Control of epidemic group A meningococcal disease in Auckland.
OBJECTIVE
To study group A meningococcal vaccine delivery to infants less than 2 years of age in Auckland in 1987 to control epidemic disease.


METHODS
Mechanisms of vaccine delivery and its facilitation are described. A detailed audit of delivery of vaccine to children less than two years using signed consent forms determined delivery source. This was the age group at highest risk, and poorly covered by routine childhood vaccines. Primary health care source of children presenting with disease was determined by telephone.


RESULTS
The epidemic of group A meningococcal disease in the winters of 1985 and 1986 abated most likely due to the vaccination of high risk children (3 months-13 years) in 1987. 90% of the target population were vaccinated. In south Auckland the majority (92%) of vaccine doses for children less than two years of age was delivered by the Plunket Society with Department of Health backing aided by community health workers. By contrast delivery by, general practitioners was greater in north-west and central Auckland (approximately 25%, of dose 1), especially after the publicity over possible side effects (approximately 50% of dose 2). Coverage for dose 1 of children < 2 years was similar (89%) in south Auckland. Of children presenting with meningococcal disease 1 in 4 did not have an identifiable general practitioner.


CONCLUSIONS
Vaccines to prevent serious paediatric illness are known to be highly cost effective. The best method of delivery of vaccinations may vary from area to area. Major community involvement including community health workers for the Maori and Pacific Island communities may have facilitated the dissemination of information in this campaign.
Lennon
D
D
Department of Paediatrics, Auckland School of Medicine, New Zealand.
Gellin
B
B
Hood
D
D
Leach
D T
DT
Woods
G M
GM
Williams
P
P
Thakur
S
S
Crombie
D
D
D000293:Adolescent; D000367:Age Factors; D001428:Bacterial Vaccines; D002648:Child; D002662:Child Health Services / Q000458:organization & administration; D002675:Child, Preschool; D004196:Disease Outbreaks / Q000517:prevention & control*; D005194:Family Practice; D006801:Humans; D007223:Infant; D008589:Meningococcal Infections / Q000453:epidemiology / Q000517:prevention & control*; D022401:Meningococcal Vaccines; D009345:Neisseria meningitidis / Q000145:classification; D009520:New Zealand / Q000453:epidemiology; D011135:Polysaccharides, Bacterial / Q000276:immunology*; D011635:Public Health Administration; D014611:Vaccination
D001428:Bacterial Vaccines; D022401:Meningococcal Vaccines; D011135:Polysaccharides, Bacterial; C043226:meningococcal group A polysaccharide