The challenge of improving immunization coverage: The New Zealand example

Immunisation Advisory Centre, University of Auckland, PO Box 17360, Greenlane, Auckland 1051, New Zealand. .
Expert Review of Vaccines (Impact Factor: 4.21). 01/2012; 11(1):9-11. DOI: 10.1586/erv.11.157
Source: PubMed
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    ABSTRACT: New Zealand continues to grapple with poor and inequitable child health and wellbeing outcomes. The associated high economic costs, the long-term impact on adult health and New Zealand's international children's rights obligations provide further grounds for action. Although there have been many different reports offering solutions and some key areas of progress, gains have been limited and there has not been sufficient clarity and agreement on wider actions. The environment is complex and solutions cross agency and disciplinary boundaries. This paper reviews the current situation and proposes a set of actions to improve child health and equity. These include a group of recommendations on high-level leadership and coordination, actions to address social conditions, and a range of specific health and wellbeing actions. Progress will require the will, commitment and courage of many to acknowledge the issues and find a way forward. Preventing suffering and ensuring the wellbeing of our youngest citizens during their formative years is an ethical issue for our nation, an issue of what we value as a society, and the best investment for a highly productive, innovative and resilient nation for the future.
    Full-text · Article · Mar 2012 · The New Zealand medical journal
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    ABSTRACT: New Zealanders can now reflect on and celebrate 50 years of polio elimination in this country. This success was followed by eliminating two other infectious diseases, brucellosis and hydatids, and an imported potential disease vector, the southern saltmarsh mosquito. However, this country has made inadequate progress in eliminating several other vaccine-preventable diseases. These include measles, mumps, and rubella, which are priority candidates for elimination, and potentially Hib disease and rotavirus infection. To achieve such successes almost certainly requires that the country: (i) builds national leadership for elimination goals; (ii) develops detailed plans; (iii) continues recent successes in enhancing routine vaccination coverage; (iv) introduces rotavirus vaccine into the childhood immunisation schedule; and (v) strengthens surveillance and research (on such questions as the cost-effectiveness of new vaccines, measures to enhance uptake, and effective border controls to reduce the risk of disease importation).
    No preview · Article · Nov 2012 · The New Zealand medical journal
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    ABSTRACT: This paper argues that significant aspects of the vaccination debate are 'deep' in a sense described by Robert Fogelin and others. Some commentators have suggested that such disagreements warrant rather threatening responses. I argue that appreciating that a disagreement is deep might have positive implications, changing our moral assessment of individuals and their decisions, shedding light on the limits of the obligation to give and respond to arguments in cases of moral disagreement, and providing an incentive to seek alternative ways of going on in the face of intractable moral disagreement. Non-coercive, non-reasoned strategies have been used or recommended to increase vaccination rates. Such strategies look problematic when judged by the standards of ideal moral and rational argumentation, but more acceptable if seen as responses to deep disagreements.
    No preview · Article · Oct 2013 · HEC Forum