The Australian Immunisation Handbook 10th Edition 2013

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PART 3 VACCINATION FOR SPECIAL RISK GROUPS 3.1 VACCINATION FOR ABORIGINAL AND TORRES STRAIT ISLANDER PEOPLE After European colonisation, Aboriginal and Torres Strait Islander (Indigenous) peoples experienced successive epidemics of infectious diseases with very high morbidity and mortality; many of these diseases have now become vaccine preventable. The diseases with the most serious impact were smallpox, tuberculosis, influenza, measles and syphilis, with estimated mortality rates of over 30% for smallpox epidemics and 20% for measles epidemics. 1 These high rates of disease were mainly due to a lack of previous exposure, 2 followed by high-density living in newly established settlements. Over many decades, higher rates of infectious disease have been associated with lower standards of living and poorer access to water, housing and health care. 3 Social determinants of health, such as low educational outcomes, lack of control over life circumstances and lack of cultural safety, are also associated with poor health outcomes, including increased infectious disease risk. 4 In recent decades, vaccination has been very successful in eliminating or substantially reducing the rates of many vaccine-preventable diseases (VPDs), such as diphtheria, polio, tetanus, hepatitis B, measles, mumps and rubella, in all Australians, and has made a substantial contribution to improvements in Indigenous child mortality. 5 For some VPDs, control is suboptimal in the general population despite high vaccination coverage (e.g. pertussis). For others, such as invasive pneumococcal disease (IPD), greater burdens of illness still occur in Indigenous persons than in non-Indigenous persons, largely due to the greater prevalence in Indigenous persons of serotypes for which vaccines do not protect, and high exposure levels associated with the environmental issues mentioned above. 5 Timeliness of immunisation can also be a factor. 5 In recognition of the higher rates of disease in the Indigenous population, some vaccines are specifically recommended for use in Indigenous persons, or for administration to a broader age range than is recommended for non-Indigenous persons (see Table 3.1.1). This chapter discusses the vaccines for which there are currently different recommendations for Indigenous persons in at least some parts of Australia, or for which there have been recent changes in this respect. For children, these are bacille Calmette-Guérin (BCG), Haemophilus influenzae type b, hepatitis A, influenza and pneumococcal vaccines. For adults, these are hepatitis B, influenza and pneumococcal polysaccharide vaccines. 104 The Australian Immunisation Handbook 10th edition
PART 3 VACCINATION FOR SPECIAL RISK GROUPS 105 Table 3.1.1: Additional* vaccines recommended for Indigenous persons, due to their higher risk of disease Vaccine Recommendation for Indigenous persons BCG Neonates living in areas of high TB incidence † 1 dose Hepatitis A Children resident in the Northern Territory, Queensland, South Australia and Western Australia Hepatitis B 2 doses in the 2nd year of life‡ Adults who have not previously been vaccinated against hepatitis B and are non-immune Influenza All persons aged ≥15 years Consider in all children aged ≥6 months, especially those aged
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The Australian Immunisation Handboo
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FOREWORD Since 1932, when Governmen
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TABLE OF CONTENTS PART 1 INTRODUCTI
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LIST OF TABLES Table 2.1.1: Pre-vac
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List 4.13.1: Conditions associated
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PREFACE The 10th edition of The Aus
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Secretariat support, Australian Tec
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PART 1 INTRODUCTION TO THE AUSTRALI
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1.2 DEVELOPMENT OF THE 10TH EDITION
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1.3 HOW TO USE THE 10TH EDITION HAN
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1.4 WHAT’S NEW All chapters have
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2.2 Administration of vaccines •
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• The section on vaccination of p
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4.6 Human papillomavirus • HPV va
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• For Aboriginal and Torres Strai
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Part 5 Passive immunisation • Inf
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without the harmful consequences of
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(vaccine failure). Often such infec
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will occur following receipt of a s
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cases, both the doctor issuing the
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Should a child or adolescent refuse
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• check that the correct time int
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Note: Please discuss this informati
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Condition or circumstance of person
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Condition or circumstance of person
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Table 2.1.3: Live attenuated parent
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An online ‘catch-up calculator’
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Use of serological testing to guide
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• For some vaccines, catch-up vac
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Figure 2.1.1: Catch-up worksheet fo
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Vaccine Minimum age for 1st dose in
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Table 2.1.6: Number of vaccine dose
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Catch-up guidelines for individual
Page 67 and 68: If 13vPCV is not available, and 10v
Page 69 and 70: Previous vaccination history 2 prev
Page 71 and 72: PART 2 VACCINATION PROCEDURES 57 Ta
Page 73 and 74: PART 2 VACCINATION PROCEDURES 59 Ta
Page 75 and 76: Catch-up schedules for persons ≥1
Page 77 and 78: For additional details on these rec
Page 79 and 80: 2.2 ADMINISTRATION OF VACCINES 2.2.
