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April 2020 COPMM newsletter

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Immunisation Update

Influenza vaccination 2020

The Tasmanian Government will again ensure free influenza vaccine is available for all children in Tasmania aged six months to less than five years under the NIP in 2020. All Aboriginal and Torres Strait Islander people from 6 months of age are eligible for free vaccine.

National Immunisation Program (NIP) changes for 2020:

  • There are no longer any 0.25ml doses for children. All vaccines are 0.5ml.
  • All influenza vaccines on the NIP in 2020 are quadrivalent.
  • FluQuadri® and Fluarix Tetra® should be prioritized for NIP-eligible medically at-risk patients but can be given from 6 months of age.
  • Vaxigrip Tetra® (Sanofi) should be prioritised for the universal 6 months to 5-year programme but can be used for people from 6 months of age.
  • Afluria Quad (Seqirus) for people aged 5 years and older.

Vaccine timing

  • Influenza vaccine is typically recommended to be given from mid-April, to ensure optimal protection at the expected peak of influenza season (August/September).
  • However, in 2020, the COVID-19 pandemic is presenting additional logistic challenges and influenza vaccine should be given as soon as it is available (from April onwards).
  • There is no evidence for the effectiveness or safety of giving two influenza vaccines in one season, except in very specific circumstances (e.g., in children under 9 years receiving vaccine for the first time, and post-transplant). Giving a “booster” dose later in the season is not currently recommended.

Vaccinations during pregnancy

  • Influenza vaccine is recommended as a routine part of standard antenatal care. It can be safely given at any stage during pregnancy and is best given prior to influenza season.
  • Pertussis vaccination is recommended between 20- and 32-weeks gestation (mid 2nd trimester to early 3rd trimester) in each pregnancy.
  • Videos and brochures for patients are available on the Australian Government's Influenza and pertussis (whooping cough) vaccination in pregnancy website

Further information and resources

Pepi-Pod Sleep Space in Tasmania

As part of a statewide strategy to protect the safety and wellbeing of babies, the government is funding a trial of the Pepi-Pod Sleep Space to provide a safe sleeping space for babies, prevent accidental suffocation and reduce the rate of Sudden Unexplained Death in Infancy (SUDI). The trial was launched at the Royal Hobart Hospital in late February 2020 and commenced in March 2020 with the young mothers and complexed care. This trial has been coupled with a safe sleep education programme, complimenting safe sleep advice already underway across the state. The Pepi-Pod Sleep Space is a portable baby sized module and includes a cover, fitted mattress, sheets and a merino blanket and is targeted at babies not yet mobile, generally used up to five months.

The Pepi-Pod Sleep Space programme is an evidence-based programme originating in New Zealand that has been shown to reduce the rate of SUDI in that country. It is being trailed in a variety of sites nationally and internationally. As part of a six-month trial, it has been planned to distribute 100 Pepi-Pods to Tasmanian women attending specialised antenatal clinics. Feedback from staff and parents will be used to evaluate the trial and inform decisions about any future rollout of the Pepi-Pod Sleep Space or an alternate safe sleeping programme across the state. The aim of the trial is to ensure the early identification of vulnerable babies and infants and provide appropriate support to their parents and family members.

Committees of COPMM

PAEDIATRIC Mortality and Morbidity

This Committee continues to be chaired by Dr Michelle Williams. In view of the current COVID-19 situation, meetings of this Committee will be deferred in order to enable our clinical members to continue to consolidate their invaluable time, focus and efforts to essential frontline duties. As such, out-of-session discussions will be undertaken where possible to continue to help progress the review and classification of statewide paediatric death cases as they arise. The previously scheduled face-to-face meeting of the Australian and New Zealand Child Death & Prevention Group (ANZCDRPG) in Sydney on April 30th to May 1st, 2020 has been cancelled due to the escalation of the COVID-19 pandemic.

