title: Public Health Amendment (Vaccination of Children Attending Child Care Facilities) Act 2013: its impact in the Northern Rivers, NSW.
abstract: OBJECTIVE
  The objective of the study was to explore the impact of implementation of the Public Health Amendment (Vaccination of Children Attending Child Care Facilities) Act 2013 on child-care centres in the Northern Rivers region of New South Wales (NSW), from the perspective of child-care centre directors. Importance of study: Immunisation is an effective public health intervention, but more than 75 000 Australian children are not fully vaccinated. A recent amendment to the NSW Public Health Act 2010 asks child-care facilities to collect evidence of complete vaccination or approved exemption before allowing enrolment.
  
  
  METHODS
  Ten child-care centre directors participated in a semiscripted interview. Interviews were recorded, transcribed and analysed.
  
  
  RESULTS
  Common themes included misinterpretation of the amendment before implementation, the importance of adequate notice for implementation, lack of understanding of assessment of compliance, increased administrative requirements, the importance of other public health efforts, and limited change in vaccination rates. Child-care centres differed in their experience of the resources provided by the government, interactions with Medicare, and ease of integration with existing record-keeping methods.
  
  
  CONCLUSIONS
  Participants felt that the amendment was successfully implemented. The amendment was felt to have fulfilled its aim of prompting parents who had forgotten to vaccinate, but failed to significantly affect conscientious objectors. Overall, the amendment was perceived to be a positive step in improving vaccination rates, but its impact was largely complementary to other components of the multifaceted vaccination policy.
authors.affiliation: School of Medicine, Western Sydney University, NSW, Australia.
authors.forename: Alice C
authors.initials: AC
authors.lastname: Fraser
authors.affiliation: School of Medicine, Western Sydney University, NSW, Australia.
authors.forename: Sarah E
authors.initials: SE
authors.lastname: Williams
authors.affiliation: School of Medicine, Western Sydney University, NSW, Australia.
authors.forename: Sarah X
authors.initials: SX
authors.lastname: Kong
authors.affiliation: School of Medicine, Western Sydney University, NSW, Australia.
authors.forename: Lucy E
authors.initials: LE
authors.lastname: Wells
authors.affiliation: School of Medicine, Western Sydney University, NSW, Australia.
authors.forename: Louise S
authors.initials: LS
authors.lastname: Goodall
authors.affiliation: School of Medicine, Western Sydney University, NSW, Australia; Sydney School of Public Health, University of Sydney, NSW, Australia; University Centre for Rural Health North Coast, Lismore, NSW, Australia, sabrina.pit@ucrh.edu.au.
authors.forename: Sabrina
authors.initials: S
authors.lastname: Pit
authors.affiliation: Sydney School of Public Health, University of Sydney, NSW, Australia; University Centre for Rural Health North Coast, Lismore, NSW, Australia.
authors.forename: Vibeke
authors.initials: V
authors.lastname: Hansen
authors.affiliation: North Coast Public Health Unit, Lismore, NSW, Australia.
authors.forename: Marianne
authors.initials: M
authors.lastname: Trent
mesh_terms: D002648:Child; D002656:Child Day Care Centers / Q000331:legislation & jurisprudence*; D002675:Child, Preschool; D006801:Humans; D007223:Infant; D007407:Interviews as Topic; D009517:New South Wales; D011634:Public Health / Q000331:legislation & jurisprudence*; D036301:Qualitative Research; D014611:Vaccination / Q000331:legislation & jurisprudence*