Comparison of text-messaging to voice telephone interviews for active surveillance of adverse events following immunisation

Objectives: In 2013, the Follow-up and Active Surveillance of Trivalent Influenza Vaccine in Mums (FASTMum) program began using short message service (SMS) to collect adverse event information in pregnant women who recently received trivalent influenza vaccine (TIV). This study was designed to compare data collected via SMS and telephone for the purposes of monitoring vaccine safety. Methods: A number of 344 women who received TIV were randomly assigned to a telephone interview group. They were telephoned seven days post-vaccination and administered a standard survey soliciting any adverse events following immunisation (AEFI) they experienced. They were matched by brand of vaccine, age group, and residence to 344 women who were sent a SMS seven days post-vaccination. The SMS solicited similar information. AEFI reported by SMS and telephone interview were compared by calculating risk ratios. Results: Response rate was higher to SMS compared to telephone interview (90.1% vs. 63.9%). Women who were surveyed by SMS were significantly less likely to report an AEFI compared to women who were surveyed by telephone (RR: 0.41; 95% CI: 0.29–0.59). The greatest discrepancies between SMS and telephone interview were for self-reported injection site reactions (3.1% vs. 16.8%) and unsolicited (or “other”) events (11.4% vs. 4.1%). Data collected by SMS was significantly timelier. Conclusions: Data collection by SMS results in significantly improved response rates and timeliness of vaccine safety data. Systems which incorporate SMS could be used to more rapidly detect safety signals and promote more rapid public health response to vaccine quality issues

Links2HealthierBubs' cohort study: Protocol for a record linkage study on the safety, uptake and effectiveness of influenza and pertussis vaccines among pregnant Australian women

Introduction Pregnant women and infants are at risk of severe influenza and pertussis infection. Inactivated influenza vaccine (IIV) and diphtheria-tetanus-acellular pertussis vaccine (dTpa) are recommended during pregnancy to protect both mothers and infants. In Australia, uptake is not routinely monitored but coverage appears sub-optimal. Evidence on the safety of combined antenatal IIV and dTpa is fragmented or deficient, and there remain knowledge gaps of population-level vaccine effectiveness. We aim to establish a large, population-based, multi-jurisdictional cohort of mother-infant pairs to measure the uptake, safety and effectiveness of antenatal IIV and dTpa vaccines in three Australian jurisdictions. This is a first step toward assessing the impact of antenatal vaccination programmes in Australia, which can then inform government policy with respect to future strategies in national vaccination programmes. Methods and analysis ' Links2HealthierBubs' is an observational, population-based, retrospective cohort study established through probabilistic record linkage of administrative health data. The cohort includes births between 2012 and 2017 (∼607 605 mother-infant pairs) in jurisdictions with population-level antenatal vaccination and health outcome data (Western Australia, Queensland and the Northern Territory). Perinatal data will be the reference frame to identify the cohort. Jurisdictional vaccination registers will identify antenatal vaccination status and the gestational timing of vaccination. Information on maternal, fetal and child health outcomes will be obtained from hospitalisation and emergency department records, notifiable diseases databases, developmental anomalies databases, birth and mortality registers. Ethics and dissemination Ethical approval was obtained from the Western Australian Department of Health, Curtin University, the Menzies School of Health Research, the Royal Brisbane and Women's Hospital, and the West Australian Aboriginal Health Ethics Committees. Research findings will be disseminated in peer-reviewed journals, at scientific meetings, and may be incorporated into communication materials for public health agencies and the public

Establishment of a sentinel surveillance network for sexually transmissible infections and blood borne viruses in Aboriginal primary care services across Australia: The ATLAS project

Background Sexually transmissible infection (STI) and blood-borne virus (BBV) diagnoses data are a core component of the Australian National Notifiable Diseases Surveillance System (NNDSS). However, the NNDSS data alone is not enough to understand STI and BBV burden among priority population groups, like Aboriginal and Torres Strait Islander people, because it lacks testing, treatment and management data. Here, we describe the processes involved in establishing a STI and BBV sentinel surveillance network representative of Aboriginal Community-Controlled Health Services (ACCHS)—known as the ATLAS network—to augment the NNDSS and to help us understand the burden of disease due to STI and BBV among Aboriginal and Torres Strait Islander peoples. Methods Researchers invited participation from ACCHS in urban, regional and remote areas clustered in five clinical hubs across four Australian jurisdictions. Participation agreements were developed for each clinical hub and individual ACCHS. Deidentified electronic medical record (EMR) data relating to STI and BBV testing, treatment and management are collected passively from each ACCHS via the GRHANITEtm data extraction tool. These data are analysed centrally to inform 12 performance measures which are included in regular surveillance reports generated for each ACCHS and clinical hub. Results The ATLAS network currently includes 29 ACCHS. Regular reports are provided to ACCHS to assess clinical practice and drive continuous quality improvement initiatives internally. Data is also aggregated at the hub, jurisdictional and national level and will be used to inform clinical guidelines and to guide future research questions. The ATLAS infrastructure can be expanded to include other health services and potentially linked to other data sources using GRHANITE. Conclusions The ATLAS network is an established national surveillance network specific to Aboriginal and Torres Strait Islander peoples. The data collected through the ATLAS network augments the NNDSS and will contribute to improved STI and BBV clinical care, guidelines and policy program-planning.Clare Bradley, Belinda Hengel, Katy Crawford, Salenna Elliott, Basil Donovan, Donna B. Mak ... et al

