Pertussis vaccination in child care workers: room for improvement in coverage, policy and practice.
BACKGROUND
The "Staying Healthy in Child Care" Australian guidelines provide for illness and disease exclusions and encourage vaccination of staff in child care settings, however these requirements are not subject to accreditation and licensing, and their level of implementation is unknown. This study aimed to describe pertussis vaccination coverage in child care workers in a regional area of northern NSW during 2010; review current staff pertussis vaccination practices; and explore barriers to vaccination.


METHODS
A cross sectional survey of all child care centre directors in the Hunter New England (HNE) area of northern NSW was conducted in 2010 using a computer assisted telephone interviewing service.


RESULTS
Ninety-eight percent (319/325) of child care centres identified within the HNE area participated in the survey. Thirty-five percent (113/319) of centres indicated that they had policies concerning respiratory illness in staff members. Sixty-three percent (202/319) of centres indicated that they kept a record of staff vaccination, however, of the 170 centre's who indicated they updated their records, 74% (125/170) only updated records if a staff member notified them. Of centres with records, 58% indicated that fewer than half of their staff were vaccinated.


CONCLUSIONS
Many childcare workers have not had a recent pertussis immunisation. This potentially places young children at risk at an age when they are most vulnerable to severe disease. With increasing use of child care, national accreditation and licensing requirements need to monitor the implementation of policies on child care worker vaccination. Higher levels of vaccination would assist in reducing the risk of pertussis cases and subsequent outbreaks in child care centres.
Hunter New England Population Health, University of Newcastle, Locked Bag 10, Wallsend, NSW, Australia 2287. Kirsty.hope@sswahs.nsw.gov.au
Kirsty
K
Hope
Michelle
M
Butler
Peter D
PD
Massey
Patrick
P
Cashman
David N
DN
Durrheim
Jody
J
Stephenson
April
A
Worley
D017028:Caregivers / Q000592:standards* / Q000706:statistics & numerical data; D002648:Child; D002656:Child Day Care Centers / Q000458:organization & administration / Q000592:standards* / Q000706:statistics & numerical data; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D019983:Guideline Adherence / Q000706:statistics & numerical data*; D006291:Health Policy; D006306:Health Surveys; D006801:Humans; D007223:Infant; D009517:New South Wales; D016134:Organizational Policy; D017410:Practice Guidelines as Topic; D014611:Vaccination / Q000592:standards / Q000706:statistics & numerical data*; D014917:Whooping Cough / Q000517:prevention & control*