Immunisation records and data explained: A guide for vaccine service providers

Queensland Health Immunisation records and data explained: A guide for vaccine service providers

Immunisation records and data explained: a guide for vaccine service providers Published by the State of Queensland (Queensland Health), June 2015 This resource is based on the 2009 Immunisation: Recording, Reporting & Rates a step-by-step guide for practice staff developed by General Practice Queensland. This document is licensed under a Creative Commons Attribution 3.0 Australia licence. To view a copy of this licence, visit creativecommons.org/licenses/by/3.0/au State of Queensland (Queensland Health) 2015 You are free to copy, communicate and adapt the work, as long as you attribute the State of Queensland (Queensland Health). For more information contact: Communicable Diseases Unit, Department of Health, GPO Box 48, Brisbane QLD 4001, email: immunisation@health.qld.gov.au, phone (07) 3328 9888. An electronic version of this document is available at www.health.qld.gov.au/clinicalpractice/guidelines-procedures/diseases-infection/immunisation/service-providers/ records/default.asp Disclaimer: The content presented in this publication is distributed by the Queensland Government as an information source only. The State of Queensland makes no statements, representations or warranties about the accuracy, completeness or reliability of any information contained in this publication. The State of Queensland disclaims all responsibility and all liability (including without limitation for liability in negligence) for all expenses, losses, damages and costs you might incur as a result of the information being inaccurate or incomplete in any way, and for any reason reliance was placed on such information.

Contents Section 1: Before you begin what you need to know... 5 1.1 What is an immunisation record? What is immunisation data?...5 1.2 What information is needed to record an accurate immunisation record?...5 1.3 What are some common recording errors? How to avoid them...6 1.4 What immunisation databases are used in Queensland?...7 1.5 What information does VIVAS need to record an immunisation?...7 1.6 What forms are needed for reporting immunisation information?...8 1.6.1 ACIR...8 1.6.2 VIVAS...8 1.7 How does immunisation affect family assistance payments?...8 1.7.1 Approved exemptions to immunisation...8 Section 2: Reporting Immunisations... 9 2.1 What are the differences between ACIR and VIVAS?...9 2.2 Do ACIR and VIVAS share information?...9 2.3 How to report immunisations for specific groups?...9 2.3.1 Children aged below ten years of age...9 2.3.2 Adolescents...10 2.3.3 Refugee children up to ten years of age...10 2.3.4 Refugees above ten years of age...10 2.3.5 Premature infants... 11 2.3.6 Birth dose hepatitis B... 11 2.3.7 Hepatitis B (how to record dose numbers for children vaccinated overseas)... 11 2.3.8 Rabies immunoglobulin & rabies vaccine (post exposure)... 11 2.3.9 Children vaccinated overseas...12 2.3.10 Immunisations given by another VSP but not recorded on ACIR...12 2.3.11 Immunisations recorded in medical software but not on ACIR or VIVAS...12 2.3.12 Children without a Medicare number...12 2.3.13 Children who are not Australian residents or citizens...12 2.3.14 Pneumovax 23 vaccine (23vPPV)...13 2.3.15 Japanese encephalitis (JE) vaccine...13 Immunisation records and data explained: a guide for vaccine service providers

2.3.16 Revaccination of oncology patients...14 2.3.17 Diphtheria/tetanus/pertussis vaccination for pregnant women...14 2.4 How to report other immunisation related information to ACIR or VIVAS?...14 2.4.1 Aboriginal and/or Torres Strait Islander status...14 2.4.2 Conscientious objection to immunisation...15 2.4.3 Natural immunity...15 2.4.4 Medical contraindication...15 2.4.5 Deceased child...15 2.4.6 Child aged under seven years on a catch-up schedule...15 2.4.7 Child who has moved overseas...15 2.4.8 Adverse event following immunisation (AEFI)...15 Section 3: Checking Immunisation Records...16 3.1 Where to find immunisation records?...16 3.1.1 If you are a vaccine service provider...16 3.1.2 If a parent requires an immunisation record for their child...16 3.2 Not sure your immunisation records are transmitting to ACIR?...17 3.2.1 Check your medical software...17 3.2.2 Check for error messages when records are transmitted...17 3.3 How to check if immunisation records have been transmitted to ACIR?...18 3.3.1 Use ACIR s secure site...18 3.3.2 Use the ACIR payment statement...18 3.3.3 Contact local public health unit...18 3.4 How to follow up children who are overdue for immunisation?...18 3.4.1 Queensland Health overdue reminder notice...19 3.4.2 Reminders using medical software...19 3.4.3 Using ACIR reports...19 Section 4: Appendices...21 Appendix 1 Contacts list...21 Appendix 2 Queensland Health vaccination record form...23 Appendix 3 Queensland Health registration of Medicare provider number/s...24 Appendix 4 VIVAS overdue reminder notice...25 Appendix 5 How to complete an ACIR immunisation history form...26

Appendix 6 ACIR immunisation history form...28 Appendix 7 Resources to help interpret overseas immunisation histories...29 Appendix 8 ACIR immunisation exemption medical contraindication form...30 Appendix 9 ACIR immunisation exemption conscientious objection form...31 Appendix 10 ACIR immunisation payment statement...32 Appendix 11 How to request access to ACIR s secure site?...35 Appendix 12 How to log onto ACIR s secure site and find a child s record?...36 Appendix 13 Sample reminder letter (for VSPs)...38 Appendix 14 The HPV Register what you need to know...39 Appendix 15 HPV vaccination register consent form...40 Abbreviations and Glossary...41 Index...43 Immunisation records and data explained: a guide for vaccine service providers

The term vaccine service provider (VSP) has been used throughout this guide. The term refers to any person involved in handling immunisation records, especially those working in a general practice setting, such as GPs, practice nurses, reception staff and/or practice managers. This guide has been written for vaccine service providers in Queensland and can be used for: training new staff or updating current staff answering frequently asked questions about immunisation record keeping troubleshooting immunisation data issues. The following symbols are used throughout the guide to draw attention to important information. R TIP! Helpful information that can save time and resources O NOTE! Important information for readers to note

Section 1: Before you begin what you need to know For definitions of terms or acronyms see the abbreviations and glossary section on page 41. 1.1 What is an immunisation record? What is immunisation data? An immunisation record refers to a person s immunisation history which includes details about when and what vaccines have been given. Immunisation records are documented by healthcare providers as part of an individual s medical history. These records can then be transmitted to centrally held databases. These collected immunisation records form data, which in its entirety can help measure the effectiveness of immunisation programs. It is therefore crucial that immunisation records are documented and reported in a consistent and accurate way. Consequently, it is essential that healthcare providers document and report immunisation records accurately. Incorrect or missing immunisation records may result in: a child s immunisation history not being complete parents/carers not receiving family assistance payments a child or adult receiving unnecessary vaccinations a general practice missing payments for immunisation records that are not reported to the national immunisation database (ACIR) inaccurate statistics about the level of community protection against vaccine-preventable diseases. 1.2 What information is needed to record an accurate immunisation record? Record Ask Check Ask Check Record Check Name (or alias) Address and postcode Date of birth Medicare number (if available) Do you or your child identify as Aboriginal and/or Torres Strait Islander? Is their Indigenous status noted in the medical software? Has the parent told Medicare that they identify as Indigenous? (Notifying Medicare makes sure the child s ACIR record is correct.) Have they told Medicare of any change in personal details? To see any immunisation history documents. Are there any missing immunisations? Are there any medical conditions that would make them eligible for additional vaccines? Any immunisations already given. Vaccine names, dose numbers, batch numbers. Are they recorded accurately? Scan any documents into medical software Has a reminder been set for follow-up immunisations? Are there any medical contraindications that need to be reported? O NOTE! Is the child up to date for their age? Do not assume a child has received all previous recommended vaccinations. For example, a child aged 12 months of age may not have received their 2, 4 or 6 month old vaccinations. Ask for documentation from the parent or check ACIR s secure site to make sure that the child is being immunised appropriately. Immunisation records and data explained: a guide for vaccine service providers 5

