Influenza immunisation programme

The influenza programme is being implemented in New Zealand this year as a two-stage programme using monovalent and trivalent vaccines.

Stage One: Early Protection Programme, commenced February 2010

This programme used Celvapan, a monovalent vaccine which protects against pandemic H1N1 influenza only. Two doses were given three weeks apart. The programme was aimed at specific priority groups including front-line health workers and people at risk of severe outcomes from pandemic H1N1 influenza.

The H1N1 vaccine was offered before the seasonal vaccine, to provide protection as early as possible to those at highest risk of influenza. Experience in the Northern Hemisphere suggested that influenza could arrive earlier this season, and the predominant strain would be pandemic H1N1.

Stage Two: Seasonal Influenza Immunisation Programme, commenced March 2010

The 2010 Seasonal Influenza vaccine has been formulated to include three strains of virus:

• A/California/7/2009(H1N1)-like strain
• A/Perth/16/2009 (H3N2)-like strain
• B/Brisbane/60/2008-like strain

Two doses needed for children under nine

All children aged from six months to eight years receiving the seasonal influenza vaccine should have two doses at least four weeks apart, in order to optimise immunity to pandemic H1N1. This is regardless of whether they have received seasonal vaccine in previous years.

Seasonal influenza immunisation is funded in 2010 for the following groups:

• People aged over 65 years
• Pregnant women (in any trimester)
• Morbidly obese people (BMI ≥35 in those aged over 18 years)
• Children aged from six months to their fifth birthday, if enrolled in an eligible practice, or considered at high risk (see below)
• People with the following chronic medical conditions:
  • Cardiovascular and cerebrovascular disease (except hypertension and/or dyslipidaemia without evidence of end-organ disease)
  • Chronic respiratory disease except asthma not requiring regular preventive therapy
  • Diabetes
  • Chronic renal disease
  • Cancer (except non-invasive basal or squamous cell carcinoma)
  • Other conditions including immune suppression, autoimmune disease, HIV, transplant recipients, neuromuscular and CNS diseases, haemoglobinopathies and people aged under 19 years on long term aspirin therapy

Children not covered in the free vaccination programme should be considered for vaccination when:

• They are in a household living, or in frequent contact, with a ‘high risk” individual
• They are in a boarding school or institutional environment

Eligibility criteria for funded vaccine for children

Children from age six months to five years may receive the seasonal influenza vaccination funded if they are enrolled at an eligible practice. Eligible practices are those which have 50% or more of enrolled children under six years identified as high needs (Māori, Pacific, high deprivation). Visit www.influenza.org.nz/?t=884 to see if your practice is eligible.

In addition to the list of eligible practices, permission has recently been granted by the Ministry of Health for general practices to use their discretion and offer free seasonal influenza immunisation to children from high deprivation backgrounds aged between six months and five years. This includes children who are considered at higher risk of the complications of influenza e.g. children living in poverty, crowded housing, recurrent medical presentations, household smoking, Māori, Pacific ethnic groups.

Best practice tip: Make it count. Practice staff claiming for vaccinations should ensure that the NHI number is included on the claim and the PHO enrolment register in order for payments to be processed.