Opportunities taken: The need for and effectiveness of secondary care opportunistic immunisation

Aim:  To evaluate the effectiveness of a formalised opportunistic immunisation (OI) system in a hospital setting. Methods:  Pre–post implementation audit of missed immunisation opportunities. Results:  Of 5583 children in the National Immunisation Register cohort seen in a hospital setting, 1641 (29.4%) were under-immunised, compared with the concurrent regional cohort of 15%. Māori children were less likely to be age-appropriately immunised (36.9% under-immunised, P < 0.0005, χ2= 41.4). Of the 1641 under-immunised children, 337 (20.5%) were deemed to have current medical reasons not to be immunised acutely, and of the remaining 1304, 244 (18.7%) declined immunisations. This left 1060 for whom immunisation was possible, and we immunised 880 (83.0%) of these. All children were re-engaged with primary care services. Conclusions:  Children in contact with secondary care services have low immunisation rates with ethnic disparity. Appropriately resourced formalised OI is effective, with potential for further improvement. The system we have implemented enhances primary care involvement.