Immunization in Australia. A continuing national challenge

An evaluation of 1994 school entry immunization certificates on the Central Coast of New South Wales

OBJECTIVE

To evaluate school entry immunization certificates and document the immunization status of children enrolled during 1994 in kindergartens on the NSW Central Coast.

METHODOLOGY

Immunization certificates and non-statutory documentation of immunization for school entry presented by parents were evaluated during visits to 68 NSW Central Coast schools in May and June 1994.

RESULTS

Immunization information for 3741 kindergarten enrollments was reviewed. Of these enrollments, 79% presented immunization certificates of which 10% were incomplete, 14% presented non-statutory documentation and 7% had no certificate or non-statutory documentation. It was considered that 19% of children were incompletely immunized; 8% of certificates presented were incorrectly completed.

CONCLUSIONS

The study found that about 80% of Central Coast school entrants were fully immunized. Reliance on immunization certificates as evidence of immunization may overestimate vaccination completion rates, as some certificates may be incorrectly completed. Education of parents, school staff and certificate providers should help to improve both immunization completion and documentation.

Increasing attendance at immunisation clinics: lessons from a trial program that failed

Previous studies suggested that the use of a baby-enrolment and reminder system for early childhood immunisation increased public immunisation clinic attendance. It was decided to run a trial to assess the effects of introducing a baby-enrolment program on attendances at local government immunisation clinics. Enrolment leaflets were distributed to each mother of a new child in six areas of greater Sydney while the mother was in the postnatal ward of the local hospital. Clinic attendance figures were monitored, interviews were conducted with mothers as well as professionals involved in early childhood health services, and the conduct of clinics was observed. The trial failed to increase attendance at public clinics. Mothers' reasons for choice of service, particularly their desire for what they believed to be a more personalised service, and the attitude of the professionals (particularly community nurses) with whom they came in contact were considered to be more influential in determining their use (or lack of use) of public immunisation services. Baby enrolment may be effective in increasing attendance at public immunisation clinics only where there is willing cooperation of all stakeholders in supporting public immunisation services.

Preventive health behaviours among parents of infants aged four months

Six preventive health behaviours have been frequently identified as having the potential to reduce mortality and morbidity during infancy: breast-feeding until the age of six months; no solid food until after four months of age; immunisation against whooping cough, diphtheria, poliomyelitis and tetanus; the use of a baby capsule to restrain the infant when travelling in a motor vehicle; regular attendance at a health care provider for preventive health checks; and no maternal smoking. This study surveyed 191 primiparous women four months after the birth of their babies to explore the proportion of parents who perform the recommended preventive health behaviours and the association among the behaviours. Thirty-nine per cent of the women reported that they were no longer breast-feeding by the time their infant was four months old; 35 per cent had introduced solids before 16 weeks of age; 35 per cent did not always use a baby capsule when travelling with their baby in their car, 25 per cent did not regularly attend the early childhood health centres and 22 per cent smoked. Forty-eight per cent of the sample were performing four or fewer of the six preventive health behaviours and 21 per cent were performing three or fewer. The relationship between performing each preventive health behaviour and a range of demographic variables was investigated. A logistic regression indicated that performing three or fewer of the health behaviours was associated with lower levels of education, having public health insurance and being born in a country other than Australia.