The Australian Immunisation Handbook 10th Edition 2013

1.2 DEVELOPMENT OF THE 10TH EDITION OF THE HANDBOOK
The 10th edition of the Handbook has been developed by the Australian Technical
Advisory Group on Immunisation (ATAGI), which provides advice to the Federal
Minister for Health on the Immunise Australia Program and other vaccinerelated
issues. In addition to technical experts from many fields, the ATAGI’s
membership includes a consumer representative and general practitioners. Staff
of the National Centre for Immunisation Research and Surveillance of Vaccine
Preventable Diseases (NCIRS) provided the technical support to the ATAGI to
develop the Handbook.
It is important to note that recommendations contained within the Handbook
do not formally address the cost-effectiveness of different vaccines or different
vaccine schedules. Since January 2006, the cost-effectiveness of vaccines
is assessed by the Pharmaceutical Benefits Advisory Committee (PBAC),
which advises government on the funding of vaccines under the National
Immunisation Program and/or Pharmaceutical Benefits Scheme (PBS). Most,
but not all, of the recommendations made within the Handbook will be funded
under the NIP, PBS or via other means, such as through special schemes and
state- or territory-based programs.
1.2.1 Process of developing Handbook recommendations
The Handbook is designed as a general guide to inform clinicians on the safest and
most effective vaccination strategies, using the highest quality evidence available.
In the absence of high-quality evidence, such as well-conducted randomised
controlled trials and meta-analyses, the ATAGI based its recommendations on
less rigorous studies, such as uncontrolled clinical trials, case-series and/or other
observational studies. Where clinical guidelines were available on specific topics,
these were also consulted to help frame recommendations, if relevant, in the
Australian setting. Further details on literature search strategies utilised for the
production of this edition can be found in Appendix 2. The ATAGI also consulted
immunisation handbooks produced by comparable countries. When published
sources were inadequate, recommendations were based on expert opinion.
However, limitations and challenges to developing recommendations continue to
exist when there are unaddressed scientific questions, complex medical practice
issues and continuous new information, as well as differences in expert opinion.
Despite these limitations, the ATAGI has sought to provide clear and relevant
recommendations wherever possible.
The 1st edition of The Australian Immunisation Handbook was published in 1975.
Due to its longevity, scope and complexity, the Handbook does differ from other
NHMRC guidelines. As such, recommendations contained in the Handbook do
not contain formal levels or grades of evidence or evidence tables. The grades of
evidence assigned to recommendations for the three newly vaccine-preventable
diseases (human papillomavirus [HPV], rotavirus and herpes zoster) that were
included in the 9th edition Handbook (and its electronic amendments) have now
PART 1 INTRODUCTION TO THE AUSTRALIAN IMMUNISATION HANDBOOK 3
1.2 DEVELOPMENT OF THE 10TH OF EDITION THE 10TH OF THE HANDBOOK
EDITION OF THE HANDBOOK