title: Immunisation issues for Indigenous Australian children.
abstract: Vaccination has provided major benefits to the health of indigenous children in the face of continuing poorer socioeconomic conditions but several issues have been identified for improvement. While indigenous children are vaccinated at high rates for the standard schedule vaccines, vaccination is more commonly delayed. Coverage for 'targeted' vaccines is substantially lower, and data on coverage for indigenous adolescents is non-existent. Improved identification of indigenous clients by immunisation providers and the expansion of the childhood register are required. The progressive removal of early-acting Haemophilus influenzae type b vaccines from schedules for indigenous children because of an international shortage raises the risk of disease re-emergence and highlights the need for vigilant surveillance including carriage. The expanded use of existing vaccines (influenza) and early adoption of new vaccines (higher valency pneumococcal conjugates) are needed to maximise benefits, in particular the potential to impact on non-invasive disease such as otitis media and non-bacteraemic pneumonia that are so prevalent in indigenous children.
authors.affiliation: Sydney Medical School, University of Sydney, Sydney Menzies School of Health Research, Charles Darwin University, Darwin, Northern Territory, Australia.
authors.forename: Robert
authors.initials: R
authors.lastname: Menzies
authors.forename: Ross
authors.initials: R
authors.lastname: Andrews
mesh_terms: D000293:Adolescent; D001315:Australia; D016667:Bacterial Capsules; D002648:Child; D002669:Child Welfare; D002675:Child, Preschool; D003140:Communicable Disease Control / Q000458:organization & administration*; D005260:Female; D018073:Haemophilus Vaccines / Q000008:administration & dosage; D006303:Health Services, Indigenous / Q000458:organization & administration*; D022362:Hepatitis A Vaccines / Q000008:administration & dosage; D006801:Humans; D007114:Immunization / Q000592:standards / Q000639:trends; D017589:Immunization Programs / Q000458:organization & administration*; D008297:Male; D020380:Needs Assessment; D022242:Pneumococcal Vaccines / Q000008:administration & dosage; D018570:Risk Assessment; D014611:Vaccination / Q000379:methods* / Q000706:statistics & numerical data
chemical_list: D018073:Haemophilus Vaccines; C044237:Haemophilus influenzae type b polysaccharide vaccine; D022362:Hepatitis A Vaccines; D022242:Pneumococcal Vaccines