For children at 24 months of age in Quarter , immunisation uptake rates of three doses of vaccines against diphtheria (D 3 ), pertussis

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1 ackground The national immunisation uptake statistics, based on available data, for Quarter are presented in this report. These immunisation uptake statistics relate to children at 12 (born between 01/07/2016 and 30/09/2016) and 24 (born between 01/07/2015 and 30/09 /2015) months of age in Quarter These children were recommended the vaccines outlined in table 1. The immunisation schedule changed in 2015 for children born on or after July 1 st 2015 after the ational Immunisation dvisory Committee (IC) recommended changing the meningococcal C (MenC) immunisation schedule in the primary childhood programme from three doses at 4, 6 and 13 months to two doses at 4 and 13 months because of evidence that a single dose of MenC vaccine provides protection for the first year of life. Please note the immunisation schedule changed in 2016 for children born on or after October 1 st Please see the H-ational Immunisation Office (IO) website at for current and detailed information on the Irish primary childhood immunisation schedule and also recommended vaccinations for older children and adults. For children at 12 months of age in Quarter , immunisation uptake rates of three doses of vaccines against diphtheria (D 3 ), pertussis (P 3 ), tetanus (T 3 ), Haemophilus influenzae type b (Hib 3 ), polio (Polio 3 ), hepatitis (Hep 3 ), one dose of meningococcal serogroup C conjugate vaccine (MenC 1 ), two doses of pneumococcal conjugate vaccine (PCV 2 ) and one dose of C vaccine are reported. For children at 24 months of age in Quarter , immunisation uptake rates of three doses of vaccines against diphtheria (D 3 ), pertussis (P 3 ), tetanus (T 3 ), Haemophilus influenzae type b (Hib 3 ), polio (Polio 3 ), hepatitis (Hep 3 ) and pneumococcal conjugate vaccine (PCV 3 ), two doses of vaccine against meningococcal group C (MenC 2 ) and one dose of vaccine against measles, mumps and rubella (MMR 1 ) are reported. One dose of vaccine against Haemophilus influenzae type b (Hib b ), one dose of meningococcal group C vaccine (MenC b ) and one dose of pneumococcal conjugate vaccine (PCV b ) given on or after 12 months of age are also reported. The uptake statistics are also presented in this report by Community Healthcare Organisation (CHO) and ocal Health Office (HO). hile there are 32 HOs the immunisation uptake data for orth ee and outh ee are reported as a combined figure. The uptake rates presented here were rounded to zero decimal place. Table 1. Primary childhood immunisation schedule for children born since 01/07/2015 ge Children born 01/07/2015 to 30/09/2016 Children born from 01/10/2016 irth C C 2 months DTaP/Hib/IPV/Hep (6 in 1) + PCV DTaP/Hib/IPV/Hep (6 in 1) + PCV+ Men+ Rota 4 months DTaP/Hib/IPV/Hep (6 in 1) + MenC DTaP/Hib/IPV/Hep (6 in 1) + Men+ Rota 6 months DTaP/Hib/IPV/Hep (6 in 1) + PCV DTaP/Hib/IPV/Hep (6 in 1) + PCV+ MenC 12 months MMR + PCV MMR + Men 13 months MenC + Hib Hib/MenC+ PCV Please note the primary immunisation schedule changed in 2015 for children born on or after 01/07/2015 and changed in 2016 for children born on or after October 1 st Please see the H-ational Immunisation Office (IO) website at for current and detailed information on the Irish primary childhood immunisation schedule and also recommended vaccinations for older children and adults C acille Calmette uerin vaccine DTaP Diphtheria, Tetanus and acellular Pertussis vaccine Hep Hepatitis vaccine Hib Haemophilus influenzae type b vaccine IPV Inactivated Polio Virus vaccine Men Meningococcal group vaccine MenC Meningococcal group C vaccine MMR Measles, Mumps and Rubella vaccine PCV Pneumococcal Conjugate Vaccine Rota Rotavirus oral vaccine H-Health Protection urveillance Centre (HPC) Tel: Middle ardiner treet, Dublin 1, Ireland Fax: Q Page 1 of 13 February, 2018

