High incidence and serotype diversity of invasive pneumococcal disease (IPD) in Indigenous childr... more High incidence and serotype diversity of invasive pneumococcal disease (IPD) in Indigenous children in remote Australia led to rapid introduction of 7-valent conjugate pneumococcal vaccine (7vPCV) at 2, 4 and 6 months in 2001, followed by 23-valent polysaccharide pneumococcal vaccine (23vPPV) in the second year of life. All other Australian children were offered 3 doses of 7vPCV without a booster from 2005. This study evaluated the impact of the unique pneumococcal vaccine schedule of 7vPCV followed by the 23vPPV booster among Indigenous Australian children. Changes in IPD incidence derived from population-based passive laboratory surveillance in Indigenous children <5 years eligible for 23vPPV were compared to non-Indigenous eligible for 7vPCV only from the pre-vaccine introduction period (Indigenous 1994-2000; non-Indigenous 2002-2004) to the post-vaccine period (2008-2010 in both groups) using incidence rate ratios (IRRs) stratified by age into serotype groupings of vaccine (7...
In 2004, 60 diseases and conditions were nationally notifiable in Australia. States and Territori... more In 2004, 60 diseases and conditions were nationally notifiable in Australia. States and Territories reported a total of 110,929 cases of communicable diseases to the National Notifiable Diseases Surveillance System (NNDSS): an increase of 4 per cent on the number of notifications in 2003. In 2004, the most frequently notified diseases were sexually transmissible infections (46,762 cases; 42% of total notifications), gastrointestinal diseases (25,247 cases; 23% of total notifications) and bloodborne diseases (19,191 cases; 17% of total notifications). There were 13,206 notifications of vaccine preventable diseases, 6,000 notifications of vectorborne diseases, 1,799 notifications of other bacterial infections (includes, legionellosis, leprosy, meningococcal infections and tuberculosis) and 877 notifications of zoonotic diseases.
Vaccine preventable diseases in indigenous populations - International perspectives. Satellite Sy... more Vaccine preventable diseases in indigenous populations - International perspectives. Satellite Symposium of the 5th International Symposium on Pneumococci and Pneumococcal Diseases, April 2006, Alice Springs, Australia. ... Menzies R, McIntyre P, Reid R, O&amp;amp;amp;#x27;Brien ...
This paper examines how the monovalent varicella vaccine for children, with an adolescent catch-u... more This paper examines how the monovalent varicella vaccine for children, with an adolescent catch-up dose, was introduced into Australia&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s National Immunisation Program (NIP), focusing on programme implementation. Semi-structured interviews were conducted with key informants involved in programme implementation. Key themes from interviews were identified through content analysis. Childhood coverage was assessed using data from the Australian Childhood Immunisation Register (ACIR) with adolescent coverage obtained from state/territory immunisation programmes. Seroprevalence data were analysed from national serosurveys conducted before and after programme commencement. Implementation challenges for both parents and providers included: (a) parental report of previous infection as an exclusion criterion; (b) introducing a vaccine on its own at 18 months of age; and (c) adding the adolescent dose into existing school-based vaccination programmes with parental reported exclusion criteria. Despite these challenges, coverage rapidly reached 83% by 24 months of age and 30-33% for the adolescent catch-up dose. When considered in conjunction with estimated pre-vaccination natural immunity in both target groups (20% and 83%, respectively) coverage can be considered high. The serosurvey under-estimated coverage in 2-year-old children but was useful to assess trends in population immunity. The introduction of a single dose of monovalent varicella vaccine at 18 months of age and a school-based catch-up programme at 11-13 years of age successfully achieved high coverage, notwithstanding some challenges. Reported natural infection has been an exclusion criterion for vaccination, but as the programme matures and circulation of wild-type virus decreases, the need for this warrants consideration. There is a need for sensitive laboratory assays to measure vaccine-induced immunity at a population level.
