18 Nov 2014

Call for major effort to lift vaccination

9:02 am on 18 November 2014

An immunisation expert says New Zealand has turned around poor immunisation rates but there is more work to do.

A woman receives an HPV vaccination

Only 55 or 56 percent of 12-year-old girls are fully immunised against HPV. Photo: SCIENCE PHOTO LIBRARY

The head of the Auckland University Immunisation Advisory Centre, Nikki Turner, is a speaker at a session today at the Paediatric Society Annual Scientific Meeting in Napier.

Dr Turner said 93.27 percent of all eight-month-old babies were fully immunised, having had all vaccinations recommended for their age.

She said that was very close to the national health target, of 95 percent of eight-month-olds fully immunised by December.

She said it was an "extraordinary result" that would put New Zealand among world leaders on immunisation.

"The eight-month target is a measure of getting vaccines to our infants on time, and I believe New Zealand will be one of the best in the world at timeliness of delivery if we can get up to 95 percent."

It is a major change from 1991, for example, when just 56 percent of all two-year-olds were fully immunised, with far lower levels of immunisation among Maori and Pacific children.

Dr Turner said a huge national effort had gone into the change, and that a similar effort now needed to go into other areas, notably boosting immunisation in four-year-olds before they start school, and 11-year-olds; boosting uptake among 12-year-old girls of the HPV vaccine against cervical cancer; and lifting immunisation rates during pregnancy.

"We need the same amount of attention and focus on these events as we have put on the infant ones."

Need to tackle influenza and whooping cough

Auckland University Immunisation Advisory Centre head Nikki Turner


Pregnant women were urged to have the flu vaccine and a vaccine against whooping cough.

New Zealand had a whooping cough epidemic, and Dr Turner said the vaccine not only protected women, "but they make a big difference in reducing disease in young infants while they are too young to have their own immunisation programme".

But uptake was low. "We believe that for the influenza vaccine, it's a bit under a third of all women are getting their vaccine, and it's considerably lower for the whooping cough vaccine."

She said it was not just an issue for maternity providers but the whole community.

"Traditionally, many of us as providers have not wanted to intervene in pregnancy - the importance of keeping pregnant women safe and not using interventions.

"However, now we have a good amount of accumulating data about the safety of these vaccines."

She said many pregnant women did not see their family doctor regularly during pregnancy and that could sometimes be a barrier to access as well.

HPV immunisation not good enough

A woman receives an ultrasound during her pregnancy

Ultrasound during pregnancy Photo: SCIENCE PHOTO LIBRARY

On the HPV vaccine, Dr Turner said 55 or 56 percent fully immunised among 12-year-old girls was "very disappointing".

She says there was strong international evidence of the effectiveness of the vaccine.

"But even more than that, there is a whole lot of other cancers that the HPV virus is implicated in, such as cancers of the throat and mouth."

Dr Turner said she did not believe the education sector had been "engaged" in the topic.

"There's still a lot of people out there in the education sector who don't understand this vaccine, who are uncomfortable with it," she said.

"There still appears to be an association with sexual activity, rather than understanding about how ubiquitous the HPV virus is. And I think many people are still unaware of the excellent safety profile of the vaccine internationally."

The Medical Association said it would like the vaccine to be given to boys as well as girls, because of anecdotal evidence of its effectiveness in reducing cancers.

Call for more resources

Both it and the College of Midwives said better information was needed on the uptake of vaccines during pregnancy.

Doctors said if they "consistently knew that patients were pregnant, we may be able to effectively recall them, but often we don't even know that the woman is pregnant".

College of Midwives midwifery adviser Alison Eddy said consideration could also be given to how services should be offered to pregnant women in a very accessible way, and to extra resources to enable midwives to provide more information to women.

The Health Ministry said it was looking at how to revitalise the HPV vaccination programme and lift vaccination rates.

It was revising resources that supported the programme, to ensure parents have the most up-to-date information when they are asked to consent to their daughter having the vaccine.

The Ministry also said it would improve connections between schools and GPs to ensure girls who do not get the vaccine at school could get it at their GP.

The Ministry also said the latest research indicated the vaccine's effectiveness did not decrease over time, especially if teens had it at age 11 or 12, rather than later.

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