2 Immunisation uptake among children at 12 months of age in Quarter ational Immunisation uptake rates in children 12 months of age in Q are presented by Community Healthcare Organisation (CHO) in table 2. ational immunisation uptake rates were 90% for D 3, T 3, P 3, Hib 3, Polio 3, Hep 3 and PCV 2 and 94% for MenC 1. C vaccine stock in all areas expired at the end of pril The H continues to experience ongoing delays with the supply of C vaccine. This continues to be a urope wide issue. The number of cases of T has been steadily falling in Ireland. The number of cases of T for the years 2014 and 2015 was at the lowest level since records began. Most uropean countries do not give C vaccine to all babies. The ational Immunisation dvisory Committee (IC), an independent expert group on immunisation and the Health Information and Quality uthority (HIQ) have both recommended that C vaccine does not now need to be given routinely to all babies in Ireland. o your baby is not at risk of T and you do not need to delay any of your baby's injections Figure 1 presents the national uptake rates at 12 months for each vaccine from Q to Q Compared to Q2-2017, national uptake rates in Q for D 3, T 3, P 3, Hib 3, Polio 3, Hep 3 and PCV 2 declined by 1% while MenC 1 was unchanged (figure 1). Community Healthcare Organisation (CHO) mong the CHOs, the uptake rates for D 3, T 3, P 3, Hib 3, Polio 3 and Hep 3 ranged from 85% to 94%, MenC 1 ranged from 91% to 97% and PCV 2 ranged from 85% to 95%, (Table 2). ocal Health Office (HO) The immunisation uptake rates by HO are shown in appendix 1. D 3, MenC 1 and PCV 2 immunisation uptake rates are mapped by HO in figures 2-4. The target uptake rate of 95% was reached in four HOs for D 3, T 3, P 3, Hib 3, Polio 3 and Hep 3, five for PCV 2 and in 18 HOs for MenC 1. Table 2. Immunisation uptake (%) at 12 months in cohort born 01/07/ /09/2016 Community Healthcare o. in cohort # C D 3 T 3 P 3 Hib 3 Polio 3 Hep 3 MenC 1 PCV 2 Organisation/HO* CHO1 (C/M, D, O/M) CHO2 (,, ) CHO3 (,, T) CHO4 (,,, ) CHO5 (,,, ) CHO6 (,, ) CHO7 (,,, K) CHO8 (/OY, D/H, H, MH) CHO9 (,, ) Ireland na = not available at this time *hown in brackets are the HOs in each CHO. Please see ppendix 3 to translate HO codes. The geographical boundaries of the CHOs are shown at # The denominator/number in cohort varied slightly according to vaccine. D 3T 3 cohorts are shown here. umber in cohort for C is 14,980. C data are unavailable for the former H orth astern rea i.e. C/M, H, MH; therefore CHO1 and CHO8 C data are incomplete. t the time of writing of this report the H continues to experience on-going delays with the supply of C vaccine. This continues to be a urope wide issue. ee point 2 above regarding C vaccine stock in Ireland. Q Page 2 of 13 February, 2018

3 Immunisation uptake among children at 12 months of age in Quarter Q Q Q Q Q Q Q Q Q Q Q Q Q Q Q Q Q Q Q Q Q Q Q Q Q Q Q Q Q Q Q Q Q Q Q Quarter/Year D3 P3 Hib3 Polio3 MenC3 Hep3 MenC2 MenC1 PCV2 C Figure 1. ational quarterly immunisation uptake rates at 12 months X-axis ranges from %. ince T3 uptake is identical to D3 uptake only D3 uptake figures presented. The Q MenC3 uptake figure is based on data from six of the eight H reas. The Q H-astern rea D3, P3, T3, Polio3 and MMR1 uptake figures exclude those born on the 31/03/2007. The Q figures are incomplete as two H reas were unable to provide data, two additional areas were unable to provide MenC2 data and one additional area was unable to provide PCV2 data. The Q figures are incomplete as three H reas were unable to provide data. The Q figures are incomplete as two H reas were unable to provide data and three were unable to provide MenC2 data. The Q figures are incomplete as two H reas were unable to provide data. The Q figures are incomplete as one H rea was unable to provide data. C uptake data are only displayed in this graph from Q as C uptake data were available for only five of the eight H-reas (this includes data from the H-outhern rea which relates to Kerry data only) from Q to Q (except Q when H-outhern rea data were not available), for three H-reas in Q3 2009, for two H-reas in Q4 2009, for three H-reas in Q and Q2 2010, for five H- reas in Q4 2010, Q and Q2 2011, for six H-reas in Q to Q and for seven H reas from Q From Q to Q H estern rea C data was not available by HO, uptake was provided for the H estern rea as a whole. In Q C data was available for alway and Roscommon- the C denominator for H estern rea in Q was the sum of the alway and Roscommon denominators. ince Q C data was available for alway, Mayo and Roscommon HOs. ee point 2 on the previous page regarding C vaccine stock in Ireland since pril Q Page 3 of 13 February, 2018

