It is appropriate to begin the Handbook by extending the Ministry’s thanks to everyone involved in supporting, promoting or delivering immunisations to the people of New Zealand. This Handbook has been designed as a comprehensive source of information on immunisation, to support you in the work you do.

Since the last edition of the Handbook, the management and purchasing of vaccines has transferred from the Ministry of Health to PHARMAC. Since July 2012 PHARMAC has been responsible for considering any changes to the National Immunisation Schedule vaccines, including the eligibility criteria, funding of new vaccines, and managing the supply of vaccines needed for localised and national disease outbreaks. PHARMAC recently approved funding for varicella, meningococcal conjugate and hepatitis A vaccines for individuals most at risk from these diseases. The rotavirus vaccine will be introduced to the National Immunisation Schedule in 2014 and is expected to significantly reduce the burden of rotavirus disease, particularly in young infants.

Immunisation coverage has significantly improved since it became a national Health Target. As at December 2013, 93 percent of 2-year-olds were fully immunised for the October to December 2013 quarter. Large gains have consistently been made for Māori children in this age group, with an increase from 85 percent in 2010 to 91 percent in December 2013. And in the Human Papillomavirus (HPV) Immunisation Programme equity has consistently been achieved for young Māori and Pacific women. Eight district health boards have achieved the HPV immunisation coverage target of 60 percent of 12 year-old girls having received all three HPV doses.

At a population level, the effects of increasing immunisation coverage are clearly discernable, with fewer cases of vaccine-preventable diseases as coverage increases. In New Zealand, we have seen significant decline in hepatitis B, Haemophilus influenzae type b, genital warts and pneumococcal diseases since the introduction of vaccines.

The health community deserves praise for this improvement, but at the same time must continue with its efforts to increase coverage toward the point where herd immunity against the most infectious diseases can be achieved.

I congratulate you on these past achievements, and encourage your ongoing commitment to improving immunisation coverage and reducing vaccine-preventable diseases in New Zealand. Pharmacists can now assist with achieving this goal. Due to a reclassification of the influenza, meningococcal, Tdap and zoster vaccines, pharmacists who have undergone Ministry-approved vaccinator training can now administer these vaccines to adults. This provides more opportunities for people to be vaccinated against these infectious diseases.

Immunisation is an important opportunity for health professionals to interact with people from all walks of life: mothers with newborns, school-age children, and adults either working or retired. Your attitude and the conversations you have with people affect their attitudes toward immunisation and their engagement with the health care system in general. We hope this Handbook will help your interactions with your patients and their families/whānau.

In closing I would like to thank the members of the Handbook Advisory Group who updated the Handbook – and also all the peer reviewers. I trust this edition, like its predecessors, will prove a valuable resource for health professionals.

Chai Chuah
Acting Director-General of Health and Chief Executive