May 2019 Australian Immunisation Register (AIR) Alison Elliott IME Consulting Registered Nurse Accredited Nurse Immuniser Acknowledgements: • Tracie Hibbard: Australian Immunisation Register, Department of Human Services • Lauren Dalton: Immunisation Liaison Officer, National Centre for Immunisation Research & Surveillance
Overview History of the Australian Immunisation Register A day in the life of AIR The importance of AIR data Accurate complete & timely data AIR enhancements Medical exemptions, contraindications & natural immunity Recording adolescent vaccines on AIR AIR reports Questions
History of the Australian Immunisation Register The Australian Childhood Immunisation Register (ACIR) was introduced in 1996 to record all immunisations administered to children from birth to 7 years of age. From 30 September 2016, the ACIR expanded to become the Australian Immunisation Register (AIR), a national register that records immunisations given to people of all ages in Australia …a whole of life register!
Australian Immunisation Register The AIR is a national register that records all vaccinations given • to individuals of all ages, including National Immunisation Program (NIP) schedule vaccines, flu, shingles and travel vaccines The AIR is administered under the Australian Immunisation • Register Act 2015 AIR data is protected under the Privacy Act 1988 •
Australian Immunisation Register As at 31 December 2018: • Over 26 million individuals of all ages registered on AIR (up from 6.2 million on ACIR in September 2016) 94.6% of 5 year olds were up to date with their vaccinations (up from 93.4% in September 2016) •
What happens at AIR? … 24 hours in the life of AIR Once per 22/1/2019 43,271 immunisations submitted through Practice Management Software month, vaccination providers are 9,438 immunisations submitted 67 immunisations submitted manually paid based on through the AIR site the number of vaccinations recorded on 5,425 (10.1%) pended transmissions the AIR 5pm Midnight Midnight 8am 638 phone calls from individuals Vaccination providers 39.5% requesting their or their child’s immunisation history statement request reports 23.5% enquiring about vaccines not recorded on the AIR to be generated through the 475 phone calls from providers AIR Site 58.1% requesting to amend data already submitted to the AIR 12.4% requesting AIR site help AIR data is sent to Families for 544 forms processed FTB Part A and Child Care 26.3% were manual encounter forms submitted to the AIR by providers Subsidy 24.6% were Immunisation History Forms used to report overseas vaccinations to the AIR
The importance of AIR data AIR data are used: • to monitor vaccination coverage across Australia − to monitor the effectiveness of vaccines and vaccination − programs to inform immunisation policy and research − to identify any parts of Australia at risk during disease − outbreaks − for eligibility for Family Tax Benefit and Child Care Subsidy payments − as proof of vaccination for entry to child care and school, and for employment purposes
Accurate, complete and timely data To assist vaccination providers with data entry, the AIR system has been updated to • include: − enhanced identity matching for individuals automated business rules − ‘real -time' processing of data entered using the AIR − site additional standard vaccines (Men ACWY, HPV) − − ‘pharmacy’ and ‘commercial’ provider types
Accurate, complete and timely data To assist with data entry, the AIR site has been updated to allow vaccination providers to: • − improve identity matching and amend Indigenous information update an individual’s record with a returned mail flag − amend / correct vaccine data they have submitted − notify natural immunity and medical contraindication − − record batch numbers and school names for all vaccines − record planned catch up schedules print immunisation history statements −
Accurate, complete and timely data − practices need to keep their practice management software (PMS) up-to-date for access to the latest AIR, Medicare and PBS functionality − submit immunisation data entry to the AIR as soon as possible, ideally at the time of service − immunisations are recorded in batches when using PMS − immunisations are recorded in ‘real time’ when using the AIR site − immunisation History Statements can be printed from the ‘Identify Individual’ menu
Secure email
A closer look at the AIR enhancements
Returned mail & planning catch-up immunisations Return mail indicator Vaccination providers can now − record planned catch up schedules using the AIR site Vaccination providers should not − put the individual on a planned catch up schedule if: they have vaccinated the − individual and the individual is no longer overdue for any vaccines they feel the parent/guardian of − the individual does not intend to vaccinate their child
Planned catch up schedules − Vaccination providers can now record planned catch up schedules using the AIR site − Vaccination providers should not put the individual on a planned catch up schedule if: they have vaccinated the individual and the individual is no longer overdue for any − vaccines they feel the parent/guardian of the individual does not intend to vaccinate their − child
Update encounter Pencil allows you to edit/update the encounter. Note: The pencil will only be visible if the encounter has NOT yet been processed by AIR Approx 10% of incoming phone calls from customers and providers are from providers requesting to amend data on the AIR
Provider access to immunisation history statements online Statements can be easily downloaded and printed/emailed to patients
Parent access to immunisation history statements online Parents registered with Medicare can access statements via the Medicare Express Plus App. Download the free App from the App Store
Immunisation medical exemptions The following groups are eligible to provide immunisation medical exemptions: • general practitioners – defined by the Health Insurance Act 1973 : • fellows of the Royal Australian College of General Practitioners (RACGP) • fellows of the Australian College of Rural and Remote Medicine (ACRRM) • on Medicare’s Vocational Register of General Practitioners − general practice registrars on an approved 3GA training placement − paediatricians − public health physicians − infectious diseases physicians − clinical immunologists
Medical contraindication The contraindications for a permanent vaccine exemption are : – anaphylaxis after a dose of a vaccine – anaphylaxis after a dose of any component of a vaccine – significant immunocompromise(live vaccines only) The contraindications for a temporary vaccine exemption are: – significant immunocompromise of short duration (live vaccines only) – pregnancy (live vaccines only)
Recording a medical contraindication
Natural immunity If an individual has had a disease, and as a result has developed a natural immunity to it, they can be exempt from receiving the vaccine A natural immunity can only be recorded for these diseases: – hepatitis B – measles – mumps – rubella – varicella (chickenpox)
Recording a natural immunity
AIR data – what can you do? Keep your practice software up-to-date for access to the latest • AIR, Medicare and PBS functionality To ensure all individuals have an up to date record on the AIR • for child care, school, employment, travel and family assistance purposes: Send immunisation data to the AIR for all individuals – Send immunisation data to the AIR at the time of service –
AIR and HPV Register AIR is now the only register for HPV vaccinations. • Due and overdue rules apply for HPV vaccinations • All HPV vaccinations recorded on the HPV Register have • been migrated to the AIR AIR site reports include HPV • Immunisation history statements display HPV vaccinations •
AIR and adolescent vaccines – 2019 AIR is now the only register for HPV vaccinations • Due and overdue rules apply for HPV vaccinations • HPV vaccinations recorded on the HPV Register have been migrated • to the AIR AIR site reports include HPV • Immunisation history statements display HPV vaccinations • Note: The HPV vaccination does not impact family assistance payments
AIR and adolescent vaccines – 2019 Apply due and overdue rules for adolescent doses of: • MEN ACWY (from 14 April 2019) for 2001 DoB − − DTP (from 1 January 2020) for 2002 DoB Update AIR site reports to include adolescent doses • Adolescent overdue reminder letters at 14.5, 17, 18 years of age • Note: these will include any vaccinations missed during childhood Increase frequency of childhood overdue reminder letters for non-Centrelink • customers (7, 13, 15, 19, 49 months) • Note: overdue reminder letters for all will continue at 10, 21 and 54 months
AIR Reports
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