15 APRIL 2004 NEW ZEALAND GAZETTE, No. 42

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(d) maintaining high quality immunisation services;
(e) giving up-to-date, accurate information and advice to parents/caregivers and the public about vaccines and immunisation; and
(f) ensuring vaccine integrity by effectively maintaining and monitoring the "cold chain";
(g) a national rapid response group B meningococcal immunisation campaign that is aiming to achieve a national target of 90% immunisation coverage for children and young people aged six weeks to 19 years of age;
(h) supporting the meningococcal B immunisation programme for children and young people enrolled in schools by referral to the school-based vaccination programme where appropriate.

1.2 Principles

Continuity of responsibility for immunisation

The Ministry of Health regards immunisation as an entitlement for all children. Consequently, both parents and health service providers have responsibilities to ensure that children are immunised (subject to parental consent).

For most children, their usual general practice provides immunisation services and is able to ensure that the child’s immunisation schedule is completed. However, some children do not have a regular provider of primary medical care, or have difficulty accessing services (for example, due to physical or financial barriers). All children should have an identified provider who is responsible for ensuring that all scheduled vaccines are given.

Responsibilities of primary care service providers for the early childhood immunisation schedule begin when the child:

▪ is transferred from the lead maternity carer after birth; or
▪ is referred from a Well Child service provider at approximately six weeks of age for immunisation services; or
▪ joins the practice.

Responsibilities end when the child:

▪ completes the immunisation episode scheduled at age four years; or
▪ is transferred to another immunisation service provider; or
▪ advice is received by the practice that the child has left the practice; or
▪ is lost to follow up (after reasonable and repeated efforts to contact the caregiver have failed, and appropriate referral has been undertaken as detailed below).

Where the immunisation episode scheduled at age 11 is not given through a school programme, each general practice is also responsible for ensuring that this episode is offered. In areas where there is a school immunisation programme, parents still have the choice to have the 11 year episode given by their general practice. The District Health Boards will assist (where privacy issues are satisfied) by supplying regular lists of children who have been vaccinated at school to all general practitioners.

When a child is late for immunisation, despite recalls, the primary care provider shall refer the child to an appropriate Well Child service provider or immunisation co-ordinator or community immunisation service (depending on local arrangements, and privacy and consent issues) to either facilitate or undertake the child’s immunisation and report back. Definitions for immunisation on time, overdue, non-responder and declined are set out in the national standardised terminology for immunisation audit.

Linkages with other services

Linkages between services can be important in ensuring that children receive their entitled immunisation and Well Child services, and that health and development problems are detected early and interventions started.

Co-ordination between providers is important to monitor trends and targets in immunisation services, and may need to be involved for some children:

(a) Immunisation co-ordinators working for a Primary Health Organisation (PHO), Independent Practitioners’ Association (IPA) or Primary Care Organisation (PCO), Immunisation Advisory Centre (IMAC), Public Health Service and Māori or Pacific Health providers;
(b) Other primary care providers;
(c) The child’s family;
(d) Other Tamariki Ora/Well Child services, including Plunket, Māori and Pacific Island child health service providers and the Māori Women’s Welfare League;
(e) Health services for "hard to reach" children;
(f) Public health services;
(g) Paediatric services;
(h) Māori and Pacific health services;
(i) IMAC;
(j) Non-medical vaccinators;
(k) Maternity service providers, including hospital and independent midwives;
(l) Early childhood education services (mostly for inquiries and certificates);
(m) Schools (mostly for inquiries and certificates);
(n) Income support and child health and welfare services and agencies (including "Family Start" and "Strengthening Family Programme"), when facilitating a child’s access to immunisation services;
(o) The Centre for Adverse Reactions Monitoring (CARM).

2 Services

2.1 Each general practitioner will provide immunisation services as specified in Schedule 3

The responsibilities of a general practitioner to provide immunisation services may be discharged by a registered nurse provided that the general practitioner ensures that the registered nurse complies with all of the terms and conditions set