Abstract
BackgroundDelayed immunisation and vaccine preventable communicable disease remains a significant health issue in Aboriginal children. Strategies to increase immunisation coverage and timeliness can be resource intensive. In a low cost initiative at the Aboriginal Medical Service Western Sydney (AMSWS) in 2008–2009, a trial of personalised calendars to prompt timely childhood immunisation was undertaken.MethodsCalendars were generated during attendances for early childhood immunisations. They were designed for display in the home and included the due date of the next immunisation, a photo of the child and Aboriginal artwork. In a retrospective cohort design, Australian Childhood Immunisation Register data from AMSWS and non-AMSWS providers were used to determine the delay in immunisation and percentage of immunisations on time in those who received a calendar compared to those who did not. Interviews were undertaken with carers and staff.ResultsData on 2142 immunisation doses given to 505 children were analysed, utilising pre-intervention (2005–2007) and intervention (2008–2009) periods and a 2 year post-intervention observation period. 113 calendars were distributed (30% of eligible immunisation attendances). Improvements in timeliness were seen at each schedule point for those children who received a calendar. The average delay in those who received a calendar at their previous visit was 0.6 months (95% CI -0.8 to 2.6) after the due date, compared to 3.3 months (95% CI −0.6 to 7.5) in those who did not. 80% of doses were on time in the group who received a calendar at the preceding immunisation, 66% were on time for those who received a calendar at an earlier point and 57% of doses were on time for those who did not receive a calendar (P<0.0001, Cochran-Armitage trend test). Interview data further supported the value and effectiveness of the calendars as both a prompt to timely immunisations and a community health education project without undue resource implications.ConclusionsPersonalised calendars can increase the timeliness of immunisations in Aboriginal children. This simple, low cost tool appears practicable and effective in an Aboriginal community setting in improving early childhood vaccination timeliness and has high potential for local adaptation to suit the needs of diverse communities.
Highlights
Delayed immunisation and vaccine preventable communicable disease remains a significant health issue in Aboriginal children
The timeliness of immunisations in Aboriginal and Torres Strait Islander children is considered the current benchmark of program effectiveness given the improvements in immunisation coverage in recent years [1]
Socioeconomic disadvantage is the strongest predictor of under-immunisation [10,11,12] and Aboriginal Australians continue to experience marked disadvantage [13]
Summary
Delayed immunisation and vaccine preventable communicable disease remains a significant health issue in Aboriginal children. The timeliness of immunisations in Aboriginal and Torres Strait Islander children is considered the current benchmark of program effectiveness given the improvements in immunisation coverage in recent years [1]. Immunisation is considered timely when received at the earliest appropriate age, defined as within 30 days of the Delayed immunisation, in the first year of life, puts Aboriginal children at increased risk of serious morbidity from diseases that have more serious outcomes in young infants (such as pertussis) or are much more common in Aboriginal infants (such as pneumococcal diseases). There is little information on barriers to timely immunisation specific to the Australian Aboriginal population. Caregiver disagreement with immunisation appears to be less common for Aboriginal Australians [9]. Incomplete or delayed immunisation has been associated with large family size [15], residential mobility [16], poor caregiver knowledge of the immunisation schedule [17] and a lack of parental concern about immunisation timing [18]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
