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Primary care practice and health professional determinants of immunisation coverage

Cameron Charles Grant · Helen Petousis‐Harris · Nikki M. Turner · Felicity Goodyear‐Smith · Ngaire M Kerse · Rhys Jones +3 more

14 citations0/0 files storedJournal of Paediatrics and Child Health

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Vaccine Coverage and Hesitancy Child and Adolescent Health Primary Care and Health Outcomes

Abstract

AIM: To identify primary care factors associated with immunisation coverage. METHODS: A survey during 2005-2006 of a random sample of New Zealand primary care practices, with over-sampling of practices serving indigenous children. An immunisation audit was conducted for children registered at each practice. Practice characteristics and the knowledge and attitudes of doctors, nurses and caregivers were measured. Practice immunisation coverage was defined as the percentage of registered children from 6 weeks to 23 months old at each practice who were fully immunised for age. Associations of practice, doctor, nurse and caregiver factors with practice immunisation coverage were determined using multiple regression analyses. RESULTS: One hundred and twenty-four (61%) of 205 eligible practices were recruited. A median (25th-75th centile) of 71% (57-77%) of registered children at each practice was fully immunised. In multivariate analyses, immunisation coverage was higher at practices with no staff shortages (median practice coverage 76% vs 67%, P = 0.004) and where doctors were confident in their immunisation knowledge (72% vs 67%, P= 0.005). Coverage was lower if the children's parents had received information antenatally, which discouraged immunisation (67% vs 73%, P = 0.008). Coverage decreased as socio-economic deprivation of the registered population increased (P < 0.001) and as the children's age (P = 0.001) and registration age (P = 0.02) increased. CONCLUSIONS Higher immunisation coverage is achieved by practices that establish an early relationship with the family and that are adequately resourced with stable and confident staff. Immunisation promotion should begin antenatally.

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References

1998Impact of anti-vaccine movements on pertussis control: the untold story 2014NZDep2013 Index of Deprivation 2009National, state, and local area vaccination coverage among children aged 19-35 months - United States, 2008.1993Risk Factors for Delayed Immunization in a Random Sample of 1163 Children From Oregon and Washington 2005Disparities in Indigenous Health: A Cross-Country Comparison Between New Zealand and the United States 1999Strategies to Sustain Success in Childhood Immunizations 2007National, State, and Local Area Vaccination Coverage Among Children Aged 19-35 Months—United States, 2006 2006Immunisation handbook 2006

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2014Is there an association between the coverage of immunisation boosters by the age of 5 and deprivation? An ecological study 2017The challenges and opportunities of translating best practice immunisation strategies among low performing general practices to reduce equity gaps in childhood immunisation coverage in New Zealand

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