The six regional LHNs are the largest aged care providers in regional SA. In the past, aged care facilities have relied heavily on primary care – GPs have been relied upon to administer NIP vaccines for aged care residents. Access to GPs in rural and remote communities has been limited due to demands on their service provision. This was recognised to be a barrier to achieving good vaccination coverage of residents in aged care facilities. Staff in aged care facilities were upskilled to administer vaccines. Staff completed immunisation training recognised under legislation. Staff were provided access to the Australian Immunisation Register (AIR) to record immunisations on the Register. Consent and declination information were recorded. Resources were developed to support staff to deliver the program. A central resource and contact point was provided for staff to access for timely and relevant information.

Many clinicians involved in childhood vaccine administration encounter individuals who are difficult to manage due to psychological or behavioural issues. Anecdotal evidence would suggest that this population is rising, in line with the increasing number of children diagnosed with anxiety and autism spectrum disorder. Some clinicians, such as General Practitioners and Paediatricians provide simple oral sedation to manage such patients, but this is not always successful, available, or feasible.

The Paediatric Sedation Service at the Women’s and Children’s Hospital, Adelaide was created when the ad hoc efforts by the Anaesthetic and Allergy/Immunology Services to vaccinate psychologically and behaviourally challenging children were supercharged by the Covid 19 pandemic.

In this talk we will share our experience from a predominantly nurse-led service that is now sedating over 100 patients a year for vaccinations. It will focus on how we manage patient flow through the service and what we do when non-pharmacological measures fail.

Post-COVID, routine adolescent vaccination coverage rates have been steadily declining- could this imply people are less engaged with adolescent immunisation services?

To answer this question, I will discuss how engagement with adolescent vaccination should not be seen as simply vaccine acceptance but as an active, two-way relationship between adolescents, families, and immunisation providers.

Drawing on research conducted by the National Centre for Immunisation Research and Surveillance (NCIRS) and the available literature, I will present evidence on what is (or isn’t) facilitating health user engagement with routine adolescent vaccination, and outline how we may need to re-think current approaches and embrace new strategies within the immunisation ecosystem.

With changes to adolescent vaccine schedules, re-engagement strategies are possible and have the potential to increase uptake in the long term. This type of change requires both systemic and community efforts though, especially to rebuild trust and develop authentic and long-term healthcare relationships with parents, carers and communities.

Background - Individuals with severe anxiety, disability and neurodiverse conditions may be difficult to vaccinate in the community. These individuals often have greater health needs, may have experienced multiple unsuccessful vaccination attempts resulting in missed or incomplete vaccines, with highly motivated families.

Approach - An increase request for assistance from families and immunisation providers, prompted the development of a tired structured approach.

Tier 1: vaccination in the community no additional support required

Tier 2 is stratified incorporating a combination of non-pharmacological (2a) and pharmacological (2b) interventions utilising simple procedural sedation

Tier 3: immunisation is clustered with other simple medical interventions (eg. blood collection) requiring procedural sedation in a tertiary setting.

Tier 4: substantial pharmacological support clustered medical interventions in a tertiary setting

An individualised plan with reasonable adjustments is devised following a pre assessment telehealth. Utilising resources like visual aids, sensory-friendly spaces, and flexible scheduling can make the experience more comfortable for children with disabilities, helping to ease any anxieties they may have.

Conclusion - Working together with families while creatively utilising available resources, is crucial in ensuring that children with disabilities are vaccinated. Collaborative efforts that incorporate both innovative strategies and compassionate care empower children with disabilities to access vital vaccinations, ensuring their health and well-being in a supportive and inclusive environment.