Immunisation

Introduction

In New South Wales, despite substantial progress, increases are needed in immunisation coverage to reduce the incidence of vaccine preventable diseases.[1]

Influenza (flu), caused by the influenza virus, is characterised by abrupt onset of fever, myalgia, headache, sore throat, and acute cough. Infuenza can cause extreme malaise lasting several days. Although usually not life threatening, influenza can be complicated by secondary bacterial pneumonia in individuals whose medical condition makes them vulnerable. Under the National Immunisation Program, influenza vaccine is provided free to all people aged 65 years and over and is recommended annually.[1] Under the National Indigenous Pneumococcal and Influenza Immunisation Program, the vaccine is provided free to Aboriginal people aged 50 years and over and to those aged 15-49 years who have chronic conditions or illness, who are heavy drinkers, or who smoke tobacco.[1]

Streptococcus pneumoniae (pneumococcus), a bacterial inhabitant of the upper-respiratory tract, is a major cause of pneumonia, meningitis, and middle ear infection, particularly in the elderly, Aboriginal and Torres Strait Islander people, and young children. The National Health and Medical Research Council recommends immunisation against pneumococcal disease for: all people aged 65 years and over; Aboriginal and Torres Strait Islander people aged 50 years and over; people over 5 years of age who are immunocompromised, suffer from chronic conditions or illness, or smoke tobacco; and people with asplenia, either functional or anatomical.[1]

The National Meningococcal C Vaccination Program commenced in January 2003, aimed at children and adolescents aged 1-18 years. Under this program, meningococcal C vaccine is available free of charge to people aged 1-19 years over the following 4 years.[1]

In 2006 the New South Wales Population Health Survey asked respondents aged 50 years and over: Were you vaccinated or immunised against flu in the past 12 months? When were you last vaccinated or immunised against pneumonia? To evaluate the success of the National Meningococcal C Vaccination Program, respondents aged 16-19 years were asked: Since January 2005 have you been vaccinated against meningococcal C disease? When were you vaccinated? and, Where did you receive the vaccine?

Results

Influenza vaccination

In adults aged 50 years and over, the proportion vaccinated against influenza in the last 12 months was 48.0 per cent, with a higher proportion of females (51.5 per cent) than males (44.2 per cent) being vaccinated. There was no significant variation between urban areas and rural areas, or among health areas, or by level of socioeconomic disadvantage. Overall, in this age group, vaccination has increased significantly between 1997 (34.6 per cent) and 2006 (48.0 per cent). This increase was significant in both males (32.1 per cent to 44.2 per cent) and females (36.8 per cent to 51.5 per cent).

In adults aged 65 years and over, the proportion vaccinated against influenza in the last 12 months was 75.0 per cent. In this age group, there was no significant difference in the proportion of females and males being vaccinated. There was no significant difference between rural areas and urban areas, or by level of socioeconomic disadvantage; however, a lower proportion of adults aged 65 years and over in the Greater Western Health Area (67.3 per cent) were vaccinated against influenza in the last 12 months, compared with the overall adult population in this age group. Overall, in this age group, vaccination has increased significantly between 1997 (57.1 per cent) and 2006 (75.0 per cent). This increase was significant in both males (55.7 per cent to 73.8 per cent) and females (58.1 per cent to 75.9 per cent).

Pneumococcal vaccination

In adults aged 50 years and over, just under one third (32.1 per cent) had a pneumococcal vaccination in the last 5 years. In this age group, 14.4 per cent were vaccinated within the last 12 months, 17.8 per cent 12 months to 5 years ago, 2.5 per cent more than 5 years ago, and 65.4 per cent had never been vaccinated. A significantly higher proportion of females (33.9 per cent) than males (30.2 per cent) had been vaccinated in the last 5 years. The proportion of adults being vaccinated increased significantly with age (from 6.2 per cent among those aged 50-54 years to 71.3 per cent among those aged 80 years and over). A significantly higher proportion of adults in rural areas (34.4 per cent) than urban areas (30.9 per cent) had a pneumococcal vaccination in the last 5 years. A higher proportion of adults in the Hunter & New England Health Area (38.6 per cent) had a pneumococcal vaccination in the last 5 years. A lower proportion of adults in the least disadvantaged quintile (28.0 per cent) had a pneumococcal vaccination in the last 5 years. Overall, in this age group, there has been a significant increase in the proportion of adults being vaccinated in the last 5 years, from 19.2 per cent in 2002 to 32.1 per cent in 2006.

In adults aged 65 years and over, the proportion vaccinated for pneumococcal pneumonia in the last 5 years was 60.9 per cent. In this age group, there was no significant variation between males and females. A significantly lower proportion of adults aged 65-69 years (46.0 per cent), and a significantly higher proportion of adults aged 75 years and over (68.8 per cent and 71.3 per cent), had been vaccinated in the last 5 years. In this age group, there was no significant difference between rural areas and urban areas, or by level of socioeconomic disadvantage; however, a higher proportion of adults in the Hunter & New England Health Area (69.2 per cent), and a lower proportion of adults in the Greater Western Health Area (53.8 per cent) had been vaccinated in the last 5 years. Overall, in this age group, there has been a significant increase in the proportion of adults being vaccinated in the last 5 years, from 38.6 per cent in 2002 to 60.9 per cent in 2006.

Meningococcal vaccination

In 2006, among adults aged 16-19 years, 72.0 per cent were vaccinated against meningococcal C in the last year. The proportion did not vary significantly between urban areas and rural areas; however, a lower proportion of adults in the Greater Western Health Area (46.9 per cent) were vaccinated against meningococcal C in the last year, compared with the overall adult population in this age group. A higher proportion of adults in the second least advantaged quintile (85.6 per cent) were vaccinated against meningococcal C in the last year.

Of those who had been vaccinated against meningococcal C in the last year, 82.7 per cent were vaccinated by a school clinic, 14.7 per cent by a general practitioner, and 1.8 per cent by a community health centre.

Overall, in this age group, there has been a significant increase in the proportion of adults being vaccinated against meningococcal C in the last year, from 62.5 per cent in 2005 to 72.0 per cent in 2006.

References

National Health and Medical Research Council. The Australian Immunisation Handbook, 8th Edition, Canberra: National Health and Medical Research Council, 2003.

Graphs

Source:	New South Wales Population Health Survey 2006 (HOIST). Centre for Epidemiology and Research, NSW Department of Health.
Print version:	Although this page can be printed directly from your web browser, a higher quality version is available as a PDF file that can be printed or viewed on screen.
Produced by:	Centre for Epidemiology and Research, Population Health Division, NSW Department of Health.
Last updated on:	1 July 2007