Driving Change in Immunisation: the Role of the National Immunisation Office 2005 - 2011
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Driving change in immunisation: The role of the National Immunisation Office 2005 - 2011 Item Type Report Authors HSE National Immunisation Office Publisher Health Service Executive (HSE) Download date 01/10/2021 18:35:24 Link to Item http://hdl.handle.net/10147/301624 Find this and similar works at - http://www.lenus.ie/hse Driving Change in Immunisation The Role of the National Immunisation Office 2005–2011 2659 HSE NIO 5 Year Report - May 21st - Single Pages.indd 1 31/05/2012 16:40 1£ FeilhiiM'.liiilllldn na Seirbbise Slainte www.immunisation.ie Health Service llxecutire 2659 HSE NIO 5 Year Report - May 21st - Single Pages.indd 1 31/05/2012 16:40 Contents driving change Foreword 2 Executive Summary 3 Mission Statement 5 Staff List 5 Introduction 7 Coordination of Immunisation Programmes 10 Vaccine Supply Chain Management 14 Education and Communication 20 National Immunisation Programmes and Campaigns 27 Research 40 The Future 43 Appendix 1 Cold Chain Products available from 44 National Cold Chain Service 2011 Appendix 2 List of Publications 2011 45 Appendix 3 Primary Childhood Immunisation Programme 46 2005–2011 Appendix 4 Changes in Immunisation 47 2005–2011 Appendix 5 National Immunisation Schedule 48 December 2011 Glossary 49 1 2659 HSE NIO 5 Year Report - May 21st - Single Pages.indd 1 31/05/2012 16:40 Driving Change in Immunisation Foreword The National Immunisation Office (NIO) was These successes are due to the commitment of established in 2005 to coordinate the implementation the seven staff members of the NIO. I would like to of standardised high quality immunisation programmes acknowledge their pivotal role in driving change in in Ireland. immunisation programmes. I also wish to recognise the members of the implementation groups and Between 2005–2011 there have been considerable subgroups and all those involved in the delivery and enhancements to the childhood and schools support of the immunisation programmes for their immunisation programmes. These improvements, hard work and dedication. together with a number of successful catch-up campaigns, have resulted in significant decreases in This report details the the role of the NIO in the morbidity and mortality. achievements in immunisation between 2005–2011 and also outlines new challenges for the future. These changes, the increasing population and the The expertise that has been developed across a range 2009 H1N1 pandemic, all created challenges for the of functions within the small team in the NIO will serve immunisation programmes and the staff involved in to overcome these challenges and deliver additional their delivery. However, despite the reductions to enhancements to the immunisation programme in a budget allocations and staffing constraints, maximum standardised coordinated way. efficiencies were achieved throughout the country and vaccine uptake rates have increased and have reached or are approaching World Health Organization (WHO) targets. This would not have been possible without the input of the NIO and the cooperation of all key Dr Kevin Kelleher stakeholders. Assistant National Director Standardisation of immunisation programmes have Integrated Services Directorate – Health Protection been progressed, clinical guidelines developed and June 2012 staff training and public communication delivered to an impressive standard. In addition considerable savings have been made with the streamlining of vaccine procurement and delivery and the centralised processing of invoices. 2 2659 HSE NIO 5 Year Report - May 21st - Single Pages.indd 2 31/05/2012 16:40 Driving Change in Immunisation Executive Summary Immunisation is one of the most cost-effective health This service has expanded since its introduction in 2005 interventions available, saving millions of people from when 1.6 million vaccines were delivered to over 1,600 illness, disability and death worldwide each year. locations to 2.3 million vaccines to 2,600 locations in A well-functioning immunisation programme is essential 2 011. to reducing child mortality and morbidity from vaccine In addition the NIO, in collaboration with key preventable diseases (VPDs). stakeholders, has developed and implemented national In 2002 a review of immunisation programmes in standards based on best practice in many aspects of Ireland identified fragmented structures and a lack of immunisation including training and education, consent standardised processes as key challenges to improving forms, medication protocols and HSE staff immunisation immunisation uptake rates. As a result the Health guidelines. Service Executive (HSE) established the National All information materials for the general public are now Immunisation Office (NIO) in 