1.3 What are some common recording errors? How to avoid them It is important that all staff using software are aware of the steps required to record and transmit accurate information. R TIP! Has the immunisation schedule changed recently? Updates for your medical software will include any changes to the immunisation schedule and will reduce the likelihood of vaccine errors. At each visit, confirm with patients that their details are up to date, e.g. address, postcode, Medicare number, Indigenous status. Does the patient or child have a Medicare number? An immunisation record will not transmit electronically to ACIR without a Medicare number. Refer to 2.3.12 for advice. Update your medical software when new upgrades or patches are released by software providers. Any changes to the immunisation schedule will then be incorporated into your medical software. VIVAS records vaccine batch numbers. Record the batch number for each vaccine given. Check the correct vaccine dose number has been entered otherwise the child s ACIR immunisation record will not reflect an accurate history. For example, the vaccine Menitorix should be recorded as Dose 1. Immunisations must always be linked to a GP Medicare provider. Immunisation records will not electronically transmit to the ACIR without a GP provider number. If the vaccine is administered by a registered nurse, record this in the comments box. Select correct vaccine names. Examples of similar vaccine names which can cause inaccuracies on a child s ACIR and VIVAS immunisation history are: RotaTeq not Rotarix or Infanrix Hexa not Infanrix. For multivalent vaccines (e.g. Infanrix Hexa) select combination option as this will eliminate antigen errors. Never use free text to record a vaccine. Select correct antigens. Vaccine name can be recorded in the comments box. Before saving an immunisation encounter always check that the actual date given, and that it matches the date in the record. Select whole of life box to ensure all vaccines given are captured on your medical software (if available on your medical software). If immunisation has been given by another vaccine service provider, record as not given here when entering history information. Notify VIVAS of any changes to GP Medicare provider numbers (including locums) using Queensland Health registration of Medicare provider number/s form (Appendix 3). O NOTE! Have you selected the right vaccine name and dose number? If the wrong vaccine name or dose number is inadvertently selected and then reported to a database, the child s immunisation record will be inaccurate and the child may be assessed as overdue for an immunisation. 6

1.4 What immunisation databases are used in Queensland? There are two immunisation databases used in Queensland: ACIR (National) holds immunisation data for: Children resident in Australia and aged from birth to 7 years of age Note: Any vaccination administered to a child in this age group can be recorded by ACIR. This includes travel vaccinations, influenza vaccination and other vaccines outside the funded National Immunisation Program. VIVAS (Queensland only) holds immunisation data for Children resident in Queensland and aged from birth to 10 years of age (including birth dose hepatitis B) School immunisation program vaccines Oncology patients up to 18 years of age (those requiring revaccination) Refugees (all ages) Rabies vaccine and immunoglobulin (postexposure) Pneumovax 23 (23vPPV) for Indigenous adults Japanese encephalitis for Torres Strait Islanders State-funded, time-limited programs such as whooping cough vaccination for pregnant women Note: VIVAS also records vaccine batch numbers O NOTE! Can your medical software transmit immunisation records for individuals above 7 years of age? Talk to your medical software provider to find out. If the software used in your practice cannot transmit vaccines outside the childhood schedule, then some vaccinations (for example Boostrix ) will not be transmitted to the database. Refer to Section 2 for information. Update: In May 2015, the federal government announced the establishment of a register to collect school-based adolescent vaccinations (due to be operational in 2017) and an adult vaccination register (due to be operational from September 2016). 1.5 What information does VIVAS need to record an immunisation? To record an immunisation encounter VIVAS requires the following details of the person being vaccinated: Full name (or alias) and address Date of birth and gender Medicare number (if available) Aboriginal and Torres Strait Islander status Vaccines administered, including date given, dose numbers, batch numbers Medicare provider number of doctor who administered vaccines Print a history or a list of immunisations given (from medical software) and fax or post to VIVAS. Refer to the contacts list in Appendix 1. R TIP! Any records which do not include the above information will be returned to the VSP. Immunisation records cannot be entered onto VIVAS without this information. Make sure you send all the required details the first time to avoid the record being returned with a request for more information. Immunisation records and data explained: a guide for vaccine service providers 7

1.6 What forms are needed for reporting immunisation information? 1.6.1 ACIR Conscientious objection to immunisation (refer to 1.7 below) Medical contraindication Immunisation history Forms can be found at www.humanservices.gov.au/health-professionals/services/ australian-childhood-immunisation-register/ 1.6.2 VIVAS Queensland Health vaccination record form HPV vaccination consent form Whooping cough vaccine program for pregnant women data collection and consent form (time-limited program) Registration of Medicare provider number/s Forms can be ordered from QHIP 1.7 How does immunisation affect family assistance payments? Parents/guardians receive family assistance payments from the federal government if their child is fully immunised. If a child is not fully immunised according to their age then these payments may be suspended unless an approved exemption (see 1.7.1 below) has been lodged with ACIR. Parents/guardians will receive notification from Centrelink if payments are affected. Family assistance payments linked to immunisation are: Child care benefit Child care rebate Family tax benefit (Part A supplement) O NOTE! Family assistance payments from the Federal government are related to a child s immunisation status on ACIR. For more information go to www.humanservices.gov.au/customer/subjects/immunising-your-children. 1.7.1 Approved exemptions to immunisation Approved exemptions to immunisation are for: Medical contraindication Conscientious objection to immunisation (refer to note below) Update: From 1 January 2016, exemptions from immunisation will only be allowed for medical reasons. From this date, parents who choose not to fully immunise their children will no longer be eligible for family assistance payments. For more information go to www.dss.gov.au/our-responsibilities/families-and-children/benefits-payments/ strengthening-immunisation-for-young-children 8

Section 2: Reporting Immunisations 2.1 What are the differences between ACIR and VIVAS? Which database? Reporting method How and when to report Important: ACIR Through Medicare Online and medical software (electronic transmission) Electronic transmission Transmit daily VSPs should consult their software provider regarding this function and for assistance with configuring and transmission procedures. VIVAS By completing a Queensland Health vaccination record or printing an immunisation list from medical software Fax or post to VIVAS Send weekly VSPs should seek assistance from their software provider to generate a list that includes all required patient details. Refer to 1.5 for advice. 2.2 Do ACIR and VIVAS share information? Yes. ACIR and VIVAS share immunisation data, although how this occurs depends on the method a VSP uses to send immunisation records to either database. If a VSP sends immunisation information to: 1. ACIR using electronic transmission (Medicare Online and medical software) VIVAS collects this data 2. VIVAS by fax or post VIVAS sends this data to ACIR 3. ACIR via telephone, fax or post VIVAS is not able to collect this data O NOTE! Avoid sending immunisation records to ACIR over the telephone, fax or via the post. If a VSP sends information to ACIR using one of these methods, VIVAS is not able to access the information and this may result in some variances between ACIR and VIVAS. 2.3 How to report immunisations for specific groups? The table below provides directions about how to report specific vaccines to ACIR or VIVAS. Table 1 How to report vaccines for specific groups to ACIR or VIVAS Immunisations for ACIR reporting method OR VIVAS reporting method 2.3.1 Children aged below ten years of age Note: Children with medical risk factors and Indigenous children may require additional vaccines. Refer to the current edition of The Australian Immunisation Handbook for advice on additional vaccines for these children. Electronic transmission through Medicare Online and medical software Complete a Queensland Health vaccination record form or print an immunisation record from medical software which includes: child s full name and address child s gender and date of birth vaccine details Medicare provider number Fax or post to VIVAS. Immunisation records and data explained: a guide for vaccine service providers 9

Immunisations for ACIR reporting method OR VIVAS reporting method 2.3.2 Adolescents For immunisations missed in the School Immunisation Program. Note: A consent form for sending records to the HPV Register needs to be completed. Contact QHIP for forms. The HPV Register sends reminder notices to parents/ guardians of children who have missed doses. 2.3.3 Refugee children up to ten years of age For vaccines funded under the National Immunisation Program. 2.3.4 Refugees above ten years of age Queensland Health funds additional vaccines Diphtheria/tetanus/pertussis Polio Hepatitis B Measles, mumps, rubella Electronic transmission through Medicare Online and medical software. Post or fax HPV consent form to VIVAS. Note: Check with your medical software provider to make sure the software can transmit immunisation records for individuals above seven years of age. If the software is not able to transmit this information, complete a Queensland Health vaccination record form or print an immunisation record from medical software which includes: child s full name and address child s gender and date of birth vaccine details Medicare provider number Fax or post to VIVAS. Electronic transmission through Medicare Online and medical software. Electronic transmission through Medicare Online and medical software. Note: Check with your medical software provider to make sure the software can transmit immunisation records for individuals above seven years of age. If the software is not able to transmit this information, complete a Queensland Health vaccination record form or print an immunisation history from medical software which includes: person s full name and address date of birth and gender vaccine details Medicare provider number Fax or post to VIVAS. Also note on immunisation record for refugee vaccination Complete a Queensland Health vaccination record form or print an immunisation record from medical software which includes: child s full name and address child s gender and date of birth vaccine details Medicare provider number Post or fax HPV consent form to VIVAS. Complete a Queensland Health vaccination record form or print an immunisation record from medical software which includes: child s full name and address child s gender and date of birth vaccine details Medicare provider number Fax or post to VIVAS. Complete a Queensland Health vaccination record form or print an immunisation record from medical software which includes: person s full name and address date of birth and gender vaccine details Medicare provider number Fax or post to VIVAS. Also note on immunisation record for refugee vaccination 10