This is the first annual report for NSW of adverse events following immunisation. It summarises A... more This is the first annual report for NSW of adverse events following immunisation. It summarises Australian passive surveillance data for adverse events following immunisation for NSW for 2009. Analysis of de-identified information on all adverse events following immunisation reported to the Therapeutic Goods Administration. 450 adverse events following immunisation were reported for vaccines administered in 2009; this is 32% higher than 2008 and the highest since 2003. The increase was almost entirely attributed to the commencement of the pandemic (H1N1) 2009 influenza vaccine in September 2009. Only 6% of the reported adverse events were serious in nature and the most commonly reported reactions were allergic reaction, injection site reaction, fever and headache. Reports of adverse events following immunisation in 2009 were dominated by the pandemic (H1N1) 2009 influenza vaccine. A large proportion of these adverse events were reported directly to the Therapeutic Goods Administration by members of the public. Reports were predominantly mild transient events, similar to those expected from the seasonal flu vaccine.
... Rob Menzies Senior Surveillance Officer AIDS/Infectious Diseases Unit, NSW Health Valerie Del... more ... Rob Menzies Senior Surveillance Officer AIDS/Infectious Diseases Unit, NSW Health Valerie Delpech Medical Epidemiologist South Eastern Sydney Public Health Unit Lizzy Griggs Surveillance Officer AIDS/Infectious Diseases Unit, NSW ... Dr Michael Giffin is production manager ...
... in alphabetical order): Guncha Ansari, Gaston Arnolda, John Brown, Lucy Burns, Magnolia Cardo... more ... in alphabetical order): Guncha Ansari, Gaston Arnolda, John Brown, Lucy Burns, Magnolia Cardona, Jennifer Chipps, Tim Churches, Glenn Close, Paul Corben, Stephen Corbett, Christine Cowie, Shing Chung Fung, Margaret Kelaher, Ed Kraa, Michael Levy, Cait Lonie, Wendy ...
To describe the epidemiology of hepatitis A in Indigenous Australian children. Analysis and mappi... more To describe the epidemiology of hepatitis A in Indigenous Australian children. Analysis and mapping of national notification and hospitalisation data. Indigenous Australian children are at far higher risk of clinical hepatitis A than their non-Indigenous counterparts, particularly in the age group 0-4 years. Rates of hospitalisation (15.5 vs. 0.3 per 100,000) and notification (24.4 vs. 1.8 per 100,000) were higher in Indigenous children aged 0-4 years compared with other children in the same age group. In the age group 5-14 years, the rates were 4.4 per 100,000 (Indigenous) versus 0.6 per 100,000 (non-Indigenous) hospitalisations. This excess morbidity falls sharply with age. Rates were the highest in the Northern Territory, South Australia, Western Australia and North Queensland. Indigenous children are at risk of hepatitis A, particularly early in life. Mapping shows that rates were the highest in jurisdictions with the largest Indigenous populations. This study presents baseline data against which to measure the success of new hepatitis A vaccination programme for Indigenous Australian children which commenced in 2005.
This, the 6th annual immunisation coverage report, documents trends during 2012 for a range of st... more This, the 6th annual immunisation coverage report, documents trends during 2012 for a range of standard measures derived from Australian Childhood Immunisation Register (ACIR) data, and National Human Papillomavirus (HPV) Vaccination Program Register data. These include coverage at standard age milestones and for individual vaccines included on the National Immunisation Program (NIP) and coverage in adolescents and adults. The proportion of Australian children 'fully vaccinated' at 12, 24 and 60 months of age was 91.7%, 92.5% and 91.2%, respectively. For vaccines available on the NIP but not assessed during 2012 for 'fully vaccinated' status or for eligibility for incentive payments (rotavirus and pneumococcal at 12 months and meningococcal C and varicella at 24 months) coverage varied. Although pneumococcal vaccine had similar coverage at 12 months to other vaccines, coverage was lower for rotavirus at 12 months (83.6%) and varicella at 24 months (84.4%). Although &...
