By many, by thousands, the work will be accomplished.
Imagine how you'd feel living in New Zealand during a pandemic with hardly anyone immunised.
We had over 90 percent immunisation when COVID-19 came to our shores in big numbers, which saved many hundreds of lives, but it wasn't so in the 1990s when measles came.
Low immunisation rates in the early 1990s led to a measles epidemic because less than 60% of children were vaccinated. There were huge equity gaps with much lower rates for Māori and Pacific children.
A government inquiry in 1993 found low coverage, inadequate monitoring and poor vaccine storage systems. The recommendations from this led to the 1995 National Immunisation Strategy which promoted district coordinators, ECE and school vaccination policies, accreditation of vaccinators, improvements to vaccine storage and making vaccine-preventable diseases notifiable. They also set a goal of getting 95% of all children fully immunised by the age of two years by 2000.
In 1994 the University of Auckland’s Goodfellow Unit (post-graduate GP education) was contracted to provide immunisation coordination for Auckland and Northland as the Northern Region Immunisation Support Service (NRISS - logo below). It started with Elaine Boyd (above) in the role of Nursing Coordinator. Vaccinator training started in 1995. Dr Nikki Turner (left) was appointed Regional Coordinator that year.
IMAC was launched in 1997, with the support of NRISS, University of Auckland and Government (Northern Regional Health Board). Its aim was to provide immunisation advice to parents and health professionals.
The 0800 line was launched on 17 November 1997.
IMAC’s contract with government was expanded from regional to nationwide coverage in 1998. It now included local coordination, education and training, promotion, and the setting of national standards.
This incorporated Well Child/Tamariki Ora promotion into IMAC’s national services, establishing links between Plunket and other Well Child/Tamariki Ora providers, hearing and vision, dental, behaviour, nutrition and immunisation programmes to promote and improve infant health, especially through the free Well Child/Tamariki Ora checks.
By 2000 IMAC had 20 staff, a national centre for immunisation and ran its first Immunisation Conference in Wellington, now an internationally renowned conference held every 2 years. It’s also the year Loretta Roberts (left), our National Director, joined us as a local Immunisation Coordinator in Taranaki. She’s seen us grow from around 24 staff to about 85 during the COVID pandemic.
In 2003 the contract expanded again to include the national influenza immunisation programme, national Cold Chain audit, Well Child/Tamariki Ora promotion, and national education and training for all vaccinators.
A vaccine against meningococcal meningitis B was introduced in 2004 in response to an outbreak and led to national monitoring of immunisation coverage. The National Immunisation Register was launched in 2005.
The work was paying off as immunisation rates had increased from 1995 as shown by a National Immunisation Survey that year – it was still well short of 95% though (eg 77% of 2 year olds).
In 2007 the Ministry of Health reintroduced the 95% target for 2 year olds by 2012. Meanwhile, IMAC started its first online immunisation update course. In 2009 the H1N1 Swine flu pandemic led to 19 deaths and mass buy-ups of Tamiflu.
By 2012 immunisation rates were greatly improved with non-Māori at 93% and Māori at 92% by the age of 2 years, while IMAC was providing research, training and communications support to vaccinators around the country.
Between 2012 and today, many of our services have continued to expand and develop but along consistent lines: education and training, monitoring, research, communications support for vaccinators on phones, websites, newsletters, events which include conferences, symposiums and workshops.
We’ve dealt with new vaccines, research on vaccine-preventable diseases, quality assurance, cold chain and the psychology of education. As new diseases and vaccines come along, we upskill appropriately and educate our vaccinators, eg from HPV, TB, Pertussis, Rotavirus, Flu, hep B; public access and private access, supporting refugees and new immigrants, and keeping the attention on equity and gaps.
IMAC is at the forefront of thinking and educating our vaccinators. At the IMAC Immunisation Workshop on 5 September 2019 we held a session called “Planning for the next Pandemic” led by Angie Perry and Diana Murfitt. It focused on an influenza pandemic, and lists preparations including access to masks, PPE, antivirals, vaccination supplies, syringes and sharps bins, and even body bags.
Through COVID-19 our experts have led the way. Our experts run from vaccinators, educators, right through to world leading experts on the World Health Organisation’s Strategic Advisory Group of Experts.
It's been an amazing journey that started from just a couple of smart and dedicated people and has expanded into a nationwide workforce which led the way through a massive pandemic – the Immunisation Advisory Centre Team has done an excellent job to protect New Zealanders from vaccine-preventable diseases. Long may it continue.