Immunisations for ACIR reporting method OR VIVAS reporting method 2.3.5 Premature infants (Gestation <32 weeks) Preterm infants should be vaccinated according to the recommended schedule at the usual chronological age. Refer to the current edition of The Australian Immunisation Handbook for advice on additional vaccines for preterm infants. 2.3.6 Birth dose hepatitis B (Birth to seven days of age; usually administered in hospital) Record as birth dose. Note: A child who has not received a dose of hepatitis B vaccine in the first seven days following birth will not be flagged as overdue. 2.3.7 Hepatitis B (how to record dose numbers for children vaccinated overseas) A child who has received 3 doses according to an overseas schedule is considered up to date for hepatitis B immunisation. This must be recorded as given at 0, 1 and 6 months. For example: i. Birth dose ii. Dose 2 given between 1 and 2 months of age iii. Dose 3 given between 6 and 18 months of age 2.3.8 Rabies immunoglobulin & rabies vaccine (post exposure) Electronic transmission through Medicare Online and medical software. Complete a Queensland Health vaccination record form or print an immunisation record from medical software which includes: child s full name and address child s gender and date of birth vaccine details Medicare provider number Fax or post to VIVAS. Complete a Queensland Health vaccination record form or print an immunisation record from medical software which includes: child s full name and address child s gender and date of birth vaccine details Medicare provider number Fax or post to VIVAS. Complete a Queensland Health vaccination record form or print an immunisation record from medical software which includes: child s full name and address child s gender and date of birth vaccine details Medicare provider number Fax or post to VIVAS. Note: Notify ACIR of correct dose numbers to ensure the child is not flagged as overdue. Contact local public health unit if required. Immunisation records and data explained: a guide for vaccine service providers 11

Immunisations for ACIR reporting method OR VIVAS reporting method 2.3.9 Children vaccinated overseas Refer to: Appendix 5 for detailed information on how to complete the ACIR immunisation history form. Appendix 6 for a sample of the ACIR immunisation history form. Appendix 7 for information on overseas immunisation schedules. Note: Public health units may be able to assist with catch-up schedules. 2.3.10 Immunisations given by another VSP but not recorded on ACIR Where there is documentation of immunisations given elsewhere in Australia but not recorded on ACIR, a VSP can report this missing information as it ensures a child s immunisation history is up to date. 2.3.11 Immunisations recorded in medical software but not on ACIR or VIVAS Any missing data needs to be reported to make sure a child s record is up to date. 2.3.12 Children without a Medicare number ACIR and VIVAS will record immunisations for children who do not have a Medicare number. Following Medicare registration it may take several weeks before a Medicare number is allocated. 2.3.13 Children who are not Australian residents or citizens These children are eligible to receive funded vaccinations as per the National Immunisation Program. ACIR and VIVAS will record these immunisations. Complete ACIR immunisation history form. Fax or post to VIVAS. Note: Check with your local public health unit as they may require a copy of the original immunisation documentation. Complete ACIR immunisation history form. Fax or post to VIVAS. Complete a Queensland Health vaccination record form or print an immunisation record from medical software which includes: child s full name and address child s gender and date of birth vaccine details Medicare provider number Fax or post to VIVAS. Complete a Queensland Health vaccination record form or print an immunisation record from medical software which includes: child s full name and address child s gender and date of birth vaccine details Medicare provider number Fax or post to VIVAS Complete a Queensland Health vaccination record form or print an immunisation record from medical software which includes: child s full name and address child s gender and date of birth vaccine details Medicare provider number Fax or post to VIVAS 12

Immunisations for ACIR reporting method OR VIVAS reporting method 2.3.14 Pneumovax 23 vaccine (23vPPV) For Indigenous adults (aged 15 years and above) and medical-at-risk children (below 10 years of age). 2.3.15 Japanese encephalitis (JE) vaccine For Indigenous people and only administered to those who are resident of the Torres Strait Islands. Electronic transmission through Medicare Online and medical software. Note: Check with your medical software provider to make sure the software can transmit immunisation records for individuals above seven years of age. If the software is not able to transmit this information, complete a Queensland Health vaccination record form or print an immunisation record from medical software which includes: person s full name and address person s gender and date of birth vaccine details Medicare provider number Fax or post to VIVAS. Electronic transmission through Medicare Online and medical software. Note: Check with your medical software provider to make sure the software can transmit immunisation records for individuals above seven years of age. If the software is not able to transmit this information, complete a Queensland Health vaccination record form or print an immunisation record from medical software which includes: person s full name and address person s gender and date of birth vaccine details Medicare provider number Fax or post to VIVAS. Complete a Queensland Health vaccination record form or print an immunisation record from medical software which includes: person s full name and address person s gender and date of birth vaccine details Medicare provider number Fax or post to VIVAS. Complete a Queensland Health vaccination record form or print an immunisation record from medical software which includes: person s full name and address person s gender and date of birth vaccine details Medicare provider number Fax or post to VIVAS. Immunisation records and data explained: a guide for vaccine service providers 13

Immunisations for ACIR reporting method OR VIVAS reporting method 2.3.16 Revaccination of oncology patients From Lady Cilento Children s Hospital and up to the age of 18 years. Refer to the current edition of The Australian Immunisation Handbook for advice on additional vaccines for oncology patients. Revaccination will be funded as per recommendations from the oncology clinic. 2.3.17 Diphtheria/tetanus/ pertussis vaccination for pregnant women Queensland Health is currently (as at June 2015) providing a timelimited, funded dtpa vaccination program for women in their third trimester of pregnancy. Electronic transmission through Medicare Online and medical software. Note: Check with your medical software provider to make sure the software can transmit immunisation records for individuals above seven years of age. If the software is not able to transmit this information, complete a Queensland Health vaccination record form or print an immunisation record from medical software which includes: child s full name and address child s gender and date of birth vaccine details Medicare provider number Fax or post to VIVAS. Complete a Queensland Health vaccination record form or print an immunisation record from medical software which includes: child s full name and address child s gender and date of birth vaccine details Medicare provider number Fax or post to VIVAS. Complete the Queensland Health whooping cough vaccine program for pregnant women data collection and consent form. Forms can be ordered from QHIP. Fax or post to VIVAS 2.4 How to report other immunisation related information to ACIR or VIVAS? The table below provides directions about how to report other information related to immunisation to ACIR or VIVAS. Table 2 How to report other immunisation related information to ACIR or VIVAS Information about ACIR reporting method OR VIVAS reporting method 2.4.1 Aboriginal and/or Torres Strait Islander status It is recommended that ALL patients are asked Are you of Aboriginal and/ or Torres Strait Islander origin? You cannot rely on appearance; the only way to find out is to ask everyone. Aboriginal and Torres Strait Islander children require additional vaccines. Refer to the current immunisation schedule for additional vaccines for Indigenous children. Record status in patient notes. Indigenous status will only be recorded on ACIR if a parent or guardian notifies Medicare. Advise parents/guardians to notify Medicare of a child s Indigenous status. Record status on Queensland Health vaccination record form. 14

Information about ACIR reporting method OR VIVAS reporting method 2.4.2 Conscientious objection to immunisation For current information on exemptions for immunisation refer to the Immunise Australia website at www.immunise.health.gov.au/. Refer to 1.7 for more information. 2.4.3 Natural immunity Usually applies to varicella (chickenpox). There is no need for serology. Refer to the current edition of The Australian Immunisation Handbook for information on serological testing for varicella immunity. 2.4.4 Medical contraindication Refer to the current edition of The Australian Immunisation Handbook for information on reasons for medical contraindication. Refer to 1.7 for more information. Use an ACIR conscientious objection form (Appendix 9), completed and signed by parent and GP provider. Fax or post to ACIR. Note: Retain a copy for your own records and in the event the form is not lodged with ACIR. Submit in writing using practice letterhead stating that the child does not require a vaccination as they have natural immunity. Include the child s personal details. The letter must be signed by a GP provider. Fax or post to ACIR. Use an ACIR medical contraindication form (Appendix 8), completed and signed by GP provider. Fax or post to ACIR. Note: Retain a copy for your own records and in the event the form is not lodged with ACIR. 2.4.5 Deceased child Submit in writing using practice letterhead, include child s personal details and signed by a GP provider. Fax or post to ACIR. 2.4.6 Child aged under seven years on a catch-up schedule This puts a notification on the child s record which allows family assistance payments to be made. Refer to the current edition of The Australian Immunisation Handbook for advice on working out catch-up. Public health units may assist with catch-up schedules. 2.4.7 Child who has moved overseas This suspends the child s record and the child will not be flagged as overdue for immunisation. A VSP can also notify ACIR if a child returns from overseas as this will reactivate their ACIR record. 2.4.8 Adverse event following immunisation (AEFI) Call ACIR on 1800 653 809. Call ACIR on 1800 653 809. Submit in writing using practice letterhead, include child s personal details and signed by a GP provider. Fax or post to VIVAS. Notify Queensland Health of an adverse event by completing the adverse event following immunisation reporting form at www.health.qld.gov.au/ publications/clinical-practice/guidelines-procedures/aefi-reporting-form. pdf. Email to: CDIS-NOCS-Support@health.qld.gov.au or fax to 07 3328 9434 Immunisation records and data explained: a guide for vaccine service providers 15

