Background

In Australia, a herpes zoster (HZ) vaccination program targeting adults aged 70 years old with catch-up for those 71-79 years began in November 2016 but there is limited information on vaccine uptake and coverage achieved since commencement.

Methods

We used a national de-identified electronic primary care dataset, MedicineInsight, and extracted records from patients turning 50–90 years old during 2016–2018. Among patients considered regular attenders, with at least one visit per year in the two years prior, we estimated the crude and adjusted average monthly HZ vaccine uptake in the target population (70–79 years old) for each year since program implementation as well as cumulative vaccine coverage until December 2018. Multivariate logistic regression was used to analyse characteristics associated with higher coverage.

Results

Among 52,229, 55,034, and 57,316 regular attenders turning 70–79 years old in 2016, 2017 and 2018 respectively, the average monthly vaccine uptake rate was 5.5%, 3.3%, and 1.6% respectively. Up to 31st December 2018, the estimated cumulative vaccine coverage in regularly attending adults was 46.9% (25,791/55,034). It was substantially lower at 41.6% (27,040/65,010) using an alternate definition of a regular attender. Vaccine coverage differed by sex (women: 48.5% versus men: 45.1%, adjusted OR = 1.1, 95% CI: 1.1–1.2); by jurisdiction (compared to New South Wales: 43.7%, South Australia: 55.6%, aOR = 1.6, 95% CI (1.5–1.8); Northern Territory: 27.6%, aOR = 0.6, (0.5–0.7)); by remoteness status (compared to major cities: 47.6%, remote/very remote areas: 38.2%, aOR = 0.7, (0.6–0.8)); and by socioeconomic disadvantage (compared to most disadvantaged: 41.8%, most advantaged: 48.6%, aOR = 1.6 (1.2–2.1)).

Conclusions

Our estimates of HZ vaccine coverage are substantially higher than the only other reports based on the Australian Immunisation Register however they still suggest that uptake is suboptimal. The use of electronic medical records can complement other data for estimating vaccine coverage in Australian adults.

中文翻译：

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引入国家疫苗接种计划前后，澳大利亚带状疱疹疫苗覆盖率

背景

澳大利亚在2016年11月启动了针对70岁成年人的71至79岁追赶者的带状疱疹（HZ）疫苗接种计划，但自开始以来关于疫苗摄取和覆盖率的信息有限。

方法

我们使用了国家身份不明的电子基层医疗数据集MedicineInsight，并提取了2016-2018年年龄在50-90岁的患者的记录。在被认为是常规护理人员的患者中，在前两年中每年至少进行一次就诊，我们估计自计划实施以来，每年目标人群（70-79岁）中每年粗略且调整后的HZ疫苗平均摄入量以及累积疫苗覆盖率直至2018年12月。多因素Logistic回归用于分析与更高覆盖率相关的特征。

结果

在分别于2016年，2017年和2018年年龄在70-79岁之间的52,229、5004和57,316名常规参与者中，平均每月疫苗摄入率分别为5.5％，3.3％和1.6％。截至2018年12月31日，定期参加的成年人的累计疫苗覆盖率估计为46.9％（25,791 / 55,034）。使用常规出席者的替代定义，该比率显着降低至41.6％（27,040 / 65,010）。疫苗的覆盖率因性别而异（女性：48.5％，男性：45.1％，调整后的OR = 1.1，95％CI：1.1-1.2）；按管辖区划分（与新南威尔士州相比：43.7％，南澳大利亚州：55.6％，aOR = 1.6，95％CI（1.5-1.8）；北领地：27.6％，aOR = 0.6，（0.5-0.7））；根据偏远状态（与主要城市相比：47.6％，偏远/非常偏远地区：38.2％，aOR = 0.7，（0.6-0.8））；以及社会经济劣势（与最弱势群体相比：

结论

我们估计的HZ疫苗覆盖率明显高于基于澳大利亚免疫登记册的其他报告，但是他们仍然认为摄取率不是最佳的。电子病历的使用可以补充其他数据，以估计澳大利亚成年人的疫苗接种率。