Abstract
In 2014, Norway became aware of potential low vaccination coverage for the second dose of measles-mumps-rubella vaccine (MMR2) in six of 19 counties. This was detected by comparing the national coverage (NC) for 16-year-olds extracted from the national immunisation registry SYSVAK with the annual status update for elimination of measles and rubella (ASU) reported to the World Health Organization (WHO). The existing method for calculating NC in 2014 did not show MMR2 coverage. ASU reporting on MMR2 was significantly lower then the NC and below the WHO-recommended 95% coverage. SYSVAK is based on the Norwegian personal identification numbers, which allows monitoring of vaccinations at aggregateded as well as individual level. It is an important tool for active surveillance of the performance of the Norwegian Childhood Immunisation Programme (NCIP). The method for calculating NC was improved in 2015 to reflect MMR2 coverage for 16-year-olds. As a result, Norway has improved its real-time surveillance and monitoring of the actual MMR2 coverage also through SYSVAK (the annual publication of NC). Vaccinators receive feedback for follow-up if 15-year-olds are missing MMR2. In 2017, only three counties had an MMR2 coverage below 90%.
Highlights
The Norwegian national immunisation registryThe Norwegian immunisation registry SYSVAK is a national Immunisation Information System (IIS) administered by the Norwegian Institute of Public Health (NIPH) [1]
It is mandatory for health personnel to report all vaccinations offered through the Norwegian Childhood Immunisation Programme (NCIP) [6] to SYSVAK [3]; consent from the vaccinee is not required
We have shown here that SYSVAK detected low MMR2 coverage in six counties and describe actions that were taken to improve this, such as a new method for measuring national coverage (NC)
Summary
SYSVAK is legally anchored in the Norwegian law for Health Registries [2] and the SYSVAK regulation [3] It has been nationwide since 1995 and covers all vaccinations in all age groups. SYSVAK offers the possibility to produce a snapshot status of the vaccination coverage against a disease at any given time. This can be done for the Norwegian population in general, for targeted geographical areas (at national, county, municipality and district level) and at an individual level. The current NCIP foresees MMR1 at age 15 months and MMR2 at age 11–12 years It is primarily public healthcare stations and school healthcare services who offer NCIP vaccinations in Norway. One of the strategies is to achieve and sustain a very high coverage of at least 95% with two doses of measles and at least one dose of rubella vaccine
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