Section 3: Checking Immunisation Records 3.1 Where to find immunisation records? 3.1.1 If you are a vaccine service provider Personal health record (PHR) or child health book (In Queensland it is commonly referred to as the red book.) Parents are provided with a PHR for a newborn prior to discharge from hospital. The PHR includes a section to record immunisations. Parents should be encouraged to bring the PHR to each immunisation appointment. ACIR VSPs can access ACIR s secure site to view a child s immunisation history. Refer to Appendix 11 and 12 for information about how to access. A VSP can print this history for a parent/guardian. VSPs can call ACIR to obtain a history. Public health unit (PHU) VSPs can contact their local public health unit to obtain a school immunisation history. Public health units may be able to provide childhood immunisation histories upon request. Staff at public health units are not able to give immunisation histories to parents/guardians. HPV Register (for HPV immunisation histories only) VSPs can telephone the HPV Register on 1800 478 734 Refer to Appendix 14 for information about the HPV Register 3.1.2 If a parent requires an immunisation record for their child Personal health record (PHR) Medicare/ACIR Parents are provided with a PHR (in Queensland commonly referred to as the red book ) for their baby prior to discharge from hospital. The PHR includes a section to record immunisations. Parents should be encouraged to bring the PHR to each appointment Parents/guardians of children aged less than 14 years can obtain a copy of their child s immunisation history by: 1. Using Medicare online accounts at www.humanservices.gov. au/customer/services/medicare/medicare-online-accounts 2. Requesting a statement at www1.medicareaustralia.gov.au/ ssl/acircirgcert. This will be sent in the mail. 3. Visiting their local Medicare office 4. Calling ACIR on 1800 653 809 Parents/guardians of children older than 14 years can contact ACIR on 1800 653 809 to request information. ACIR also sends history statements to parents/guardians of children aged 18 months of age and 5 years of age. O NOTE! Public health units cannot give immunisation histories directly to members of the public. Public health units can only give immunisation histories to a vaccine service provider. 16

3.2 Not sure your immunisation records are transmitting to ACIR? 3.2.1 Check your medical software VSPs use a range of software to manage their clinical and billing records. Each software package records patient details and medical information using its own specific format. VSPs are advised to consult their software provider for training and assistance with technical issues. To help troubleshoot electronic transmission problems, consider the following questions or check with the software provider: Can the software electronically transmit immunisation records to ACIR? If yes, do I need to turn on this function? How is this done? Can the software transmit all (children and adult) immunisation records to ACIR? If not, you will need to know how to report adolescent and adult immunisations. Refer to 2.3 for information. Are there any ways I can check that immunisation records have been transmitted to ACIR? How do I print a detailed list of immunisations given? Refer to section 1.2 for list of required information. Refer to Appendix 1 for a contact details for medical software vendors. R TIP! Do you use different clinical and billing software packages? If so, make sure the two are integrated otherwise immunisation records will not be transferred from the clinical module to the billing module. This will prevent immunisation data being transmitted to ACIR with your Medicare claims. Check with your medical software vendor for advice. 3.2.2 Check for error messages when records are transmitted Immunisation records are transmitted to ACIR in batches, usually with Medicare claims. Missing information in one record can prevent a batch from being transmitted to ACIR. These errors need to be corrected before the batch can be transmitted. Check for the following errors: missing Medicare numbers. Refer to 2.3.12 for information on reporting immunisations for children without a Medicare number incorrect Medicare provider number incorrect dose numbers missing postcode or errors in postal address R TIP! Is there any missing patient information, such as Medicare numbers or postcodes? Immunisation records will not transmit to ACIR without them. A child will be flagged on ACIR as not up to date. The parent may receive reminder letters from ACIR or be notified that family assistance payments could be suspended. Immunisation records and data explained: a guide for vaccine service providers 17

3.3 How to check if immunisation records have been transmitted to ACIR? R TIP! Use ACIR s secure site to check a child s immunisation history. ACIR s secure site can give you quick access to a child s current immunisation history. Refer to Appendix 11 about how to register. O NOTE! Is your access to ACIR s secure site blocked? If you enter the wrong username or password more than three times your access will be revoked. If you do not use the secure site for more than three months, your password will expire. To reset the password call ACIR s secure site help desk on 1300 650 039. Access to the secure site is through a GP Medicare provider number * the GP provider must notify ACIR and delegate authority to another person to allow ACIR help desk staff attend to your query. 3.3.1 Use ACIR s secure site Access ACIR s secure site to view a child s immunisation history and check if immunisations have been recorded. Refer to Appendices 11 and 12 for details on how to access and use the site. VSPs can request reports from ACIR s secure site which give a list of children due and/or overdue for immunisations for their practice or for individual providers. Refer to 3.4.3 for more details. 3.3.2 Use the ACIR payment statement GP providers 1 are paid $3.00 for reporting age-based 2 childhood immunisations to ACIR. The statement is sent every month to all GP providers and lists the immunisations reported to ACIR and payments made. Are all immunisations encounters accounted for? Report any missing encounters by calling ACIR s general enquiries line on 1800 653 809. Follow up any immunisations that have been rejected for payment. Errors can be corrected by calling ACIR s general enquiries line on 1800 653 809. Alternatively, write the details on the immunisation payment statement and fax it to ACIR. Refer to Appendix 1 for contact details. Appendix 10 shows a sample immunisation payment statement 3.3.3 Contact local public health unit The local public health unit may be able to provide information on immunisations given to individuals aged above seven years. 3.4 How to follow up children who are overdue for immunisation? The Royal Australian College of General Practitioners (RACGP) promotes reminders to initiate prevention, before or during the patient visit. They can be either opportunistic or proactive. 3 1 The ACIR immunisation payment is paid to the GP who reports either all or the last vaccine that completes an age-based immunisation schedule. 2 A completed age-based immunisation schedule must include an immunisation against each disease listed on the NIP. For example, a child at two months of age should receive vaccines for diphtheria, tetanus, pertussis, polio, hepatitis B, Haemophilus influenzae type b (Hib), pneumococcal and rotavirus to be considered as a complete age-based schedule. 3 Royal Australian College of General Practitioners (RACGP) 2006, Putting prevention into practice 2nd edition ( The Green Book ). 18

3.4.1 Queensland Health overdue reminder notice Sent to VSPs every eight weeks. Refer to Appendix 4 for a sample copy. Check these reminders against medical records. Do you need to report any new or missing data? Write on the reminder notice and return it along with any copies of relevant immunisation documents to local public health unit. Follow up with parents/guardians of children overdue for immunisation. 3.4.2 Reminders using medical software 1. Check with medical software provider about how to set up a reminder system. 2. Proactively send reminders by searching through the medical records (in your software) for a particular date of birth range, for example, children aged four years old. 3. Once a list is created, review the records for immunisation status to check for children overdue for scheduled immunisations. For example, four year old children should receive their fourth dose of scheduled vaccines however they may not have returned for follow-up since their last immunisation at around 18 months of age. A reminder will be important to prompt their parents that immunisations are required at this age point. 4. If any children have missed an immunisation, call or send a reminder letter to parents/guardians. Refer to Appendix 14 for a sample reminder letter. R TIP! Use the reminder system in the medical software to help keep track of scheduled immunisations. Set the reminder at each immunisation encounter to make sure prompts are made for future immunisation appointments. 3.4.3 Using ACIR reports VSPs can request the following reports from ACIR s secure site. These reports identify children who are either due or overdue for any scheduled immunisation. Available reports are: ACIR010A ACIR Due/Overdue practice report Lists children identified as not fully immunised 4 seen by the requesting practice. Available for all GPs in a practice registered with the Practice Incentives Program. MBS item numbers are used to link a child to a practice for the purposes of this report. Available electronically and can be requested once, monthly or quarterly. ACIR021A Due/Overdue report by Medicare GP Allows individual GPs (and other registered immunisation providers) to identify children not fully immunised based on Medicare Benefits Schedule (MBS) services provided by the practitioner. Can be sorted according to overdue immunisations against a particular disease, e.g. measles. Can be sorted based on location or multiple locations for the practitioner. Available electronically and can be requested once, monthly or quarterly. To request these reports, a VSP will need to have access to ACIR s secure site (refer to Appendix 11). The reports are then requested and are usually available for download from the secure site approximately 24-48 hours after the request is submitted. For assistance with accessing these reports, contact ACIR s secure site helpdesk on 1300 653 039. 4 According to National Due and Overdue Rules Immunisation records and data explained: a guide for vaccine service providers 19

