Measles prevention in adolescents: lessons learnt from implementing a high school catch-up vaccination programme in New South Wales, Australia, 2014-2015

Abstract

IntroductionIn response to a significant increase of measles cases and a high percentage of unvaccinated adolescents in New South Wales, Australia, a measles high school catch-up vaccination programme was implemented between August and December 2014. This study aimed to explore the factors affecting school-based supplementary immunization activities (SIAs) and to inform future SIA and routine school-based vaccination programme implementation and service provision.MethodsFocus group analysis was conducted among public health unit (PHU) staff responsible for implementing the SIA catch-up programme. Key areas discussed were pre-programme planning, implementation, resources, consent materials, media activity and future directions for school vaccination programme delivery. Sessions were audio recorded, transcribed verbatim and reviewed. Thematic analysis was conducted to identify the major themes.ResultsTwo independent focus groups with 32 participants were conducted in January 2015. Barriers to the SIA implementation included lead time, consent processes, interagency collaboration, access to the targeted cohort and the impact of introducing a SIA to an already demanding curriculum and school programme immunization schedule. A positive PHU school coordinator rapport and experience of PHU staff facilitated the implementation. Consideration of different approaches for pre-clinic vaccination status checks, student involvement in the vaccination decision, online consent, workforce sharing between health districts and effective programme planning time were identified for improving future SIA implementation.ConclusionAlthough many barriers to school programme implementation have been identified in this study, with adequate resourcing and lead time, SIAs implemented via a routine school vaccination programme are an appropriate model to target adolescents.

Measles high school vaccination program, 2014–2015: online survey of parents in NSW, Australia

“…8 Increasing student involvement in the consent process was suggested by parents in this survey and during the NSW PHU focus groups. 6 Parental recall and access to previous vaccination records More than half of the parents (54%) reported difficulties finding their child's previous MMR vaccination records, which supports unpublished findings from implementing the 2014 and 2015 MMR SIAs. Although more than 11 000 were vaccinated in the 2014 SIA, a further 8000 students had parental consent and were not vaccinated; in the 2015 SIA, 20 000 students had parental consent and only 4200 students required a vaccine.…”

“…Focus groups undertaken with NSW public health unit (PHU) staff (who are responsible for delivering these SIAs) in 2015 identified important considerations for future SIA implementation, such as the importance of adequate lead time and planning time, online consent, student involvement, and facilitating access to schools by the immunisation nurses. 6 This survey identified a number of improvements for consideration in routine school vaccination program delivery and future SIAs in NSW.…”

“…An electronic approach was also raised during the PHU staff focus groups. 6 With evolving information technology and national immunisation register developments, this should be pursued further as a potentially efficient and effective tool to obtain informed consent for the NSW school vaccination program and future SIAs.…”

“…PHU focus groups identified that a good rapport between the PHU and the school coordinator facilitated program implementation. 6 It is recommended that PHUs develop a greater rapport with school staff to increase support.…”