East African immigrant children in Australia have poor immunisation coverage

Authors

  • Georgia A Paxton,

    Corresponding author
    1. Royal Children's Hospital, Murdoch Childrens Research Institute
    Search for more papers by this author
  • James Rice,

    1. Royal Children's Hospital
    Search for more papers by this author
    • Current addresses: Women's and Children's Hospital, 55 King William Rd, North Adelaide, SA 5006, Australia;

  • Gabrielle Davie,

    1. Clinical Epidemiology and Biostatistics Unit, Royal Children's Hospital
    Search for more papers by this author
    • Department of Preventive and Social Medicine, University of Otago, 364 Leith Walk, Dunedin 9016, New Zealand;

  • Jonathan R Carapetis,

    1. Department of Paediatrics, University of Melbourne, Murdoch Childrens Research Institute, Royal Children's Hospital
    Search for more papers by this author
    • Menzies School of Health Research, Charles Darwin University, Ellengowan Dr, Casuarina, NT 0810, Australia.

  • Susan A Skull

    1. Clinical Epidemiology and Biostatistics Unit, University of Melbourne, Department of Paediatrics, Royal Children's Hospital, Parkville, Melbourne, Victoria, Australia
    Search for more papers by this author
    • Menzies School of Health Research, Charles Darwin University, Ellengowan Dr, Casuarina, NT 0810, Australia.


  • Conflict of interest: None.

  • Funding sources: Department of Human Services, Victoria.

Dr Georgia Paxton, Department of General Medicine, Royal Children's Hospital, Flemington Road, Parkville, Vic. 3052, Australia. Fax: +61 3 9345 4751; email: georgia.paxton@rch.org.au

Abstract

Aim:  To provide data on the immunisation status of recently arrived East African children and adolescents in Australia.

Methods:  A prospective audit was conducted at a hospital-based paediatric immigrant health clinic, in Melbourne, Australia, over the time period November 2000–January 2002. Study subjects were consecutive children and adolescents born in East Africa, arriving in Australia after January 1998. Vaccination status was ascertained by parent report and review of patient-held records where available, and by serological testing for immunity to hepatitis B, tetanus, diphtheria, rubella and measles.

Results:  Among 136 participants, 132 (97%) had incomplete or unknown immunisation status based on parent report and vaccination records; written records were available for 5/136 (4%) of participants. Only 21/136 (15%) had serological immunity to all five of measles, rubella, tetanus, diphtheria and hepatitis B, despite a total of 395 visits to vaccine providers by participants since migration. A higher proportion of children had serological immunity to measles (90%) compared to the proportion with serological immunity to rubella (77%), tetanus (61%), diphtheria (45%) and hepatitis B (33%). The predictive value of parent-reported vaccination status for serological immunity was poor.

Conclusions:  Paediatric East African immigrants in Victoria are very likely to be inadequately immunised and parent-reported vaccination status does not predict serological immunity. Full catch-up immunisation is recommended where immunisation status is unknown and written records are unavailable. Consideration should be given to policy and program development to provide timely and complete immunisation coverage in this group after arrival in Australia.

Ancillary