Preventing the spread of vaccine preventable diseases in NSW – exploring new strategies to improve vaccine uptake in vulnerable people

Abstract

Although the benefits of immunisation are well documented in the literature, there continue to be outbreaks of vaccine preventable diseases such as measles and pertussis in New South Wales (NSW), Australia. Immunisation program planners need to consider new approaches to engage immunisation providers and recipients to ensure optimal vaccine uptake, particularly during a new program. This thesis is based on four applied research activities associated with implementing a measles catch-up Supplementary Immunisation Activity (SIA) in high schools and an antenatal pertussis vaccination program. The first two applied research activities address a gap in knowledge regarding the use of SIAs. Focus groups were conducted with Public Health Unit (PHU) staff responsible for implementing the measles SIA to identify program strengths and areas of improvement. A survey was undertaken with parents to gain insight into their experience of the program and seek suggestions for improvement. Key findings from both research activities have already informed subsequent time-limited SIAs and the routine school-based vaccination program. This is the first time that a NSW Health immunisation officer has engaged formally with parents and PHU staff and it is recommended that this engagement continues regularly. The second research activities focus on the design and implementation of an antenatal pertussis vaccination program and development of an educational program to support midwives and maternity staff. Pre- and post-program audits were undertaken with frontline staff to determine their needs and verify consistent program implementation. The pre-program audit identified the need for an online education program to increase midwives’ confidence and promote high vaccine uptake. Pre and post surveys were undertaken with learners completing the education program. This work identified the importance of program planners’ engagement with frontline staff before and during the roll-out of a new immunisation program. These are important findings as an informed and confident maternity workforce will facilitate high maternal vaccine uptake and incorporate pertussis vaccination consistently into routine antenatal care in NSW. The importance of engagement with key stakeholders is demonstrated in this work to inform immunisation program implementation, which contributes to essential knowledge on immunisation program planning and implementation.