4 D O/M T/ D/H MH K/ /OY C/M H o Data Figure 2. D 3 immunisation uptake rates (%) by HO, in those 12 months of age in Quarter , in () Ireland and () Dublin. Please see ppendix 3 to translate HO codes. D O/M T/ D/H C/M H MH K/ /OY o Data Figure 3. MenC 1 immunisation uptake rates (%) by HO, in those 12 months of age in Quarter , in () Ireland and () Dublin. Please see ppendix 3 to translate HO codes. D O/M C/M H D/H MH K/ /OY T/ o Data Figure 4. PCV 2 immunisation uptake rates (%) by HO, in those 12 months of age in Quarter , in () Ireland and () Dublin. Please see ppendix 3 to translate HO codes. Q Page 4 of 13 February, 2018

5 Immunisation uptake among children 24 months of age in Quarter ational The immunisation schedule changed in 2015 for children born on or after July 1 st 2015 after the IC recommended changing the meningococcal C (MenC) immunisation schedule in the primary childhood programme from three doses at 4, 6 and 13 months to two doses at 4 and 13 months because of evidence that a single dose of MenC vaccine provides protection for the first year of life. Hence MenC 2 is now measured at 24 months of age. In previous quarters MenC 3 was measured at 24 months of age. ational uptake rates were 95% for D 3, T 3, P 3, Hib 3, Polio 3 and Hep 3, 92% for MMR 1 and PCV b, 91% for Hib b and PCV 3, 88% for MenC b and 86% for MenC 2 (table 3). Compared to the previous quarter national uptake rates in Q increased by 1% for Hib b, Hep 3 and PCV 3 and were unchanged for the remainder (figure 5). Figure 5 presents the national uptake rates at 24 months for each vaccine from Q to Q Community Healthcare Organisations (CHOs) The target uptake of 95% was reached for D 3, P 3, T 3, Hib 3, Polio 3 and Hep 3 in six CHOs, in one for MenC b, PCV b and PCV 3 and in none for Hib b, MenC 2 and MMR 1 (table 3). ocal Health Office (HO) Immunisation uptake rates in children 24 months of age in Q are presented by HO in ppendix 2. D 3, Hib b, MenC 3, MenC b, PCV 3, PCV b and MMR 1 immunisation uptake rates are mapped by HO in figures The target uptake of 95% was reached in 20 HOs for D 3, T 3, P 3 and Hib 3, 19 for Polio 3, 18 for Hep 3, 9 for PCV b, 6 for MMR 1, 5 for Hib b, 4 for MenC b, 3 for PCV 3 and 1 for MenC 2. Table 3. Immunisation uptake (%) at 24 months in cohort born 01/07/ /09/2015 Community Healthcare Organisation/HO o. in Cohort* D 3/T 3/ P 3/ Polio 3 Hib 3 Hib b Hep 3 MenC 2 MenC b PCV 3 PCV b MMR 1 CHO1 (C/M, D, O/M) CHO2 (,, ) CHO3 (,, T) CHO4 (,,, ) CHO5 (,,,) CHO6 (,, ) CHO7 (,,, K) CHO8 (/OY, D/H, H, MH) CHO9 (,, ) Ireland Please see ppendix 3 to translate HO codes na = not available * s the denominator/number in cohort varied slightly according to vaccine D 3T 3 cohorts are shown here % Uptake Q Q Q Q Q Q Q Q Q Q Q Q Q Q Q Q Q Q Q Q Q Q Q Q Q Q Q Q Q Q Q Q Q Q Q Q Q Q Quarter/Year D3 P3 Hib3 Hibb Polio3 Hep3 MenC3 MenC2 MenCb PCV3 PCVb MMR1 Figure 5. ational quarterly immunisation uptake rates at 24 months otes: The Q MMR 1 figure is based on data from seven of the eight H-reas. The Q MMR 1 figure includes the H-astern rea figure that is an estimate only. The Q1-2007, Q3-2007, Q and Q Hib b figures are based on data from seven of the eight H reas. In Q the H- changed their Hib b data extraction method compared to previous quarters; in Q the uptake of Hib b in the H- was 83% compared to 53% in Q The Q MenC 3 figure is based on data from six of the eight H reas. The Q H-astern rea D 3, P 3, T 3, Polio 3 and MMR 1 uptake figures exclude those born on the 31/03/2007. The Q H-astern rea Hib b uptake figures exclude uptake figures from Dublin orth. The Q figures are based on data from seven of the eight H reas. The Q Hib b figures also exclude uptake figures from Dublin orth. The Q figures are based on data from six of the eight H reas. The Q Hib b figures also exclude uptake figures from Dublin orth. The Q and Q figures are based on data from seven of the eight H reas. MenC b and PCV b data were only available for 6 of the 8 H reas from Q to Q MenC b and PCV b data were only available for 8 CHOs from Q Q but are available for all since Q Q CHO3 Hib b figures were unavailable. Q Page 5 of 13 February, 2018