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Section 4: Appendices Appendix 1 Contacts list Note: current at time of publication Queensland Health Telephone Facsimile Postal address Immunisation Program (07) 3328 9888 (07) 3328 9720 Reply Paid 2368 VIVAS (07) 3328 9398 (07) 3328 9434 Fortitude Valley BC 4006 Public health units Telephone Facsimile Postal address Metro North (Brisbane North) (07) 3624 1111 (07) 3624 1199 Metro South (Brisbane South) (07) 3176 4000 (07) 3000 9130 Cairns and Hinterland (includes Cape York and Torres Strait) (07) 4226 5555 (07) 4031 1440 Central Queensland (Rockhampton) (07) 4920 6989 (07) 4920 6865 Darling Downs (Toowoomba) (07) 4699 8240 (07) 4699 8477 Gold Coast (07) 5687 9000 (07) 5687 9113 Mackay (07) 4911 0400 (07) 4953 2031 North West (Mount Isa and Gulf) (07) 4744 7186 (07) 4744 7192 Sunshine Coast (07) 5409 6600 (07) 5443 5488 Townsville (07) 4753 9000 (07) 4753 9001 West Moreton (Ipswich) (07) 3818 4700 (07) 3818 4701 Wide Bay (Bundaberg) (07) 4303 7500 (07) 4303 7599 Wide Bay (Hervey Bay) (07) 4184 1800 (07) 4184 1809 Locked Bag 2 Stafford DC Qld 4053 PO Box 333 Archerfield Qld 4108 PO Box 1103 Cairns Qld 4870 PO Box 946 Rockhampton Qld 4700 PO Box 405 Toowoomba Qld 4350 PO Box 10363 Southport Business Centre Qld 4215 PO Box 5925 Mackay MC Qld 4741 PO Box 1097 Mount Isa Qld 4825 PO Box 577 Maroochydore Qld 4558 Locked Bag No 4016 Townsville Qld 4810 PO Box 188 Goodna Qld 4300 PO Box 185 Bundaberg Qld 4670 PO Box 724 Hervey Bay Qld 4655 Immunisation records and data explained: a guide for vaccine service providers 21

Australian Childhood Immunisation Register (ACIR) General enquiries Assistance with immunisation histories for parents and VSPs Stationary orders 1800 067 307 Telephone Facsimile Postal address 1800 653 809 (08) 9254 4810 GPO Box M933 Perth WA 6843 Secure site help desk 1300 650 039 Assistance with secure site (for VSPs) Web addresses ACIR s secure site Information for VSPs Information for parents/carers Stationary orders for VSPs www1.medicareaustralia.gov.au/ssl/acircirgseco www.humanservices.gov.au/health-professionals/forms/im006 Medicare Australia Telephone Web address ebusiness Service Centre 1800 700 199 www.humanservices.gov.au/health-professionals/subjects/ doing-business-online-for-health-professionals National HPV Vaccination Program Register Telephone Facsimile Web address Enquiries 1800 478 734 (03) 8360 8699 www.humanservices.gov.au/health-professionals/services/australianchildhood-immunisation-register/ www.humanservices.gov.au/customer/services/medicare/australianchildhood-immunisation-register www.hpvregister.org.au/healthprofessionals Medical software vendors Telephone Web address Best Practice (07) 4155 8800 www.bpsoftware.com.au Communicare Systems (08) 6212 6900 www.communicaresystems.com.au Genie Solutions (07) 3870 4085 www.geniesolutions.com.au GP Complete 1300 794 471 www.pmsc.com.au Medical Director/PracSoft 1300 788 802 http://medicaldirector.com MedTech 1800 148 165 www.medtechglobal.com/au PractiX 1300 364 747 http://practix.isofthealth.com Stat Health 1300 007 828 http://stathealth.com.au Zedmed 1300 933 000 www.zedmed.com.au 22

Appendix 2 Queensland Health vaccination record form VSP Number (e.g. BN 0000) AND Medicare Provider No. Doctor/Clinic Details (place stamp here) Surname Given Names Alias Surname Alias Given Names Date of Vaccination Vaccine/Antigen Dose Number Batch Number Infanrix hexa Rotavirus 1 1 2 2 3 3 4 Date of Birth Medicare Number Gender M F Ref No Prevenar 13vPCV MMR 1 2 3 4 1 2 3 Hib/MenCCV 1 2 3 Please Tick Box Aboriginal Aboriginal and TSI TSI Non Aboriginal or TSI Not Stated Hepatitis A MMR/Varicella dtpa/ipv 1 2 3 1 2 1 2 Residential Address Influenza 1 2 3 4 23vPPV (Pneumovax) 1 2 3 Telephone Number Birth Dose Hepatitis B Given: Date Given: Surname Given Names Alias Surname Alias Given Names Date of Birth Medicare Number YES Postcode Gender M F Ref No Varicella Hepatitis B dtpa (Boostrix) BCG Other 1 1 1 1 1 2 2 2 2 2 3 3 3 3 3 4 4 Date of Vaccination Vaccine/Antigen Dose Number Batch Number Infanrix hexa 1 2 3 4 Rotavirus 1 2 3 Prevenar 13vPCV 1 2 3 4 MMR 1 2 3 VACCINATION RECORD FORM Hib/MenCCV 1 2 3 Please Tick Box Aboriginal Aboriginal and TSI TSI Non Aboriginal or TSI Not Stated Hepatitis A MMR/Varicella dtpa/ipv 1 2 3 1 2 1 2 Residential Address Influenza 1 2 3 4 23vPPV (Pneumovax) 1 2 3 Postcode Varicella 1 2 3 Telephone Number Hepatitis B 1 2 3 dtpa (Boostrix) 1 2 3 Birth Dose Hepatitis B Given: YES BCG 1 2 3 4 Date Given: Other 1 2 3 4 ORIGINAL Forward every week to Queensland Health using VIVAS, CDU, REPLY PAID 2368, FORTITUDE VALLEY BC QLD 4006 Immunisation records and data explained: a guide for vaccine service providers 23

Appendix 3 Queensland Health registration of Medicare provider number/s Communicable Diseases Unit Registration of Medicare Provider Number/s On completion, return this form/s to QHIP, Communicable Diseases Unit, Queensland Health, PO Box 2368, Fortitude Valley BC 4006 or fax to (07) 3328 9720. PHOTOCOPY THIS FORM IF REQUIRED PLEASE PRINT CLEARLY Current VSP number of the practice Current name of practice registered on VIVAS Address of the above practice: Postal address: Practice Telephone No: Practice Facsimile No: Practice Email Address (if available): Please provide details below for doctors to be registered at the practice and/or doctors who are no longer working at the practice. (Please tick appropriate box.) PLEASE ENSURE DOCTOR S NAME IS AS REGISTERED WITH MEDICARE New Registration Commencement Date:../../. To be Removed 1. Doctor s Surname: Given Names: Medicare Provider Number New Registration Commencement Date:../../. To be Removed 2. Doctor s Surname: Given Names: Medicare Provider Number New Registration Commencement Date:../../. To be Removed 3. Doctor s Surname: Given Names: Medicare Provider Number New Registration Commencement Date:../../. To be Removed 4. Doctor s Surname: Given Names: Medicare Provider Number 24

Appendix 4 VIVAS overdue reminder notice Immunisation records and data explained: a guide for vaccine service providers 25

Appendix 5 How to complete an ACIR immunisation history form The immunisation history form is used for submitting: overseas immunisation history vaccinations administered by another VSP but have not been reported to ACIR. The history form can be downloaded or ordered from ACIR. Refer to Appendix 1 for contact information for ACIR stationary orders. Three copies are required and should be distributed to: Original copy Provider s copy Parents copy VIVAS PO Box 2368 Fortitude Valley BC Qld 4006 Or Fax: 07 3328 9434 Retain for your own medical records. This can be scanned into the child s medical file (or kept in the paper file if applicable). Give a copy to the parent/guardian for their records. Steps to complete the form: 1. Sight proof of immunisation before completing Part B (figure 1 below). 2. If the immunisations were given to the child while overseas, please mark an X in the If given overseas box (column on right side of the form). 3. If there is an error or an omission on the child s ACIR history, only report the immunisation details that are missing. This is most often used when updating information for children vaccinated in other states and the vaccination details are not on the child s ACIR record. 4. When recording vaccine details in Part B, if the vaccine brand name is unknown, then select other (please specify), for example use dtpa rather than Infanrix. This allows ACIR to identify the correct antigens and record the details on the child s record. Figure 1 26

