Factors associated with immunisation coverage and timeliness in New Zealand.

BACKGROUND: Immunisation coverage in New Zealand is lower than what is necessary to prevent large epidemics of pertussis. Primary care is where most immunisation delivery occurs. General practices vary in their structure and organisation, both in a general sense and specifically with respect to immunisation delivery. AIM: To identify the structural and organisational characteristics of general practices associated with higher immunisation coverage and more timely immunisation delivery. DESIGN OF STUDY: A random sample of practices during 2005 and 2006. SETTING: General practices in the Auckland and Midland regions, with over-sampling of indigenous Maori governance practices. METHOD: Practice immunisation coverage and timeliness were measured. Primary care practice characteristics relevant to immunisation delivery by the practice were described. Associations of these practice characteristics with higher practice immunisation coverage and more timely immunisation delivery were determined. RESULTS: A total of 124 (61%) of 205 eligible practices were recruited. A median (25th to 75th centile) of 71% (57-77%) of registered children at each practice were fully immunised, and 56% (40-64%) had no immunisation delay. In multivariate analyses, both practice immunisation coverage (P<0.001) and timeliness (P<0.001) decreased with increased social deprivation. After adjustment for socioeconomic deprivation, region, and governance, immunisation coverage and timeliness were better at practices that enrolled children at a younger age (coverage: P = 0.002; timeliness P = 0.007), used one of the four available practice management systems (coverage: P<0.001; timeliness: P = 0.006), and had no staff shortages (coverage: P = 0.027; timeliness: P = 0.021). CONCLUSION: Practice immunisation coverage and timeliness vary widely in New Zealand. General organisational and structural aspects of general practices are key determinants of general practice immunisation delivery.

The use and misuse of media headlines: lessons from the MeNZB immunisation campaign.

AIM: Tracking the use of headlines with single issue stories in the New Zealand print media from their source, three case studies of the MeNZB vaccination campaign's presentation in the print media were examined. METHOD: Article headlines were tracked in the three case studies. All headlines were coded between two researchers to review for accurate or misleading presentations in terms of whether the headlines matched the article content. RESULTS: In these three case studies 26 out of 51 headlines were inaccurate when compared with the article content (51%), with a further 6 being misleading (total of 61%). CONCLUSIONS: These small case studies illustrate the difficulties arising at the intersection between media and public health interests. There is an inherent tension between public health publicity needs, and the print media needs. To maintain public confidence, health planners constantly need to develop and review their health promotion messages and relationships with the media. Close and ongoing dialogue between media and public health professionals are important, with recognition on each side of the different drivers and needs in two different sectors.