Hull Brynley P, Mahajan Deepika, Dey Aditi, Menzies Rob I, McIntyre Peter B
National Centre for Immunisation Research and Surveillance of Vaccine Preventable Diseases, The Children's Hospital at Westmead and University of Sydney, Westmead, New South Wales.
Commun Dis Intell Q Rep. 2010 Sep;34(3):241-58.
This, the 2nd annual immunisation coverage report, documents trends during 2008 for a range of standard measures derived from Australian Childhood Immunisation Register data, including overall coverage at standard age milestones and for individual vaccines included on the National Immunisation Program (NIP). Coverage by indigenous status and mapping by smaller geographic areas as well as trends in timeliness are also summarised according to standard templates. With respect to overall coverage, Immunise Australia Program targets have been reached for children at 12 and 24 months of age but not for children at 5 years of age. Coverage at 24 months of age exceeds that at 12 months of age, but as receipt of varicella vaccine at 18 months is excluded from calculations of 'fully immunised' this probably represents delayed immunisation, with some contribution from immunisation incentives. Similarly, the decrease in coverage estimates for immunisations due at 4 years of age from March 2008, is primarily due to changing the assessment age from 6 years to 5 years of age from December 2007. A number of individual vaccines on the NIP are not currently assessed for 'fully immunised' status or for eligibility for incentive payments. These include pneumococcal conjugate and meningococcal C conjugate vaccines for which coverage is comparable to vaccines which are assessed for 'fully immunised' status, and rotavirus and varicella vaccines for which coverage is lower. Coverage is also suboptimal for vaccines recommended for Indigenous children only (i.e. hepatitis A and pneumococcal polysaccharide vaccine) as previously reported for other vaccines for both children and adults. Delayed receipt of vaccines is an important issue for vaccines recommended for Indigenous children and has not improved among non-Indigenous children despite improvements in coverage at the 24-month milestone. Although Indigenous children in Australia have coverage levels that are similar to non-indigenous children at 24 months of age, the disparity in delayed vaccination between Indigenous and non-indigenous children, which is up to 18% for the 3rd dose of DTP, remains a challenge.
这份第二届年度免疫接种覆盖率报告记录了2008年期间一系列源自澳大利亚儿童免疫接种登记数据的标准指标的趋势，包括标准年龄节点的总体覆盖率以及国家免疫规划（NIP）中所含各疫苗的覆盖率。还按照标准模板总结了按原住民身份划分的覆盖率、较小地理区域的分布图以及及时性趋势。就总体覆盖率而言，澳大利亚免疫接种计划针对12个月和24个月大儿童的目标已经实现，但5岁儿童的目标尚未实现。24个月大儿童的覆盖率超过了12个月大儿童的覆盖率，但由于计算“完全免疫”时不包括18个月大时接种的水痘疫苗，这可能代表免疫接种延迟，免疫接种激励措施也有一定作用。同样，2008年3月起4岁应接种疫苗的覆盖率估计值下降，主要是因为自2007年12月起评估年龄从6岁改为5岁。NIP中的一些个别疫苗目前未评估“完全免疫”状态或激励支付资格。这些疫苗包括肺炎球菌结合疫苗和脑膜炎球菌C结合疫苗，其覆盖率与评估“完全免疫”状态的疫苗相当，以及轮状病毒疫苗和水痘疫苗，其覆盖率较低。仅针对原住民儿童推荐的疫苗（即甲型肝炎疫苗和肺炎球菌多糖疫苗）的覆盖率也不理想，此前针对儿童和成人的其他疫苗也有类似报告。延迟接种疫苗是针对原住民儿童推荐疫苗的一个重要问题，尽管24个月节点的覆盖率有所提高，但非原住民儿童的这一问题并未改善。尽管澳大利亚原住民儿童在24个月大时的覆盖率水平与非原住民儿童相似，但原住民和非原住民儿童在延迟接种疫苗方面的差距仍然是一个挑战，三剂白喉、破伤风、百日咳混合疫苗（DTP）的差距高达18%。
