The Royal Hobart Hospital (RHH), Launceston General Hospital (LGH) and Northwest Regional Hospital (NWRH) have joined the Every Week Counts: National Preterm Birth Prevention Collaborative (‘the Collaborative’) with 62 other hospitals Australia wide.

The Collaborative is part of an historic world-leading initiative, funded by the Commonwealth Government. It aims to improve health outcomes for women and babies by safely reducing preterm and early term birth by 20 per cent by March 2024.

Tasmanian update

In 2018, the Royal Hobart Hospital, as the tertiary referral hospital, implemented the nationally endorsed seven key strategies to prevent preterm birth. In 2020, Tasmanian data demonstrated a reduction of preterm birth by the adoption of evidence-based changes in clinical care. The aim of this project, through ongoing collaboration, is to maintain our reduction in preterm birth, and to reduce it further.

Support of Tasmania’s clinical community is integral for the Collaborative to achieve its objective in reducing preterm and early term birth rates safely over the next 18 months. There are also educational events and networking opportunities covering topics including key strategies to prevent preterm birth in Tasmania, Tasmania’s participation in the Collaborative, and what clinicians can do to improve the health of women and babies.

Mandatory Reporting of Perinatal Death Cases in Tasmania

As part of legislative requirements, clinicians must report details of any perinatal death cases in their care. COPMM has recently endorsed the use of the new Australian Perinatal Mortality Audit Tool in line with national standards. This form replaces the National Perinatal Death Clinical Audit Tool (NPDCAT). The new form is longer, but has a clearer and easier format to follow.

Australian Perinatal Mortality Audit Tool

Clinicians in Tasmania must complete and submit the new Australian Perinatal Mortality Audit Tool following all reported perinatal death cases.

Download the Australian Perinatal Mortality Audit Tool

If you have any data queries, please email pppr.perinataldata@health.tas.gov.au.

Email your completed form to pppr.perinataldata@health.tas.gov.au (preferred) or post to:

Health Information Monitoring, Reporting and Analysis Unit
Policy, Purchasing, Performance and Reform Group
Department of Health
GPO Box 125
Hobart TAS 7001

Australia and New Zealand Child Death Review and Prevention Group

The Australia and New Zealand Child Death Review and Prevention Group (ANZCDR&PG) was established in 2005 and forms a collaboration of all state and territory child death review teams across Australia and New Zealand.

Latest statistics

ANZCDR&PG recently released its latest report detailing Australian and New Zealand Death statistics based on available 2020 jurisdictional data. Some of the key trends from the analysis of child deaths during 2020 include:

• Infants (children under one year) had the highest rates of child deaths in all jurisdictions, accounting for 60 per cent of all child deaths in Australia.
• Child mortality rates varied between 19.7 and 81.1 per 100,000 population aged 0 to 17 years.
• Infant mortality rates varied between 1.8 and 8.3 per 10,000 live births.
• Indigenous child mortality rates were 1.5 to 3.9 times higher than non-Indigenous child mortality rates.
• Deaths from diseases and morbid conditions accounted for 69 per cent of all child deaths.
• Suicide was the leading external cause of death in five jurisdictions. In three of the jurisdictions transport and suicide were equal leading causes. Transport was the leading external cause in South Australia and Western Australia.
• The rate of infant deaths from Sudden Infant Death Syndrome (SIDS) and undetermined causes ranged between 0.16 and 0.52 per 1,000 live births.

Immunisation update

Influenza vaccination 2023

• Annual influenza vaccination is recommended and funded for all children aged from 6 months up to 5 years, and all adults aged 65 years or over.
• Annual influenza vaccination is also recommended for all people aged between 5 and 65 years of age, but only funded in the following specific populations in this age group due to their increased risk of complications from influenza. This includes pregnant women (during any stage of pregnancy), all Aboriginal and Torres Strait Islander people, and people who have certain medical conditions.
• Annual vaccination, especially among these at-risk cohorts, is the most important measure to prevent influenza and its complications.

National Immunisation Program (NIP) in 2023

• All influenza vaccines on the NIP in 2023 are quadrivalent.
• Fluarix Tetra® and Vaxigrip Tetra® can be given from 6 months of age.
• Afluria Quad (Seqirus) can be given to people aged 5 years and older.
• For adults aged 65 years and over, the adjuvanted FluadQuad is recommended over standard quadrivalent influenza vaccine, for a stronger immune response in this cohort.

Vaccine timing

• Annual vaccination should ideally occur before the onset of each influenza season.
• The period of peak influenza circulation is typically June to September in most parts of Australia. In 2022, as international travel resumed, Australia observed a resurgence of influenza with an early season commencement.
• During 2023, influenza epidemiology may be atypical, particularly in the context of COVID-19. Vaccination is the most important measure to prevent influenza and its complications.
• While protection is generally expected to last throughout the year, the highest level of protection occurs in the first 3 to 4 months after vaccination.
• Vaccination should continue to be offered as long as influenza viruses are circulating, and a valid vaccine (before expiration date) is available. Some vaccine brands have an expiry date of February 2024.
• If a person had a 2022 influenza vaccine in late 2022 or early 2023, they are still recommended to receive a 2023 formulation of influenza vaccine when it becomes available (from late March 2023).

