The Australian Immunisation Handbook 10th Edition 2013

3.1.3 Service delivery
General practitioners, Aboriginal Community Controlled Health Services,
Community Health Services, the Royal Flying Doctor Service and state/territory
corrective services all provide vaccination services to Indigenous persons and
are important to the success of programs to vaccinate Indigenous persons. While
vaccination coverage estimates vary over time and between communities, a
relatively consistent finding has been higher coverage in Indigenous persons in
remote areas than in urban areas. 46,47 More recently, however, this has not been
the case for Indigenous children, where coverage has been high in both remote
and urban areas; 48 coverage in remote areas is lower for adults than for children. 5
For vaccines recommended for both Indigenous and non-Indigenous persons,
coverage is as high, or higher, in Indigenous persons as in non-Indigenous
persons, 5 but vaccination is more frequently delayed. 49-52 For example, one study
reported that at 7 months of age only 45.2% of Indigenous infants in the Northern
Territory had completed the recommended schedule for that age point (DTPahepB-IPV-Hib/PCV/rotavirus),
but by 18 months of age this figure had risen
to 81.2%. 51 Coverage for vaccines recommended only for Indigenous persons is
generally lower than for vaccines that are funded for all persons in a particular
age group. 53
These disparities point to the importance of identification of Indigenous status,
particularly in mainstream health services, and particularly in urban areas. The
use of patient information systems to record Indigenous status and schedule
preventive health services has the potential to increase opportunistic vaccination
and enable the provision of patient reminders, with resultant improvements
in coverage and timeliness. 54 Culturally appropriate service delivery and
communication strategies, as well as use of Indigenous-specific Medicare
items, will also assist in improving access to health services for Indigenous
Australians. 55-57
References
A full reference list is available on the electronic Handbook or website
www.immunise.health.gov.au
112 The Australian Immunisation Handbook 10th edition