Vaccine Preventable Diseases and Vaccination Coverage in Aboriginal and Torres Strait Islander People, Australia, 2003 to 2006

Vaccination coverage estimates from the Australian Childhood Immunisation Register for Aboriginal and Torres Strait Islander versus other children

Disclaimer: Produced by the National Centre for Immunisation Research and Surveillance of Vaccine Preventable Diseases and the Australian Institute of Health and Welfare on behalf of the Australian Government Department of Health and Ageing. Published as a supplement to the Communicable Diseases Intelligence journal Volume 32, June 2008.

Page last updated: 30 June 2008

Calculating vaccination coverage estimates from the ACIR

A child is now defined as being ‘fully vaccinated’ at 12 months of age if he or she has received a third dose of DTPa and poliomyelitis vaccine (oral or inactivated), a second or third dose of Hib vaccine, and either a second or a third dose of Hep B vaccine. Doses of 7vPCV, varicella and meningococcal C conjugate vaccines are not included in this calculation.

A child is now defined as being ‘fully vaccinated’ at 24 months of age if he or she has received a third or fourth dose of DTPa (depending on whether he or she is in the birth cohort for which the recommendation of DTPa at 18 months has been removed), a third dose of poliomyelitis vaccine (oral or inactivated), a third or fourth dose of Hib vaccine, either a second or a third dose of Hep B vaccine and a first dose of MMR vaccine.

A child is now defined as being ‘fully vaccinated’ at 72 months of age if he or she has received a fifth dose of DTPa (children born before March 2002 would have been subject to the recommendation of a DTPa dose at 18 months), a fourth dose of poliomyelitis vaccine (oral or inactivated), and a second dose of MMR vaccine.

Vaccination coverage of two vaccines that became relevant to Aboriginal and Torres Strait Islander children in the Northern Territory, Queensland, South Australia and Western Australia since 2003, namely the hepatitis A vaccine and the 23vPPV booster dose at 18–24 months of age, are published in this report for the first time. The two doses of the hepatitis A vaccine are scheduled for administration at 12 and 18 months of age in Western Australia and the Northern Territory, and at 18 and 24 months of age in Queensland and South Australia. The 23vPPV booster dose following the primary 7vPCV course in infancy is scheduled for administration at 18 months of age in Western Australia and the Northern Territory, and at 24 months of age in Queensland and South Australia. To enable comparability between jurisdictions for coverage of this 23vPPV booster dose, the observation time point at 6–<9 months after the scheduled dosing time adopted in the respective jurisdictions has been selected for reporting.

More detail on the methods used for these calculations, including issues pertaining to identification of Indigenous status in the ACIR, has been discussed in the Methods section of this report.

Fully vaccinated children

Vaccination coverage estimates for Aboriginal and Torres Strait Islander children, compared with children not identified as Aboriginal and Torres Strait Islander, expressed in terms of the percentage who were ‘fully vaccinated’ for age, are shown in Table 17 below.

At age 12 months, the proportion of Australian Aboriginal and Torres Strait Islander children who were fully vaccinated was 83%, compared with 91% for other children (Table 17). Coverage was lower in Aboriginal and Torres Strait Islander children compared with other children in all jurisdictions except for the Australian Capital Territory. The extent of the difference varied among jurisdictions, in some being more than 10 percentage points.

However, by age 24 months, the coverage estimates for Indigenous children had increased and the disparities with non-Indigenous children almost disappeared nationally and in most jurisdictions. The proportions of children who were fully vaccinated were 91% for Aboriginal and Torres Strait Islander children and 92% for other children nationally (Table 17).

At age 72 months, the proportion of Australian children who were recorded as being ‘fully vaccinated’ was generally lower than that at earlier age milestones. There was little difference between Indigenous and other children at the national level (76% and 77%, respectively) while, for individual jurisdictions, coverage in Indigenous children ranged from 9% lower to 12% higher than in non-Indigenous children (Table 17).

