The National Immunisation Program (NIP) and National Immunisation Program Schedule (NIP Schedule) is the national vaccination schedule for all children and adults in Australia. The program is a joint federal, state and territory government initiative that funds all vaccinations on the schedule for all people eligible for Medicare.[1] It aims to reduce the prevalence of preventable diseases and increase vaccination coverage in the Australian population.[2] NIP-funded vaccines are available through general practices, local council and community health clinics, Aboriginal Community Controlled Health Services and pharmacies.[3] Like all vaccinations, schedule immunisations are not mandatory, although some additional government benefits and early education providers require vaccination or an approved exemption.
The NIP Schedule lists vaccinations for all Australians from birth through to adulthood. Childhood vaccinations are recommended at birth, 2 months, 4 months, 6 months, 12 months, 18 months, and 4 years.[4] Adolescent vaccinations are recommended at 12-13 years and 14-16 years, and are usually given at free school-based clinics.[5] Adult vaccinations are recommended for all pregnant women, and people aged over 65 and 70 years.[6] Additional or early vaccinations are funded for Aboriginal and/or Torres Strait Islander peoples and people with specific medical conditions due to a higher rate or risk of infection and serious illness.[7][8] The program also funds some catch-up vaccinations for people who were not immunised as children, up until 20 years of age. Catch-up vaccination is also available for free until 25 years of age for HPV vaccination, or through all of adulthood for refugees and humanitarian visa holders.[9]
History
The National Immunisation Program was first introduced in Australia in 1997. The program was set up by the Commonwealth, state and territory governments.[10] The most recent update to the National Immunisation Program was effective since 1 April 2019. This was an update from the 2007 schedule, one change including the introduction of meningococcal ACWY vaccination for adolescents. The National Immunisation Program Schedule includes vaccines that are funded for children, adolescents and adults.[11] Additional vaccinations necessary when traveling to particular countries are not included in the program, nor are they funded.
"At September 2019, the national immunisation coverage rates were:
94.27% for all one-year-olds
91.43% for all two-year-olds
94.82% for all five-year-olds" according to the Australian Government Department of Health.[12]
The national coverage rate has increased over the last 10 years, as of 2019.[12]
Program operation
The Australian Immunisation Handbook (AIH) is the national clinical guideline that sets out vaccination recommendations, based on scientific research such randomised controlled trials and meta-analyses.[13] All NIP Schedule vaccinations are recommended by the AIH, and are selected for national funding based on the clinical and cost effectiveness of each vaccine.[14][15] All states and territories fund various additional vaccinations that are recommended by the AIH, but not funded under the NIP.[1]
Vaccination incentives
Vaccinations listed on the NIP Schedule, like all vaccinations, are not mandatory. Patients or their guardian have the choice whether or not to receive NIP vaccinations.[16] NIP schedule vaccinations are, however, a requirement for some federal government tax benefits, with approved exemptions where vaccination is medically contraindicated.
The Australian Government requires children to receive all NIP Schedule vaccines, or have an approved exemption, appropriate for their age for the parent or guardian to receive the full Family Tax Benefit Part A or the federal Child Care Subsidy.[17] All vaccinations administered or medical exemptions in Australia must be reported by the clinician to the Australian Immunisation Register (AIR), linked to the child's Medicare registration. When parents or guardians apply to Services Australia to receive either payment, they must provide the Medicare details of the child. Services Australia will then confirm that the child is up-to-date with NIP Schedule vaccinations by searching the AIR.[18]
Most state and territories either allow or require early childhood education providers to decline enrolments for unvaccinated children. All states and territories either allow or require providers or public health physicians to exclude unvaccinated children if there is an outbreak of NIP vaccine-preventable diseases.[17]
↑ Health, Australian Government Department of (20 April 2018). "National Immunisation Program". Australian Government Department of Health. Retrieved 29 January 2020.
