Europe’s journal on infectious disease epidemiology, prevention and control © Eurosurveillance,© 2012 Special edition: Immunisation registers in Europe and elsewhere April 2012 • This special edition of Eurosurveillance presents experiences with immunisation registers from six European countries, Australia and Canada. It illustrates opportunities and challenges of such systems, as well as alternative solutions that may be available in the absence of registers. www.eurosurveillance.org Editorial team Editorial advisors Based at the European Centre for Albania: Alban Ylli, Tirana Disease Prevention and Control (ECDC), Austria: Reinhild Strauss, Vienna 171 83 Stockholm, Sweden Belgium: Koen De Schrijver, Antwerp Telephone number Belgium: Sophie Quoilin, Brussels +46 (0)8 58 60 11 38 or +46 (0)8 58 60 11 36 Bosnia and Herzogovina: Nina Rodić Vukmir, Banja Luka Fax number Bulgaria: Mira Kojouharova, Sofia +46 (0)8 58 60 12 94 Croatia: TBC, Zagreb Cyprus: Chrystalla Hadjianastassiou, Nicosia E-mail Czech Republic: Bohumir Križ, Prague [email protected] Denmark: Peter Henrik Andersen, Copenhagen Editor-in-chief England and Wales: TBC, London Ines Steffens Estonia: Kuulo Kutsar, Tallinn Finland: Outi Lyytikäinen, Helsinki Scientific editors France: Judith Benrekassa, Paris Kathrin Hagmaier Germany: Jamela Seedat, Berlin Williamina Wilson Greece: Rengina Vorou, Athens Karen Wilson Hungary: Ágnes Csohán, Budapest Assistant editors Iceland: Haraldur Briem, Reykjavik Alina Buzdugan Ireland: Lelia Thornton, Dublin Ingela Söderlund Italy: Paola De Castro, Rome Associate editors Kosovo (under UNSCR 1244/99): Lul Raka, Pristina Andrea Ammon, Stockholm, Sweden Latvia: Jurijs Perevoščikovs, Riga Tommi Asikainen, Frankfurt, Germany Lithuania: Milda Zygutiene, Vilnius Mike Catchpole, London, United Kingdom Luxembourg: Thérèse Staub, Luxembourg Denis Coulombier, Stockholm, Sweden The FYR of Macedonia: Elisaveta Stikova, Skopje Christian Drosten, Bonn, Germany Malta: Tanya Melillo Fenech, Valletta Karl Ekdahl, Stockholm, Sweden Netherlands: Paul Bijkerk, Bilthoven Johan Giesecke, Stockholm, Sweden Norway: Hilde Klovstad, Oslo Herman Goossens, Antwerp, Belgium Poland: Malgorzata Sadkowska-Todys, Warsaw David Heymann, London, United Kingdom Portugal: Isabel Marinho Falcão, Lisbon Heath Kelly, Melbourne, Australia Romania: Daniela Pitigoi, Bucharest Irena Klavs, Ljubljana, Slovenia Serbia: Tatjana Pekmezovic, Belgrade Karl Kristinsson, Reykjavik, Iceland Scotland: Norman Macdonald, Glasgow Daniel Lévy-Bruhl, Paris, France Slovakia: Lukáš Murajda, Martin Richard Pebody, London, United Kingdom Slovenia: Alenka Kraigher, Ljubljana Panayotis T. Tassios, Athens, Greece Spain: Elena Rodríguez Valín, Madrid Hélène Therre, Paris, France Sweden: Christer Janson, Stockholm Henriette de Valk, Paris, France European Commission: Paolo Guglielmetti, Luxembourg Sylvie van der Werf, Paris, France World Health Organization Regional Office for Europe: Nedret Emiroglu, Copenhagen Design / Layout Fabrice Donguy / Arne Haeger www.eurosurveillance.org © Eurosurveillance, 2012 Contents Special edition: Immunisation registers in Europe and elsewhere Immunisation registers Editorials Research Articles Immunisation registers – important for vaccinated Immunisation registers in Italy: a patchwork of individuals, vaccinators and public health 2 computerisation 60 by K Johansen, PL Lopalco , J Giesecke by V Alfonsi, F D’Ancona, MC Rota, C Giambi, A Ranghiasci, S Iannazzo, Regional coordinators for infectious diseases and Vaccine registers – experiences from Europe vaccinations and elsewhere 5 by R Pebody Surveillance and outbreak reports Perspectives Use of the vaccination register to evaluate influenza vaccine coverage in seniors in the 2010/11 influenza Measuring childhood vaccine coverage in England: season, Navarre, Spain 66 the role of Child Health Information Systems 8 by I Aguilar, M Reyes, I Martínez-Baz, M Guevara, E Albéniz, by G Amirthalingam, J White, M Ramsay MJ Belza, J Castilla The Norwegian immunisation register – SYSVAK 14 by L Trogstad, G Ung, M Hagerup-Jenssen, I Cappelen, IL Haugen, B Feiring Computerised vaccination register for the Murcia region, Spain, 1991 to 2011 21 by PJ Bernal-González, JA Navarro-Alonso, JJ Pérez-Martín The Danish vaccination register 27 by T Grove Krause, S Jakobsen, M Haarh, K Mølbak Præventis, the immunisation register of the Netherlands: a tool to evaluate the National Immunisation Programme 33 by A van Lier, P Oomen, P de Hoogh, I Drijfhout, B Elsinghorst, J Kemmeren, M Conyn-van Spaendonck, H de Melker Australian immunisation registers: established foundations and opportunities for improvement 39 by LK Chin, NW Crawford, G Rowles, JP Buttery Immunisation registers in Canada: progress made, current situation, and challenges for the future 47 by JA Laroche, AJ Diniz Estimating vaccination coverage in the absence of immunisation registers – the German experience 53 by A Siedler, T Rieck, A Reuss, D Walter, G Poggensee, C Poethko-Müller, S Reitern © Eurosurveillance, 2012 www.eurosurveillance.org 1 Editorials Immunisation registers – important for vaccinated individuals, vaccinators and public health K Johansen ([email protected])1, P L Lopalco1, J Giesecke1 1. European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden Citation style for this article: Johansen K, Lopalco PL, Giesecke J. Immunisation registers – important for vaccinated individuals, vaccinators and public health. Euro Surveill. 