title: School immunisation certificates--a review over time in a disadvantaged community.
abstract: OBJECTIVE
  To compare proportions of kindergarten children in Auburn presenting School Immunisation Certificates (SIC) or other school-entry immunisation documentation over time, and to examine the immunisation status of these children.
  
  
  METHODS
  Immunisation records of kindergarten children enrolled in all primary schools in the Auburn local government area were reviewed in 1994 and 1998.
  
  
  RESULTS
  Eight hundred and thirty-three and 737 school entry records of children enrolled in kindergarten were reviewed in 1998 and 1994 respectively. There was no change in the overall proportion of children with immunisation documentation and SICs. Sixty-nine per cent (571/833) of children had SICs in 1998, compared with 72% (531/737) in 1994. Thirteen per cent of children had other immunisation documentation in 1998, compared with 11% in 1994. The proportion of invalid certificates fell from 39.2% in 1994 to 12.6% in 1998 (p<0.001). The 1998 survey indicated that 80.2% of children provided a certificate indicating they were completely immunised compared with 56.7% in 1994 (p<0.001).
  
  
  CONCLUSIONS
  Although SICs play an important role in promoting the importance of immunisation among parents and in the school community, there continues to be a substantial number of children whose immunisation status is unknown. In the event of an outbreak, an effective public health response may need to incorporate the use of additional objective measures, such as the Australian Childhood Immunisation Register or personal health records.
authors.affiliation: Department of Public Health and Community Medicine, University of Sydney at Westmead, New South Wales. Smita_Shah@wsahs.nsw.gov.au
authors.forename: S
authors.initials: S
authors.lastname: Shah
authors.forename: S
authors.initials: S
authors.lastname: Raman
authors.forename: C
authors.initials: C
authors.lastname: Moreira
authors.forename: C R
authors.initials: CR
authors.lastname: MacIntyre
mesh_terms: D002675:Child, Preschool; D003467:Cultural Deprivation; D003625:Data Collection; D004282:Documentation / Q000592:standards*; D006801:Humans; D007114:Immunization / Q000331:legislation & jurisprudence* / Q000706:statistics & numerical data*; D009517:New South Wales; D011996:Records / Q000592:standards*; D012574:Schools / Q000331:legislation & jurisprudence*; D012959:Socioeconomic Factors