The Australian Immunisation Handbook 10th Edition 2013

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4.5.12 Variations from product information The product information for Infanrix hexa states that this vaccine is indicated for primary immunisation of infants from the age of 6 weeks. The ATAGI recommends that this vaccine may also be used for catch-up of the primary schedule in children
4.6 HUMAN PAPILLOMAVIRUS 4.6.1 Virology Human papillomaviruses (HPVs) are small, non-enveloped viruses with circular double-stranded DNA. HPVs infect and replicate primarily within cutaneous and mucosal epithelial tissues. More than 100 HPV genotypes have been identified based on sequence variations in the major genes. They differ in their preferred site of infection; approximately 40 HPV types infect the anogenital tract. Some HPV types, including types 16, 18, 31, 33, 35, 45, 52 and 58, are designated as ‘high-risk’, as they are causally associated with the development of cancer. Other HPV types, including types 6, 11, 40, 42, 43, 44, 54, 61, 70, 72, 81 and 89, have been classified as ‘low-risk’ and are predominantly associated with non-malignant lesions, such as genital warts. The other types are uncommon and their associations with disease are undetermined, but they are not currently believed to be significant causes of cancer. 1,2 4.6.2 Clinical features Transmission of anogenital HPV occurs primarily through sexual intercourse; however, virus transmission can less commonly occur following non-penetrative sexual contact. 3 Perinatal transmission of HPV can cause laryngeal infection in infants, rarely resulting in recurrent respiratory papillomatosis. 4 HPV infection is often subclinical, but, dependent upon the infecting HPV genotype, may result in lesions that include cutaneous warts, genital warts, respiratory papillomatosis (low-risk HPV types), and dysplasias and cancers of the cervix, vulva, vagina, penis, anus, and the oral cavity and oropharynx (high-risk HPV types). Most genital HPV infections are cleared (no longer detectable via HPV DNA testing) within 12 to 24 months. In about 3 to 10% of infections, the virus persists. Persons with persistent HPV infection constitute the at-risk group for development of HPV-associated cancers. 5-7 The causal link between persistent cervical HPV infection and cervical cancer is well established. The strength of association between HPV infection and other cancers varies by site and oncogenic HPV type. 8 Cellular changes that occur in the cervix as a result of HPV infection are referred to as cervical intraepithelial neoplasia (CIN). The majority of these changes regress, but a minority will progress to cervical cancer. Malignant transformation in the cervix usually occurs 10 to 20 years following infection with high-risk HPV types, but has been reported to occur in less than 2 years. 9 The clinical features of other HPV-associated cancers and their precursor lesions in the anogenital region and oropharynx vary, and also depend on the anatomical site. The process of progression of HPV-associated precursor lesions to cancers in these sites is less well understood than the process in the cervix. Anogenital warts may present as painless lumps, or with local tenderness, itching or PART 4 VACCINE-PREVENTABLE DISEASES 231 4.6 HUMAN PAPILLOMAVIRUS
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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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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
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 and 228: For older children and young adults
Page 229 and 230: Vaccine Age of vaccine recipient Do
Page 231 and 232: Combination hepatitis A/hepatitis B
Page 233 and 234: Management of infants born to mothe
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Page 239 and 240: immune memory persists and is thoug
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Page 243: Table 4.5.3: Post-exposure prophyla
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
Page 279 and 280: 4.8.8 Pregnancy and breastfeeding I
Page 281 and 282: 4.9 MEASLES 4.9.1 Virology Measles
Page 283 and 284: 4.9.4 Vaccines Monovalent measles v
Page 285 and 286: 4.9.6 Dosage and administration The
Page 287 and 288: Table 4.9.1: Recommendations for me
Page 289 and 290: increase in adverse events from vac
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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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