Page 81 and 82: • Never freeze a vaccine after it
Page 83 and 84: PART 2 VACCINATION PROCEDURES 69 In
Page 85 and 86: 2.2.5 Vaccine injection techniques
Page 87 and 88: Interruption to a vaccination If th
Page 89 and 90: 2.2.7 Positioning for vaccination I
Page 91 and 92: Children ≥12 months of age Cuddle
Page 93 and 94: 2.2.8 Identifying the injection sit
Page 95 and 96: • Place the palm over the greater
Page 97 and 98: 2.2.9 Administering multiple vaccin
Page 99 and 100: 2.3 POST-VACCINATION 2.3.1 Immediat
Page 101 and 102: Management of an immediate adverse
Page 103 and 104: Management of anaphylaxis Rapid IM
Page 105 and 106: Autoinjectors are generally not app
Page 107 and 108: Australia. 16 This vaccine is no lo
Page 109 and 110: Any serious or unexpected adverse e
Page 111 and 112: Consumers and immunisation service
Page 113 and 114: When relevant, immunisation service
Page 115 and 116: National Human Papillomavirus Vacci
Page 117: Immunisation service providers enro
Page 121 and 122: Thus, a vaccine to prevent Hib dise
Page 123 and 124: 3.1.2 Adults Hepatitis B Indigenous
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Page 127 and 128: 3.2 VACCINATION FOR INTERNATIONAL T
Page 129 and 130: • vaccination history (including
Page 131 and 132: departure to allow for the period w
Page 133 and 134: Selected vaccines based on travel i
Page 135 and 136: Tick-borne encephalitis Tick-borne
Page 137 and 138: PART 3 VACCINATION FOR SPECIAL RISK
Page 141 and 142: 3.2.5 Vaccinating the traveller wit
Page 143 and 144: • Travel health and quarantine se
Page 145 and 146: whether the AEFI is likely to recur
Page 147 and 148: (see Appendix 1 Contact details for
Page 157 and 158: avoided, except in situations where
Page 159 and 160: 3.3.3 Vaccination of immunocompromi
Page 161 and 162: Use of live viral or live bacterial
Page 163 and 164: Influenza vaccination is recommende
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Haematopoietic stem cell transplant
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Vaccine Months after HSCT Comments
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depending on the number of vaccines
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Persons with functional or anatomic
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Table 3.3.5: Recommendations for va
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Persons with autoimmune diseases an
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Table 3.3.6: Recommended intervals
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3.3.7 Vaccination of persons at occ
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Occupation Vaccine Providers of hom
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against certain vaccine-preventable
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3.3.11 Vaccination of persons who i
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waters. All cases of cholera report
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Children aged 2-6 years Three doses
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4.1.11 Adverse events The inactivat
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4.2.4 Vaccines Diphtheria toxoid is
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• Adacel - Sanofi Pasteur Pty Ltd
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antibodies at an age when waning of
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children aged
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4.3 HAEMOPHILUS INFLUENZAE TYPE B 4
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• Hiberix - GlaxoSmithKline (PRP-
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4.3.7 Recommendations Infants A Hib
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4.3.11 Public health management of
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In recent years, hepatitis A notifi
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Inactivated hepatitis A vaccines ar
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Co-administration with other vaccin
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Recommendations for the use of comb
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4.4.10 Adverse events The most comm
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4.5.3 Epidemiology The prevalence o
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4.5.4 Vaccines Monovalent hepatitis
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For older children and young adults
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Vaccine Age of vaccine recipient Do
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Combination hepatitis A/hepatitis B
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Management of infants born to mothe
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Household or other close (household
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with occult hepatitis B infection.
