Parents should be paid to immunise - report

The Ministry of Health should look into paying parents to encourage them to vaccinate their children, a report into New Zealand's lagging immunisation rates says.

The proposal is one of 30 outlined in a parliamentary report released yesterday following a health select committee inquiry into improving rates of childhood immunisation.

New Zealand's immunisation rates against deadly diseases such as measles are poor compared with other developed countries.

Only 88 percent of children are fully immunised by the age of two, which falls short of the 95 percent needed to ensure the population is safe from disease.

The report ruled out making immunisation compulsory but directed the Ministry of Health to consider immunisation incentive payments to parents, or linking existing parental benefits to immunisation.

The current incentive scheme offers payments to primary health organisations for reaching certain immunisation targets but no direct payments to parents.

In Australia, parents on any income are eligible for two payments of $A122.75 ($NZ166.91) if they ensure their children have met immunisation schedule requirements by certain ages.

There, immunisation rates of one-year-olds increased from 75 percent in 1997 to more than 90 percent in 2004. However, the rate drops to 83 percent by the time children are four.

Immunisation and child health experts in New Zealand are reserved about the incentive proposal.

Helen Petousis-Harris, a researcher at Auckland University's Immunisation Advisory Centre (IAC), said there were other improvements that could be made before introducing an incentive.

That included further work on making sure primary care practices were reimbursed properly for delivering immunisations, and removing barriers that prevented people seeing doctors.

Mrs Petousis-Harris noted the Australian reimbursement scheme was part of a broader package, rather than being introduced in isolation.

"They implemented a whole lot of things at once, including reimbursing parents when they made a decision about immunisation.

"It wasn't based on whether they immunised or not but just making the decision to immunise. I think that was the key point - it's important people make a decision."

Plunket clinical advisor Alison Hussey said she was not familiar enough with the evidence on incentive payments to comment but added that progress on immunisation rates had been made in recent years by reaching out to families.

"Our view would probably be that when we're thinking about improving rates, we need to look at what's been happening recently and think about how we can keep improving those sort of approaches that do seem to be working."

The report said immunisation rates for under-twos had improved markedly in recent years but made a number of suggestions to strengthen existing immunisation programmes, including:

* The Ministry of Health immediately adopt a 95 percent immunisation target for all under-fours and improve the national immunisation register;

* the ministry hold district health boards accountable by aligning funding and contracting arrangements to immunisation rates;

* communications about immunisation be tailored to parents rather than organisations; and

* the ministry implement the IAC's "six star plan", which aims to strengthen and expand existing immunisation programmes at an estimated cost of $2.14 million.

Health select committee chair Paul Hutchison said immunisation was a highly effective strategy for preventing infectious diseases but there was no silver bullet.

"For too long completion rates of immunisation for New Zealand children have been unacceptably low and I am optimistic the select committee's recommendations will be taken seriously," Dr Hutchison said.

Ministry of Health acting manager of immunisation Kim Albrecht said the Government had 90 days to formally respond to the report.

"The ministry's views will be considered in preparing that response, and we will be able to comment once this process is complete."