6 Conclusions In Quarter , national uptake rates at 24 months for D 3, T 3, P 3, Hib 3, Polio 3 and Hep 3 reached the target of 95%. Uptake of the remaining vaccines are lower; doses of these remaining vaccines are given at 12 and 13 months of age suggesting that parents are less likely to get the necessary vaccines for their children at this age. Uptake of Hib b, Hep 3 and PCV 3 increased by one percent in Quarter compared to the previous quarter. cknowledgements HPC would like to thank all those involved in childhood immunisation including the eneral Practitioners, Practice urses, H reas, Public Health urses, Immunisation Co-ordinators, pecialists in Public Health Medicine, urveillance cientists and ystems nalysts for their assistance. Q Page 6 of 13 February, 2018

7 D O/M C/M H D/H MH /OY K/ T/ o Data Figure 6. D 3 immunisation uptake rates (%) by HO, in those 24 months of age in Quarter , in () Ireland and () Dublin. Please see ppendix 3 to translate HO codes. D O/M C/M H D/H MH /OY K/ /T o Data Figure 7. Hib b immunisation uptake rates (%) by HO, in tho se 24 months of age in Quarter , in () Ireland and () Dublin. Please see ppendix 3 to translate HO codes. Q Page 7 of 13 February, 2018

8 D O/M C/M H D/H MH K/ /OY T/ o Data Figure 8. MenC 2 immunisation uptake rates (%) by HO, in those 24 months of age in Quarter , in () Ireland and () Dublin. Please see ppendix 3 to translate HO codes. D O/M C/M H D/H MH /OY K/ /T o Data Figure 9. MenC b immunisation uptake rates (%) by HO, in those 24 months of age in Quarter , in () Ireland and () Dublin. Please see ppendix 3 to translate HO codes. Q Page 8 of 13 February, 2018

9 D O/M C/M H D/H MH K/ /OY T/ o Data Figure 10. PCV 3 immunisation uptake rates (%) by HO, in those 24 months of age in Quarter , in () Ireland and () Dublin. Please see ppendix 3 to translate HO codes. D O/M C/M H D/H MH K/ /OY T/ o Data Figure 11. PCV b immunisation uptake rates (%) by HO, in those 24 months of age in Quarter , in () Ireland and () Dublin. Please see ppendix 3 to translate HO codes. Q Page 9 of 13 February, 2018

10 D O/M C/M H D/H MH K/ /OY T/ o Data Figure 12. MMR 1 immunisation uptake rates (%) by HO, in those 24 months of age in Quarter , in () Ireland and () Dublin. Please see ppendix 3 to translate HO codes. Q Page 10 of 13 February, 2018

