Table 1. Immunisation coverage: Population-based studies (national and regional) with high response rates
Study |
Location |
Design |
Final sample size and age |
Response rate* (%) |
Strategy and date |
Validation |
---|---|---|---|---|---|---|
ABS (1989)6 | Australia (national) | Cross-sectional population survey | Multistage, random sample of 12,732 children aged 0-14 years | 96% | Household interviews with data for children 0-14 years collected by parental report | Parent Held Record (PHR) consulted in 45% cases |
ABS (1995)5 | Australia (national) | Cross-sectional population survey | 14,591 children aged 0-14 years (6,768 aged 0-6 years) | >95% | Household interviews. Parental report | PHR consulted in 61% cases |
Australian Childhood Immunisation Register (ACIR)18 | Australia (national) | Birth cohort, Immunisation Register | All Australian children aged 0-6 years (birth cohort 259,167 children in 1996) | >76% NSW >86% Victoria | Providers submit immunisation data to national database | Provider held records used |
Victorian Maternal and Child Health database7 | Victoria (state-wide) | Birth cohort using MCH records | All children age 0-6 years attending maternal and child health clinics (birth cohort 62,857 children in 1996) | 90% of all births, decreasing with increased age | MCH nurses collect data and this is collated annually | Use verified records |
Carnie J et al 1995116 | Three areas of metropolitan Melbourne | Cross-sectional population survey | Cluster sample (WHO method) of 630 children aged 18 months to 3 years | N/A | Household interviews in 1991. Parental report | PHR or provider held records used |
Thorman et al (1997)11 | Northern Territory (NT) (state-wide) | Birth cohort, Immunisation Register | All children born after January 1996 (part of ACIR) (birth cohort 35,000 in 1996) | 87% | Providers submit immunisation data to NT database | Provider held records used |
Mitchell et al (1997)10 | Darwin urban area | Birth cohort, Immunisation Register | All children immunised in Darwin urban area (approx birth cohort 2,500 in 1995) | 91% | Providers submit immunisation data to database | Provider held records used |
Skinner et al (1995)110 | Northern Sydney Health region | Birth cohort (retrospective) | 1,004 children aged 2 years from a 3 month birth cohort | 58% | Parent questionnaire (sent by mail) in 1994 | Providers contacted. 60% agreement with parents |
Herceg et al (1995)113 | Newcastle, NSW | Cross-sectional population survey | Cluster sample of 187 children aged 2 years | 97% | Household interviews in 1994. Parental report | PHR or provider held record |
Sullivan et al (1998)124 | NSW | Cross-sectional population survey | Multistage, random sample of 322 children aged 3-24 months | 100% | Household interviews undertaken in 1992 | PHR only (produced in 84% of cases) |
Bond et al (1998)17 | NW Melbourne Victoria | Randomised controlled trial | 405 children 9 months or 16 months | 100% | Children on the ACIR who were late for their vaccinations were randomised with 2 arms to evaluate a home vaccination service | PHR and provider held records used |
Parker et al (1996)8 | Darling Downs, SW Queensland | Birth cohort, Immunisation Register | 50,000 vaccination events for children born 1994 onwards | N/A | Vaccination rates calculated from vaccination events | Provider held records used |
Guthridge et al (1993)112 | NT (remote Aboriginal communities in 3 districts) | Birth cohort, Immunisation Register | 461 Aboriginal children born in 1990, and aged between 12-24 months | 90% | Data analysed on all vaccinations received by cohort until December 1992 | Provider held records used |
Young et al (1994)114 | North Coast Health Region of NSW | Cross-sectional survey | 1,094 Aboriginal children aged from 0-11 years | 93% of study population | Review of provider held immunisation records from 10 areas in Region in 1991 | Provider held records used |
Hall et al (1994)58 | Western NSW (4 rural health districts) | Cross-sectional survey | Cluster sample of 211 children (WHO method) aged 2-4 years | >98% | Survey by telephone and household interview using modified WHO method in 1993 | PHR cited in most cases |
McCall et al (1995)109 | West Moreton, Queensland | Birth cohort (retrospective) | 108 children aged 18 months | 55% | Household interviews. Significant difference between respondents and non-respondents | Provider held records used |
Hanna et al (1995)118 | Queensland (10 Aboriginal and Torres Strait Islander communities) | Cross sectional serological survey (HBV, OPV, measles) | 101 Aboriginal children median age 24.5 months (non-random) | N/A | Serosurvey of fully vaccinated children to assess immunity to HBV, OPV, measles | Provider held records and serosurvey |
Kilmartin et al (1998)111 | Southern Tasmania | Prospective birth cohort | 242 mothers of infants born between June 1994 and February 1995 | 75% at 1 week and 61% at 12 months | Mothers completed questionnaires by interview (1 week) and mail (12 months) postpartum | PHR used |
Andrews et al (1995)30 Part 1 of study, see Table 4 | Victoria (Upper Yarra) | Retrospective review of immunisation records | 845 children aged 2-4 years | N/A | Review of immunisation records from Shire of Upper Yarra's Shire database in 1995 | Provider held records used |
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Table 2. Immunisation coverage: Studies (population and settings based) with less than 50 per cent response rates
Study |
Location |
Design |
Final sample size and age |