Table 17. Percentage of Australian children who were ‘fully vaccinated’ based on data on 3-month birth cohorts as at 31 March 2007 from the ACIR, by Indigenous status

  State or territory  
  ACT NSW NT Qld SA Tas Vic WA Australia
‘Fully vaccinated’ at 12 months (born Oct–Dec 2005)
Indigenous
95.8
85.8
84.8
84.2
77.7
84.9
88.2
75.1
83.3
Others
92.1
91.3
94.0
90.8
90.5
92.8
91.2
90.8
91.1
‘Fully vaccinated’ at 24 months (born Oct–Dec 2004)
Indigenous
88.2
91.1
95.9
93.7
90.9
91.4
87.0
85.8
91.1
Others
93.4
91.3
93.7
91.2
92.8
94.3
93.2
90.8
92.0
‘Fully vaccinated’ at 72 months (born Oct–Dec 2000)
Indigenous
75.0
69.8
86.8
80.7
64.7
82.5
72.5
70.5
75.6
Others
81.5
74.8
74.9
78.4
74.0
82.0
80.0
72.9
76.9

Coverage remained stable over time between 2003 and 2006 for both Indigenous and non-Indigenous children aged 12 months and 24 months (Figure E1 and Table E1 in Appendix E).

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Individual vaccines or antigens

The proportion of Aboriginal and Torres Strait Islander children who had received three doses (primary course) of 7vPCV at age 12 months progressively increased, by yearly birth cohorts, since its recommendation in June 2001 (Figure 17). Given that universal infant vaccination with 7vPCV was recommended in September 2003 but not funded until January 2005, coverage of 7vPCV in other children lagged behind that of Aboriginal and Torres Strait Islander children until the program was funded. Under the funded universal program, coverage of 7vPCV was lower in Aboriginal and Torres Strait Islander children than other children for those born in 2005 (Figure 17). Coverage for individual jurisdictions showed a similar pattern (Table E2 in Appendix E).

Figure 17. Percentage of Australian children who had received three doses of 7-valent pneumococcal conjugate vaccine at age 12 months, by Indigenous status and birth cohort

Figure 17. Percentage of Australian children who had received three doses of 7-valent pneumococcal conjugate vaccine at age 12 months, by Indigenous status and birth cohort

Source: Australian Childhood Immunisation Register, data as at 31 March 2007.

The proportions of Indigenous children who had received the 23vPPV booster, as recommended for Indigenous children in the Northern Territory, Queensland, South Australia and Western Australia at 18–24 months of age, are presented in Figure 18. Coverage varied among these jurisdictions, with the highest at about 64% in the Northern Territory (Figure 18). There was no clear trend in coverage of this dose over a two-year period; however, in all jurisdictions coverage increased between the two cohorts.

Figure 18. Percentage of Aboriginal and Torres Strait Islander children who had received the 23vPPV booster within 6 to <9 months after the due date (18–24 months of age)

Figure 18. Percentage of Aboriginal and Torres Strait Islander children who had received the 23vPPV booster within 6 to &lt;9 months after the due date (18–24 months of age)

Source: Australian Childhood Immunisation Register, data as at 31 March 2007.

Figure 19 shows the coverage of hepatitis A vaccine (two doses) in Aboriginal and Torres Strait Islander children born between January and June 2004 by age 30–<33 months in these four jurisdictions. The coverage levels were initially higher in Queensland, probably reflecting the effect of the earlier regional program in northern Queensland and the variable uptake in the early phase of introduction of this vaccine in other relevant jurisdictions.

Figure 19. Percentage of Aboriginal and Torres Strait Islander children born between January and June 2004 who had received two doses of hepatitis A vaccine at age 30 to <33 months, by jurisdiction

Figure 19. Percentage of Aboriginal and Torres Strait Islander children born between January and June 2004 who had received two doses of hepatitis A vaccine at age 30 to &lt;33 months, by jurisdiction

Source: Australian Childhood Immunisation Register, data as at 31 March 2007.

Coverage data for other individual vaccines or antigens by jurisdiction are provided in Tables E2, E3 and E4 in Appendix E, with the exception of varicella and meningococcal C vaccines, as estimates are not sufficiently reliable such a short time after their introduction.