5. In the event that there is no recorded evidence of a child s immunisation history, a decision may be made by the GP to choose the OR tick box option (figure 2 below). Note: Using this option will not update the child s history on ACIR as this option only allows family assistance payments to be made. It does not provide ACIR with an immunisation history and therefore there will be no vaccine details for the child on ACIR. It is strongly recommended that this option is only used after careful discussion with the child s parent or guardian. It does not eliminate the need for further assessment and a catch-up immunisation plan to bring the child up to date as per the National Immunisation Program. Figure 2 Immunisation records and data explained: a guide for vaccine service providers 27

Appendix 6 ACIR immunisation history form Australian Childhood Immunisation Register immunisation history form Part A Child s details Medicare number Ref no. Date of birth / / Male Female Family name First given name Initial CLAIM ID Address Postcode Part B Immunisation details Only immunisations that are not already recorded on the ACIR need to be included on this form. Recommended age Vaccines given (Please mark with an X) Date of immunisation Birth Engerix-B B HBVax ll B / / Infanrix 1 InfanrixHepB 1 Infanrix Hexa 1 Infanrix IPV 1 Infanrix Penta 1 / / Pediacel 1 Poliacel 1 Quadracel 1 Tripacel 1 / / IPOL 1 Oral Polio 1 / / Comvax 1 PedvaxHIB 1 / / Prevenar 1 / / 2 months 4 months 6 months Rotarix 1 RotaTeq 1 / / Other (please specify) / / Infanrix 2 InfanrixHepB 2 Infanrix Hexa 2 Infanrix IPV 2 Infanrix Penta 2 / / Pediacel 2 Poliacel 2 Quadracel 2 Tripacel 2 / / IPOL 2 Oral Polio 2 / / Comvax 2 PedvaxHIB 2 / / Prevenar 2 / / Rotarix 2 RotaTeq 2 / / Other (please specify) / / Infanrix 3 InfanrixHepB 3 Infanrix Hexa 3 Infanrix IPV 3 Infanrix Penta 3 / / Pediacel 3 Poliacel 3 Quadracel 3 Tripacel 3 / / IPOL 3 Oral Polio 3 / / Prevenar 3 / / RotaTeq 3 / / Other (please specify) / / M-M-R II 1 Priorix 1 / / Comvax 3 Hiberix 4 PedvaxHIB 3 / / 12 months Meningitec 1 NeisVac-C 1 Menjugate 1 / / Other (please specify) / / Varilrix 1 Varivax 1 / / 18 months Other (please specify) / / Infanrix 4 Infanrix IPV 4 Quadracel 4 Tripacel 4 / / IPOL 4 Oral Polio 4 / / 4 years M-M-R II 2 Priorix 2 / / Other (please specify) / / OR Immunisation history is not available but I believe the child identified on this form is age appropriately immunised or is following an approved catch-up schedule. Part C Immunisation provider s details and declaration Note: A recognised immunisation provider must complete and sign this section (e.g. GP, Council, etc.). Medicare provider/ ACIR registration number Telephone number ( ) Date next vaccination due / / Provider name I certify that the information provided on this form is true and correct, and that I have obtained proof of the vaccination(s) given. Date Provider s signature / / Please return this form to the Department of Human Services, GPO Box 295, HOBART TAS 7001 or your local Medicare Service Centre. For further information about the ACIR go to our website humanservices.gov.au/acir or call 1800 653 809. Note: Call charges apply from mobile phones. IMMU13.1302 If given overseas 28

Appendix 7 Resources to help interpret overseas immunisation histories 1. The World Health Organization provides an online tool (available at http://apps.who.int/immunization_ monitoring/globalsummary/schedules) which lists international vaccination schedules including antigens and their description. This can assist with identifying catch-up schedules for children from overseas where no health record is available. To use the tool: Step 1 Select the country of interest from the countries list Step 2 Click on select all vaccines Step 3 Click OK > a vaccination schedule for the chosen country will be provided. 2. The US Centers for Disease Control (CDC) provides a guide to foreign immunisation language terms (available at www.cdc.gov/vaccines/pubs/pinkbook/downloads/appendices/b/foreign-products-tables.pdf) Includes lists of: terms for vaccine preventable diseases, vaccines and other items that might be found on an immunisation record (by language) names of specific vaccines that are used, or have been used, internationally, along with the manufacturer and country or region (where known). This information can help with translating immunisation documents from other countries. Immunisation records and data explained: a guide for vaccine service providers 29

Appendix 8 ACIR immunisation exemption medical contraindication form Australian Childhood Immunisation Register Immunisation Exemption Medical Contraindication When to use this form Use this form if you are a recognised immunisation provider and would like to declare a child's vaccination exemption due to a medical contraindication. For more information For more information about the Australian Childhood Immunisation Register go to our website humanservices.gov.au/acir or email acir@humanservices.gov.au or call 1800 653 809 Monday to Friday, between 8.00 am and 5.00 pm, Australian Eastern Standard Time. Filling in this form Please use black or blue pen Print in BLOCK LETTERS Mark boxes like this with a or Returning your form Check that you have answered all the questions you need to answer and that you have signed and dated this form. Send completed form to: Australian Childhood Immunisation Register GPO Box 295 HOBART TAS 7001 or fax: 03 6281 0555 Privacy notice Centrelink, Medicare, Child Support and CRS Australia are all part of the Australian Government Department of Human Services (Human Services). Personal information held by Human Services is protected by law, including the Privacy Act 1988. The information provided on this form will be used by the Australian Childhood Immunisation Register to record details of vaccine exemption due to medical contraindication. Its collection is authorised by the Health Insurance Act 1973. This information may also be used by other areas within Human Services, disclosed to a parent or guardian of the stated child, and to authorised immunisation providers and bodies as authorised or required by law. Child's details 1 Medicare number 2 Family name First given name 3 Postal address Ref no. 4 Date of birth / / 5 Sex Male Female Vaccines exempt due to medical contraindication 6 Select one of the following: Comvax Menjugate Priorix Hiberix Meningitec Quadracel Infanrix Hexa NeisVac-C RotaTeq Infanrix IPV PedvaxHIB Rotarix Infanrix Penta Prevenar 13 Varilrix Other vaccine (specify below) Varivax The latest edition of the Australian Immunisation Handbook contains full details of contraindications to vaccination. Any adverse reaction to an immunisation should be reported to the relevant state or territory Health Authority. A list of telephone numbers is available in the Australian Immunisation Handbook. Provider declaration 7 I declare that: the child identified on this form should have a vaccine exemption due to a medical contraindication. The reason for contraindication may include one or more of the following: unstable neurological disease encephalopathy within 7 days after a previous vaccination immediate severe acute allergic or anaphylactic reaction after any previous vaccination malignant disease and/or immunosuppressive therapy and/or immunosuppression allergy to preservative or antibiotic contained in the vaccines OR the child has other non-permanent contraindication and vaccination is deferred to the following date: / / Medicare provider/australian Childhood Immunisation Register number Provider's signature Date / / Postcode IMMU11.1302 1 of 1 30

Appendix 9 ACIR immunisation exemption conscientious objection form (Note: From 1 January 2016 this form may no longer be available due to proposed changes to immunisation exemptions. Refer to 1.7.) Australian Childhood Immunisation Register Immunisation exemption conscientious objection form When to use this form This form must be completed by a recognised immunisation provider and the parent/guardian of the child. For more information For more information about the Australian Childhood Immunisation Register or for assistance completing this form go to our website humanservices.gov.au/healthprofessionals >Other programs >Australian Childhood Immunisation Register or call 1800 653 809 Monday to Friday, between 8.00 am and 5.00 pm, Australian Eastern Standard Time. Note: Call charges apply from mobile phones. Filling in this form Please use black or blue pen Print in BLOCK LETTERS Mark boxes like this with a or Returning your form Send the completed and signed form to: Department of Human Services GPO Box 295 Hobart TAS 7001 or fax: 03 6281 0555 Privacy notice Your personal information is protected by law, including the Privacy Act 1988, and is collected for a Social Security, Family Assistance, Medicare, Child Support and CRS purpose, depending on the service or payment concerned. This information may be required by law or collected voluntarily when you apply for services or payments. Your information is used for the assessment and administration of payments and services and may also be used within Human Services, or disclosed to other parties or agencies, where you have provided consent or it is required or authorised by law. You can get more information about privacy by going to our website humanservices.gov.au/privacy or requesting a copy of the full privacy policy at one of our Service Centres. Child s details 1 Medicare card number 2 Family name First given name Ref no. Initial 3 Postal address 4 Date of birth / / 5 Sex Male Female Provider declaration Postcode 6 I declare that: I have explained the benefits and risks associated with immunisation to the parent or guardian of the child named, and have informed him/her of the potential dangers if a child is not immunised. the information provided in this form is complete and correct. I understand that: giving false or misleading information is a serious offence. Medicare provider/acir registration number Signature Date / / Parent/guardian declaration 7 I declare that: I have discussed the benefits and risks of immunisation with the provider named above and have considered the information given. I have also been given the opportunity to discuss any concerns about immunisation with the provider. I have a personal, philosophical, religious or medical belief involving a conviction that vaccination under the National Immunisation Program should not take place. On this basis, I choose not to have my child immunised. the information provided in this form is complete and correct. I understand that: Giving false or misleading information is a serious offence. Parent/guardian name (please print) Signature Date / / IMMU12.1302 1 of 1 Immunisation records and data explained: a guide for vaccine service providers 31

