The Australian Immunisation Handbook 10th Edition 2013

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4.9.13 Variations from product information The product information for MMR and MMRV vaccines recommends that women of child-bearing age should be advised not to become pregnant for 3 months after vaccination. The ATAGI instead recommends avoiding pregnancy for 28 days after vaccination. 38 The product information for Priorix, M-M-R II, Priorix-tetra and ProQuad states that persons with a history of anaphylactic or anaphylactoid reactions to egg should not be vaccinated. The ATAGI recommends instead that either Priorix, M-M-R II, Priorix-tetra or ProQuad can be given in this situation. 25 The product information for Priorix-tetra states that it should be given by SC injection. The ATAGI recommends that it may also be given by IM injection. The product information for ProQuad states that this vaccine is indicated for vaccination in individuals 12 months through 12 years of age. The product information for Priorix-tetra states that this vaccine can be used in persons from 9 months of age. The ATAGI recommends instead that both MMRV vaccines can be given to persons up to 14 years of age. The ATAGI also recommends that MMRV vaccine should not be used routinely as the 1st dose of MMR-containing vaccine in children aged
4.10 MENINGOCOCCAL DISEASE 4.10.1 Bacteriology Meningococcal disease is caused by the bacterium Neisseria meningitidis (or meningococcus), a Gram-negative diplococcus. There are 13 known serogroups distinguished by differences in surface polysaccharides of the outer membrane capsule. Meningococcal serogroups are designated by letters of the alphabet. Globally, serogroups A, B, C, W 135 and Y most commonly cause disease. Meningococci can be further classified by differences in their outer membrane proteins, which are referred to as serotypes and serosubtypes. 1 More recently, molecular typing has been used to further differentiate meningococci. There is no consistent relationship between serogroup or serotype/subtype and virulence. 2 4.10.2 Clinical features N. meningitidis can cause meningitis, septicaemia or a combination of the two. Other localised infections, including pneumonia, arthritis and conjunctivitis, may also occur but are uncommon. Septicaemia, with or without meningitis, can be particularly severe. The overall mortality risk for invasive disease is high (between 5 and 10%), despite appropriate antibiotic therapy. 2 Of those who survive, approximately 10 to 20% develop permanent sequelae, including limb deformity, skin scarring and neurologic deficits. 1 Prior invasive meningococcal disease does not induce protective immunity against the implicated serogroup of meningococci. Therefore, persons with a history of meningococcal disease should still be vaccinated if required. N. meningitidis is carried and transmitted only by humans. There are no known animal reservoirs. Asymptomatic respiratory tract carriage of meningococci is present in about 10% of the population, and the prevalence may be higher when groups of people occupy small areas of living space. 3,4 Recent studies indicate that there may be a number of factors that contribute to the increased risk of contracting meningococcal disease, including exposure to smokers, recent illness, living in crowded conditions and multiple intimate kissing partners. 2-4 Persons with inherited disorders of phagocytosis associated with properdin deficiency or absence of the terminal components of complement, as well as persons with functional or anatomical asplenia, have an increased risk of meningococcal infection. 1 The disease is transmitted via droplets and has an incubation period of between 1 and 10 days, but commonly 3 to 4 days. 4 The capacity of meningococcal disease to have a fulminant and rapidly fatal course in previously healthy (and usually young) persons causes it to be greatly feared. Intensive public health follow-up is required after each single case to trace contacts and to institute appropriate public health measures for them. As a result of all these factors, this disease can cause widespread community alarm and generate significant media interest. 4 PART 4 VACCINE-PREVENTABLE DISEASES 283 4.10 MENINGOCOCCAL DISEASE
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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
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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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Page 247 and 248: women. The prevalence of high-risk
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Page 257 and 258: 4.7 INFLUENZA 4.7.1 Virology The in
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Page 273 and 274: 4.8 JAPANESE ENCEPHALITIS 4.8.1 Vir
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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 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 323 and 324: in the previous 10 years. 19,45 Adu
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Page 329 and 330: The product information for Quadrac
Page 331 and 332: 4.13 PNEUMOCOCCAL DISEASE 4.13.1 Ba
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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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