Australia vaccination program compromised, thousands at risk

Australia's multi-million-dollar vaccination program is seriously compromised, according to a landmark report released Monday in Sydney. The report, "Protecting Australia -- closing the gap in immunization for migrants and refugees," shows that migrants and refugees are often susceptible to many of the vaccine-preventable diseases included on the National Immunization Strategy, yet there is no "catch-up" immunization available to them. "A key action of the National Immunization Strategy is to ensure equity of access to immunization services for all Australians and to develop a national agreement on the provision of free catch-up immunization," according to Doctor Anita Heywood at the University of New South Wales (UNSW). "However, migrant and refugee groups were not explicitly addressed in the strategy," according to the findings of the report produced by the National Health and Medical Research Council (NHMRC) Center for Research Excellence in Immunization, based at UNSW. The report urges the federal government to immediately implement a National Immunization Strategy comprehensively addressing the immunization needs of migrants and refugees. One gap highlighted in the report is the Human Papillomavirus ( HPV) vaccine. Some people miss the funded school-based program provided in Year 7. While the HPV vaccine is recommended for young adults up to 26 years, free catch-up is no longer provided for those aged 14- 26 years and the cost of HPV vaccination is prohibitive for many, including those in refugee and migrant groups. As another example, the outbreak of measles in 2012-2013 in Sydney was linked to vulnerable under-immunized migrants groups who missed out on vaccines delivered through our immunization program and who are generally not included on Australia's immunization register. This illustrates that despite high national rates of vaccination, under-immunized communities can sustain epidemics of vaccine-preventable diseases in Australia. "The immunization gap among migrants and refugees is everyone's business, and we cannot afford to pass the buck," says UNSW Professor Raina MacIntyre, who leads the NHMRC Center for Research Excellence. "The recent outbreaks of measles in Sydney occurred despite high rates of measles vaccination as measured by our immunization register. We cannot control infectious diseases in Australia without closing this gap. It is in our national interest to find a way forward to address this gap in communicable disease control." Other findings would see an immunization program universally funded and a whole-of-life immunization program for Australia with improved identification of high-risk migrant and refugee groups in the health system needed. MacIntyre told local media in February that under-immunization in refugee and migrant communities is risking outbreaks of vaccine- preventable disease across Australia. "We've seen large outbreaks of measles the largest since 1998 in the last couple of years in Sydney and western Sydney and these have been definitely linked to under-immunized migrant populations. " Eastern Access Community Health runs clinics and refugee health programs on the east coast of Australia, reporting that up to 70 percent of its clients were not fully immunized. Professor MacIntyre pointed to gaps in government funding. "There is no universal, national initiative to catch up under- immunized migrants and refugees. Say a child comes to Australia as a refugee or migrant at the age of 12 and so they've missed out on scheduled immunization points on our national immunization schedule. There's no national mechanism to ensure they get catch- up vaccinations that is funded." The Dean of UNSW Medicine, Professor Peter Smith, told Xinhua the recommendations of the research were "concrete." "It is important for groups such as this, who are independent of vested interests, to take on an advocacy role for identified gaps in public health. The recommendations from this workshop are concrete, actionable ideas which are a valuable contribution to national disease control efforts." "I look forward to seeing some or all of these recommendations considered and implemented nationally," Prof. Smith added.