Appendix 10 ACIR immunisation payment statement If not delivered return to GPO Box M933 Perth WA 6843 24 February 2009 Phone: 1800 653 809 (Call charges apply from mobile or pay phones only) Provider: 0000001K DR J CITIZEN FAMILY MEDICAL PRACTICE 123 ALPHABET LANE BRISBANE QLD 4000 Page 1 Immunisation payment statement For: February 2009 This statement contains information about your monthly Australian Childhood Immunisation Register (ACIR) information payments calculated using information recorded on the ACIR. Processing details Total encounters included in this statement 6 Number of encounters returned for clarification 2 Payment details 3 information payments $9.00 Total payment $9.00 Name of bank: Commonwealth Bank Account number: 123 456 789 Branch number (BSB): 001-001 Payment date: 24 February 2009 Medicare Australia ABN: 5174030967 More information If you have any questions about this statement, please contact us on 1800 653 809. Write: GPO Box M933 Perth WA 6843 Phone: 1800 653 809 Fax: 08 9254 4810 Web: www.medicareaustralia.gov.au Page 1 of 4 32

If not delivered return to GPO Box M933 Perth WA 6843 Phone: 1800 653 809 (Call charges apply from mobile or pay phones only) Provider: 0000001K Claims processed Below are the details of claims processed since your last statement. Page 2 Date of Medicare Date of ACIR Explanation Child name birth number service Vaccine Dose payment code Claim ID: X999828 Grey, Fred M 19 Jul 08 1111111111 1 22 Nov 08 Comvax 2 3.00 Infanrix IPV 2 Prevenar 2 Claim ID: T0000001 House, Cayden 10 Mar 07 1111111122 1 01 Apr 08 Priorix 1 3.00 Comvax 3 Claim ID: A089900 Smith, Jackson R 21 Jun 07 1222222222 3 02 Aug 08 Comvax 3 Priorix 1 3.00 NeisVac-C 1 Willow, Jen 15 Feb 08 1333333333 4 10 Aug 08 RotaTeq 3 850 Details of encounters that have been reported. If an immunisation encounter is rejected for payment, a code will be displayed in this column. Write: GPO Box M933 Perth WA 6843 Phone: 1800 653 809 Fax: 08 9254 4810 Web: www.medicareaustralia.gov.au Page 2 of 4 Immunisation records and data explained: a guide for vaccine service providers 33

If not delivered return to GPO Box M933 Perth WA 6843 Phone: 1800 653 809 (Call charges apply from mobile or pay phones only) Provider: 0000001K Please return to Medicare Australia Please clarify the claims below so that payment can be made. You may correct the details on this page and return it to Medicare Australia by: post GPO Box M933 Perth WA 6843 or phone the corrections 1800 653 809. Date of Medicare Date of Explanation Child name birth number service Vaccine Dose code Claim ID: J200003 Paper, Polly 01 Mar 07 1234567890 1 01 Apr 08 MMR II 1 Infanrix Hexa 1 PAID Comvax 3 101 Meningitec 1 Fraser, Mal 30 Dec 08 1234567891 3 01 Feb 09 Prevenar 1 300 Page 3 I certify that the changes indicated on this form are corrections to information previously supplied, and that the information which now appears on this form is true and correct. Name: Phone number: Signature: Write: GPO Box M933 Perth WA 6843 Phone: 1800 653 809 Fax: 08 9254 4810 Web: www.medicareaustralia.gov.au Page 3 of 4 If not delivered return to GPO Box M933 Perth WA 6843 Phone: 1800 653 809 (Call charges apply from mobile or pay phones only) Provider: 0000001K Explanation codes 101 The period between doses is less than the minimum reported 300 Duplicate this services has previous been reported to the ACIR 850 Vaccine not included in payment calculation Page 4 Write: GPO Box M933 Perth WA 6843 Phone: 1800 653 809 Fax: 08 9254 4810 Web: www.medicareaustralia.gov.au Page 4 of 4 34

Appendix 11 How to request access to ACIR s secure site? VSPs can access the immunisation history of an individual child and a range of immunisation reports through the ACIR secure area of HPOS (Health Professional Online Services). 1. Go to www.medicareaustralia.gov.au/hpos/index.jsp 2. Click on ACIR logon under Register (figure 1) 3. Complete details on Request Access screen. 4. Select Yes for email notification. 5. Click on Request Access. Figure 1 6. A notification letter from Medicare/ACIR will be sent advising of the access details, including the authentication file. This letter is posted to the practice address as registered with Medicare. The authentication file is an electronic file (htm format) that should be downloaded and saved to the VSPs computer network to allow relevant staff members to access ACIR s secure site. The authentication file is required each time a user wishes to log onto ACIR s secure site. Immunisation records and data explained: a guide for vaccine service providers 35

Appendix 12 How to log onto ACIR s secure site and find a child s record? VSPs can access the immunisation history of an individual child through the ACIR secure area of HPOS (Health Professional Online Services). Refer to Appendix 11 for information about how to set up access to ACIR s secure site. O NOTE! Ensure you have your authentication file, username and password available. O NOTE! If an incorrect password is entered three times, access will be revoked. You will need to contact the ACIR secure site help desk to have the password reset. 1. Go to www.medicareaustralia.gov.au/hpos/index.jsp 2. Click on ACIR logon only (figure 1) under Claim and payment services 3. At the logon screen (figure 2) select Browse. 4. Insert the authentication file. A pop-up box will appear requesting a username and password. Enter these details. 5. Select OK. 6. The Main Menu screen will open. From the list, select Identify Child. Figure 1 Figure 2 36

Figure 3 7. The Identify Screen (figure 3) will appear. To locate a child s record, required details are: surname and first name date of birth Medicare number (optional) (The child s reference number is not necessary) 8. At the next screen (figure 4) the child s Due Details and Immunisation History can be viewed by clicking on each one. The history can be printed from this screen (the steps required to print will depend on the software program being used.) Figure 4 Immunisation records and data explained: a guide for vaccine service providers 37

Appendix 13 Sample reminder letter (for VSPs) 38

Appendix 14 The HPV Register what you need to know The HPV Register supports the National HPV Vaccination Program by collecting information about HPV vaccine doses given across Australia. The Register can provide: completion and history statements reminders information should a booster be required in the future In Queensland, doses given through the School Immunisation Program and in general practice are reported to the HPV Register by VIVAS. The Queensland Health HPV vaccination register consent form (Appendix 15) allows immunisation information to be transmitted from VIVAS to the HPV Register. VSPs are advised to call the HPV Register on 1800 478 734 with questions regarding online access or to obtain an adolescent s immunisation history. VSPs can apply for online access to the register to: check immunisation status of patients request overdue reports which list patients who have incomplete HPV vaccination courses. Go to: www.hpvregister.org.au/health-professionals Immunisation records and data explained: a guide for vaccine service providers 39

