Vaccine Preventable Diseases in Australia, 2005 to 2007

1. Introduction

Page last updated: 24 December 2010

This is the fifth national surveillance report on the morbidity and mortality from vaccine preventable diseases (VPDs) in Australia. The first (1993 to 1998) was published in 2000, the second (1999 to 2000) in 2002, the third (2001 to 2002) in 2004, and the fourth (2003 to 2005) in 2007.1–4 The overall progressive decline in the incidence of all the childhood VPDs continues. Most striking has been the very substantial decline in the numbers of deaths from these diseases since the pre-vaccination era, despite the Australian population increasing almost 3-fold (Table 1.1), and the close association of declines in individual disease mortality with the introduction of specific vaccination programs.5 However, continual effective surveillance for vaccine preventable diseases is still important, as there are recently introduced vaccines for which effectiveness is yet to be demonstrated, and remaining challenges like outbreaks of measles, mumps or pertussis, particularly in infants too young to be vaccinated.

Table 1.1: Number of deaths from diseases commonly vaccinated against, Australia, 1926 to 2005,* by decade

Period
Diphtheria Pertussis Tetanus Poliomyelitis Measles Population estimate
(yearly average)
1926–1935
4,073
2,808
879
430
1,102
6,600,000
1936–1945
2,791
1,693
655
618
822
7,200,000
1946–1955
624
429
625
1,013
495
8,600,000
1956–1965
44
58
280
123
210
11,000,000
1966–1975
11
22
82
2
146
13,750,000
1976–1985
2
14
31
2
62
14,900,000
1986–1995
2
9
21
0
32
17,300,000
1996–2005
0
17
7
0
0
19,310,000

* Sources: Feery B. One hundred years of vaccination. N S W Public Health Bull 1997;8(8–9):61–63; Feery B. Impact of immunisation on disease patterns in Australia. Med J Aust 1981;2(4):172–176. Deaths recorded for 1966–1975 and 1996–2005 updated with data from the AIHW National Mortality Database.

† Excludes deaths from subacute sclerosing panencephalitis.

Indicates decade in which community vaccination started for the disease.

The past two decades has seen the introduction of a number of major surveillance and vaccination initiatives in Australia:

  • a national disease notification system (NNDSS) in 1991
  • the Australian Childhood Immunisation Register in 19966
  • the Seven Point Plan in 1997 (this included the Measles Control Campaign in the later part of 1998)7
  • initiatives to encourage and remind parents to have their children immunised on time – currently referred to as the Maternity Immunisation Allowance initiative8
  • the General Practice Immunisation Initiative in 19989
  • implementation of new national notifiable diseases definitions, daily data updates to NNDSS and online data publication in 2004
  • new vaccination programs across the age spectrum (see Appendices 6.4 and 6.5 for details):
    • for infants and children
      • Haemophilus influenzae type b (Hib)
      • hepatitis B
      • meningococcal C disease
      • pneumococcal disease
      • varicella-zoster virus
      • rotavirus
    • for adolescents and young adult women
      • hepatitis B
      • pertussis
      • varicella
      • human papillomavirus
    • for older people
      • influenza
      • pneumococcal disease
    • specific programs for Aboriginal and Torres Strait Islander people
      • influenza
      • pneumococcal disease
      • hepatitis A

Despite their limitations, data from routinely collected datasets remain a valuable information source especially with respect to trends over time. This fifth report uses similar methods to the previous four reports in the series, bringing together all major data sources at the national level relevant to VPDs and vaccination – notifications, coded hospitalisations and death certificates. This report is unique as a source of systematically analysed hospitalisation data on key VPDs, which gives an index of more severe disease presentations compared to notified cases.