This, the 5th annual immunisation coverage report, documents trends during 2011 for a range of st... more This, the 5th annual immunisation coverage report, documents trends during 2011 for a range of standard measures derived from Australian Childhood Immunisation Register data, and National Human Papillomavirus (HPV) Vaccination Program Register data. The proportion of children 'fully vaccinated' at 12, 24 and 60 months of age was 91.4%, 92.2% and 89.5% respectively. Although pneumococcal vaccine had similar coverage at 12 months to other vaccines, coverage was lower for rotavirus at 12 months (83.8%) and varicella at 24 months (83.9%). By late 2011, the percentage of children who received the 1st dose of DTPa vaccine dose at less than 8 weeks of age was greater than 50% in 3 jurisdictions, the Australian Capital Territory, Victoria, and Queensland and at 70% for New South Wales and Tasmania. Although coverage at 12 months of age was lower among Indigenous children than non-Indigenous children in all jurisdictions, the extent of the difference varied. Overall, coverage at 24 m...
This report summarises Australian passive surveillance data for adverse events following immunisa... more This report summarises Australian passive surveillance data for adverse events following immunisation (AEFI) reported to the Adverse Drug Reactions Advisory Committee for 2005, and describes reporting trends over the six year period 2000 to 2005. There were 839 AEFI records for vaccines received in 2005. This is an annual AEFI reporting rate of 4.1 per 100,000 population, the lowest since 2000 and a 22 per cent decrease compared with 2004 (1,081 records; 5.4 AEFI records per 100,000 population). The decrease was not consistent across age groups. Reporting of AEFI increased for children aged <1 year in 2005 (60.7 versus 50.3 per 100,000 population) and decreased for the 7 to <20 year age group (0.9 versus 8.9 per 100,000 population). Dose-based AEFI reporting rates in 2005 were 11.0 per 100,000 doses of scheduled vaccines for children aged <7 years and 2.0 per 100,000 doses of influenza vaccine for adults aged >18 years. The majority of records described non-serious event...
Abstract Pertussis, or whooping cough, notifications, and deaths declined dramatically after the ... more Abstract Pertussis, or whooping cough, notifications, and deaths declined dramatically after the introduction of mass vaccination in the 1950s, to the extent that many states stopped collecting notifications. However, since 1990, notification rates have increased noticeably ...
Background: Delayed immunisation and vaccine preventable communicable disease remains a significa... more Background: Delayed immunisation and vaccine preventable communicable disease remains a significant health issue in Aboriginal children. Strategies to increase immunisation coverage and timeliness can be resource intensive. In a low cost initiative at the Aboriginal Medical Service Western Sydney (AMSWS) in 2008-2009, a trial of personalised calendars to prompt timely childhood immunisation was undertaken. Methods: Calendars were generated during attendances for early childhood immunisations. They were designed for display in the home and included the due date of the next immunisation, a photo of the child and Aboriginal artwork. In a retrospective cohort design, Australian Childhood Immunisation Register data from AMSWS and non-AMSWS providers were used to determine the delay in immunisation and percentage of immunisations on time in those who received a calendar compared to those who did not. Interviews were undertaken with carers and staff. Results: Data on 2142 immunisation doses given to 505 children were analysed, utilising pre-intervention (2005)(2006)(2007) and intervention (2008)(2009) periods and a 2 year post-intervention observation period. 113 calendars were distributed (30% of eligible immunisation attendances). Improvements in timeliness were seen at each schedule point for those children who received a calendar. The average delay in those who received a calendar at their previous visit was 0.6 months (95% CI -0.8 to 2.6) after the due date, compared to 3.3 months (95% CI −0.6 to 7.5) in those who did not. 80% of doses were on time in the group who received a calendar at the preceding immunisation, 66% were on time for those who received a calendar at an earlier point and 57% of doses were on time for those who did not receive a calendar (P<0.0001, Cochran-Armitage trend test). Interview data further supported the value and effectiveness of the calendars as both a prompt to timely immunisations and a community health education project without undue resource implications.
