The Australian Immunisation Handbook 10th Edition 2013

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• For persons undertaking high-risk travel, a 5-yearly booster dose with dT or dTpa should be considered for protection against tetanus. In other travellers, a booster dose of tetanus-containing vaccine should be provided if 10 years have elapsed since the previous dose. • More information on the definition of ‘tetanus-prone wounds’ is provided, and the table (Table 4.19.1) on wound management has been updated to include recommendations for use of tetanus immunoglobulin (TIG) in immunocompromised persons. • Information on diphtheria antitoxin is now contained in Part 5 of the Handbook. 4.3 Haemophilus influenzae type b • Combination Hib-meningococcal C vaccine (Hib-MenCCV) included. • Hib vaccination recommendations apply to all children, including Aboriginal and Torres Strait Islander children, as only PRP-T Hib vaccines have been in use in recent years. 4.4 Hepatitis A • The section on serological testing for hepatitis A prior to vaccination has been expanded, and more detail provided as to rationale for vaccination of certain groups. • Hepatitis A vaccination is recommended in preference to NHIG for use in post-exposure prophylaxis in immunocompetent persons ≥12 months of age. 4.5 Hepatitis B • Different schedules for hepatitis B vaccination, including minimum intervals between doses, have been described in more detail. • Advice is provided regarding the validity of a hepatitis B vaccine schedule used for children born overseas, who were vaccinated at birth, 1 month and 6 months of age. • Information is provided on checking for infection/immunity to hepatitis B in infants born to mothers with chronic hepatitis B infection 3 to 12 months after the primary vaccine course. • It is now recommended that Aboriginal and Torres Strait Islander people have their risks and vaccination status for hepatitis B reviewed, be offered testing for previous hepatitis B infection, and be offered vaccination if non-immune. • Migrants from hepatitis B endemic countries should be offered testing for hepatitis B, and vaccination if appropriate. • The section on serological testing for hepatitis B prior to vaccination has been expanded, and more detail provided as to rationale for testing and/or vaccination of certain groups, including hepatitis B vaccine non-responders. 12 The Australian Immunisation Handbook 10th edition
4.6 Human papillomavirus • HPV vaccination is now recommended for girls at the optimal age for vaccination of 11–13 years. • HPV vaccination is now not routinely recommended for women aged 19–26 years. A risk-benefit assessment should be conducted when contemplating vaccination of women in this and older age groups. • Recommendations for use of HPV in males have been included. HPV vaccination is recommended for males aged 9–18 years, with the optimal age for vaccination being 11–13 years. • Specific recommendations regarding the use of HPV vaccine in immunocompromised persons and men who have sex with men are now included. 4.7 Influenza • Intradermal influenza vaccines are included. • Ages for which different brands of influenza vaccine are registered have been specified. • Readers are referred to the Immunise Australia website (www.immunise. health.gov.au) to check annual statements on influenza vaccine availability and recommendations for use. • Information on the disease burden and benefits of influenza vaccination in pregnancy and in children aged ≥6 months and
Page 1 and 2: The Australian Immunisation Handboo
Page 3 and 4: FOREWORD Since 1932, when Governmen
Page 5 and 6: TABLE OF CONTENTS PART 1 INTRODUCTI
Page 7 and 8: LIST OF TABLES Table 2.1.1: Pre-vac
Page 9 and 10: List 4.13.1: Conditions associated
Page 11 and 12: PREFACE The 10th edition of The Aus
Page 13 and 14: Secretariat support, Australian Tec
Page 15 and 16: PART 1 INTRODUCTION TO THE AUSTRALI
Page 17 and 18: 1.2 DEVELOPMENT OF THE 10TH EDITION
Page 19 and 20: 1.3 HOW TO USE THE 10TH EDITION HAN
Page 21 and 22: 1.4 WHAT’S NEW All chapters have
Page 23 and 24: 2.2 Administration of vaccines •
Page 25: • The section on vaccination of p
Page 29 and 30: • For Aboriginal and Torres Strai
Page 31 and 32: Part 5 Passive immunisation • Inf
Page 33 and 34: without the harmful consequences of
Page 35 and 36: (vaccine failure). Often such infec
Page 37 and 38: will occur following receipt of a s
Page 39 and 40: cases, both the doctor issuing the
Page 41 and 42: Should a child or adolescent refuse
Page 43 and 44: • check that the correct time int
Page 45 and 46: Note: Please discuss this informati
Page 47 and 48: Condition or circumstance of person
Page 49 and 50: Condition or circumstance of person
Page 51 and 52: Table 2.1.3: Live attenuated parent
Page 53 and 54: An online ‘catch-up calculator’
Page 55 and 56: Use of serological testing to guide
Page 57 and 58: • For some vaccines, catch-up vac
Page 59 and 60: Figure 2.1.1: Catch-up worksheet fo
Page 61 and 62: Vaccine Minimum age for 1st dose in
Page 63 and 64: Table 2.1.6: Number of vaccine dose
Page 65 and 66: Catch-up guidelines for individual
Page 67 and 68: If 13vPCV is not available, and 10v
Page 69 and 70: Previous vaccination history 2 prev
Page 71 and 72: PART 2 VACCINATION PROCEDURES 57 Ta
Page 73 and 74: PART 2 VACCINATION PROCEDURES 59 Ta
Page 75 and 76: 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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Page 151 and 152:
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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-
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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
Page 537 and 538:
varicella-zoster immunoglobulin, 45
Page 539 and 540:
INDEX 525 INDEX
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The Australian Immunisation Handbook 10th Edition 2013

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