11 ppendix 1 Community Healthcare Organisation (CHO) CHO1 Immunisation uptake (%) at 12 months of age in cohort born 01/07/ /09/2016 Immunisation Uptake (%) o. in o. in cohort cohort for for C* # D 3 T 3 C* D 3 T 3 P 3 Hib 3 Polio 3 Hep 3 MenC 1 PCV 2 HO/CHO Cavan/Monaghan na 479 na Donegal ligo/eitrim CHO1 Total* CHO2 CHO3 CHO4 CHO5 CHO6 CHO7 CHO8 CHO9 alway Mayo Roscommon CHO2 Total Clare imerick Tipperary R/ast imerick CHO3 Total orth Cork orth outh ee est Cork Kerry CHO4 Total Carlow/Kilkenny outh Tipperary aterford exford CHO5 Total Dublin outh Dublin outh ast icklow CHO6 Total Dublin outh City Dublin outh est Dublin est Kildare/est icklow CHO7 Total aois/offaly ongford/estmeath outh na 460 na Meath na 782 na CHO8 Total* Dublin orth est Dublin orth Central Dublin orth CHO9 Total na=not available Ireland * *C data w ere unavailable for Cavan/Monaghan, outh and Meath C vaccine stock in all areas expired at the end of pril The H continues to experience ongoing delays w ith the supply of C vaccine. This continues to be a urope w ide issue. The number of cases of T has been steadily falling in Ireland. The number of cases of T for the years 2014 and 2015 w as at the low est level since records began. Most uropean countries do not give C vaccine to all babies. The ational Immunisation dvisory Committee (IC), an independent expert group on immunisation and the Health Information and Quality uthority (HIQ) have both recommended that C vaccine does not now need to be given routinely to all babies in Ireland. o your baby is not at risk of T and you do not need to delay any of your baby's injections w w.hse.ie/eng/health/immunisation/new s/c17.html #The denominator/number in cohort varied slighly according to vaccine. D3T3 cohort show n here. Please note w hile orth ee and outh ee are tw o separate HOs their combined immunisation uptake data are reported here. Q Page 11 of 13 February, 2018

12 ppendix 2 Community Healthcare Organisation (CHO) CHO1 Immunisation uptake (%) at 24 months of age in cohort born 01/07/ /09/2015 o. in cohort Immunisation Uptake (%) HO/CHO * for D 3 T 3 D 3 T 3 P 3 Hib 3 Hib b Polio 3 Hep 3 MenC 2 MenC b PCV 3 PCV b MMR 1 Cavan/Monaghan Donegal ligo/eitrim CHO1 Total CHO2 CHO3 CHO4 CHO5 CHO6 CHO7 CHO8 CHO9 alway Mayo Roscommon CHO2 Total Clare imerick Tipperary R/ast imeric CHO3 Total orth Cork orth outh ee est Cork Kerry CHO4 Total Carlow/Kilkenny outh Tipperary aterford exford CHO5 Total Dublin outh Dublin outh ast icklow CHO6 Total Dublin outh City Dublin outh est Dublin est Kildare/est icklow CHO7 Total aois/offaly ongford/estmeath outh Meath CHO8 Total Dublin orth est Dublin orth Central Dublin orth CHO9 Total Ireland na=not available *The denominator/number in cohort varied slighly according to vaccine. D3T3 cohorts show n here. Please note w hile orth ee and outh ee are tw o separate HOs their combined immunisation uptake data are reported here. Q Page 12 of 13 February, 2018

13 ppendix 3 ocal Health Office (HO) bbreviations (used in maps in this report) ocal Health Office (HO) Clare C/M Cavan/Monaghan Carlow/Kilkenny D Donegal Dublin orth Dublin orth Central Dublin orth est Dublin outh Dublin outh City Dublin outh ast Dublin outh est Dublin est alway K/ Kildare/est icklow Kerry imerick D/ ongford/estmeath H outh /OY aois/offaly MH Meath Mayo orth Cork * orth outh ee* Roscommon O/M ligo/eitrim T/ Tipperary orth /ast imerick outh Tipperary est Cork aterford exford icklow *Please note while orth ee and outh ee are two separate HOs their combined immunisation uptake data are reported here Q Page 13 of 13 February, 2018

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