PART 4: FORMAL AND INFORMAL SUPPORTS

Childhood Immunisation

Immunisation programmes are regarded as an important public health measure in preventing the spread of infectious diseases and as the most effective of all health-promoting interventions, after clean water, shelter and food. Large-scale immunisation programmes have significantly impacted on the prevention of vaccine-preventable diseases. 68

Measure

The distribution of timing of 1st antenatal visit by trimester (1st trimester = < 15 weeks; 2nd trimester = 15-27 weeks; and 3rd trimester = > 28 weeks) for all women delivering live or stillborn babies.

Key findings

  • Overall, the level of uptake of immunisation has increased among children aged up to 12 months (see Table 100). The increases range from about 81% in 2003 to 87% in 2007 for DPT3, HiB3 and polio, and from 89% to 93% for BCG over the same period.
  • Overall, the percentage uptake of immunisation in 2007 was about 87%. This was the highest over the 5-year period under examination.

Table 100: Immunisation uptake rates at 12 months (2003-2007)

Vaccine 2003 2004 2005 2006 2007
P3 80 83 85 86 87
D3 81 83 85 86 87
T3 81 83 85 86 87
HiB3 81 83 85 86 87
Polio3 81 83 85 86 87
MenC3 80 83 85 85 87
BCG 89 91 93 93 93

Source: Immunisation Uptake Statistics, Health Protection Surveillance Centre, HSE

  • The level of uptake of immunisation among children aged up to 24 months also increased over this period (see Table 101). This ranged from about 86% in 2003 to 92% in 2007 for DPT3 and polio vaccines.
  • The increase was also evident for Meningococcal Type C vaccine (MenC3) and measles, mumps and rubella vaccine (MMR1). In 2003, the percentage uptake for MenC3 was 84% for children aged 24 months; while in 2007 this percentage had increased to 91%. The immunisation rate for the MMR1 vaccine was 78% in 2003 and had increased to 87% by 2006.

Table 101: Immunisation uptake rates at 24 months (2003-2007)

Vaccine 2003 2004 2005 2006 2007
P3 85 89 90 91 92
D3 86 89 90 91 92
T3 86 89 90 91 92
HiB3 86 89 90 91 92
Polio3 86 89 90 91 92
MenC3 84 88 89 90 91
MMR1 78 81 84* 86+ 87

* The national figure for MMR is incomplete since Q4-2005 MMR data was not available for the HSE Eastern Region. The MMR figure is based on data from Q1-2005 to Q3-2005.

+ Includes the HSE Eastern Region MMR1 Q1-2006 uptake figure, which is an estimate only (due to technical problems with extracting MMR1 data from the HSE Eastern Region database).

Source: Immunisation Uptake Statistics, Health Protection Surveillance Centre, HSE

 

Differences by geographic area

  • In 2006, immunisation rates for the 12-month-old cohort were about 86% for the State as a whole (see Table 102). Uptake rates were lowest in the former Eastern Regional Health Authority (at about 82%) and highest in the former Midland Health Board Area (at about 92%).

Table 102: Immunisation uptake rates at 12 months, by former Health Board Area (2006)

Former Health Board Area D3 P3 T3 HiB3 Polio3 MenC3 BCG
Eastern Regional Health Authority 82 82 82 82 82 82 n/a
Midland Health Board 92 92 92 92 92 92 94
Mid-Western Health Board 89 89 89 89 89 89 93
North-Eastern Health Board 89 89 89 89 89 86 n/a
North-Western Health Board 92 92 92 91 92 91 92
South-Eastern Health Board 86 86 86 86 86 86 94
Southern Health Board 87 87 87 87 87 86 88
Western Health Board 88 88 88 88 88 87 n/a
Mean average - State 86 86 86 86 86 85 93

n/a = data not available

Source: National Perinatal Reporting System, ESRI

 

  • Similar regional patterns were apparent for the 24-month-old cohort. In 2006, the national immunisation uptake rates for this cohort were at about 91% (see Table 103). The lowest rates (88%) were in the former Eastern Regional Health Authority, while the highest rates (96%-97%) were in the former Midland Health Board Area.

Table 103: Immunisation uptake rates at 24 months, by former Health Board Area (2006)

Former Health Board Area D3 P3 T3 HiB3 Polio3 MenC3 MMR
Eastern Regional Health Authority 88 88 88 88 88 88 82*
Midland Health Board 97 97 97 96 97 97 94
Mid-Western Health Board 91 91 91 91 91 91 88
North-Eastern Health Board 93 93 93 93 93 92 89
North-Western Health Board 95 95 95 95 95 93 91
South-Eastern Health Board 91 91 91 91 91 90 87
Southern Health Board 93 93 93 93 93 93 88
Western Health Board 93 92 93 93 93 90 86
Mean average - State 91 91 91 91 91 90 86

* Includes the HSE Eastern Region MMR1 Q1-2006 uptake figure, which is an estimate only (due to technical problems with extracting MMR1 data from the HSE Eastern Region database).

Source: Immunisation Uptake Statistics, Health Protection Surveillance Centre, HSE

 

  • In 2006, the rate of completed vaccination for diphtheria, tetanus, pertussis and polio in Ireland was among the lowest in the EU, at 91% (see Figures 42 and 43). 17 EU countries, where data was available, had completed vaccination rates of 95% or higher in the same year.

