How do we improve falling rates of immunisation in New Zealand?

Concerns about New Zealand's childhood immunisation system are not new. Numerous reports have been written and reviews undertaken of the immunisation system over the decades. All have identified many systemic issues as reasons for low immunisation uptake in some population groups. None of these reviews, however, have resulted in effective policy or practice to address the widespread systemic issues. The biggest failing of the system is the persistent ethnic inequalities, despite multiple government policies to address these.

The Ministry of Health has monitored immunisation coverage since the 1990s. For more than twenty years, there have been successful efforts to improve immunisation coverage in NZ to reduce gaps in equity and encourage uptake of vaccines by all. However, despite excellent progress, coverage has failed to consistently reach the 95% community immunity threshold, and barriers and equity gaps remain.

An Immunisation Taskforce was convened in 2022 after the rates for children five and under hit record lows. The report noted that NZ's haphazard immunisation system was failing children, especially in vulnerable communities. The pandemic played a role, with part of the problem being that vaccinators were diverted to the Covid response. This caused childhood immunisation rates in NZ to fall drastically. These rates are now the lowest they have ever been. The report, released in 2023, made 54 recommendations to try to turn around the country's dire and unfair childhood immunisation rates. These included training and employing more vaccinators, improving rates for pregnant women to protect vulnerable newborns, going out to vaccinate children rather than waiting for them to turn up to clinics, listening to and using grassroots health providers more, and a national, centrally coordinated system to catch up on current low rates. 

We have certainly made progress. Over the past 5 months, the Ministry of Health, announced two new digital tools for better managing immunisations. My Health Record, built by redeveloping the old My Covid Record platform, now allows people to check their vaccination records as part of its first phase of implementation. Additional health information, including lab reports, are in the pipeline. Another tool, the Aotearoa Immunisation Register (AIR), which replaced the National Immunisation Register, was recently expanded to allow health providers and vaccinators to view an individual's immunisation history and identify gaps to offer them any needed vaccinations. Expanding access to immunisation records, either via their existing patient management systems or the AIR Vaccinator Portal, also helps them to identify communities which require outreach support.  

There is much ground to be covered. Suffice to say that we are off to a promising start!