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immune memory persists and is thoug
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to suggest that a higher proportion
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Table 4.5.3: Post-exposure prophyla
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4.6 HUMAN PAPILLOMAVIRUS 4.6.1 Viro
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women. The prevalence of high-risk
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• Gardasil - CSL Limited/Merck &
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If scheduled doses have been missed
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However, some adult males may gain
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4.6.9 Contraindications The only ab
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4.7 INFLUENZA 4.7.1 Virology The in
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Figure 4.7.1: Influenza notificatio
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Always check annual seasonal influe
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7.5 µg of viral haemagglutinin (in
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Table 4.7.1: Recommended doses of i
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• Chronic respiratory conditions,
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Residents of residential aged care
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influenza vaccine prior to administ
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4.8 JAPANESE ENCEPHALITIS 4.8.1 Vir
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28 days following vaccination with
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When using JEspect in children aged
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4.8.8 Pregnancy and breastfeeding I
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4.9 MEASLES 4.9.1 Virology Measles
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4.9.4 Vaccines Monovalent measles v
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4.9.6 Dosage and administration The
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Table 4.9.1: Recommendations for me
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increase in adverse events from vac
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Immunoglobulin or blood product adm
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approximately 5%. 2,25 There is als
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Table 4.9.2: Post-exposure prophyla
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4.10 MENINGOCOCCAL DISEASE 4.10.1 B
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4.10.4 Vaccines There are different
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Polysaccharide vaccines Quadrivalen
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Interchangeability of meningococcal
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• Children (aged ≥9 months) and
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Appendix 1 Contact details for Aust
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4.11 MUMPS 4.11.1 Virology Mumps is
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Trivalent measles-mumps-rubella (MM
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4.11.7 Recommendations Infants aged
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Vaccination with other live attenua
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acquired from healthcare workers. 1
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demonstrated a more rapid decline,
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• Boostrix-IPV - GlaxoSmithKline
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in the previous 10 years. 19,45 Adu
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(see ‘Women who are planning preg
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an HHE. An HHE may last from a few
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The product information for Quadrac
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4.13 PNEUMOCOCCAL DISEASE 4.13.1 Ba
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non-Indigenous children (88%). 19,2
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10-valent pneumococcal conjugate va
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lesser antibody responses to 2nd or
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Table 4.13.1: Recommendations for p
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Category B: Conditions associated w
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Children aged >5 years to 15 years)
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Non-Indigenous adults A single dose
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Adults who have a condition listed
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4.13.11 Adverse events 10-valent pn
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5 years with a condition(s) associa
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virtually eradicated in India, but
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formaldehyde, glutaraldehyde, polys
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4.14.8 Pregnancy and breastfeeding
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4.15 Q FEVER 4.15.1 Bacteriology Q
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4.15.4 Vaccine • Q-Vax - CSL Limi
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individuals, which can be accessed
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Refer to 3.3 Groups with special va
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4.16 RABIES AND OTHER LYSSAVIRUSES
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4.16.4 Rabies vaccines • Mérieux
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of an even more accelerated schedul
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Pre-exposure prophylaxis for rabies
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The relevant state/territory health
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Although data are limited on the ef
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Table 4.16.2: Post-exposure prophyl
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Figure 4.16.2: Post-exposure prophy
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Figure 4.16.3: Booster algorithm fo
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allergic reaction occurs following
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age group11,12 and affecting 3.8% o
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of age, the risk of IS was increase
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Interchangeability of rotavirus vac
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gestational age; median 34 weeks) w
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Infants living in households with p
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4.17.12 Variations from product inf
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2003, rubella notifications in Aust
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zoster virus [Oka strain]). Lyophil
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children
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A number of commercial assays for t
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Germany indicates that no case of v
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case. Seronegative women of child-b
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4.19 TETANUS 4.19.1 Bacteriology Te
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Formulations for children aged
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4.19.5 Transport, storage and handl
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foreign bodies (especially wood spl
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studies indicate that the adverse r
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The product information for Adacel
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of MDR-TB cases identified has incr
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BCG vaccination procedures BCG vacc
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Occupational groups There is some e
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In developed countries, typhoid fev
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A 4th capsule taken on day 7 has be
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4.22 VARICELLA 4.22.1 Virology Vari
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as a case of wild-type varicella oc
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Reconstituted Varivax Refrigerated
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adequate protection from varicella.
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eceived varicella vaccine while bre
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immunoglobulin and other blood prod
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eported in a 9-year follow-up of 70
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high-dose intravenous NHIG are like
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4.23 YELLOW FEVER 4.23.1 Virology Y
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Co-administration with other vaccin
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Vaccine-associated neurotropic adve
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1000 cases per 100 000 population i
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administration of Zostavax with 23-
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diagnosis. In addition, the risk of
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Laboratory testing to check for an
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the immunoglobulin preparations con
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Prevention of measles Measles vacci
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who are being treated with immunosu
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limb with a separate syringe, and a
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APPENDIX 1: CONTACT DETAILS FOR AUS
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APPENDIX 2: LITERATURE SEARCH STRAT
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APPENDIX 3: COMPONENTS OF VACCINES
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Vaccine component* Vaccine brand
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APPENDIX 4: COMMONLY ASKED QUESTION
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When should preterm infants be vacc
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If a parent decides not to have a c
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Should vaccines be given to persons
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eason not to vaccinate. Asthma, ecz
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Does MMR vaccine cause inflammatory
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(either alone or in combination) fo
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A4.5 Questions about the need for i
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APPENDIX 5: GLOSSARY OF TECHNICAL T
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Enzootic enzootic infections are pr
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Rotavirus a virus that is a common
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APPENDIX 6: COMMONLY USED ABBREVIAT
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OPV oral poliomyelitis vaccine PCEC
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Year Vaccine 2003 Varicella 2003 Me
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identifying the injection site, 79-
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Australian Capital Territory advers
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and travellers, 119 vaccines, 177-1
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abies and other lyssaviruses (inclu
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HPV Vaccination Program, 234 human
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interferon-gamma release assays (IG
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mercury, in vaccines. see thiomersa
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Northern Territory ACIR reporting,
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and Haemophilus influenzae type b (
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espiratory syncytial virus monoclon
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Therapeutic Goods Administration (T
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varicella-zoster immunoglobulin, 45
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INDEX 525 INDEX
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