2012;17(16):pii=20151. Available online: http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=20151 Article submitted on 17 April 2012/ published on 19 April 2012 Vaccines save lives, protect against disability and highlighted during the large immunisation campaigns improve health. Diseases such as smallpox, tuberculo- following the 2009 pandemic. A need for accurate and sis, poliomyelitis, diphtheria, tetanus, pertussis, inva- rapid information on vaccine coverage by target group sive diseases related to Haemophilus influenzae type was identified and individual-level data were requested b and Neisseria meningitides group C infection, that by stakeholders assessing pandemic vaccine safety only half a century ago were all communicable disease and effectiveness. threats to Europeans, are now rare entities or, as in the case of smallpox, eradicated [1]. Consequently, some Most established immunisation registers are able to at of them are almost forgotten by the younger general least (i) collect data on vaccines provided, (ii) gener- public. However, despite the availability of safe and ate reminders and recall vaccination notices for each effective vaccines against measles and rubella and client, (iii) provide official vaccination forms upon the considerable decline in the number of cases in the request for the individual, and (iv) allow vaccination last decades, Europe is still struggling to eliminate coverage assessments. They are therefore also referred them. In 2011 alone, over 30,000 cases of measles and to as Immunisation Information Systems (IISs). Such more than 3,000 cases of rubella were reported in the systems are confidential, population-based and com- European Union (EU) [2]. To help improve coverage with puterised systems that collect vaccination data about recommended vaccines in the childhood and other age residents within a geographic area or with a healthcare or risk group-specific immunisation programmes and provider. IISs are among the most important tools to assess their impact, immunisation registers have been strengthen and improve the performance of immunisa- or are being developed in a number of countries. In tion programmes by consolidating vaccination records a special issue of Eurosurveillance, published in two of all immunisation clients from multiple vaccination parts in this and the following week, country-specific providers. Access to complete records of all previous experiences with established immunisation registers vaccinations makes it easier for the healthcare provider are shared in a series of articles [3-11]. to ensure that individuals receive recommended vac- cines. Systems can also be used to increase and sus- During the upcoming European Immunization Week, the tain high vaccination coverage through identification measles and rubella elimination 2015 goal for Europe of pockets of unvaccinated individuals or groups and will be advocated by EU Member States, the European serve as a basis for tailored vaccination campaigns. Centre for Disease Prevention and Control (ECDC) and the World Health Organization (WHO) through activi- Population-based electronic IISs are preferably created ties such as (i) communication packages [12], (ii) a at birth if possible through linkage with electronic birth video produced in collaboration between the ECDC records. IISs can then be linked to health-outcome and the European news channel Euronews that pre- databases with clinical information and data on medi- sents the severe complications that can occur follow- cal care provided by general practitioners or hospitals. ing measles infections and (iii) a number of national Upon linkage of different data sources, anonymised conferences. While this creates awareness, it is also data can be made available through newly-developed essential to continue the development of technical software that even permits sharing of data across support to the immunisation programmes. One exam- national borders [13]. Linkage of such different data ple of such technical development are immunisation