immunisation coverage data?

6. Can my child be identified from the immunisation coverage data?

7. What does ‘Dep’ mean?

8. Why does immunisation coverage vary between district health boards (DHBs)?

9. Some district health boards (DHBs) only have data for the 6 and 12 month milestone ages. Where is the 18 month milestone age data?

10. When will the Ministry of Health report on immunisation coverage for two year olds?

11. What is the Ministry doing to help district health boards progress towards achieving the national immunisation coverage target of 95 percent of children fully immunised by two years of age?

12. Why is the immunisation coverage target ‘ 95 percent of children fully immunised by two years of age?

13. Who can I contact for more information about immunisation?

1. What does the immunisation coverage data show?

The immunisation coverage data shows the number of children who have turned the milestone age (6, 12 or 18 months) during the previous 3 months nationally and in each district health board (DHB).

Of those children who turned the milestone age during the previous 3 months, the coverage data shows how many received all of their age appropriate immunisations by the time they turned the milestone age.

Table One below indicates the immunisations on the National Childhood Immunisation Schedule 2006 included at each milestone age.

Table One: Immunisations included at each milestone age

Milestone Age	National Childhood Immunisation Schedule Visits
6 month	6 weeks, 3 months, 5 months
12 month (1 year)	6 weeks, 3 months, 5 months
18 month	6 weeks, 3 months, 5 months, 15 months
24 month (2 years)	6 weeks, 3 months, 5 months, 15 months
5 years	6 weeks, 3 months, 5 months, 15 months, 4 years
12 years	6 weeks, 3 months, 5 months, 15 months, 4 years, 11 years

Note: the MeNZB^TM immunisation is a special programme, therefore the MeNZB^TM immunisations are not included in the immunisation coverage data from the National Childhood Immunisation Schedule.

For information on the immunisations offered free to children, see Immunisation Schedule.

2. Why does national immunisation coverage increase from 6 months to 12 months, and then decrease at 18 months?

If a child starts their immunisations late and receives any of the 6 week, 3 month or 5 month immunisations after they turn the 6 month milestone age, they are not fully immunised for their age. So immunisation coverage is low at the 6 month milestone age. (Refer to Table One above containing the immunisations included at each milestone age.)

Between 6 and 12 months of age, no extra immunisations are scheduled as part of the National Childhood Immunisation Schedule, (excluding MeNZB^TM). Therefore, there is more time for a child to 'catch up' and receive their 6 week, 3 or 5 month immunisations before the child turns 12 months of age. If the 6 week, 3 month and 5 month immunisations are then received before the child turns 12 months of age, they are considered fully immunised for their age. The ‘catch up’ period explains the increase in coverage.

At 15 months of age, two further immunisations are scheduled as part of the National Childhood Immunisation Schedule (the Hib vaccine and the measles, mumps and rubella vaccine). If the 15 month immunisation is not received by the time a child turns the 18 month milestone age or previous immunisations are not completed, the child is not fully immunised. Therefore immunisation coverage levels are lower.

It is expected that the proportion of children fully immunised will increase as the National Immunisation Register (NIR) is used by primary care providers and district health boards to follow up children and improve immunisation coverage.

To give your child the best protection against disease, on-time immunisation is advised.

3. Why has the Ministry of Health published the immunisation coverage data?

Publication of the immunisation coverage data allows anyone interested in immunisation in New Zealand to monitor immunisation coverage rates. The immunisation coverage data also shows progress towards the immunisation coverage target of 95 percent of children fully immunised by two years of age.

4. When will the immunisation coverage data be updated?

The immunisation coverage data will be updated on the Ministry of Health website every three months.

5. Who will access and use the immunisation coverage data?

Anyone interested in immunisation coverage in New Zealand can access and use the immunisation coverage data on the Ministry of Health website.

For example:

DHBs can use the data to evaluate strategies to improve immunisation coverage
the public can look at national data and data for their region
New Zealand reports on immunisation coverage to international organisations such as the World Health Organization as a measure of child health in New Zealand.

6. Can my child be identified from the immunisation coverage data?

No. Children cannot be identified from the immunisation coverage data. The immunisation coverage data only shows the numbers and percentages of children immunised.

To further protect privacy, the reports do not show data where there are less than 10 children in the ‘Number Eligible’ group.

