Download Coverage Update, Cold Chain, 2017 Schedule Changes, Infectious

1-3 The Terrace
P.O Box 5013
Wellington
Date:
16 December 2016
To:
Primary Care Teams, Health Professionals
Rayoni Keith, Manager, Immunisation
From:
Subject:
Pages: 1 of 2
Coverage update, Cold Chain, 2017 Schedule Changes, Infectious
Disease legisation.
Coverage update from Dr Pat Tuohy
As we head towards the end of another busy year, we would like to thank you for your continued
commitment to protecting our children’s health through ensuring high levels of immunisation. The
success that has been achieved for immunisation in New Zealand is in large part due to the
promotion of immunisation by everyone that families come into contact with at general practices,
as well as robust precall, recall and referral systems.
By the end of October, immunisation coverage at age 5 years had further increased to 88.4
percent, while immunisation at age 8 months remained steady at 93.2 percent. Thanks once again
for your ongoing support.
Cases of mumps have been reported in Auckland – please be vigilant for that and other infectious
diseases over the summer period.
Cold chain
Please read your cold chain policy and familiarise yourself with it. Recently there have been two
significant cold chain failures, resulting in the wastage of around $40,000 worth of vaccines and the
revaccination of 400 children. Be vigilant about downloading data loggers and acting on the
information obtained. Your local immunisation coordinator can assist with any questions.
Remember to check minimum/maximum vaccine fridge temperatures daily. The Ministry
recommends downloading the data logger weekly, especially if your refrigerator is over 7 years old.
If you have been advised to replace your fridge, please do so as the replacement cost for a fridge
is significantly lower than the cost of the vaccines wasted in a cold chain failure. For more
information, see www.health.govt.nz/coldchain and www.immune.org.nz/health-professionals/coldchain
Changes to the National Immunisation Schedule
The Immunisation Advisory Centre has produced a five minute information video about the
schedule changes viewable at vimeo.com/191906155, which may be of interest to providers.
From 1 January 2017 - HPV
Everyone aged 9 to 26 inclusive will be eligible for HPV immunisation from 1 January 2017,
including boys and young men.
Vaccine distribution
Gardasil 9 (HPV9) will be distributed to practices once nationwide stocks of Gardasil (HPV4) have
run out. Those who have begun immunisation on Gardasil (HPV4) can continue on Gardasil 9
(HPV9) when it becomes available, according to the recommended timeframes for HPV9. This
means that someone aged 14 or under would be considered fully immunised if they have had one
dose of HPV4 followed by one dose of HPV9 after an interval of at least six months.
Dr Nikki Turner (Director, Immunisation Advisory Centre and GP at NUHS Broadway Strathmore)
recommends that practices do not delay vaccination in anticipation of the arrival of HPV9, as this
leaves patients, particularly older teenagers, at risk of being exposed to the most common types of
HPV before they are protected. Gardasil (HPV4) is an excellent vaccine that protects against the
most common serotypes (types 16 and 18) that lead to cancers. While Gardasil 9 (HPV9) does
offer broader protection, protection against the most important oncogenic virus types is well
covered with Gardasil (HPV4).
Practice Management Systems
The Ministry has made changes to the NIR and Proclaim systems to enable the schedule change.
Practice Management System (PMS) updates are also underway and will be released in
December. We remind practices to check their PMS has all its previous updates installed, to
ensure the upcoming PMS release will work with their system. Medtech users will need to have
release version 22.6 (build 5223) loaded before they load version 22.7 (build 5243) for the HPV9
changes.
Resources and promotion
The Ministry has produced a new leaflet to help practices inform patients about HPV immunisation
for boys and girls - this will be available to order from HealthEd before they close for Christmas on
18 December. New school consent forms have been printed, and the Ministry will undertake a
national media campaign promoting HPV immunisation in February 2017, focussing primarily on
school based immunisation for year 8 students.
The Immunisation Advisory Centre has developed an online course for health professionals
providing advice to parents/caregivers or general public on the HPV immunisation programme:
www.immune.org.nz/education-and-training/hpv-vaccination-module. The Ministry has published
HPV fact sheet updates to its website at www.health.govt.nz/our-work/preventative-healthwellness/immunisation?mega=Our%20work&title=Immunisation .
IMAC has further information at
www.immune.org.nz/sites/default/files/resources/ProgrammeHpvQA20161121V01Final.pdf
Varicella eligibility from 1 July 2017
From 1 July 2017 varicella vaccine will be funded on the National Immunisation Schedule for
children born on or after 1 April 2016, at their 15 month immunisation event. Parents of children
born before this date can continue to purchase the vaccine. Funded varicella immunisation will
also be available for children who turn age 11 years on or after 1 July 2017 if they have not
previously been infected with chickenpox or vaccinated.
IMAC is developing resources to support vaccinators delivering four vaccines to 15 month olds in
one visit.
One dose of varicella vaccine is funded, which will protect around 4 out of 5 children from
chickenpox and reduce the severity of any breakthrough cases. A second dose is not funded, but
can be purchased.
New infectious disease legislation – 4 January 2017
New infectious disease notification and management legislation is coming into force on 4 January
2017, which updates the Health Act 1956 and replaces the Health (Infectious and Notifiable
Disease) Regulations and Schedules and makes a number of changes to the notification process.
These changes provide new powers for the management of infectious diseases, including contact
tracing. The IT and related updates to notification processes will not all be fully functional by 4
January 2017, and a phased roll out is planned for 'Section C diseases'. In the interim AIDS will
continue to be notified by clinicians (as is done currently) to the local Medical Officer of Health;
laboratories will report HIV infection directly to the AIDS Epidemiology Group and gonorrhoea
cases directly to ESR; and syphilis reporting will be limited to Sexual Health and Family Planning
Clinics. Primary health care providers will be informed by their local Medical Officers of Health as
the new arrangements are progressively introduced in early 2017. For more information see
www.health.govt.nz/news-media/news-items/new-legislation-notification-and-managementinfectious-diseases.
If you have any queries about anything in this update, please email
[email protected].