Legislation for school entry immunisation certificates in Victoria.

: In 1982 the National Health and Medical Research Council recommended that every state introduce legislation requiring immunisation certificates at school entry. Victoria was the first state to enact such legislation. This paper explores the process and difficulties encountered in achieving this legal requirement, describes the requirements under the legislation as it was finally introduced, and examines the early data available to the state health department regarding its implementation. Compliance with the legislation and immunisation status of children enrolling in government primary schools were ascertained from mid-year census data. In 1992 almost 90 per cent of children complied with the legislation, but because 10.2 per cent of children did not present a certificate it was possible to estimate only the lower limit of statewide coverage at 85 per cent against the prescribed diseases. School entry immunisation legislation may provide an important safety net to identify children with incomplete immunisation. However, the effectiveness of the legislation in Victoria remains unproven, and the requirements of the legislation are demanding for parents, local councils, and schools. The failure to document immunisation status in over 10 per cent of children indicates that further efforts to increase compliance are needed. This will require information on the vaccination status of those without certificates and the reasons they have not complied. The impact of the legislation needs further evaluation, although it may be years before its effectiveness can be gauged. Its effectiveness may depend upon enforcement of the requirement to exclude unimmunised children in disease outbreaks.