The Australian Immunisation Handbook 10th Edition 2013

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All travellers to Asia (and other tropical regions) must be fully aware of the need to take appropriate measures to avoid mosquito bites. The risk of JE to travellers to Asia is determined by the season of travel, the regions visited, the duration of travel, the extent of outdoor activity and the extent to which mosquito avoidance measures are taken. 1 Clearly the risk is greater during prolonged travel to rural areas of Asia during the wet season; it is probably negligible during short business trips to urban areas. Torres Strait Islands JE vaccination is recommended for: • all residents (≥12 months of age) of the outer islands in the Torres Strait • all non-residents (≥12 months of age) who will be living or working on the outer islands of the Torres Strait for a cumulative total of 30 days or more during the wet season (December to May). Note: The period of greatest risk is from February to March and the vaccination course should be completed before February. Those arriving in the outer islands late in the wet season (i.e. in May) will arrive after the risk period and do not require vaccination. Those visiting the outer islands in the dry season (June to November) do not require vaccination. Those visiting only the inner islands, including Thursday Island, do not require vaccination. Laboratory personnel JE vaccination is recommended for all research laboratory personnel who will potentially be exposed to the virus. Booster doses Currently there is limited evidence available to inform recommendations regarding the need and appropriate time interval for a booster dose of either Imojev or JEspect. A booster dose of Imojev is not currently recommended. Preliminary data from a subset of participants in a phase II randomised controlled trial demonstrated considerable persistence of seroprotective antibody levels 60 months following a single dose of Imojev12 (see 4.8.4 Vaccines above). Some data suggest that if the primary series of JEspect was administered >1 year previously, and there is an ongoing or high risk of JE virus exposure, a booster dose should be offered. 16 For individuals previously vaccinated with the mouse brain-derived JE vaccine, either Imojev or JEspect can be used for revaccination if there is an ongoing risk of JE virus exposure. 264 The Australian Immunisation Handbook 10th edition
4.8.8 Pregnancy and breastfeeding Imojev is a live attenuated viral vaccine and is contraindicated in pregnant women. Pregnancy should be avoided for 28 days after vaccination. There are no data on whether the Imojev vaccine virus is excreted in breast milk; the vaccine should not be given to breastfeeding women. JEspect vaccine is not routinely recommended for pregnant or breastfeeding women. However, as JE virus infection during the first and second trimesters has been associated with miscarriage, pregnant women at risk of acquiring JE should be offered JE vaccination. Although this inactivated JE vaccine might pose a theoretical risk to the developing fetus, no adverse outcomes of pregnancy have been attributed to vaccination against JE. No specific data are available regarding the administration of JEspect to breastfeeding women. Breastfeeding women who are at increased risk of acquiring JE should be offered JE vaccination. Refer to 3.3 Groups with special vaccination requirements, Table 3.3.1 Recommendations for vaccination in pregnancy for more information. 4.8.9 Contraindications JE vaccines are contraindicated in persons who have had: • anaphylaxis following a previous dose of any JE vaccine • anaphylaxis following any vaccine component. Imojev is a live attenuated viral vaccine and must not be administered to pregnant or breastfeeding women or to any person who is immunocompromised due to either disease and/or medical treatment. 4.8.10 Precautions JE vaccines should not be administered during an acute febrile illness. There are few data on the safety and efficacy of JEspect vaccine in persons who are immunocompromised. Such persons may not mount an adequate immune response, but, as JEspect is an inactivated vaccine, safety and reactogenicity are not expected to be of concern in those who are immunocompromised. 4.8.11 Adverse events Local reactions and minor systemic reactions are common to very common following vaccination against JE. In adults, adverse events following Imojev were similar to those in placebo recipients, 9,12 but occurred less often than in recipients of the mouse brainderived JE vaccine. 9 The most common adverse events in two key studies were injection site pain, headache, fatigue and malaise; most symptoms resolved within 3 days. 9 Similarly, in children aged 12–24 months, the frequency of adverse events after Imojev was comparable to that after the hepatitis A vaccine. PART 4 VACCINE-PREVENTABLE DISEASES 265 4.8 JAPANESE ENCEPHALITIS
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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-
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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
Page 227 and 228: For older children and young adults
Page 229 and 230: Vaccine Age of vaccine recipient Do
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Page 243 and 244: Table 4.5.3: Post-exposure prophyla
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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
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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 273 and 274: 4.8 JAPANESE ENCEPHALITIS 4.8.1 Vir
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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
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Page 295 and 296: Table 4.9.2: Post-exposure prophyla
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
Page 311 and 312: Trivalent measles-mumps-rubella (MM
Page 313 and 314: 4.11.7 Recommendations Infants aged
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Page 319 and 320: demonstrated a more rapid decline,
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Page 323 and 324: in the previous 10 years. 19,45 Adu
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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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