ON THE SPOT VACCINATION - DOES IT WORK

Objective: To trial and evaluate a system of 'on the spot' vaccination for children up to the age of 15 years in the Early Childhood Centres of the Central Sydney Area Health Service, at the Royal Alexandra Hos pital for Children and in a number of general practices in the area. M ethodology: A brief questionnaire was used to collect data from parent s and health care professionals about the child's vaccination status a nd vaccines given 'on the spot'. Results: Over an 8 week period in Aug ust-September 1993, 5162 questionnaires were completed; 71% of childre n were up to date with their vaccination. If Haemophilus influenzae ty pe b vaccine, which had been introduced only 2 months before commencem ent of the study, was excluded, 84% of the children were up to date. A total of 441 children were given 663 vaccinations 'on the spot'. Very few children were too ill to be vaccinated (6%). However, only 30% of those who needed vaccination 'on the spot' actually received it (441 of 1480), and only 41% (24 of 58) of a subset of those who were not va ccinated were known to have complied 1 month later. Children attending Early Childhood Centres were younger than children attending general practices or the hospital. Conclusions: A high proportion of children who attended for routine or acute health care had vaccinations overdue (30%). If this scheme could be continued and expanded it would have a n important impact on vaccination coverage, and hence on the incidence of vaccine-preventable diseases.