Regional Immunisation Initiatives: Improving immunisation service for Victoria's adolescents Chelsea Taylor Senior Project Officer and Policy Advisor, Immunisation Section August 2014

Regional Immunisation Initiatives December 2010 Minister approved a range of initiatives and projects targeting immunisation service delivery including: –Enhanced adverse event surveillance –New immunisation service at Monash MC –Expanded service at RCH –Low coverage program through GPV –Low coverage HPV initiative through Cancer Council AND… Regional Immunisation Initiatives and Address secondary school coverage in all regions Targeted Indigenous initiatives (identified regions)

comparison of state-wide immunisation coverage: Childhood and adolescent programs ~ 20% gap

Regional Secondary School Participation In 2010, every region had below 80% coverage for each program In 2010, 5 out of 8 regions had ≤ 70% coverage for 1 or more programs 7 out of 8 regions had a reduction in coverage between 2008, 09, 10 for 1 or more programs 6 out of 8 regions had a reduction in coverage by > 5% between for 1 or more programs

Student participation by DH region and year Secondary school Year 10 - dTpa

Student participation by DH region and year Secondary school Year 7 - HPV In 2012 no data provided by Ararat (Grampians), Hobsons Bay (Western), Kingston (Southern) or Wyndham (Western) councils indicating Yr 7 female enrolment number data not released from HPV Register and therefore not available

Student participation by DH region and year Secondary school Year 9 – HPV males time-limited HPV program for Year 9 boys

Student participation by DH region and year Secondary school Year 7 & 9 HPV program 2013

Hume Region Secondary school Year 10 - dTpa

Hume Region Secondary school Year 7 - HPV No data for 2012 reflects council not providing a Yr 7 female enrolment number data not released from HPV Register and therefore not available Councils’ 2012 service provision by Wodonga Mobile Van Councils* 2013 service included in Wodonga data

Hume Region Secondary school Year 9 – HPV males Councils* 2013 service included in Wodonga data time-limited HPV program for Year 9 boys

3 changes to 2015 school vaccine program 1.Changes to the PHWA Regulations Principals are authorised to release student/parent contact details to councils 2.dTpa moving to Year 7 only from 2016; Year 7,8,9 &10 to be immunised in 2015 Letter to CEOs/MAV for support sent March & April 2014 Letter to education sectors for support sent March s to all councils with CEO letters attached May 2014 Upfront administrative bonus payment in July Cease Year 9 HPV boys Time limited program for Year 9 (14-15 boys) ends 31 December 2014 No catch-up program in 2015

The Victorian Regional Immunisation Initiatives Resource Development Development of consistent models of practice Education provision Capacity building Goal To increase immunisation participation and coverage rates amongst Victorian adolescents Objectives Raise awareness (providers, students, parents, teachers) Build capacity amongst immunisation providers to enhance service delivery Improve delivery of school-based immunisation program (providers, schools) Improve access for hard-to-reach adolescent communities

What we’re doing…Snapshot of strategies

Public Health & Wellbeing Amendment (Immunisation Services) Regulations 2013 Under previous arrangements, privacy legislation restricted schools’ ability to release contact details parents to local council. Therefore local council reliant on information being communicated via school to the student to the parent. Unable to follow-up those students who didn’t return a card. Local Council SchoolStudentsParents Consent Card Distribution Consent Card Return

Public Health & Wellbeing Amendment (Immunisation Services) Regulations 2013 Effective from 1 December 2013: (1)…a Council may request the principal of a secondary school located within the municipal district to disclose the following information about a student enrolled at the school – a)The name of the student; b)The student’s date of birth; c)The student’s gender; d)The class or group to which the student is attached; e)The name of the parents or guardians of the student and their telephone numbers, addresses and postal addresses f)The languages spoken at the student’s home (2) On receiving a request under the subregulation (1), the principal may disclose information held by the school. –Results in: »Councils ability to directly communicate information and follow-up with parents/guardians »Relieving schools of administrative burden; limited resources directed core business of health promotion and program support

Accessible, credible, reliable, engaging information regarding adolescent immunisation One-stop shop for schools, students, parents and teachers

Immune Hero

School immunisation kit and agreement 1.Agreement 2.Guide 3.Ready Reference Formalises agreement between immunisation provider and school principal Outlines school-based immunisation program process and activities Clarifies roles and responsibilities of school and council staff

PREZI - School-based educational resource Education sessions for school Community-(Teachers, Parent's, Students) Facilitate meetings with councils & A/P’s to discuss SSI program and clarify roles and responsibilities Partnership with DEECD School Nursing Program

Targeting at-risk youth – headspace Project headspace (National Youth Mental Health Foundation) Provide general health, mental health and counselling, education, employment, alcohol and other drug services for at-risk youth Increased focus on primary health care and opportunistic service delivery Four pilot sites – Sunshine, Knox, Collingwood, Glenroy Promote opportunistic immunisation and catch-up Fortnightly nurse-led immunisation clinic Data collection to inform expanded policy/program delivery

headspace Resources

RII - Evaluation framework Enablers Aims Implementation Strategies Outcomes Improve uptake of immunisation of Victorian young people Improve uptake of immunisation of Aboriginal children Identify barriers Regional engagement Consultation Appropriate, effective strategies Resource development Guideline development Education Capacity building Strategies address ID’ed barriers Improved systems Monitoring and assessment Improved immunisation uptake Improved awareness State-wide implementation of improved strategies Final Report May 2015

VRHN: Needs analysis of immunisation in refugee and asylum seeker communities Determine issues regarding access to vaccines, catch-up immunisation programs and service delivery for people of refugee background in Vic Final report May 2014 highlighted –public health significance due to pre and post arrival risk factors –eligibility and access to funded vaccine –service delivery and access to immunisation services Key recommendations –Secure funding for vaccines to comprehensively provide catch-up schedule –Pilot improved service delivery models – local council program in ELS –Improve surveillance data for immunisation register and coverage for refugee and asylum seeker populations –Improve/develop resources for community –Improve strategies for personal vaccine record use –Increase capacity of providers (guidelines, training, clinical practice) Next step… DH consideration and funding determined

Questions… Chelsea Taylor