Annual influenza vaccination: Uptake, barriers, and enablers among student health care providers at the University of Notre Dame Australia, Fremantle

Despite national and international recommendations, annual influenza vaccination uptake among health care providers (HCPs) remains sub-optimal. This study investigated the uptake, enablers, and barriers to annual influenza vaccination in medicine, nursing, and physiotherapy students at the University of Notre Dame Australia, Fremantle, using an online survey and semi-structured interviews. In 2013, uptake rate of influenza vaccination was 36.3% (95% CI = 31.8–40.8%). Employment as a HCP (OR 1.6, 95% CI 1.1–2.5), being a medical student (OR 2.5, 95% CI 1.2–5.1) and eligibility for government-funded vaccine (OR 7.1, 95% CI 2.7–18.6) were independently associated with increased uptake. Awareness, cost, and convenience were identified as key barriers to vaccination with interview data suggesting that raising awareness of the benefits of influenza vaccination, along with improving student HCPs’ access to affordable, convenient vaccination are likely to improve uptake. Responsibility to increase uptake should be shared between universities and student HCPs

Annual influenza vaccination

Despite national and international recommendations, annual influenza vaccination uptake among health care providers (HCPs) remains sub-optimal. This study investigated the uptake, enablers, and barriers to annual influenza vaccination in medicine, nursing, and physiotherapy students at the University of Notre Dame Australia, Fremantle, using an online survey and semi-structured interviews. In 2013, uptake rate of influenza vaccination was 36.3% (95% CI = 31.8-40.8%). Employment as a HCP (OR 1.6, 95% CI 1.1-2.5), being a medical student (OR 2.5, 95% CI 1.2-5.1) and eligibility for government-funded vaccine (OR 7.1, 95% CI 2.7-18.6) were independently associated with increased uptake. Awareness, cost, and convenience were identified as key barriers to vaccination with interview data suggesting that raising awareness of the benefits of influenza vaccination, along with improving student HCPs' access to affordable, convenient vaccination are likely to improve uptake. Responsibility to increase uptake should be shared between universities and student HCPs

Starting healthy habits early: Influenza vaccination among student health care workers

Background: A 2014 study demonstrated low rates of influenza vaccination among health care worker [HCW] students at the University of Notre Dame [UND], 56% (95% CI 52-60%) overall weighted average, 53%, 57% and 61% for nursing, physiotherapy and medical students, respectively. Since then, annual influenza vaccination and/or documentation of influenza vaccination status has become mandatory for these students. On- campus influenza vaccination became available in 2018. Method: HCW students at UND were invited to participate in online surveys of influenza vaccination uptake in 2018 and 2019. Semi-structured interviews were conducted to collect qualitative data on enablers and barriers to vaccination. Results: A total of 422 students responded to the survey (199 in 2018 and 223 in 2019). The overall weighted vaccination rate of respondents was 91% (95% CI 88-93%) (79%, 90% and 95% for nursing, physiotherapy and medical students, respectively), a significant increase from 2014. Vaccination uptake in medical students increased from 83% (95% CI 76-90%) in 2018 to 99% (95% CI 96-100%) (P < 0.001) after reporting of vaccination status was mandated in 2019. Qualitative data regarding enablers, barriers, knowledge and understanding of influenza and the influenza vaccine, among HCW students and will be presented at the conference. Conclusion: Influenza vaccination uptake among UND HCW students increased significantly following the introduction of mandatory vaccination/reporting of vaccination, and is higher than the 50% observed in HCWs employed by the WA Department of Health. It is hoped that this behaviour will continue after graduation upon entering workplaces where vaccination is not mandated

The impact of a vaccine mandate and the COVID-19 pandemic on influenza vaccination uptake in Western Australian health care students

Annual influenza vaccination of health care students and workers helps protect themselves and patients from influenza, which has a high disease burden during seasonal peaks in Australia. Health care students are an important cohort whose early attitudes and habits towards influenza vaccination may influence future behaviours. We explored the knowledge, attitudes, and behaviours towards influenza vaccination of health care students in two universities from 2018 to 2020 using convergent mixed methodology. We also assessed the impact of two external events – the introduction of mandatory influenza vaccination for select students in 2019, and the COVID-19 pandemic in 2020. We found a significant increase in self-reported vaccination uptake between 2018 (73.5%) and 2020 (89.6%), with the mandate and COVID-19 pandemic being likely drivers of increased uptake. Vaccine mandates are effective but must be supported by easy accessibility, adequately addressing concerns around effectiveness and safety, and promotion of voluntary acceptance and trust