PERINATAL Mortality and Morbidity

The Committee chaired by Professor Dargaville continues to recommend that Tasmania’s private hospitals use PSANZ guidelines to report on perinatal cases to provide COPMM with more comprehensive information on reported stillbirth cases as required. As noted previously, the Tasmanian Perinatal Data Collection Form has been updated and available for reference and use via the COPMM website.

Clinicians who are undertaking the review of cases are advised that the PSANZ Clinical Practice Guideline for Perinatal Mortality (Second Edition Version 2.2, 2009) has been updated to the Third Edition Version 3.1 in March 2018. Clinicians are requested to use the Third Edition Version 3.1 for classification of all perinatal deaths from 2019 onwards.

MATERNAL Mortality and Morbidity

This Committee that is chaired by Associate Professor Amanda Dennis is currently finalising its 2018 Committee Report as well as progressing the review and classification of maternal death cases reported in Tasmania in 2019. Progress of the Australian Maternity Outcomes Surveillance System (AMOSS Project) will continue to be tracked and its relevance to Tasmania’s reporting assessed etc.

Data Management

Now that perinatal data for 2018 has been finalised, the Data Management Committee’s Working Group is currently progressing the latest COPMM Annual Report with a view to have this report tabled in Parliament later in 2020 (if possible). The Chair of this Committee and members of the Working Group met with members of the Tasmanian Clinical Genetic Service earlier this year in February 2020 to discuss issues around the development of a more comprehensive Tasmanian Congenital Abnormality Register. It was agreed that Tasmania currently offered a very limited collection with congenital anomalies often missed. Council has supported this Committee’s proposal to await the development of a national congenital anomalies data collection before pursuing the development of a modified Tasmanian Congenital Register. The Committee will therefore continue to monitor national developments in the Congenital Abnormality Registers.

This Committee through the support of Council has also sought to include a question on maternal education status on the Tasmanian perinatal data collection form and the ObstetrixTas system for future collection. The Commissioner for Children & Young People has recently highlighted her latest report Investing in the Wellbeing of Tasmania’s Children and Young People (Feb 2020) to illustrate the lack of consistent data on numerous indices of childhood well-being (including education) and the need to access consistent population-based data to inform strategies for change.

Council News

As outlined previously, Council’s latest Annual Report is currently being progressed by members of the Data Management Committee’s Working Group with a view to have it tabled in Parliament late-2020 depending upon the COVID-19 situation. It is expected that the Progress Against Actions report in response to the last year’s tabled COPMM Annual Report will now be delayed due to the current pandemic crisis. It will be progressed and submitted to the Health Minister for consideration in due course.

Membership for the current term (May 2019- May 2022) in accordance with the Terms of Reference includes:

  • Dr Michelle Williams (Chair- Paediatrician & RACP rep)
  • Professor Peter Dargaville (employed in the delivery of Neonatal Services)
  • Dr Anagha Jayakar (UTAS rep)
  • Associate Professor Amanda Dennis (UTAS Rep)
  • Dr Jill Camier (RACGP rep)
  • Ms Kate Cuthbertson, Barrister at Law (Council nomination)
  • Ms Sue McBeath (ACMTas rep)
  • Dr Tania Hingston (RANZCOG rep)
  • Dr Scott McKeown (Department of Health Representative) and
  • Commissioner for Children and Young People, Ms Leanne McLean.

The Council meeting scheduled to be held in May 2020 will be suspended and the timing of future quarterly meetings in 2020 will be adapted according to the COVID-19 situation. In the meantime, the COPMM Manager will continue to update and seek member input on significant issues relevant to the activities of Council as they arise.

The Council website continues to archive newsletters, Annual Reports and other relevant resource information. Enquiries: To Manager, Dr Jo Jordan; email: [email protected].

Wishing all Readers good health and extra safety during these unprecedented times and an inspired Easter sojourn with your loved ones at home!

Learn more about the Council of Obstetric and Paediatric Mortality and Morbidity (COPMM)

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