Better data left up in the AIR

Has the government missed an opportunity to turn the Australian Immunisation Register into a more useful clinical tool?

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New legislation may require that all vaccinations be reported to the Australian Immunisation Register (AIR), but immunisation researchers fear the register still fails to record relevant data.

Since the beginning of the month, it has been mandatory for all vaccination providers to upload every immunisation to the AIR, including the influenza and COVID-19 vaccines.

The AIR was created in 2016, and reporting vaccines has always been a discretionary duty.

In a Perspective piece in the MJA, childhood immunisation researcher Professor Jane Tuckerman and colleagues called for additional information on medical risk factors to be collected by the AIR.

“Identifying whether someone has medical risk factors helps determine whether they need to be recommended specifically [for a vaccine] or if they fall into an at-risk category,” she told TMR.

These risk factors include conditions like pregnancy, immune deficiencies, asthma and cardiac conditions.

Being able to access medical risk factors in the same system as vaccination history would ensure GPs deliver vaccines more efficiently, according to Professor Tuckerman.

“When you’ve got a large volume of at-risk people, it’s more of a systematic approach as opposed to [asking patients their vaccine history],” she said.

“Clinicians are often very busy during consultations, and the information isn’t always there, so [having more data in the AIR] can make it easier for GPs to provide evidence-based care.”

As a researcher, Professor Tuckerman is also interested in using the richer dataset to monitor the success of targeted vaccine programs for vulnerable groups.

“If we could identify specific groups of, say, pregnant women who weren’t receiving vaccines or specific groups of children that didn’t get the flu vaccine, it could inform strategies for improved uptake,” she said.

Currently, targeted immunisation campaigns are evaluated by extrapolating from population-level data, which Professor Tuckerman and colleagues believe is less than ideal.

“The lack of pregnancy status capture in the AIR necessitates the use of other data sources, such as perinatal datasets in jurisdictions where maternal immunisation is collected, or population surveys to obtain coverage estimates, but these are of no use to clinicians at the individual level,” the authors wrote in the MJA.

“This is also the case for children who are medically at?risk, with no capacity to link medical risk factors with vaccine receipt for identification and tracking of these children.”

Professor Tuckerman and co-authors acknowledge that the changes they propose could prove “cumbersome” to clinicians, but are seeking support from the broader medical community to make changes a priority.