The Australian Immunisation Handbook 10th Edition 2013

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of seroconversion increases progressively from approximately 35% after the 1st dose to more than 90% after the 3rd dose. <strong>The</strong>re is evidence of immunity in most vaccine recipients after administration of 2 doses of a 3-dose schedule. However, the 3rd dose is necessary to increase the percentage of responders and to provide long-term protection. Alternative 2-dose schedule for adolescents Several studies have demonstrated that adolescents 11–15 years of age who receive 2 doses of adult formulation monovalent hepatitis B vaccine 4 to 6 months apart develop similar protective antibody levels to those vaccinated using paediatric formulations in the standard 3-dose schedule. 41-43 Using a 2-dose schedule for the 11–15 years age group may improve compliance and will provide comparable immunogenicity to that of a 3-dose paediatric schedule. Adolescents (11–15 years of age) can be vaccinated with the adult formulation of either H-B-Vax II or Engerix-B in a 2-dose schedule (see Table 4.5.1). Table 4.5.1: Recommended schedules for use of monovalent hepatitis B and hepatitis B combination vaccines Vaccine Age of vaccine recipient Recommended infant schedule Engerix-B (paediatric formulation) or H-B-Vax II (paediatric formulation) Combination hepatitis B-containing vaccine (e.g. Infanrix hexa (DTPa-hepB-IPV-Hib) birth 2, 4 and 6 ‡ months Dose (HBsAg protein) 10 µg (Engerix-B) or 5 µg (H-B-Vax II) Volume per dose (mL) Number of doses 0.5 1 10 µg 0.5 3 Monovalent hepatitis B vaccines – standard 3-dose schedule Engerix-B (paediatric formulation) Engerix-B (adult formulation) H-B-Vax II (paediatric formulation)
Vaccine Age of vaccine recipient Dose (HBsAg protein) Volume per dose (mL) Number of doses Monovalent hepatitis B vaccines – standard 3-dose schedule H-B-Vax II (adult formulation) H-B-Vax II (dialysis formulation) ≥20 years 10 µg 1.0 3 ≥20 years 40 µg 1.0 3 Recommended schedule intervals* † 1st dose: day 0 (day of vaccination) 2nd dose: 1 month after 1st dose 3rd dose: 6 months after 1st dose 1st dose: day 0 (day of vaccination) 2nd dose: 1 month after 1st dose 3rd dose: 6 months after 1st dose Monovalent hepatitis B vaccines – 2-dose schedule ONLY for adolescents aged 11–15 years Engerix-B (adult formulation) H-B-Vax II (adult formulation) 11–15 years 11–15 years Combination hepatitis A/hepatitis B vaccines Twinrix (720/20) § Twinrix Junior (360/10) 1–
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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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2.2 ADMINISTRATION OF VACCINES 2.2.
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• Never freeze a vaccine after it
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PART 2 VACCINATION PROCEDURES 69 In
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2.2.5 Vaccine injection techniques
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Interruption to a vaccination If th
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2.2.7 Positioning for vaccination I
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Children ≥12 months of age Cuddle
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2.2.8 Identifying the injection sit
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• Place the palm over the greater
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2.2.9 Administering multiple vaccin
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2.3 POST-VACCINATION 2.3.1 Immediat
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Management of an immediate adverse
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Management of anaphylaxis Rapid IM
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Autoinjectors are generally not app
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Australia. 16 This vaccine is no lo
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Any serious or unexpected adverse e
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Consumers and immunisation service
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When relevant, immunisation service
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National Human Papillomavirus Vacci
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Immunisation service providers enro
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PART 3 VACCINATION FOR SPECIAL RISK
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Thus, a vaccine to prevent Hib dise
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3.1.2 Adults Hepatitis B Indigenous
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een low in younger Indigenous adult
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3.2 VACCINATION FOR INTERNATIONAL T
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• vaccination history (including
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departure to allow for the period w
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Selected vaccines based on travel i
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Tick-borne encephalitis Tick-borne
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3.2.5 Vaccinating the traveller wit
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• Travel health and quarantine se
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whether the AEFI is likely to recur
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(see Appendix 1 Contact details for
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avoided, except in situations where
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3.3.3 Vaccination of immunocompromi
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Use of live viral or live bacterial
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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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Page 179 and 180: Persons with autoimmune diseases an
Page 181 and 182: Table 3.3.6: Recommended intervals
Page 183 and 184: 3.3.7 Vaccination of persons at occ
Page 185 and 186: Occupation Vaccine Providers of hom
Page 187 and 188: against certain vaccine-preventable
Page 189 and 190: 3.3.11 Vaccination of persons who i
Page 191 and 192: waters. All cases of cholera report
Page 193 and 194: Children aged 2-6 years Three doses
Page 195 and 196: 4.1.11 Adverse events The inactivat
Page 197 and 198: 4.2.4 Vaccines Diphtheria toxoid is
Page 199 and 200: • Adacel - Sanofi Pasteur Pty Ltd
Page 201 and 202: antibodies at an age when waning of
Page 203 and 204: children aged
Page 205 and 206: 4.3 HAEMOPHILUS INFLUENZAE TYPE B 4
Page 207 and 208: • Hiberix - GlaxoSmithKline (PRP-
Page 209 and 210: 4.3.7 Recommendations Infants A Hib
Page 211 and 212: 4.3.11 Public health management of
Page 213 and 214: In recent years, hepatitis A notifi
Page 215 and 216: Inactivated hepatitis A vaccines ar
Page 217 and 218: Co-administration with other vaccin
Page 219 and 220: Recommendations for the use of comb
Page 221 and 222: 4.4.10 Adverse events The most comm
Page 223 and 224: 4.5.3 Epidemiology The prevalence o
Page 225 and 226: 4.5.4 Vaccines Monovalent hepatitis
Page 227: For older children and young adults
Page 231 and 232: Combination hepatitis A/hepatitis B
Page 233 and 234: Management of infants born to mothe
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Page 237 and 238: with occult hepatitis B infection.
Page 239 and 240: immune memory persists and is thoug
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Page 243 and 244: Table 4.5.3: Post-exposure prophyla
Page 245 and 246: 4.6 HUMAN PAPILLOMAVIRUS 4.6.1 Viro
Page 247 and 248: women. The prevalence of high-risk
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Page 251 and 252: If scheduled doses have been missed
Page 253 and 254: However, some adult males may gain
Page 255 and 256: 4.6.9 Contraindications The only ab
Page 257 and 258: 4.7 INFLUENZA 4.7.1 Virology The in
Page 259 and 260: Figure 4.7.1: Influenza notificatio
Page 261 and 262: Always check annual seasonal influe
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Page 265 and 266: Table 4.7.1: Recommended doses of i
Page 267 and 268: • Chronic respiratory conditions,
Page 269 and 270: Residents of residential aged care
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Page 273 and 274: 4.8 JAPANESE ENCEPHALITIS 4.8.1 Vir
Page 275 and 276: 28 days following vaccination with
Page 277 and 278: 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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