7. What does ‘Dep’ mean?

‘Dep’ stands for deprivation index. The reports show immunisation coverage by level of deprivation.

The deprivation index is the average level of deprivation of people living in an area at a particular point in time, relative to the whole of New Zealand. Deprivation refers to areas (based on New Zealand Census meshblocks) rather than individuals.

Nine indicators are combined to give the deprivation index. The indicators reflect aspects of material and social deprivation.

The nine indicators are:

income derived from benefits
unemployment
low income earning
access to car
access to telephone
sole-parent families
lack of formal educational qualifications
level of home ownership
living space within a home.

Dep 1-2 are areas with the least deprivation, Dep 9-10 are areas with the most deprivation. In the immunisation coverage reports, the address of the individual is matched to the level of deprivation for that area.

Increasing levels of deprivation are associated with higher mortality rates and higher rates of many diseases (Salmond and Crampton, NZDep2001 Index of Deprivation, 2002).

See the Ministry of Health’s Health & Disability Intelligence Publications page for more information about the Deprivation Index.

8. Why does immunisation coverage vary between district health boards (DHBs)?

There are many reasons why immunisation coverage levels vary between DHBs, including:

the number of children in the DHB, variations in ethnicity, deprivation level, rurality and number of providers
different strategies used within DHBs to improve coverage.

All DHBs are working towards achieving the national immunisation coverage target of 95 percent of children fully immunised by two years of age.

9. Some district health boards (DHBs) only have data for the 6 and 12 month milestone ages. Where is the 18 month milestone age data?

In some DHBs, the National Immunisation Register (NIR) has not been in operation long enough to give immunisation coverage data for the 18 month milestone age.

The NIR started in New Zealand during 2005 for new babies. The first DHBs to "go live" (start using the NIR for new babies) were Counties Manukau and Waitemata on 18 April 2005. Nelson Marlborough was the last DHB to go live on 5 December 2005.

The immunisation coverage data only includes children born after the NIR started in their DHB.

As the children enrolled on the NIR grow older, the coverage reports will show immunisation coverage for the 24 month (two year), five year and 12 year milestone ages.

10. When will the Ministry of Health report on immunisation coverage data for two-year-olds?

From January 2008 the Ministry of Health will report on immunisation coverage for two-year-old children for every DHB.

11. What are the Ministry and district health boards (DHBs) doing to progress towards achieving the national immunisation coverage target of 95 percent of children fully immunised by two years of age?

The Ministry and DHBs are working together to improve immunisation coverage in New Zealand and to progress towards the target of 95 percent of children fully immunised by two years of age. Every three months DHBs report to the Ministry of Health on progress towards the immunisation coverage target.

DHBs have each formed an immunisation steering group. Members of the steering group may include:

NIR Administrators
Planning and Funding Managers
PHO representatives
Māori and Pacific health providers
Immunisation Coordinators
Outreach Immunisation Service providers.

The steering groups meet regularly to develop strategies and implement activities to improve immunisation coverage in their DHB. To contribute to these discussions, Ministry representatives may attend DHB immunisation steering group meetings and regional meetings of DHB NIR Administrators.

The Ministry is developing new resources for health care providers, parents, whanau and care givers to improve understanding about the importance of immunisation.

12. Why is the immunisation coverage target ‘95 percent of children fully immunised by two years of age’?

The World Health Organization (WHO) recommends an immunisation coverage target of 95 percent of children fully immunised by two years of age. The WHO’s Global Immunization Vision and Strategy, 2006-2015 outlines a range of goals - including all countries will reach at least 90 percent national vaccination coverage by 2010.

WHO Global Immunization Vision and Strategy, 2006-2015

High immunisation coverage is important to protect not only the health of your child but to protect the community as well. High immunisation coverage is necessary to eliminate some diseases, or to prevent disease outbreaks.

13. Who can I contact for more information about immunisation?

You can contact the following people or groups:

your general practitioner or practice nurse
your primary health care provider
Public Health Units
Māori or Pacific healthcare providers eg Kai awhina
Immunisation Advisory Centre (IMAC)
phone 0800 IMMUNE (0800 466 863)
www.immune.org.nz

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Page last updated: 13 June 2008