The Australian Immunisation Handbook 10th Edition 2013

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and of significant impact (e.g. influenza and hepatitis A), and to those diseases that, although less common, have severe potential adverse outcomes (e.g. Japanese encephalitis and rabies). Booster doses should be considered where appropriate (see Table 3.2.1). Because of the imminence of departure, sometimes an ‘accelerated schedule’ may be considered appropriate (e.g. for hepatitis B or the combined hepatitis A/hepatitis B vaccine – see the relevant disease-specific chapters in Part 4). Note that, while immunity may be established sooner with the accelerated schedule, an additional dose is required about a year later for completion of the course to augment long-term protection. For children, the lower age limits for recommendation of selected vaccines should be noted (see Table 3.2.2). Vaccines required by International Health Regulations or for entry into specific countries Currently, yellow fever vaccination is the only vaccination that may be required by the International Health Regulations for travelling in certain situations, for the purpose of individual protection if one is likely to be exposed and/or for protection of vulnerable populations (in countries with relevant vectors) from importation of the disease. Some countries, including Australia, may require documented evidence of yellow fever vaccination as a condition of entry or exit. Although there are exceptions, this would mostly be relevant for travellers who originate from, or have travelled or made transit through, countries in Africa or South America (see 4.23 Yellow fever and 3.2.6 Further information below). Current requirements should be referred to when advising travellers regarding yellow fever immunisation requirements. The Ministry of Health of Saudi Arabia annually issues specific requirements and recommendations for entry visas for travellers on pilgrimage to Mecca in Saudi Arabia (Hajj and Umra). For pilgrims travelling directly from Australia, only evidence of quadrivalent meningococcal vaccination is currently mandatory. However, current requirements should be referred to when advising prospective Hajj and Umra pilgrims (see 3.2.6 Further information below). Vaccine administration and documentation It is not unusual that multiple vaccines would be required before travelling. The standard recommendations and precautions for administration of multiple vaccines are applicable (see 2.2 Administration of vaccines). Multiple clinic visits may be necessary when multiple vaccines and vaccines that involve multiple doses are involved (e.g. rabies pre-exposure prophylaxis or hepatitis B vaccine). Special attention should be paid to the appropriate scheduling of these visits, taking into account dose interval precautions (e.g. multiple live vaccines), requirement for pre-vaccination tests (e.g. tuberculin skin test), and potential interference by some antimalarials if relevant (e.g. rabies vaccine). Ideally, vaccination courses should be started early enough before 116 The Australian Immunisation Handbook 10th edition
departure to allow for the period when most adverse events are expected to occur and to allow sufficient time for adequate immunity to develop. It is important to document travel vaccines appropriately, not only in the clinic’s record but also in a suitable record that can be carried by the traveller. It is recommended that the record also includes all the other ‘routinely recommended’ vaccines that the traveller has ever received. An International Certificate of Vaccination or Prophylaxis (ICVP), issued by an authorised medical practitioner in accordance with the International Health Regulations (2005), is required for yellow fever vaccination. 3.2.4 Vaccines Detailed information regarding each of the vaccines discussed below is provided in each of the corresponding disease-specific chapters of this Handbook. This section provides some general guidance in considering whether a particular vaccine may be advisable for a traveller. All prospective travellers should have been vaccinated according to the recommended vaccination schedule appropriate for the traveller’s age and underlying health conditions. All children should be vaccinated according to the NIP schedule. In exceptional circumstances, the NIP vaccines may be administered at the minimum age rather than the recommended age (see 2.1.5 Catch-up, Table 2.1.5 Minimum acceptable age for the 1st dose of scheduled vaccines in infants in special circumstances). Children vaccinated using the minimum age rather than the recommended age may require extra vaccine doses to ensure adequate protection. The minimum interval requirements between doses must be observed (see 2.1.5 Catch-up, Table 2.1.7 Minimum acceptable dose intervals for children
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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
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If 13vPCV is not available, and 10v
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Previous vaccination history 2 prev
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PART 2 VACCINATION PROCEDURES 57 Ta
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PART 2 VACCINATION PROCEDURES 59 Ta
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Catch-up schedules for persons ≥1
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For additional details on these rec
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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
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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
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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 and 118: Immunisation service providers enro
Page 119 and 120: PART 3 VACCINATION FOR SPECIAL RISK
Page 121 and 122: Thus, a vaccine to prevent Hib dise
Page 123 and 124: 3.1.2 Adults Hepatitis B Indigenous
Page 125 and 126: een low in younger Indigenous adult
Page 127 and 128: 3.2 VACCINATION FOR INTERNATIONAL T
Page 129: • vaccination history (including
Page 133 and 134: Selected vaccines based on travel i
Page 135 and 136: Tick-borne encephalitis Tick-borne
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
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Page 157 and 158: avoided, except in situations where
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Page 161 and 162: Use of live viral or live bacterial
Page 163 and 164: Influenza vaccination is recommende
Page 169 and 170: Haematopoietic stem cell transplant
Page 171 and 172: Vaccine Months after HSCT Comments
Page 173 and 174: depending on the number of vaccines
Page 175 and 176: Persons with functional or anatomic
Page 177 and 178: Table 3.3.5: Recommendations for va
Page 179 and 180: 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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The Australian Immunisation Handbook 10th Edition 2013

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