Peer-reviewed article
Immunisation status of children presenting to the emergency department: Linkage of a longitudinal birth cohort with national immunisation data
Gerben Keijzers, Amy Sweeny, Julia Crilly, Norm Good, Cate M Cameron et al. ·
Summary
Written by AI, not yet AICS's view · claude-sonnet-5-5This study linked data from a birth cohort of 3404 children born in Southeast Queensland and Far North New South Wales (2006-2011) with the national immunisation registry and emergency department records. It looked at whether immunisation status was related to emergency department visits for infectious disease in children up to 5 years old. Most children were fully immunised, but rates were lower than the national average. Children presenting with infectious disease did not differ in immunisation status from other emergency presentations, except that RSV was diagnosed more often in unimmunised children. The authors conclude that linking these databases is feasible.
Key points
- Of 1490 children with immunisation data, 87.2% were fully immunised by 12 months and 84.6% by 24 months.
- Including partially immunised children raised coverage to 93.2% at 12 months and 91.4% at 24 months.
- Nearly two-thirds of all children made at least one ED presentation.
- Children with infectious disease presentations were younger, more likely to live with other children, had longer ED stays and higher admission rates.
- RSV was more frequently diagnosed in unimmunised children; other infectious disease presentations were not significantly linked to immunisation status.
Limitations
This is a proof-of-concept data linkage in one existing birth cohort from a limited region, and only 1490 of the cohort had usable immunisation data, so results may not apply to all children. It describes associations only and does not test an intervention.
Abstract
AimTo describe the relationship between emergency department (ED) diagnosis of infectious disease and immunisation status in children ≤5 years. We also aimed to demonstrate feasibility of proof‐of‐concept linkage between disparate databases.MethodsData from a cohort of 3404 children born in Southeast Queensland/Far North New South Wales between 2006 and 2011 were linked to Australian Childhood Immunisation Registry data and Emergency Department Information System data for presentations between 2006 and 2014. Immunisation status was assigned using the 2009 National Immunisation Program schedule.ResultsOf 1490 children (79% of those consented) with data on immunisation status, 87.2 and 84.6% were fully immunised by 12 and 24 months, respectively. Adding partially immunised children increased this to 93.2 and 91.4% at 12 and 24 months, respectively. Nearly two‐thirds of all children made at least one ED presentation. Children presenting to ED with an infectious disease did not differ in immunisation status compared to children with other (non‐infectious disease type) presentations but were younger, more likely to live with other children and had a longer ED stay and higher admission rate. Respiratory syncytial virus (RSV) was more frequently diagnosed in unimmunised children.ConclusionsIn an existing birth cohort, immunisation rates were lower than the national average. RSV was more prevalent in unimmunised children presenting to ED, but immunisation status was not significantly associated with other infectious disease presentations. Linkage between national immunisation data and Australian ED data is feasible and has the potential to identify previously unrecognised factors related to child immunisation status and health‐care utilisation.