Achieving high immunisation rates amongst children in the Australian Capital Territory: a collaborative effort
Authors: Moore Anthony M. , Burgess Sandra , Shaw Hailey , Banks Carolyn , Passaris Irene , Guest Charles 
Published: February 2011

Background.
In September 2008 the ACT achieved the highest childhood coverage rates in Australia with rates of 93.5% (12–15-month age cohort), 94.9% (24–27-month age cohort) and 90.58% (60–63-month age cohort).

Purpose.
To analyse the key contributing factors and policy initiatives that have likely to have led to high childhood immunisation rates in the ACT.

Methods.
Data used in this report were sourced from the Australian Childhood Immunisation Register (ACIR) held at Medicare Australia, General Practice Immunisation Incentives (GPII) ‘calculation’ data held at ACT Division of General Practice and internal immunisation databases held at Health Protection Service.

Outcomes.
Although the reasons for the high coverage rates seen in children are multi factorial (including national and consumer factors), key reasons locally in the ACT include: (a) the implementation of an ACT-wide immunisation strategy; (b) proactive follow up of children overdue for immunisation; (c) more sustainable provision of immunisation services across both public and private health providers; and (d) a centralised vaccine delivery service and ‘cold chain’ monitoring system.

Conclusions.
Although nationwide immunisation policy has been successful in increasing childhood coverage rates across all Australian jurisdictions, it is important to also acknowledge local factors that have likely to have contributed to the successful implementation of the Immunise Australia Program at the coal face.

What is known about the topic?
Childhood immunisation rates have risen significantly in Australia since the mid 1990s following a plethora of initiatives at both a national and state and territory level. This article examines in depth the various factors over the past decade that have likely to have contributed to the high childhood immunisation rates currently seen in the Australian Capital Territory

What does this paper add?
The ACT changed its strategic thinking towards immunisation provision in 2004 with an increased focus on immunisation delivery in general practice. Immunisation coverage rates improved in the ACT between 2005 and 2008 with general practice increasing their contribution to immunisation provision from 35 to 57% during this time period. This was despite of a drop in full-time equivalent general practices (GPs) in the ACT between 2003 and 2008. At face value the initial decision to increase immunisation provision through general practice in the face of a dwindling GP workforce appeared counter intuitive. What this article illustrates is the importance of having the right mix and proportion of providers delivering immunisation (public clinics v. general practice) as well as having well resourced support systems for vaccine delivery, provider education and data analysis. More importantly this paper illustrates that any disruption in any component of immunisation provision is likely to have a negative effect on coverage rates (examples provided in the article).

What are the implications for practitioners?
Achieving high immunisation in the ACT has been a collaborative effort by a range of immunisation stakeholders. These groups have formed strong partnerships to raise awareness of the value of immunisation and the importance of receiving vaccinations at the correct time. It is this collective effort across the health portfolio that is likely to have contributed to the ACT achieving high immunisation coverage rates amongst children. It is important for immunisation practitioners to retain strong professional networks with clear delineation of roles in order to maintain high immunisation rates. Such networks must also be adequately prepared for challenges on the horizon (i.e. change in government policy, loss of personnel, change in consumer attitudes towards immunisation, etc.) that may pose a threat towards high immunisation rates.