SURE opens door to novel immunisation data linkage study
The study will shed light on the effectiveness of vaccination

A new linked data project using the Sax Institute’s Secure Unified Research Environment (SURE) is providing the first comprehensive information on how Australia’s childhood vaccination programs are performing in terms of real-world health outcomes.

By analysing linked health and birth data from two states and Australian Childhood Immunisation Research (ACIR) data for the first time, researchers will provide a full picture on how well vaccination programs are working on the ground and who should be targeted to improve on-time vaccination rates.

Heather Gidding
Researcher A/Prof Heather Gidding is using SURE to conduct linked data research on immunisation.

Study chief investigator Associate Professor Heather Gidding, from the School of Public Health and Community Medicine at UNSW, said accurate data was vital to optimising both the health and cost benefits of vaccination programs.

But until now, information could only be derived from stand-alone databases using study designs that lacked control for important clinical and demographic confounders of vaccine effects.

Associate Professor Gidding said the new linkage study aimed to accurately measure the relationship between vaccination uptake, timeliness of vaccination, and development of disease, particularly in specific risk populations that are not able to be identified using stand-alone databases and who might experience a higher burden of infection.

Access through SURE

The study involves a 17-year birth cohort of almost 2 million children born in WA and NSW between 1996 and 2012. For the first time, the research team is linking the cohort’s state-based health data with national death and ACIR databases to get a full picture of vaccination and disease.

Associate Professor Gidding said access to the datasets had been made possible via SURE, which is a purpose-built remote-access data research laboratory for analysing routinely collected data. The facility enables researchers to log in remotely and securely analyse data from a range of sources.

“SURE has provided us with the vehicle to access and analyse these data remotely and securely, so has enabled us to get approval for the linkage of the datasets,” she said.

“The other good thing about SURE is that not only does it meet the needs of the Commonwealth Health Department to access linked data, but we have been able to work on the data across different locations and all access the same work space.”

Building a complete picture of immunisation

Associate Professor Gidding said the project would also shed light on issues such as factors associated with getting vaccinations late and whether improving the timeliness of vaccinations could reduce the burden of disease.

“We can work out the immunisation status of every single child at a given point in time and therefore measure rates of vaccine preventable diseases by number of vaccine doses received,” she said. “Not only are we looking at whether the children get disease, by linkage to emergency department and hospital admissions, the severity of disease can also be measured.”

Paving the way for future research

Associate Professor Gidding said through strong collaboration with the Population Health Research Network (PHRN), state and Commonwealth government stakeholders, and state and national data linkage units, a process for linking the state and Commonwealth datasets was established and this has hopefully paved the way for other researchers to conduct similar linkages.

Regarding the databases already linked, she said: “It is a resource we would like other researchers to use if they can – we are keen for them to talk to us about whether the data might be suitable for use in other projects.”

SURE was established and is operated with funding from the Australian Government National Collaborative Research Infrastructure Strategy (NCRIS) as part of the Population Health Research Network (PHRN). The PHRN is a collaboration that was set up in 2009 to further develop Australia’s data linkage capabilities.

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