Barriers to immunisation in Australia – Nature of vaccines requiring follow-up vaccination and effective monitoring of follow-up vaccination

Apart from monitoring refugees and immigrants to ensure they have received needed vaccination, constant monitoring of the immunisation status of the entire population is necessary to effect positive outcomes of immunisation programs. In last ten years, Australia has not been adequately monitoring its own immunisation status resulting in a proportion of its inhabitants lacking protection against vaccine preventable diseases. This for instance results in cases of vaccines with different method, booster, and update requirements. Vaccines differ in their requirements for booster update and immunisation methods to achieve the maximum protection (ASQ 2012). Where, for instance, the protection of a vaccine does not last a lifetime, a booster is required to maintain the immunity because the immunity will decrease over time in the body of the immunised. Failure to give such boosters would mean loss of immunity and hence an increase in the risk of re-introducing the disease.

An example of a vaccine that requires boosters is the whopping cough vaccine. Whopping cough vaccine is often given to parents or grandparents of a new born baby, to provide a herd immunity among the family, to prevent the infants from expose to whopping cough. Failure to give such immunisation would subject the infants to a heightened risk of infection thus result into the reintroduction of the disease in the community. This indicates that even with immunisation programs targeted at the newborn being in place, such newborns may be subject to infection from family members whose protection has waned over time after their previous immunisation period. This makes it critical for everyone who can be seroconvert to be vaccinated to reduce the gap in public health by creating herd immunity (ASQ 2012). Such would only be ensured through periodic monitoring to identify the immunisation status of the inhabitants.

Other than the booster dose, there are also other ways to increase the immunity. One of these ways is to give a regular update dose. It is very important to have immunisation updated because the disease or viruses may change over time. One of the most commonly updated immunisation is the influenza vaccine. The influenza vaccine requires updating annually; this is due to the changes of the influenza virus from year to year. Therefore, an annual update in the influenza vaccine is required to provide protection to against the dynamic virus states (McIntyre and Menzies 2005). Where such updates are not conducted, the result would be giving ineffective vaccinations. Such ineffective vaccination would further enhance beliefs of inefficacy of vaccination, thus foster resistance to vaccination campaigns.

Other immunisations are required to be given several times over a certain period of time to build long lasting protections. This kind of vaccine builds up the immunity in body by a series of two to three vaccines over a certain period of time (McIntyre and Menzies 2005). The most common example is diphtheria-tetanus-pertussis vaccine, commonly referred to as DTPa. It is given to a child to protect against diphtheria, whopping cough, commonly known as pertussis, and tetanus. If a child has been given only one or two doses of diphtheria-tetanus-pertussis vaccine, they will only be partially protected against the diphtheria, pertussis and tetanus. Hence, they may become sick if exposed to those diseases. A third dose may be required to achieve the full protection for the child. Failure to meet the required dose thus exposes the child to infection thus defeating the essence of immunisation programs targeted to such children.

In summary, the nature of vaccines has affected the extent to which the immunisation programs in Australia have been effective, in a number of ways. Firstly, vaccines requiring frequent updates, boosters or a given number of doses for full protection to be achieved have necessitated setting up of effective monitoring processes. Such monitoring processes for instance include having an updated childhood immunisation register. Such, a complete childhood vaccination register, as documented by McIntrye et al (2005) is lacking. Where present, such a register would enable the identification of children who have not followed up on their initial immunisation thus foster their vaccination to avoid re-introduction of the disease to the community. Secondly, failure to receive such follow-ups, thus affecting the potency of the vaccine, may create a perspective of the vaccine being ineffective. When such arises, the public fear that challenges acceptance of immunisation in society would creep in thus challenging immunisation efforts of the Australian government. Accordingly, for public health gains to be realized following vaccination, the government ought to educate the population on the importance of ensuring the full course of the vaccine is provided.

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