2005 as a coordinating unit developed and distributed by the NIO who also manage for immunisation to ensure high quality standardised implementation of all publicly funded immunisation the national immunisation website www.immunisation.ie. programmes (primary childhood, schools, seasonal This website has received ongoing accreditation from influenza and others as required). the World Health Organization (WHO) since 2006 as one of only 34 websites worldwide providing good The NIO has a current complement of seven full time information practices relating to credibility and content. staff members who are responsible for the coordination of immunisation programmes through collaboration Since 2005 the NIO has coordinated the successful with all all those involved in their delivery and support. implementation of the introduction of hepatitis B and In addition the NIO is also responsible for managing pneumococcal vaccines to the Primary Childhood vaccine procurement and distribution, developing Immunisation Programme with an increase in vaccine training and communication materials for health uptakes approaching World Health Organization professionals and the general public and controlling a targets. Human papillomavirus (HPV) vaccine has been budget of over €38 million in 2011. introduced to the schools immunisation programme with an uptake for the three vaccine doses of 82% exceeding Vaccine procurement accounts for over 90% of this the target of 80% in the first year of the programme. budget and since 2005 purchase of all vaccines for national programmes has been centralised and managed In 2011 the NIO coordinated the implementation by the NIO. This has resulted in significant efficiencies of the first national IT immunisation system which through better forecasting to ensure continuity of supply records HPV vaccinations. This system will allow easier and prolonged shelf life, improved stock management, implementation, monitoring and deliver timely vaccine reduction of vaccine wastage and centralised invoice uptakes. processing. Catch-up campaigns have also been implemented Distribution of all vaccines under validated cold chain which had higher than expected uptake rates. conditions (essential for vaccine potency) is provided The pneumococcal conjugate vaccine (PCV) catch-up by the HSE National Cold Chain Service with overall programme had a 68% uptake and resulted in a 91% management, monitoring and control by the NIO. reduction in pneumococcal disease caused by vaccine 3 2659 HSE NIO 5 Year Report - May 21st - Single Pages.indd 3 31/05/2012 16:40 Driving Change in Immunisation serotypes in children under 2 years of age. The MMR It is likely that a new vaccine for Meningococcal Group vaccine campaign in second level schools to control a B (Men B) infection will soon be licensed. As Ireland has national mumps outbreak had 71% uptake and resulted one of the highest rates of Men B infection in Europe in a dramatic and sustained decline in mumps cases. considerable planning will be required to include this vaccine in the routine schedule and for any catch-up The low uptake of seasonal influenza vaccine particularly campaign once this is agreed. among health care workers is insufficient to protect them and their patients from serious effects of influenza In addition, vaccines such as varicella and zoster have disease. The NIO is actively examining ways to address been recommended in many other countries and there this low uptake in consultation with other stakeholders. are at least 30 other vaccines and new methods of administration in development which have the potential New challenges for the future include the to impact on morbidity and mortality in Ireland. implementation of a National Immunisation Information System (NIIS) as an essential component of a well The expertise developed within the small team in functioning national immunisation programme. This will the NIO across a wide range of functions will serve provide a national register of all immunisations, deliver to coordinate and drive the delivery of high quality timely vaccine uptakes, facilitate better follow up of immunisation programmes in the new challenges ahead. clients including defaulters and result in significant efficiencies by streamlining the numerous regional and local Information Communication Technology (ICT) systems currently in use. Ireland is committed to the WHO European strategy for Measles and Rubella elimination 2015. However there is still a large school going cohort who have not received two doses of MMR vaccine and ongoing measles outbreaks so a catch-up campaign is needed to achieve the required target of 95% to comply with the agreed WHO strategy. 4 2659 HSE NIO 5 Year Report - May 21st - Single Pages.indd 4 31/05/2012 16:40 Driving Change in Immunisation Mission Statement The mission of the National