High incidence and serotype diversity of invasive pneumococcal disease (IPD) in Indigenous childr... more High incidence and serotype diversity of invasive pneumococcal disease (IPD) in Indigenous children in remote Australia led to rapid introduction of 7-valent conjugate pneumococcal vaccine (7vPCV) at 2, 4 and 6 months in 2001, followed by 23-valent polysaccharide pneumococcal vaccine (23vPPV) in the second year of life. All other Australian children were offered 3 doses of 7vPCV without a booster from 2005. This study evaluated the impact of the unique pneumococcal vaccine schedule of 7vPCV followed by the 23vPPV booster among Indigenous Australian children. Changes in IPD incidence derived from population-based passive laboratory surveillance in Indigenous children <5 years eligible for 23vPPV were compared to non-Indigenous eligible for 7vPCV only from the pre-vaccine introduction period (Indigenous 1994-2000; non-Indigenous 2002-2004) to the post-vaccine period (2008-2010 in both groups) using incidence rate ratios (IRRs) stratified by age into serotype groupings of vaccine (7...
In 2004, 60 diseases and conditions were nationally notifiable in Australia. States and Territori... more In 2004, 60 diseases and conditions were nationally notifiable in Australia. States and Territories reported a total of 110,929 cases of communicable diseases to the National Notifiable Diseases Surveillance System (NNDSS): an increase of 4 per cent on the number of notifications in 2003. In 2004, the most frequently notified diseases were sexually transmissible infections (46,762 cases; 42% of total notifications), gastrointestinal diseases (25,247 cases; 23% of total notifications) and bloodborne diseases (19,191 cases; 17% of total notifications). There were 13,206 notifications of vaccine preventable diseases, 6,000 notifications of vectorborne diseases, 1,799 notifications of other bacterial infections (includes, legionellosis, leprosy, meningococcal infections and tuberculosis) and 877 notifications of zoonotic diseases.
Vaccine preventable diseases in indigenous populations - International perspectives. Satellite Sy... more Vaccine preventable diseases in indigenous populations - International perspectives. Satellite Symposium of the 5th International Symposium on Pneumococci and Pneumococcal Diseases, April 2006, Alice Springs, Australia. ... Menzies R, McIntyre P, Reid R, O&amp;amp;amp;#x27;Brien ...
This paper examines how the monovalent varicella vaccine for children, with an adolescent catch-u... more This paper examines how the monovalent varicella vaccine for children, with an adolescent catch-up dose, was introduced into Australia&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s National Immunisation Program (NIP), focusing on programme implementation. Semi-structured interviews were conducted with key informants involved in programme implementation. Key themes from interviews were identified through content analysis. Childhood coverage was assessed using data from the Australian Childhood Immunisation Register (ACIR) with adolescent coverage obtained from state/territory immunisation programmes. Seroprevalence data were analysed from national serosurveys conducted before and after programme commencement. Implementation challenges for both parents and providers included: (a) parental report of previous infection as an exclusion criterion; (b) introducing a vaccine on its own at 18 months of age; and (c) adding the adolescent dose into existing school-based vaccination programmes with parental reported exclusion criteria. Despite these challenges, coverage rapidly reached 83% by 24 months of age and 30-33% for the adolescent catch-up dose. When considered in conjunction with estimated pre-vaccination natural immunity in both target groups (20% and 83%, respectively) coverage can be considered high. The serosurvey under-estimated coverage in 2-year-old children but was useful to assess trends in population immunity. The introduction of a single dose of monovalent varicella vaccine at 18 months of age and a school-based catch-up programme at 11-13 years of age successfully achieved high coverage, notwithstanding some challenges. Reported natural infection has been an exclusion criterion for vaccination, but as the programme matures and circulation of wild-type virus decreases, the need for this warrants consideration. There is a need for sensitive laboratory assays to measure vaccine-induced immunity at a population level.
