The Australian Immunisation Register
The Australian Childhood Immunisation Register (ACIR) was established on 1 January 1996, and included all children under the age of 7 years enrolled in Medicare. Participation in the ACIR was opt-out so it constituted a nearly complete population register, a s approximately 99% of children are registered with Medicare by 12 months of age. Children not enrolled in Medicare could also be added to the ACIR via a supplementary number. Since 2001, immunisations given overseas may be recorded if a provider endorses their validity. From 30 September 2016, the Australian Childhood Immunisation Register (ACIR) became the Australian Immunisation Register (AIR), a national register that records vaccinations given to people of all ages in Australia. The AIR records vaccinations given through general practices, community clinics, Aboriginal health services, and hospitals. Data are transferred nightly from the Medicare database to the AIR when a recognised immunisation provider supplies details of an eligible immunisation either through practice management software, the Internet using the Medicare Australia website or by submitting paper encounter forms. The existence of medical contraindications to immunisation are also recorded on the AIR. All vaccination records for a person remain on the register indefinitely. The AIR does not record vaccinations provided through school vaccination programs.
For an immunisation to be recorded on the Register as a valid dose, it must be given in accordance with current guidelines published in The Australian Immunisation Handbook. Notifications falling outside these guidelines or duplicate notifications prompt an enquiry with the provider and, if their validity cannot be established, they are rejected.
Measuring immunisation coverage using the Australian Immunisation Register
The cohort method has been used for calculating coverage at the population level (national and state or territory) since the Register's inception, with each cohort defined by date of birth in 3-month age groups. Cohort immunisation status is assessed at 12 months of age (for vaccines due at 6 months), 24 months of age (for vaccines due at 12 and 18 months), and 5 years of age (for vaccines due at 4 years). A minimum 3-month lag period is allowed for late notification of immunisations to the Register, but only immunisations given on or before a child's 1st, 2nd or 5th birthday are considered. If a child's records indicate receipt of the last dose of a vaccine that requires more than 1 dose to complete the series, it is assumed that earlier vaccinations in the sequence have been given. This assumption has been shown to be valid.
The proportion of children designated as 'fully immunised' is calculated using the number of Medicare-registered children completely immunised with the vaccines of interest by the designated age as the numerator and the total number of Medicare-registered children in the age cohort as the denominator. 'Fully immunised' at 12 months of age is defined as a child having a record on the AIR of three doses of a diphtheria (D), tetanus (T) and pertussis-containing (P) vaccine; 3 doses of polio vaccine; 2 or 3 doses of PRP-OMP containing Haemophilus influenzae type b (Hib) vaccine or 3 doses of any other Haemophilus influenzae type b (Hib) vaccine; 3 doses of hepatitis B (hepB) vaccine; and 3 doses of 13-valent pneumococcal conjugate vaccine (13vPCV). 'Fully immunised' at 24 months of age is defined as a child having a record on the AIR of 4 doses of a DTP-containing vaccine; 3 doses of polio vaccine; 3 or 4 doses of PRP-OMP Hib vaccine or 4 doses of any other Hib vaccine; 3 doses of hepatitis B vaccine; 2 doses of a measles, mumps and rubella-containing (MMR) vaccine; 1 dose of meningococcal C (MenC) vaccine; and 1 dose of varicella vaccine. 'Fully immunised' at 60 months of age is defined as a child having a record on the AIR of 5 doses of a DTP-containing vaccine; 4 doses of polio vaccine; and 2 doses of an MMR-containing vaccine.
Table 1 shows the Australian National Immunisation Program (NIP) schedule for children in 2017.
|Australian National Immunisation Program schedule for children in 2017|
|2 months||Hep B||DTPa||Hib||Polio||13vPCV||Rotavirus|
|4 months||Hep B||DTPa||Hib||Polio||13vPCV||Rotavirus|
|6 months||Hep B||DTPa||Hib||Polio||13vPCV||Rotavirus*||Flu††|
|18 months||DTPa||MMRV§||Hep A‡¶||13vPCV¶||Flu††|
|24 months||Hep A‡¶||13vPCV¶||Flu††|
* 3rd dose of rotavirus vaccine at 6 months of age is dependent on vaccine brand used in each state or territory.
† In July 2013, the combined Haemophilus influenzae type b (Hib) and meningococcal serogroup C (Men C) vaccine, Menitorix®, was added to the NIP Schedule at 12 months of age. This combination vaccine replaces the single dose of monovalent meningococcal C conjugate vaccine (Men C) and booster dose of monovalent Hib vaccine previously scheduled at 12 months of age.
‡ Aboriginal and Torres Strait Islander children – doses at 12 months and 18 months of age in the Northern Territory and Western Australia and 18 and 24 months of age in Queensland and South Australia (schedule changed in July 2013 so doses administered at 12 months and 18 months of age in all four jurisdictions).
§ Measles-mumps-rubella-varicella vaccine introduced onto NIP Schedule on 1 July 2013.
¶ Booster dose for medically at risk children at 12 months of age and Aboriginal and Torres Strait Islander children in the Northern Territory, Western Australia, Queensland and South Australia at 12–18 months of age.
# To be given only if MMRV vaccine was not given at 18 months of age. The dose of measles-mumps-rubella vaccine at 4 years of age ceased on 1 January 2016.
** Medically at-risk children
††Annual vaccination, all Aboriginal and Torres Strait Islander children aged 6 months to < 5 years and all children aged ≥ 6 months with medical risk factors, Aboriginal and Torres Strait Islander people aged ≥15 years, non-Indigenous adults aged ≥65 years.
The latest national annual immunisation coverage report (for 2016) was published on the NCIRS website in March 2018.
Research Group Coordinator
Last updated 17 September 2018