Figure 42: Percentage of relevant age group receiving 3rd dose of diphtheria, tetanus and pertussis vaccines, by country (2006)

fig42

Source: Immunisation Uptake Statistics, Health Protection Surveillance Centre, HSE

 

Figure 43: Percentage of relevant age group receiving 3rd dose of polio vaccine, by country (2006)

fig42

Source: Immunisation Uptake Statistics, Health Protection Surveillance Centre, HSE

 

  • In 2007, 87% of children aged up to 24 months had received their first dose of the MMR1 vaccine (see Figure 44 and Table 104). The immunisation rate has increased consistently year on year from 2003 to 2007.

Figure 44: MMR1 vaccine uptake rate (2003-2007)

fig42

Source: Immunisation Uptake Statistics, Health Protection Surveillance Centre, HSE

 

  • Uptake rates of the MMR1 vaccine increased in all 8 of the former Health Board Areas between 2002 and 2006 (see Table 104).
  • The former Midland Health Board Area showed the largest increase - of 22 percentage points over the period (see Figure 45).

Table 104: MMR1 vaccine uptake rate, by former Health Board Area (2002-2006)

  2002 2003 2004 2005 2006
Eastern Regional Health Authority 64 74 76 78* 82+
Midland Health Board 72 88 91 93 94
Mid-Western Health Board 80 80 84 86 88
North-Eastern Health Board 79 81 83 89 89
North-Western Health Board 80 83 87 89 91
South-Eastern Health Board 82 83 87 86 87
Southern Health Board 76 80 83 85 88
Western Health Board 74 74 78 83 86
Mean average - State 73 78 81 84* 86+

* The national figure for MMR is incomplete since Q4-2005 MMR data was not available for the HSE Eastern Region. The MMR figure is based on data from Q1-2005 to Q3-2005.

+ Includes the HSE Eastern Region MMR Q1-2006 uptake figure, which is an estimate only (due to technical problems with extracting MMR1 data from the HSE Eastern Region database).

Source: Immunisation Uptake Statistics, Health Protection Surveillance Centre, HSE

 

Figure 45: MMR1 vaccine uptake rate, by former Health Board Area (2002 and 2006)

fig45

Source: Immunisation Uptake Statistics, Health Protection Surveillance Centre, HSE

 

  • In 2006, Ireland had the 3rd lowest uptake of measles-containing vaccine in the EU, at 86% (see Figure 46).

Figure 46: Percentage of relevant age group receiving measles-containing vaccine, by country (2006)

fig45

Source: Immunisation Uptake Statistics, Health Protection Surveillance Centre, HSE

 

Technical notes
Irish statistics on immunisation are compiled by the Health Protection Surveillance Centre (HPSC) of the Health Service Executive (HSE), using data from the former Health Board areas. There is no national database on immunisation.

International data on immunisation coverage is collected by the World Health Organization (WHO) to monitor and assess the impact of strategies and activities for reducing morbidity and mortality of vaccine-preventable diseases. In most countries, the data collected refer to the number of doses administered to the target population divided by the total estimated number of people in the target population. The target population groups vary from country to country and are dependent on the national immunisation schedule in place.

In Ireland, each former Health Board area is responsible for maintaining an immunisation register. A listing of all birth notifications in the area is received from the General Register's Office (GRO). Public health nurses follow up on all new births, visit the mother and register the child's details and details of the GP nominated by the mother to perform the required immunisations. This information is returned to the local immunisation office and recorded on the childhood immunisation register used by that area. The local office monitors the child's immunisation record and issues reminders when immunisations fall due. Following each vaccination, the GP makes a return to the local immunisation office, indicating details of the vaccine and date of administration. This information is maintained on the local immunisation register and is provided to the HPSC for the compilation of immunisation uptake statistics.

Immunisation against Meningococcal Type C disease was introduced in October 2000. Rates of uptake of this vaccine are available from 2002 onwards.

In Tables 100-104 for this indicator, the reference year refers to the year in which the recipients of the vaccine reached either 12 or 24 months of age, depending on the cohort being considered. The following are the definitions of the vaccines referred to in these indicators:

DTaP3
These terms refer respectively to 3 doses of a combined diphtheria, tetanus and pertussis vaccine (DTaP3). The data shown in Figure 42 represent the proportion of children in the relevant age group who had received one or other of these vaccines. Completed vaccination (3 doses) among children in subsequent years was registered by disease-specific vaccines (D3, P3 and T3).
D3
Refers to a combined diphtheria and tetanus vaccine, administered in 3 doses at 2, 4 and 6 months of age.
P3
Refers to a pertussis vaccine, administered in 3 doses at 2, 4 and 6 months of age.
T3
Refers to a tetanus vaccine administered in 3 doses at 2, 4 and 6 months of age.
HiB3
Refers to the vaccine for Haemophilus Influenzae Type B, administered in 3 doses at 2, 4 and 6 months of age.
Polio3
Refers to the vaccine for poliomyelitis, administered in 3 doses at 2, 4 and 6 months of age.
MenC3
Refers to the vaccine for Meningococcal Type C disease, administered in 3 doses at 2, 4 and 6 months of age. This vaccine was introduced in October 2000. Data on uptake of the vaccine is available from 2002 onwards.
MMR1
Refers to the first dose of the combined vaccine for measles, mumps and rubella, administered between the ages of 12 and 15 months.
BCG
Refers to the Bacillus Calmette-Guerin, which is a vaccine that protects against tuberculosis.

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68 WHO (2005) The World Health Report 2005: Make Every Mother and Child Count. Copenhagen: World Health Organization.