This is the first annual report for NSW of adverse events following immunisation. It summarises A... more This is the first annual report for NSW of adverse events following immunisation. It summarises Australian passive surveillance data for adverse events following immunisation for NSW for 2009. Analysis of de-identified information on all adverse events following immunisation reported to the Therapeutic Goods Administration. 450 adverse events following immunisation were reported for vaccines administered in 2009; this is 32% higher than 2008 and the highest since 2003. The increase was almost entirely attributed to the commencement of the pandemic (H1N1) 2009 influenza vaccine in September 2009. Only 6% of the reported adverse events were serious in nature and the most commonly reported reactions were allergic reaction, injection site reaction, fever and headache. Reports of adverse events following immunisation in 2009 were dominated by the pandemic (H1N1) 2009 influenza vaccine. A large proportion of these adverse events were reported directly to the Therapeutic Goods Administration by members of the public. Reports were predominantly mild transient events, similar to those expected from the seasonal flu vaccine.
... Rob Menzies Senior Surveillance Officer AIDS/Infectious Diseases Unit, NSW Health Valerie Del... more ... Rob Menzies Senior Surveillance Officer AIDS/Infectious Diseases Unit, NSW Health Valerie Delpech Medical Epidemiologist South Eastern Sydney Public Health Unit Lizzy Griggs Surveillance Officer AIDS/Infectious Diseases Unit, NSW ... Dr Michael Giffin is production manager ...
... in alphabetical order): Guncha Ansari, Gaston Arnolda, John Brown, Lucy Burns, Magnolia Cardo... more ... in alphabetical order): Guncha Ansari, Gaston Arnolda, John Brown, Lucy Burns, Magnolia Cardona, Jennifer Chipps, Tim Churches, Glenn Close, Paul Corben, Stephen Corbett, Christine Cowie, Shing Chung Fung, Margaret Kelaher, Ed Kraa, Michael Levy, Cait Lonie, Wendy ...
To describe the epidemiology of hepatitis A in Indigenous Australian children. Analysis and mappi... more To describe the epidemiology of hepatitis A in Indigenous Australian children. Analysis and mapping of national notification and hospitalisation data. Indigenous Australian children are at far higher risk of clinical hepatitis A than their non-Indigenous counterparts, particularly in the age group 0-4 years. Rates of hospitalisation (15.5 vs. 0.3 per 100,000) and notification (24.4 vs. 1.8 per 100,000) were higher in Indigenous children aged 0-4 years compared with other children in the same age group. In the age group 5-14 years, the rates were 4.4 per 100,000 (Indigenous) versus 0.6 per 100,000 (non-Indigenous) hospitalisations. This excess morbidity falls sharply with age. Rates were the highest in the Northern Territory, South Australia, Western Australia and North Queensland. Indigenous children are at risk of hepatitis A, particularly early in life. Mapping shows that rates were the highest in jurisdictions with the largest Indigenous populations. This study presents baseline data against which to measure the success of new hepatitis A vaccination programme for Indigenous Australian children which commenced in 2005.
This, the 6th annual immunisation coverage report, documents trends during 2012 for a range of st... more This, the 6th annual immunisation coverage report, documents trends during 2012 for a range of standard measures derived from Australian Childhood Immunisation Register (ACIR) data, and National Human Papillomavirus (HPV) Vaccination Program Register data. These include coverage at standard age milestones and for individual vaccines included on the National Immunisation Program (NIP) and coverage in adolescents and adults. The proportion of Australian children 'fully vaccinated' at 12, 24 and 60 months of age was 91.7%, 92.5% and 91.2%, respectively. For vaccines available on the NIP but not assessed during 2012 for 'fully vaccinated' status or for eligibility for incentive payments (rotavirus and pneumococcal at 12 months and meningococcal C and varicella at 24 months) coverage varied. Although pneumococcal vaccine had similar coverage at 12 months to other vaccines, coverage was lower for rotavirus at 12 months (83.6%) and varicella at 24 months (84.4%). Although &...