Vaccination during pregnancy

• Influenza vaccine is recommended as a routine part of standard antenatal care. Pregnant women and young infants are at increased risk of severe illness from influenza. Vaccination provides protection directly to the mother and indirectly to the developing fetus.
  • Influenza vaccine is recommended in every pregnancy and at any stage of pregnancy.
  • For women who received an influenza vaccine in 2022, it is recommended to also get the 2023 influenza vaccine if it becomes available before the end of pregnancy.
  • For women who receive influenza vaccine before becoming pregnant, revaccination is recommended during pregnancy to maximise the protection of the mother and the infant in the first six months of life.
• Consider influenza vaccination a prompt for other important vaccinations in pregnancy, including pertussis and COVID-19 vaccines.
  • Influenza vaccine can safely be given at the same time as a pertussis vaccine and/or COVID-19 vaccine.
  • Pertussis vaccination is recommended between 20 and 32 weeks gestation (mid 2^nd trimester to early 3rd trimester) in each pregnancy.
  • Pregnant women are recommended to receive a primary course of COVID-19 vaccine if not previously received. Pfizer original 12 years or older formulation (purple cap) is the recommended vaccine for a primary course in pregnant women due to the substantial data on its safe use in pregnancy. Pregnant women who have completed a primary course should discuss with their immunisation provider whether a booster dose is required during their pregnancy. Pregnancy is not currently considered a risk factor for severe illness in a woman who has already completed a primary course and booster and who does not have any medical risk conditions.

Further information and resources

• ATAGI advice on seasonal influenza vaccines in 2023
• ATAGI 2023 booster advice
• Australian Immunisation Handbook
• Clinical recommendations for COVID-19 vaccines
• COVID-19 vaccination – Shared decision making guide for women who are pregnant, breastfeeding or planning pregnancy
• Immunisation
• Influenza and pertussis (whooping cough) vaccination in pregnancy (brochures and videos) 
• Influenza fact sheet (National Centre for Immunisation Research and Surveillance)
• Vaccine safety surveillance updates from AusVaxSafety

Release of new out-of-home care report

Out-of-home care is overnight care for children and young people under 18 who can’t live with their families due to a range of child safety concerns, including having lost their parents. 

The Commissioner for Children and Young People (Tasmania) recently released the latest out-of-home care report (Monitoring Report No. 2: Key Data on Tasmania’s Out-Of-Home Care System, 2020-2021). At the report launch, the Commissioner called for greater transparency in the operation of Tasmania’s out-of-home care system.

Learn more about the latest out-of-home care report and key findings

Latest findings from The Australian Child Maltreatment Study (ACMS)

The Australian Child Maltreatment Study (ACMS) randomly surveyed 8,503 randomly selected Australians (aged 16 to over 65 years), including an oversample of 3,500. They generated the first nationally representative rates of all five types of child maltreatment (physical abuse, sexual abuse, emotional abuse, neglect, and exposure to domestic violence) and their associated outcomes in Australia. The findings have been alarming, showing that child maltreatment is widespread among Australians and, as such, underscores the need to develop a coordinated long-term plan for generational reform.

Learn more about the Australian Child Maltreatment Study

COPMM committees

Paediatric Mortality & Morbidity

This Committee chaired by Dr Michelle Williams will hold meetings as required to progress the review and classification of reported statewide paediatric death cases. This year the Australian and New Zealand Child Death & Prevention Group (ANZCDRPG) will meet (in hybrid format) on May 23rd and May 25th, 2023.

Perinatal Mortality & Morbidity

Members of this Committee that is chaired by Professor Peter Dargaville will continue to review and classify all perinatal deaths reported in this state. Tasmania’s private hospitals are again recommended to use PSANZ guidelines to report on perinatal cases to provide COPMM with more comprehensive additional information (including histology and pathology reports on reported stillbirth cases). As agreed at a recent COPMM meeting, the updated Australian Perinatal Mortality Audit Tool will replace the National Perinatal Death Clinical Audit Tool to bring Tasmania in line with national reporting requirements.

Download the Australian Perinatal Mortality Audit Tool

To improve health literacy, COPMM have requested that a maternal education question be integrated into our state’s perinatal data collection, and as such, it will be uploaded to both the ObstetrixTas system and the Tasmanian Perinatal Data Collection form at the earliest opportunity. All private and public hospital Mortality & Morbidity committees are also encouraged to use their respective meetings to assist with the review and classification of reported perinatal death cases.

Download the Clinical Practice Guideline for Care Around Stillbirth and Neonatal Death

Maternal Mortality & Morbidity

This Committee that is chaired by Associate Professor Amanda Dennis will finalise its review and classification of maternal death cases reported in Tasmania in 2021 to 2022.

Data Management Committee

The Data Management Committee will oversee preparations for the next Annual Report based on available audited data that will be scheduled to be tabled in Parliament together with COPMM’s latest Operations Report 2022-23 in October 2023 (exact date to be confirmed). The Committee continues to monitor national developments in the Congenital Abnormality Registers as well as a national push to improve data timeliness and in-principle support for earlier supply of mortality data to the Australian Institute of Health and Welfare (AIHW).

Council news

Council’s first meeting in 2023 was held on the 23^{rd of} February. Membership of the Council for this new term in accordance with the Terms of Reference includes:

• Associate Professor Amanda Dennis (COPMM Chair & UTAS representative)
• Dr Jill Camier (RACGP representative)
• Ms Kate Cuthbertson, Barrister at Law (Council nomination)
• Professor Peter Dargaville (employed in the delivery of Neonatal Services)
• Dr David Gartlan (RANZCOG (Tas Branch) representative)
• Dr Anagha Jayakar (UTAS representative)
• Dr Scott McKeown (Department of Health Representative)
• Ms Leanne McLean (Commissioner for Children and Young People)
• Ms Lynne Staff (ACMTas representative)
• Dr Michelle Williams (Paediatrics & Child Health Division of RACP representative)