Public health: Immunisation rates in excess of 95 per cent have been achieved in a school programme in Co Longford.
After the provision of clean drinking water, immunisation is the most significant public health intervention that has saved lives in modern times. An immunisation rate of 95 per cent is required to eradicate infectious diseases such as measles, whooping cough, rubella and mumps.
Most programmes have fallen well short of this target and some of the professionals involved believed a 95 per cent uptake rate was impossible to achieve in the Irish setting.
The Irish Medical Journal has published a scientific paper by the school immunisation team in Longford/Westmeath which shows it has achieved rates consistently greater than 95 per cent. It is believed no other Irish immunisation programme has reached or surpassed this target.
The paper details the methods used to maximise the uptake rates. According to the study, the school environment provides an excellent opportunity to immunise children. If parents failed to sign a consent card then mobile phone numbers were used to obtain consent over the phone.
The nurses on the team also gave vaccine injections, which allowed the doctor to deal with other matters. Care was taken to treat each child as an individual and to deal sympathetically with any anxieties that they had. Where parents had concerns there was a doctor on-hand to give information. A number of "mop-up" clinics were held to immunise those who were absent at the time of the school visit.
The Midlands Health Board team fully recognised the right of a parent to refuse an immunisation. However, the team adopted an approach that all parents should make an "active" decision either to accept or to refuse the immunisation offered. Other programmes probably failed to achieve similar rates by assuming that a parent was "refusing" when they did not attend or forgot to sign a consent card. Various methods were adopted to avoid such passive "refusals".
One of the authors, Dr Johanna Joyce, believes most parents will allow their child to be immunised if the true information is given and properly explained. In most cases of parental concern the real problem seems to be fear of the unknown - such concerns melt away when the real facts are explained.
The school-based programme absorbs only a fraction of the costs and resources that other immunisation programmes incur yet it provides superior figures. It is, therefore, "excellent value for money". Almost 8,000 immunisations were administered in the study.