The diseases covered in this report include those for which vaccines were funded nationally for children during the review period (diphtheria, invasive Hib disease, acute hepatitis B, invasive pneumococcal disease, measles, meningococcal [C] disease, mumps, pertussis, poliomyelitis, rubella, tetanus and varicella), those for which vaccines were available but only publicly funded or recommended for specific population groups with high risk (hepatitis A, influenza and Q fever), and rotavirus, for which new vaccines became available in 2006. Data potentially relevant for human papillomavirus (HPV) disease, against which there has been a vaccine since mid 2007, are not included in this report. This report does not include tuberculosis, for which reports are found elsewhere,10,11 or diseases that are currently of limited national public health significance in Australia, such as Japanese encephalitis and yellow fever.

This and the previous four reports, all compiled by the National Centre for Immunisation Research and Surveillance of Vaccine Preventable Diseases (NCIRS), provide evidence of the impact of various vaccination policies over the past 16 years, as listed in Appendix 6.4, on the epidemiology of key vaccine preventable diseases in Australia and a baseline against which further initiatives can be evaluated.

With the publication in 2009 of national vaccination coverage data for 2007, together with the time trends of national data up to 2007,12 and the plan for publication of national vaccination coverage reports annually from 2009, this report does not include national vaccination coverage data. The reports for 2007 and 2008 are available in Communicable Diseases Intelligence.12,13

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References

1. McIntyre P, Amin J, Gidding H, Hull B, Torvaldsen S, Tucker A, et al. Vaccine Preventable Diseases and Vaccination Coverage in Australia, 1993–1998. Commun Dis Intell 2000;24(Suppl):S1–S83.

2. McIntyre P, Gidding H, Gilmour R, Lawrence G, Hull B, Horby P, et al. Vaccine Preventable Diseases and Vaccination Coverage in Australia, 1999 to 2000. Commun Dis Intell 2002;26(Suppl):S1–S111.

3. Brotherton J, McIntyre P, Puech M, Wang H, Gidding H, Hull B, et al. Vaccine Preventable Diseases and Vaccination Coverage in Australia, 2001 to 2002. Commun Dis Intell 2004;28(Suppl 2):S1–S116.

4. Brotherton J, Wang H, Schaffer A, Quinn H, Menzies R, Hull B, et al. Vaccine Preventable Diseases and Vaccination Coverage in Australia, 2003 to 2005. Commun Dis Intell 2007;31(Suppl):S1–S152.

5. Gidding HF, Burgess MA, Kempe AE. A short history of vaccination in Australia [erratum appears in Med J Aust 2001;174(5):260]. Med J Aust 2001;174(1):37–40.

6. Hull BP, McIntyre PB, Heath TC, Sayer GP. Measuring immunisation coverage in Australia: a review of the Australian Childhood Immunisation Register. Aust Fam Physician 1999;28(1):55–60.

7. Australian Government Department of Health and Ageing, Immunise Australia Program. Immunise Australia: seven point plan. Available from: http://www.immunise.health.gov.au/internet/immunise/publishing.nsf/Content/history-of-ia-prog Accessed on 29 June 2010.

8. Australian Government Department of Human Services, Centrelink. Maternity immunisation allowance. Available from: http://www.centrelink.gov.au/internet/internet.nsf/payments/maternity_allow.htm Accessed on 29 June 2010.

9. Australian Government Department of Human Services, Medicare Australia. General Practice Immunisation Incentive (GPII). Available from: http://www.medicareaustralia.gov.au/provider/incentives/gpii/index.jsp Accessed on 29 June 2010.

10. Roche PW, Krause V, Konstantinos A, Bastian I, Antic R, Brown L, et al. Tuberculosis notifications in Australia, 2006. Commun Dis Intell 2008;32(1):1–11.

11. Barry C, Konstantinos A, National Tuberculosis Advisory Committee. Tuberculosis notifications in Australia, 2007. Commun Dis Intell 2009;33(3):304–315.

12. Hull B, Deeks S, Menzies R, McIntyre P. Immunisation coverage annual report, 2007. Commun Dis Intell 2009;33(2):170–187.

13. Hull B, Menzies R, McIntyre P. Immunisation coverage annual report, 2008. Commun Dis Intell 2010;34(3):241–258.

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