Reducing the impact of a meningococcal group C outbreak with a emergency vaccination programme to over 34,000 children

Today the New Zealand Medical Journal is publishing The Northland Emergency Meningococcal C Vaccination Programme co-authored by Northland District Health Board Medical Officer of Health Dr Clair Mills, with Researcher Liane Penney. 

The collaborative efforts of the Northland health sector enabled the timely delivery of a quality emergency vaccination programme to over 34,000 children and young people (73% of the target population) in twelve weeks. While a significant achievement, it has also provided opportunities to identify gaps and potential for improvements to routine immunisation services.

“Equitable vaccination coverage cannot be achieved without implementing strategies to improve the availability of a range of accessible and appropriate services”, said Dr Mills.

“Community clinics, with a “walk in, no appointment” approach, in a range of fixed locations and mobile units, provided an appropriate and accessible option for over three thousand children and young people (10% of the total vaccinated) who may not have otherwise received a Meningitec® vaccination”.

General practice services remain an essential option for accessing vaccination, particularly for the pre-school population. General practice services are also the preferred option for some school aged children and youth. However meningococcal C vaccination coverage in Northland suggests general practice teams need to continuously review and improve their processes in order to optimise access for their patients and reach high equitable vaccination coverage.

School based programmes demonstrate that equitable, high coverage can be achieved when vaccination services are taken to where children are, reducing barriers to access. However, school programmes also need to continuously review their systems and processes to ensure all students have equal opportunity to access vaccination services at school, particularly young adults.

The outstanding lesson for the Northland health sector is that a sharp focus on improving access for those who have previously been missed, and a will to innovate across all parts of the health sector is necessary, if immunisation coverage is to improve. Continuing to deliver vaccination services without system changes will not increase coverage or eliminate inequalities.


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Aim The paper describes an emergency meningococcal C vaccination programme implemented in Northland, New Zealand in 2011.

The programme aimed to reduce the impact of a meningococcal group C outbreak on the Northland population, through vaccination of 85% of children and youth 12 months to <20 years with a meningococcal serogroup C conjugate vaccine.

Method The emergency vaccination programme targeted an estimated population of 44,000 children and youth. Vaccinations were promoted and delivered by Northland District Health Board Public Health Nursing Service, Primary Health Organisations, General Practice, and Maori provider services, at schools, general practice clinics, via community clinics and outreach home-based vaccination services.

Results 32,410 children and youth were vaccinated. Overall coverage reached 73% (72% Māori, 75% non-Māori). Coverage differed across age, ethnic groups, school decile and geographic location. Vaccination coverage was highest for children 5 to <13 years at 84% for Māori and 81% for non-Māori. Coverage was lowest for the 17 to <20 year age group at 46% for Māori and 63% for non-Māori. In the pre-school population, 67% of Māori and 76% of non-Māori children 12 months to <5 years received vaccination. The 13 to <17 year age group reached 71% coverage for Māori and 70% for non-Māori.

Conclusion Equitable, high vaccination coverage is attainable in an emergency vaccination programme in New Zealand. However a range of service options, including community outreach, are necessary to reduce access barriers for some groups. The programme presented useful insights into what is possible with focused attention to adapting services to meet diverse needs.

NZMA Meningococcal C Vaccination Dr Mills.pdf

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