The DPT vaccine or DTP vaccine is a class of combination vaccines to protect against three infectious diseases in humans: diphtheria, pertussis, and tetanus (lockjaw). The vaccine components include diphtheria and tetanus toxoids, and either killed whole cells of the bacterium that causes pertussis or pertussis antigens. The term toxoid refers to vaccines which use an inactivated toxin produced by the pathogen which they are targeted against to generate an immune response. In this way, the toxoid vaccine generates an immune response which is targeted against the toxin which is produced by the pathogen and causes disease, rather than a vaccine which is targeted against the pathogen itself. The whole cells or antigens will be depicted as either "DTwP" or "DTaP", where the lower-case "w" indicates whole-cell inactivated pertussis and the lower-case "a" stands for "acellular". In comparison to alternative vaccine types, such as live attenuated vaccines, the DTP vaccine does not contain any live pathogen, but rather uses inactivated toxoid to generate an immune response; therefore, there is not a risk of use in populations that are immune compromised since there is not any known risk of causing the disease itself. As a result, the DTP vaccine is considered a safe vaccine to use in anyone and it generates a much more targeted immune response specific for the pathogen of interest.
The National Childhood Vaccine Injury Act (NCVIA) of 1986 was signed into law by United States President Ronald Reagan as part of a larger health bill on November 14, 1986. NCVIA's purpose was to eliminate the potential financial liability of vaccine manufacturers due to vaccine injury claims to ensure a stable market supply of vaccines, and to provide cost-effective arbitration for vaccine injury claims. Under the NCVIA, the National Vaccine Injury Compensation Program (NVICP) was created to provide a federal no-fault system for compensating vaccine-related injuries or death by establishing a claim procedure involving the United States Court of Federal Claims and special masters.
A vaccination schedule is a series of vaccinations, including the timing of all doses, which may be either recommended or compulsory, depending on the country of residence. A vaccine is an antigenic preparation used to produce active immunity to a disease, in order to prevent or reduce the effects of infection by any natural or "wild" pathogen. Vaccines go through multiple phases of trials to ensure safety and effectiveness.
The schedule for childhood immunizations in the United States is published by the Centers for Disease Control and Prevention (CDC). The vaccination schedule is broken down by age: birth to six years of age, seven to eighteen, and adults nineteen and older. Childhood immunizations are key in preventing diseases with epidemic potential.
Immunization during pregnancy is the administration of a vaccine to a pregnant individual. This may be done either to protect the individual from disease or to induce an antibody response, such that the antibodies cross the placenta and provide passive immunity to the infant after birth. In many countries, including the US, Canada, UK, Australia and New Zealand, vaccination against influenza, COVID-19 and whooping cough is routinely offered during pregnancy.
The Haemophilus influenzae type B vaccine, also known as Hib vaccine, is a vaccine used to prevent Haemophilus influenzae type b (Hib) infection. In countries that include it as a routine vaccine, rates of severe Hib infections have decreased more than 90%. It has therefore resulted in a decrease in the rate of meningitis, pneumonia, and epiglottitis.
A vaccination policy is a health policy adopted in order to prevent the spread of infectious disease. These policies are generally put into place by state or local governments, but may also be set by private facilities, such as workplaces or schools. Many policies have been developed and implemented since vaccines were first made widely available.
Pertussis vaccine is a vaccine that protects against whooping cough (pertussis). There are two main types: whole-cell vaccines and acellular vaccines. The whole-cell vaccine is about 78% effective while the acellular vaccine is 71–85% effective. The effectiveness of the vaccines appears to decrease by between 2 and 10% per year after vaccination with a more rapid decrease with the acellular vaccines. The vaccine is only available in combination with tetanus and diphtheria vaccines. Pertussis vaccine is estimated to have saved over 500,000 lives in 2002.
A vaccine-preventable disease is an infectious disease for which an effective preventive vaccine exists. If a person acquires a vaccine-preventable disease and dies from it, the death is considered a vaccine-preventable death.
A Vaccine Information Statement (VIS) is a document designed by the Centers for Disease Control and Prevention (CDC) to provide information to a patient receiving a vaccine in the United States. The National Childhood Vaccine Injury Act requires that medical professionals provide a VIS to patients before receiving certain vaccinations. The VIS includes information about the vaccine's benefits and risks, a description of the vaccine, indications and contraindications, instructions for patients experiencing an adverse reaction, and additional resources.
Tetanus vaccine, also known as tetanus toxoid (TT), is a toxoid vaccine used to prevent tetanus. During childhood, five doses are recommended, with a sixth given during adolescence.