This, the 5th annual immunisation coverage report, documents trends during 2011 for a range of st... more This, the 5th annual immunisation coverage report, documents trends during 2011 for a range of standard measures derived from Australian Childhood Immunisation Register data, and National Human Papillomavirus (HPV) Vaccination Program Register data. The proportion of children 'fully vaccinated' at 12, 24 and 60 months of age was 91.4%, 92.2% and 89.5% respectively. Although pneumococcal vaccine had similar coverage at 12 months to other vaccines, coverage was lower for rotavirus at 12 months (83.8%) and varicella at 24 months (83.9%). By late 2011, the percentage of children who received the 1st dose of DTPa vaccine dose at less than 8 weeks of age was greater than 50% in 3 jurisdictions, the Australian Capital Territory, Victoria, and Queensland and at 70% for New South Wales and Tasmania. Although coverage at 12 months of age was lower among Indigenous children than non-Indigenous children in all jurisdictions, the extent of the difference varied. Overall, coverage at 24 m...
This report summarises Australian passive surveillance data for adverse events following immunisa... more This report summarises Australian passive surveillance data for adverse events following immunisation (AEFI) reported to the Adverse Drug Reactions Advisory Committee for 2005, and describes reporting trends over the six year period 2000 to 2005. There were 839 AEFI records for vaccines received in 2005. This is an annual AEFI reporting rate of 4.1 per 100,000 population, the lowest since 2000 and a 22 per cent decrease compared with 2004 (1,081 records; 5.4 AEFI records per 100,000 population). The decrease was not consistent across age groups. Reporting of AEFI increased for children aged <1 year in 2005 (60.7 versus 50.3 per 100,000 population) and decreased for the 7 to <20 year age group (0.9 versus 8.9 per 100,000 population). Dose-based AEFI reporting rates in 2005 were 11.0 per 100,000 doses of scheduled vaccines for children aged <7 years and 2.0 per 100,000 doses of influenza vaccine for adults aged >18 years. The majority of records described non-serious event...
Abstract Pertussis, or whooping cough, notifications, and deaths declined dramatically after the ... more Abstract Pertussis, or whooping cough, notifications, and deaths declined dramatically after the introduction of mass vaccination in the 1950s, to the extent that many states stopped collecting notifications. However, since 1990, notification rates have increased noticeably ...
Background: Delayed immunisation and vaccine preventable communicable disease remains a significa... more Background: Delayed immunisation and vaccine preventable communicable disease remains a significant health issue in Aboriginal children. Strategies to increase immunisation coverage and timeliness can be resource intensive. In a low cost initiative at the Aboriginal Medical Service Western Sydney (AMSWS) in 2008-2009, a trial of personalised calendars to prompt timely childhood immunisation was undertaken. Methods: Calendars were generated during attendances for early childhood immunisations. They were designed for display in the home and included the due date of the next immunisation, a photo of the child and Aboriginal artwork. In a retrospective cohort design, Australian Childhood Immunisation Register data from AMSWS and non-AMSWS providers were used to determine the delay in immunisation and percentage of immunisations on time in those who received a calendar compared to those who did not. Interviews were undertaken with carers and staff. Results: Data on 2142 immunisation doses given to 505 children were analysed, utilising pre-intervention (2005)(2006)(2007) and intervention (2008)(2009) periods and a 2 year post-intervention observation period. 113 calendars were distributed (30% of eligible immunisation attendances). Improvements in timeliness were seen at each schedule point for those children who received a calendar. The average delay in those who received a calendar at their previous visit was 0.6 months (95% CI -0.8 to 2.6) after the due date, compared to 3.3 months (95% CI −0.6 to 7.5) in those who did not. 80% of doses were on time in the group who received a calendar at the preceding immunisation, 66% were on time for those who received a calendar at an earlier point and 57% of doses were on time for those who did not receive a calendar (P<0.0001, Cochran-Armitage trend test). Interview data further supported the value and effectiveness of the calendars as both a prompt to timely immunisations and a community health education project without undue resource implications.
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Papers by Rob Menzies