The Australian Immunisation Handbook 10th Edition 2013

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communities reported laboratory-confirmed cases of A(H1N1)pdm09 (pH1N1) influenza, including more than 18 000 deaths. 14 In Australia, a total of 44 403 confirmed cases of pH1N1 influenza occurred between May 2009 and November 2010, including 6767 cases in 2010. A total of 213 pandemic influenza-associated deaths were reported, 22 of which occurred in 2010. 15 Evidence from multiple outbreak sites demonstrated that the A(H1N1)pdm09 virus rapidly established itself and was the dominant influenza strain in most parts of the world. The clinical picture of pH1N1 influenza appeared to be largely consistent across all countries, with most affected persons experiencing moderate illness. Risk factors for severe disease included obesity, pregnancy, diabetes mellitus and, in Australia, being of Aboriginal or Torres Strait Islander descent (see 3.1 Vaccination for Aboriginal and Torres Strait Islander people). Although influenza can cause very severe and fatal illness, particularly in the elderly, the impact of pH1N1 influenza in younger healthy adults and in pregnant women was proportionally greater than normal seasonal outbreaks, even though the absolute number of such cases remained low. During the last quarter of 2009, Australia introduced a non-adjuvanted, inactivated, egg-derived, monovalent A(H1N1)pdm09 vaccine for administration to all persons aged ≥6 months (Panvax, CSL Limited). Expired monovalent vaccine supplies were withdrawn in December 2010. 16 In Australia, there was ongoing summer activity of A(H1N1) pdm09 in late 2009, and the virus continued to circulate in 2010 and 2011, replacing the previously circulating seasonal H1N1 strain. 2 The A(H1N1)pdm09 strain was included in trivalent seasonal influenza vaccine formulations used in the southern hemisphere in 2010, 2011 and 2012. 4.7.4 Vaccines The administration of influenza vaccine to persons at risk of complications of infection is the single most important measure in preventing or attenuating influenza infection and preventing mortality. After vaccination, most adults develop antibody levels that are likely to protect them against the strains of virus represented in the vaccine. In addition, there is likely to be protection against many related influenza variants. Infants, the very elderly, and persons who are immunocompromised may develop lower post-vaccination antibody levels. Under these circumstances, influenza vaccine may be more effective in preventing lower respiratory tract involvement or other complications of influenza than in preventing influenza infection. 246 The Australian Immunisation Handbook 10th edition
Always check annual seasonal influenza vaccine availability statements on www.immunise.health.gov.au. Vaccines and age eligibility change from year to year. Vaccines for intramuscular administration Children aged ≥6 months and adults (see Table 4.7.1 for dosage information for different age groups) • Agrippal – Novartis Vaccines and Diagnostics Pty Ltd (inactivated influenza virus). Each 0.5 mL pre-filled syringe contains 15 µg haemagglutinin of each of the three recommended strains. May contain traces of kanamycin, neomycin, formaldehyde, barium sulphate, cetrimonium bromide (CTAB), polysorbate 80 and egg protein. • Fluarix – GlaxoSmithKline (inactivated influenza virus). Each 0.5 mL pre-filled syringe contains 15 µg haemagglutinin of each of the three recommended strains. May contain traces of formaldehyde, gentamicin, polysorbate 80, octoxinol 10 and egg protein. • Influvac – Abbott Products Pty Ltd (inactivated influenza virus). Each 0.5 mL pre-filled syringe contains 15 µg haemagglutinin of each of the three recommended strains. May contain traces of formaldehyde, CTAB, polysorbate 80, gentamicin and egg protein. • Influvac Junior (6 months to
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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
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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-
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 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
Page 249 and 250: • Gardasil - CSL Limited/Merck &
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
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Page 267 and 268: • Chronic respiratory conditions,
Page 269 and 270: Residents of residential aged care
Page 271 and 272: influenza vaccine prior to administ
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
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Page 289 and 290: increase in adverse events from vac
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Page 293 and 294: approximately 5%. 2,25 There is als
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Page 297 and 298: 4.10 MENINGOCOCCAL DISEASE 4.10.1 B
Page 299 and 300: 4.10.4 Vaccines There are different
Page 301 and 302: Polysaccharide vaccines Quadrivalen
Page 303 and 304: Interchangeability of meningococcal
Page 305 and 306: • Children (aged ≥9 months) and
Page 307 and 308: Appendix 1 Contact details for Aust
Page 309 and 310: 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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