Appendix 15 HPV vaccination register consent form A joint Australian, State and Territory Government initiative Human Papillomavirus (HPV) Vaccination Register Consent Form Statement about Personal Information The National HPV Vaccination Program Register was developed by the Australian Government (through the Department of Health and Ageing) to collect data about the HPV Vaccination Program. By completing all information below you are giving consent for your personal details to be sent to Queensland Health who will securely store and then forward the information to the Department of Health and Ageing who operates the National HPV Register. A new form will be completed for each dose of HPV vaccine you receive. All your details will be kept confidential. Only information that does not identify you will be used to evaluate the program. The purpose of the National HPV register is to: maintain accurate records allowing recall if doses are missed/overdue inform you if future studies suggest that booster doses are required measure the effectiveness of the vaccine in preventing cervical cancer by linking vaccination data to the Cervical Screening Register. Client Details Surname:... Date of birth: / / Given names:...... Medicare number: Ref no: Gender: Female Male Address:... Postcode:... Aboriginal Aboriginal and Torres Strait Islander(TSI) TSI Not Aboriginal or TSI Not stated/ Unknown Telephone number/s: (H)...(W)...(M)... Consent I have read and understand the information about the National HPV Vaccination Register. I understand this completed form will be forwarded to Queensland Health who will securely store my vaccination details and then provide the information from this form to the National HPV Vaccination Program Register. Signed:... Date:... /.../... Comments:... Provider Details Service Provider Use Only VSP No. Practice name:... Practice address:... Postcode:... GP Provider name:... Provider numbers: Batch number: Date of vaccination:... /... /... Dose Number: Original: Forward this form weekly to VIVAS, PO Box 2368, FORTITUDE VALLEY BC QLD 4006 Duplicate: Retain this copy for your records 2013 40

Abbreviations and Glossary Abbreviation Name Explanation ACIR AEFI AIH Australian Childhood Immunisation Register ACIR s secure site Adverse Event Following Immunisation (AEFI) Australian Immunisation Handbook, 10 th edition 2013 Child Care Benefit Child Care Rebate Due & Overdue Rules A national register administered by Medicare Australia that records details of immunisations given to children under seven years of age who live in Australia. ACIR s secure online system accessible by recognised immunisation providers. Go to: www.medicareaustralia.gov.au/hpos/index.jsp Any untoward medical occurrence that follows immunisation and does not necessarily have a causal relationship to the usage of the vaccine. 5 For information on reporting adverse events go to www.health.qld. gov.au/cdcg/index/adverse.asp Go to: www.health.gov.au/internet/immunise/publishing.nsf/ Content/Handbook10-home Paid by the federal government Department of Human Services to help with costs of approved child care. Parents will need to have had their children fully immunised, be on a recognised immunisation catch up schedule, or have an approved exemption to receive the payment. Used by ACIR to determine a child s immunisation status as either due or overdue for immunisation. Centrelink payments may be suspended for children determined to be overdue for immunisation. To download a copy go to: www.humanservices.gov.au/healthprofessionals/services/australian-childhood-immunisation-register/ HHS NHMRC NCIRS Family Tax Benefit (Part A Supplement) Fully Immunised Health and Hospital Service HPV Register National Health & Medical Research Council National Centre for Immunisation Research & Surveillance Paid by the federal government Department of Human Services to help with the cost of raising children. Parents will need to have their children fully immunised, be on a recognised immunisation catchup schedule, or have an approved exemption during the financial years that each child turns one, two and five years of age to obtain the payment for that period. A child who is vaccinated as per the National Immunisation Program schedule (exemptions may apply). For current criteria go to: www.humanservices.gov.au/customer/subjects/immunising-yourchildren#a5 Statutory bodies with responsibility for providing public sector health services in Queensland. National HPV Vaccination Program Register records immunisation data on human papillomavirus (HPV) immunisation. Promotes the development and maintenance of public and individual health standards. Provides information for vaccine service providers. Based at The Children s Hospital at Westmead in Sydney. Go to: www.ncirs.edu.au/ 5 The Australian Immunisation Handbook. 10 th edition. Canberra; Australian Government Department of Health, 2013 Immunisation records and data explained: a guide for vaccine service providers 41

Abbreviation Name Explanation NIP PHR National Immunisation Program Personal health record A federal government initiative that provides free vaccines to the Australian community through state and territory governments. For the current immunisation schedule go to: www.health.qld.gov.au/ publications/clinical-practice/guidelines-procedures/immunisationschedule.pdf May also be referred to as the red book a child health record provided by Queensland Health. PHU Public health unit Part of Queensland Health with responsibility for protecting health at a population/community level. RACGP SIP QHIP VIVAS VRF Royal Australian College of General Practitioners School immunisation program Queensland Health immunisation program Vaccine Information and Vaccination Administration System Vaccination record form Peak body for GPs, GP registrars and medical students. Develops the Standards for General Practice and provides education and training for general practice. A Queensland Health initiative that provides free vaccinations for adolescent children delivered through secondary schools. Responsible for implementing the National Immunisation Program in Queensland. A Queensland Health database that records immunisations for children as well as some vaccines given to adolescents and adults immunised in Queensland. Used to report immunisations to Queensland Health. Available from Queensland Health Immunisation Program. Call QHIP to order. VSP WHO Vaccine service provider World Health Organization Any healthcare service or provider that provides an immunisation service. The directing and coordinating authority for health within the United Nations system. 42

Index Aboriginal and Torres Strait Islander additional vaccines for Indigenous children... 14 and Japanese encephalitis vaccination... 7, 13 identifying as... 5 recording status... 14 recording status on VIVAS... 7 ACIR (Australian Childhood Immunisation Register)... 7, 41 contact details... 22 difference from VIVAS... 9 forms... 8 history statements for parents/guardians... 16 information sharing with VIVAS... 9 reports for VSPs... 19 ACIR immunisation history form how to complete... 26 sample copy... 28 ACIR immunisation payment statement for VSPs... 18 sample copy... 32 ACIR s Secure Site access blocked... 18 for checking a child s record... 16 for finding a child s record... 36 request access to... 18 Adverse event following immunisation (AEFI)... 15, 41 Approved exemptions to immunisation proposed changes from January 2016... 8 Australian Immunisation Handbook... 41 Batch numbers and recording an immunisation encounter... 7 recording by VIVAS... 6 Catch-up schedules... 12, 15, 41 Centrelink... 8 Children vaccinated overseas... 12 how to complete an ACIR immunisation history form... 26 recording hepatitis B dose numbers... 11 Common recording errors... 6 Conscientious objection to immunisation approved exemptions... 8 reporting to ACIR... 15 Deceased child, reporting to ACIR... 15 Dose numbers and accurate recording... 5, 6 checking for incorrect numbers... 17 hepatitis B birth dose... 11 hepatitis B given overseas... 11 Due & Overdue Rules, see ACIR (Australian Childhood Immunisation Register)... 41 Family assistance payments... 5, 8 and fully immunised... 8 and notifying ACIR of catch-up schedule... 15 child care rebate... 41 family tax benefit... 41 notification from Centrelink... 8 reason for payments being suspended... 8 Fully immunised, definition... 41 Hepatitis B children vaccinated overseas... 11 recording birth dose... 11 HPV Register contact details... 22 immunisation histories... 16 Queensland Health consent form... 40 Immunisation databases, see also ACIR and VIVAS... 7 Immunisation payments to VSPs... 18 Immunisation records, accurate recording of... 5 Immunisation records, where to find... 16 for parents/guardians... 16 for vaccine service providers... 16 Immunisation reminders from Queensland Health... 19 Queensland Health reminder, sample copy... 25 using medical software... 19 Immunise Australia website... 15 Indigenous, see Aboriginal and Torres Strait Islander... 14 Medical contraindication approved exemptions... 8 reporting to ACIR... 15 Medical software vendors list of vendors and contact details... 22 medical software issues... 17 Medicare Australia ebusiness Service Centre contact details... 22 Medicare numbers, missing,... 6, 17 see also children without a Medicare number... 12 Medicare provider number and immunisation records... 6 and recording an immunisation... 7 for accessing ACIR s Secure Site... 18 incorrect number... 17 notifying VIVAS of changes... 6 registration of Medicare provider number form, sample form... 24 Multivalent vaccines, accurate recording... 6 Immunisation records and data explained: a guide for vaccine service providers 43

Natural immunity, reporting to ACIR... 15 Oncology patients revaccination of... 14 Overseas immunisation histories ACIR immunisation history form, sample copy... 28 resources for interpreting histories... 29 see also how to complete an ACIR immunisation history form... 26 Personal health record (the red book)... 16 Public health units contact details... 21 giving immunisation histories... 16 QHIP (Queensland Health Immunisation Program) contact details... 21 Reminders as defined by RACGP... 18 Reporting immunisations for specific groups... 9 adolescents... 10 children... 9 children without a Medicare number... 12 non-residents or non-australian citizens... 12 refugees... 10 revaccination for oncology patients... 14 Reporting related information... 14 adverse event following immunisation (AEFI)... 15 child on a catch up schedule... 15 conscientious objection to immunisation... 15 deceased child... 15 medical contraindication... 15 natural immunity... 15 Vaccine service provider... 4, 42 VIVAS (Vaccine Information and Vaccination Administration System)... 7, 42 contact details... 21 difference from ACIR... 9 forms... 8 sharing information with ACIR... 9 World Health Organization... 42 resources for interpreting histories... 29 44