2011 Handbook Changes including “Catch Ups”

Outline

• Eligibility for Public Funded Vaccines

• Handbook Changes 2011

• NIR and PMS Data Entry

• Planning Immunisation Catch Ups

Eligibility for Public Funded Vaccines

• Vaccine available free of charge are:

– Those on the National Schedule

– Those eligible for the high risk programmes eg infants of hepatitis B carrier mothers, neonatal BCG, influenza, pneumococcal high risk

• The immunisation benefit is paid by DHBs to providers for the administration of:

– All childhood schedule vaccines

– Influenza vaccine to eligible children and adults

– Hepatitis B, Hib, IPV, pneumococcal conjugate and/or polysaccharide, MMR and meningococcal vaccines for eligible children and adults.

• Currently the vaccines are available free of charge but there is no funding provided for the administration of Td boosters given at 45 and 65 years of age.

Eligibility for Public Funded Vaccines

• The Health and Disability Services Eligibility Direction 2011 issued by Minister of Health sets out the eligibility criteria for publicly funded health and disability services in New Zealand.

• Children ineligible for other health services are eligible to receive funded Schedule vaccines, and providers may claim the immunisation benefit for these children. This requires an NHI

• The Health and Disability Services Eligibility Direction 2011 has been gazetted and took effect 16 April 2011. www.moh.govt.nz/eligibility. These changes clarify that vaccinations on the Immunisation Schedule are publicly funded for all children.

• Child means a person who is under the age of 18 years. http://www.moh.govt.nz/moh.nsf/pagesmh/10574/$File/eligibility-direction-2011.pdf

Eligibility for Public Funded Vaccines

• For an NHI, Contact Sector Services Contact Centre on:Telephone 0800 855 151 Monday – Friday 8:00am – 5:00pm,(Except Wednesday when the Contact Centre’s hours are 9:30am – 5:00pm )

• All children are also eligible for Well Child/Tamariki Ora services, regardless of immigration and citizenship status. (http://www.moh.govt.nz/eligibility).

• Note that non-resident girls aged up to 16 years can only receive funded HPV vaccine if they are staying in New Zealand for longer than eight months.

• Current eligibility for National Schedule vaccines is up to 16 years. There have been changes for eligibility for non resident children that covers up to 18 years. The MOH is currently addressing this.

Changes to the Handbook in 2011

• All chapters have been updated and revised since the 2006 edition, where necessary.

• The stand-alone key points section has been removed, and key changes are inserted into the relevant disease chapters

• The disease case definitions have been moved from the General Considerations chapter to a new appendix (Appendix 9: Notifiable Disease Case Definitions and Serological Tests)

• The disease chapters have been reordered to match the order in which the vaccines are given on the Schedule (e.g., the pneumococcal chapter is before measles and after poliomyelitis)

Changes to the Handbook in 2011

• There are new, separate chapters for human papillomavirus and rotavirus

• The appendix on meningococcal invasive disease has been removed

• There is a new Measles Specimen Collection appendix (Appendix 10)

• Planning Immunisation Catch-ups (Appendix 2), Immunisation Standards (Appendix 3) and Authorisation of Vaccinators (Appendix 4) appendices have been revised

NIR/PMS Changes• Pneumococcal conjugate vaccine will be scheduled as PCV without

specifying which vaccine to use for the routine Schedule, catch-up and pneumococcal schedules. Once you vaccinate you will be able to record in the PMS and NIR which vaccine was used. The options available will be:

– PCV7 (Prevenar)

– PCV10 (Synflorix)

– PCV13 (Prevenar 13)

– 23PPV (Pneumovax 23)

• There is now the ability to record electronically the result of the 5 month serology test for babies of HBsAg positive mothers and any additional hepatitis B vaccine doses (if required) at ages 6 and 7 months and a repeat serology test at age 8 months.

• Note: There will be specific order process for PCV13 for High Risk. MOH will notify this.

NIR/PMS Changes

• Recording vaccines given overseas.

– The responsibility of the vaccinator is to assess what a child needs to complete a course of immunisation and provide adequate protection. If the vaccinator has documented evidence of an immunisation given overseas they can record that event in their PMS as ‘complete, given overseas’.

– The only mandatory information required on the PMS will be the date given - the batch and vaccinator details are optional fields.

• If a child has received a dose of Hib after 1 year of age the NIR will not schedule a dose of Hib at age 15 months.

• PMS vendors will advise their providers when their software has been updated and what changes have been made.

Payment Systems

• Two new pneumococcal conjugate vaccine codes have been added PCV10 (Synflorix) and PCV13 (Prevenar 13) to enable primary care providers to claim the immunisation benefit (including manually) when administering these vaccines to eligible individuals.

• Vaccinators will be able to claim for the additional hepatitis B vaccine doses when extra doses are needed to be given to babies of HBsAg positive mothers at ages 6 and 7 months.

NIR – Entry of PCV

Med Tech 32• Childhood Immunisation Schedule 2011.• Shows Generic PCV Task for 6W, 3M,5M 15M

Med Tech 32 cntd.Administration of Generic PCV Vaccine defaults to ‘Alternative Given’ in the application and the 3 Alternatives available for selection

Med Tech 32 cntd.Shows the selection of one of the Generic PCV alternatives, and automating disabling of other alternatives on selection

Med Tech 32 cntd.Showing administration of PCV10 as an alternative to the Generic PCV

Planning Immunisation Catch Ups

• Cath ups are for children who start late or who are more than one month behind

• Please refer to Appendix 2 for Principles and Guidelines

• It is essential that vaccinators have a sound understanding of the number of antigens and the spacing of doses needed for a primary course and any booster vaccine requirements

• When planning a catch-up schedule, focus on the antigens received versus the antigens required - not the vaccine combinations available or trade names. There is no need to think in terms of events missed (e.g the six-week, three-month, five-month, or 15-month vaccination event).

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