Immunisation

Consent should be sought from someone with legal capacity before each vaccination. The individual providing consent should have the intellectual capacity to understand specific information and agree voluntarily without pressure, coercion or manipulation. The consent process should include written advice about benefits and harms of the vaccines, risk of not having the vaccine, and what to do after receiving the vaccine. 

Information on providing valid consent is available within the Australian Immunisation handbook.

The National Immunisation Program Schedule (NIPS) lists the recommended funded vaccines for all Australian residents. There may be other vaccines that are not funded but are recommended in the Australian immunisation handbook, depending on occupation or travel. There may be variability in vaccines recommended/funded (eg hepatitis A vaccine).

Adults or children who develop asplenia, human immunodeficiency virus (HIV) infection or a haematological malignancy, or who have received a bone marrow or other transplant, may not be fit for some vaccinations, or may require additional or repeat vaccinations.

What are the key equity issues and who is at risk?

GPs need to be aware of groups with lower levels of age-appropriate immunisation.³ Socioeconomic characteristics associated with lower immunisation rates at 12 months⁴ include:

• being Aboriginal or Torres Strait Islander
• being born overseas
• no private health insurance
• being in the highest or lowest socioeconomic quintile
• being of low birth weight and singleton birth.

All of these factors were also associated with lower immunisation coverage at 24 months, with the exception of low birth weight, which was only significant in the very low birth weight category.

What can GPs do?

Evidence supports a number of strategies in improving immunisation rates that could reduce inequities if efforts were focused on at-risk groups:

• audit of immunisation coverage of at-risk groups in the practice
• use of recall-and-reminder systems and catch-up plans, with a focus on at-risk groups
• integrating vaccination status checks into routine health assessments for those target population groups.

Table 6.1.1

Summary of the main requirements from the National Immunisation Program Schedule

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Table 6.1.2

Vaccines recommended but not funded in National Immunisation Program

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Immunisation information resources include:

• National Immunisation Program Schedule (NIPS)
• Australian immunisation handbook
• Australian Childhood Immunisation Register (ACIR)
  • The ACIR can be used to obtain information on the vaccination history of individuals from birth to 7 years of age given since 1 January 1996. The ACIR can be contacted by email or telephone (1800 653 809).
• National Centre for Immunisation Research & Surveillance

Notification of adverse events

The reporting of adverse events following vaccinations varies geographically. It is possible to report directly to the Therapeutic Goods Administration (TGA) from anywhere in Australia or by telephone on 1800 044 114