Editorial
Volume 49, Issue 10, October 2020

Vaccinations

Margie Danchin   
doi: 10.31128/AJGP-10-20-1234e   |    Download article
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Vaccination during the COVID-19 pandemic

Vaccination has never been more important. Australia has an enviable National Immunisation Program, the Australian Immunisation Register capturing immunisations across the lifespan, and a skilled and dedicated immunisation workforce. However, the COVID-19 pandemic has affected all aspects of our lives, including routine immunisation coverage. Decreases in immunisation coverage have been reported in the UK1 because of the enforced public health restrictions, but Australian data are not yet showing a decline.2 However, it has been reported that one in five children has had a routine vaccine delayed.3

Globally, undervaccination is a pressing problem. Outbreaks of vaccine-preventable diseases have been increasing, with a 300% global increase in measles cases alone in 2019.4 With disruption to routine immunisation services from the COVID-19 pandemic, there are now more than 80 million children aged <1 year at risk from diseases such as measles, diphtheria and polio.5 In the face of rising vaccine misinformation and antivaccination activity, as well as disruption to routine vaccination services, we still need strategies to increase and maintain vaccination uptake in Australia and globally.

COVID-19 vaccines are being heralded as the solution to control the pandemic and resume our previous way of life. This issue of Australian Journal of General Practice (AJGP) highlights the key role of general practitioners (GPs) and nurses in primary care being at the forefront of vaccine delivery and acceptance.6 The expedited vaccine development process for COVID-19 vaccines and anticipated key vaccine target groups is discussed. Low intention by adults to refuse COVID-19 vaccines has been reported in Australia (7.6%),7 but we expect that population attitudes towards the COVID-19 vaccines will fluctuate with perception of disease severity and the waves of the pandemic, necessitating regular tracking of vaccine confidence among different population groups. Effective risk communication by GPs and immunisation nurses in general practice, along with strong endorsement from government, will be crucial to achieve sustained vaccine confidence and uptake.

This issue of AJGP focuses on key immunisation issues for GPs in Australia, including maternal vaccination,8 immunisation and allergy in children and adults,9 safe revaccination following vaccine-proximate seizures in children10 and the role of Bacillus Calmette–Guérin (BCG) vaccination.11 The protection of pregnant women and young infants through maternal vaccination for influenza and pertussis and the expanding role of maternal vaccination, with new vaccines in the pipeline, are discussed. Adverse events following immunisation are commonly seen in general practice, often with concerns about vaccine allergy in adults and children. The authors provide a guideline to identify potential hypersensitivity reactions to ensure accurate reporting and manage future immunisations. In light of the increasing interest in BCG vaccination for both established and novel indications, BCG vaccination in the Australian context is reviewed and some of the exploratory off-target effects of BCG, including potential protection against COVID-19, are discussed.

Australia is a leader in vaccine research, development and service delivery; however, with the advent of the COVID-19 pandemic, it is imperative that we respond quickly to ensure catch-up and maintenance of routine vaccination. We also need to prepare the public for the advent of the COVID-19 vaccines in the pipeline to optimise the health and wellbeing of Australians for the future.

References
  1. McDonald HI, Tessier E, White JM, et al. Early impact of the coronavirus disease (COVID-19) pandemic and physical distancing measures on routine childhood vaccinations in England, January to April 2020. Euro Surveill 2020;2519:2000848. doi: 10.2807/1560-7917.ES.2020.25.19.2000848. Search PubMed
  2. Australian Government Department of Health. Current coverage data tables for all children. Canberra, ACT: DoH, updated 2020. Available at www.health.gov.au/health-topics/immunisation/childhood-immunisation-coverage/current-coverage-data-tables-for-all-children [Accessed 7 September 2020]. Search PubMed
  3. The Royal Children’s Hospital National Child Health Poll. Routine childhood vaccinations: Effects of the COVID-19 pandemic. Poll Number 18. Parkville, Vic: RCH, 2020. Available at www.rchpoll.org.au/wp-content/uploads/2020/08/nchp-immunisationembargoed.pdf [Accessed 7 August 2020]. Search PubMed
  4. Mahase E. Measles cases rise 300% globally in first few months of 2019. BMJ 2019;365:l1810. Search PubMed
  5. World Health Organization. At least 80 million children under one at risk of diseases such as diphtheria, measles and polio as COVID 19 disrupts routine vaccination efforts, warn Gavi, WHO and UNICEF. 22 May 2020. Available at www.who.int/news-room/detail/22-05-2020-at-least-80-million-children-under-one-at-risk-of-diseases-such-as-diphtheria-measles-and-polio-as-covid-19-disrupts-routine-vaccination-efforts-warn-gavi-who-and-unicef [Accessed 7 September 2020]. Search PubMed
  6. Danchin M, Biezen R, Manski-Nankervis J, Kaufman J, Leask J. Preparing the public for COVID-19 vaccines: How can general practitioners build vaccine confidence and optimise uptake for themselves and their patients? Aust J Gen Pract 2020;49(10):625–29. Search PubMed
  7. Rhodes A, Hoq M, Measey M, Danchin M. Intention to vaccinate against COVID-19 in Australia. Lancet Infect Dis 2020. doi: 10.1016/S1473-3099(20)30724-6. [Epub ahead of print] Search PubMed
  8. Kong KL, Krishnaswamy S, Giles ML. Maternal vaccinations. Aust J Gen Pract 2020;49(10):630–35. Search PubMed
  9. Cheung A, Perrett KP. Immunisation and allergy in children and adults: A case-based approach. Aust J Gen Pract 2020;49(10):637–43. Search PubMed
  10. Deng L, Wood N, Danchin M. Seizures following vaccination in children: Risks, outcomes and management of subsequent revaccination. Aust J Gen Pract 2020;49(10):644–49. Search PubMed
  11. Taylor JW, Curtis N, Denholm J. BCG vaccination: An update on current Australian practices. Aust J Gen Pract 2020;49(10):651–55. Search PubMed

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