Universal Immunisation Programme (UIP) is a vaccination programme launched by the Government of India in 1985. It became a part of Child Survival and Safe Motherhood Programme in 1992 and is currently one of the key areas under the National Health Mission since 2005. The programme now consists of vaccination for 12 diseases- tuberculosis, diphtheria, pertussis, tetanus, poliomyelitis, measles, hepatitis B, rotaviral gastroenteritis, Japanese encephalitis, rubella, pneumonia and Pneumococcal diseases. Hepatitis B and Pneumococcal diseases were added to the UIP in 2007 and 2017 respectively. The cost of all the vaccines are borne entirely by the Government of India and is funded through taxes with a budget of ₹7,234 crore (US$870 million) in 2022 and the program covers all residents of India, including foreign residents.
The Vaccine Damage Payment is a provision of the welfare state in the United Kingdom that provides a payment of £120,000, as of 2023, for people who can show that they have suffered a vaccine injury.
Mission Indradhanush is a health mission of the Government of India. It was launched by Union Health Minister J. P. Nadda on 25 December 2014. The scheme this seeks to drive towards 90% full immunisation coverage of India and sustain the same by year 2022. Vaccination is being provided against eight vaccine-preventable diseases nationally, i.e. Diphtheria, Whooping Cough, Tetanus, Polio, Measles, severe form of Childhood Tuberculosis and Hepatitis B and meningitis & pneumonia caused by Haemophilus influenza type B; and against Rotavirus Diarrhea and Japanese Encephalitis in selected states and districts respectively.
DTaP-IPV/Hib vaccine is a 5-in-1 combination vaccine that protects against diphtheria, tetanus, whooping cough, polio, and Haemophilus influenzae type B.
DTaP-IPV-HepB vaccine is a combination vaccine whose generic name is diphtheria and tetanus toxoids and acellular pertussis adsorbed, hepatitis B (recombinant) and inactivated polio vaccine or DTaP-IPV-Hep B. It protects against the infectious diseases diphtheria, tetanus, pertussis, poliomyelitis, and hepatitis B.
A hexavalent vaccine, or 6-in-1 vaccine, is a combination vaccine with six individual vaccines conjugated into one, intended to protect people from multiple diseases. The term usually refers to the children's vaccine that protects against diphtheria, tetanus, pertussis, poliomyelitis, haemophilus B, and hepatitis B, which is used in more than 90 countries around the world including in Europe, Canada, Australia, Jordan, and New Zealand.
Immunisation against infectious disease, popularly known as The Green Book, provides information on vaccines for vaccine-preventable diseases. It acts as a guide to the UK's vaccination schedule for health professionals and health departments that give vaccines in the United Kingdom.
Trudy Virginia Noller Murphy is an American pediatric infectious diseases physician, public health epidemiologist and vaccinologist. During the 1980s and 1990s, she conducted research at Southwestern Medical School in Dallas, Texas on three bacterial pathogens: Haemophilus influenzae type b (Hib), Streptococcus pneumoniae (pneumococcus), and methicillin-resistant Staphylococcus aureus (MRSA). Murphy's studies advanced understanding of how these organisms spread within communities, particularly among children attending day care centers. Her seminal work on Hib vaccines elucidated the effects of introduction of new Hib vaccines on both bacterial carriage and control of invasive Hib disease. Murphy subsequently joined the National Immunization Program at the Centers for Disease Control and Prevention (CDC) where she led multi-disciplinary teams in the Divisions of Epidemiology and Surveillance and The Viral Hepatitis Division. Among her most influential work at CDC was on Rotashield™, which was a newly licensed vaccine designed to prevent severe diarrheal disease caused by rotavirus. Murphy and her colleagues uncovered that the vaccine increased the risk of acute bowel obstruction (intussusception). This finding prompted suspension of the national recommendation to vaccinate children with Rotashield, and led the manufacturer to withdraw the vaccine from the market. For this work Murphy received the United States Department of Health and Human Services Secretary's Award for Distinguished Service in 2000, and the publication describing this work was recognized in 2002 by the Charles C. Shepard Science Award from the Centers for Disease Control and Prevention.
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