MeNZB silver lining: national immunisation register

New Zealanders who invested about $200 million in creating and using a vaccine for serogroup B meningococcal disease — just in time for it to be used as that epidemic began to wane naturally — did gain an important longterm legacy: the National Immunisation Register (NIR).

The NIR went live nationally in December 2005, to make all immunisation records of newborn babies available to health practitioners online. It provides authorities with timely and continuing estimates of coverage, and a method for identifying those who have missed out on childhood vaccination.

Researchers who have analysed the MeNZB immunisation programme — initially delivered 2004-2006 as a “circuit-breaker” to the epidemic — were critical in a paper in the Journal of Paediatrics and Child Health about the late engagement of the Ministry of Health. “Many more cases and deaths might have been prevented if action had been progressed earlier on in the epidemic cycle,” they said. “The weight of this failure to act fell on the disadvantaged of the population”.

“However, the MeNZB campaign has at least left a legacy: the NIR,” the researchers said.”This tool should enable NZ to reduce the significant ethnic inequity in the distribution of vaccine-preventable diseases, as long as the information obtained from the register is translated into vaccine-delivery activities and practices”.

In the meningococcal B epidemic, poverty was a key risk factor, and Maori were 30 times more likely to fall ill than non-Polynesians, with Pacific Islanders at 60 times greater risk. In the case of Pacific Islanders, a high immunisation rate of 83 percent for children under five countered the “vaccine inverse care law” that suggests patients most at risk of disease are those least likely to receive vaccine. But other high-risk ethnic groups, such as Maori children (67 percent) did not fare as well. European and other children had a vaccination rate of 76 percent.

“The National Immunisation Register … is an important spin-offof the (MeNZB) programme, which should result not only in better measured vaccine covereage, but improved and more equitable vaccine delivery,” the researchers said.

The register gives an up to date snapshot of a child’s immunisation status and helps cut down on delays in delivering immunisations, and links children more closely to immunisation and primary health services. – Kent Atkinson