Response rate* (%) |
Strategy and date |
Validation |
---|---|---|---|---|---|---|
Edwards BM et al (1995)51 | Western Australia (WA) (state-wide) | Birth cohort (retrospective) | 487 children born in April 1993 (and aged 2 years at time of survey) | 49% | Questionnaire mailed to mothers across WA, randomly selected from midwives database | 96.5% mothers referred to PHR (not validated by researchers) |
Conaty et al (1996)57 | Western Sydney, NSW | Cross-sectional telephone survey | 483 children aged 2 years | 36% | Telephone household survey conducted in 1995 in Western Sydney and Wentworth Health Areas | 86% respondents cited PHR |
Ferson MJ et al (1995)74 | NSW (Eastern Sydney) | Randomised controlled trial of primary school intervention | 103 in final sample (249 randomised) from kindergarten in 1991 | 43% of randomised children | Kindergarten children screened and non-fully immunised children randomised into 2 intervention arms | Screening cards completed by school nurses |
Miles et al (1996)102 | Hunter Health Area, NSW | Cross-sectional survey | 69 children aged 2 years attending formal child-care | 29% | Review of immunisation records held by childcare services in 1995 | Provider held record used |
* Response rate shows % of original sample in the final sample
Top of pageTable 3. Immunisation Coverage: Population-based studies (national and regional) single vaccine studies
Study |
Location |
Design |
Sample size and age |
Response rate* (%) |
Strategy and date |
Validation |
---|---|---|---|---|---|---|
Causer et al (1998)54 | Central and Southern Sydney, NSW | Cross-sectional serological survey (measles and rubella only) | 580 children aged 18 months to 5 years | 75% approx | Household interviews and venous blood samples | PHR and serosurvey |
McIntyre et al 1995)122 | Sydney Statistical Division | Cross-sectional population survey (Hib only) | 549 children aged 0-4 years from 412 households | 82% | Random telephone sample to households in August 1993 | 50% sub-sample had records verified from providers |
McIntyre et al (1994)61 | Sydney Statistical Division | Cross-sectional population survey (Hib only) | 551 children aged 0-4 years from 394 households | 74% | Random telephone sample to households in August 1994 (repeat of 1993 survey) | 50% sub-sample had records verified from providers |
O'Brien et al (1997)6 | ACT (state-wide) | Birth cohort using immunisation register (Hib only) | 9,790 children aged either 9 or 24 months | N/A | Providers submitted immunisation data to ACT central database | Provider held records used |
Oman et al (1997)119 | Victoria (state-wide) | Birth cohort using MCH records (Hepatitis B only) | 3,611 children at risk of HBV aged 12-24 months | 63% of infants at increased risk of HBV | MCH nurses collected data on 'targeted' infants born between July 1992 - June 1993 | Provider held records used |
Ferson et al 1998)121 | NSW | Population-based serosurvey using data from National Survey of Lead in Children | 347 children aged 1-4 years in 1995 who provided adequate blood sample for two assays | 50% provided adequate blood sample | Blood samples collected from National Lead survey were tested for measles and compared with parental report and PHRs | Serosurvey |
* Response rate shows % of original sample in the final sample
Top of pageTable 4. Immunisation coverage in childcare settings
Study |
Location |
Design |
Final sample size and age |
Response rate* (%) |
Strategy |
Validation |
---|---|---|---|---|---|---|
Hanna et al (1994)97 | Northern Queensland (Cairns area) | Cross-sectional survey | Cluster sample of 613 children aged 0-5 years attending formal childcare | 94% | Review of immunisation status using PHR and provider held records | PHR and provider held records used |
Lloyd et al (1996)99 | Illawarra region, NSW | Cross-sectional survey | 1,109 children aged 0-2 years attending 80 childcare centres | 94% of childcare centres | Review of immunisation records held at childcare centres in 1995 | Provider held records used |
Menzies et al (1996)101 | NSW (state-wide) | SSISS Immunisation register‡‡ | 745 children aged 2 years attending childcare centres | N/A | Review of sample of records in SSISS register in 1995 | Provider held records used |
Chow et al (1995)55 | Western Sydney, NSW | Cross-sectional survey | 1,092 children aged 2-3 years attending 95 long day care centres | 83% of childcare centres | Review of immunisation records held by centres in Western Sydney and Wentworth Health Areas | Provider held records used |
Mitchell et al (1997)106 | NT (Territory-wide) | Cross-sectional survey | 269 children aged 2 years in 39 childcare centres | 66% of children from 87% of centres | Review of immunisation records held at childcare centres in 1995 | Provider held records used |
Andrews et al (1995)48 Part 2 of study (see Table 1) | Victoria (Upper Yarra) | Cross-sectional survey | 250 children randomly selected from 700 Family Day Care and pre-school records in 1995 (2-4 years old) | 75% | Parent questionnaire (mailed) | Immunisation Register used to validate responses |
* Response rate shows % of original sample in the final sample
‡ State-wide Sentinel Immunisation Surveillance System
This article was published in Communicable Diseases Intelligence Volume 23, No 6, 10 June 1999.
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Communicable Diseases Surveillance
CDI Vol 23, No 6, 10 June 1999
Immunisation coverage in Australian children: a systematic review 1990-1998
Communicable Diseases Intelligence