The Australian Immunisation Handbook 10th Edition 2013

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4.10.3 Epidemiology Meningococci cause both sporadic and epidemic disease throughout the world. Serogroup A disease occurs predominantly in low-income countries, such as those in Africa and Asia, while serogroup B is the major cause of sporadic meningococcal disease in most developed countries, including Australia. Serogroup C meningococci have been occasionally associated with small clusters of meningococcal disease cases in schools, universities and nightclubs in Australia in the past. 5-7 Rarely, there are clusters of meningococcal disease cases associated with serogroup B. 8 As in other temperate climates, meningococcal disease cases occurring in Australia tend to follow a seasonal trend, with a large proportion of cases reported during late winter and early spring. The overall notification rate for invasive meningococcal disease to the National Notifiable Diseases Surveillance System reached a peak of 3.5 per 100 000 in 2001, but declined to 1 case per 100 000 in 2010. 9,10 There have been considerable differences noted in the incidence of meningococcal disease between Australian states and territories in the past. Notifications include meningococcal disease cases that were diagnosed on clinical grounds alone, and those cases that were confirmed by laboratory methods such as culture, serology or nucleic acid testing of clinical material. In 2009, 259 cases were reported nationally, of which 194 were laboratoryconfirmed. 9,10 The majority of laboratory-confirmed meningococcal cases were serogroup B (83%) and serogroup C (5.6%). 10 There has been a sustained decline in serogroup C meningococcal disease among the 1–19 years age group, as well as other age groups not targeted in the vaccine program, since the 2003 introduction of routine serogroup C vaccination and catch-up programs. 9-11 In other countries that introduced a meningococcal C vaccination program, this herd immunity effect has also resulted in a reduction in incidence in age groups not targeted by the program. 12-14 Meningococcal disease can occur in any age group, but a large proportion of cases occur in those
4.10.4 Vaccines There are different types of meningococcal vaccines: • meningococcal C conjugate vaccines (MenCCV) • Haemophilus influenzae type b–meningococcal C combination vaccine (Hib- MenCCV) • quadrivalent meningococcal conjugate vaccines (4vMenCV) • quadrivalent meningococcal polysaccharide vaccines (4vMenPV). Conjugate vaccines Meningococcal C conjugate vaccines (MenCCV) • Meningitec – Pfizer Australia Pty Ltd (meningococcal serogroup C–CRM conjugate). Each 0.5 mL pre-filled syringe contains 10 µg 197 Neisseria meningitidis serogroup C oligosaccharide conjugated to approximately 15 µg of non-toxic Corynebacterium diphtheriae CRM197 protein; aluminium phosphate. • Menjugate Syringe – CSL Limited/Novartis Vaccines and Diagnostics Pty Ltd (meningococcal serogroup C–CRM 197 conjugate). Lyophilised powder in a monodose vial with a pre-filled diluent syringe. Each 0.5 mL reconstituted dose contains 10 µg N. meningitidis serogroup C oligosaccharide conjugated to 12.5–25 µg of non-toxic C. diphtheriae CRM 197 protein; 1.0 mg aluminium hydroxide. • NeisVac-C – Baxter Healthcare (meningococcal serogroup C–tetanus toxoid conjugate). Each 0.5 mL pre-filled syringe contains 10 µg N. meningitidis serogroup C polysaccharide conjugated to 10–20 µg of tetanus toxoid; 0.5 mg aluminium as aluminium hydroxide. Combination vaccine that contains meningococcal C • Menitorix – GlaxoSmithKline (Haemophilus influenzae type b [PRP-T]meningococcal serogroup C–tetanus toxoid conjugate). Lyophilised powder in a monodose vial with a pre-filled diluent syringe. Each 0.5 mL reconstituted dose contains 5 µg Hib capsular polysaccharide (PRP) conjugated to 12.5 µg tetanus toxoid, and 5 µg N. meningitidis serogroup C polysaccharide conjugated to 5 µg tetanus toxoid; traces of trometamol and sucrose. Quadrivalent meningococcal conjugate vaccines (4vMenCV) • Menactra – Sanofi Pasteur Pty Ltd (meningococcal serogroups A, C, W , Y–diphtheria toxoid conjugate). Each 0.5 mL monodose vial 135 PART 4 VACCINE-PREVENTABLE DISEASES 285 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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4.6 HUMAN PAPILLOMAVIRUS 4.6.1 Viro
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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 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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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 331 and 332: 4.13 PNEUMOCOCCAL DISEASE 4.13.1 Ba
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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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