The Australian Immunisation Handbook 10th Edition 2013

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Pregnancy and breastfeeding below). Data to evaluate the effectiveness of indirect protection to infants from the cocoon approach are lacking. 28 However, this approach is expected to reduce infection risk to infants from family members, known to be an important source of pertussis infection, 13,14 especially for the youngest infants. 11,12 4.12.4 Vaccines Pertussis vaccine is available in Australia only in combination with diphtheria, tetanus and other antigens. The acronym DTPa, using capital letters, signifies child formulations of diphtheria, tetanus and acellular pertussis-containing vaccines. The acronym dTpa is used for formulations that contain substantially lesser amounts of diphtheria toxoid and pertussis antigens than child (DTPa-containing) formulations; dTpa vaccines are usually used in adolescents and adults. Acellular pertussis-containing vaccines have been used for both primary and booster vaccination of children in Australia since 1999. Whole-cell pertussiscontaining vaccines were used exclusively before 1997. Between 1997 and 1999 acellular vaccines were used for booster doses. There are a number of acellular pertussis-containing vaccines that contain three or more purified components of B. pertussis. In the 3-component vaccines, these components are pertussis toxin (PT), filamentous haemagglutinin (FHA) and pertactin (PRN). In the 5-component vaccines, fimbrial (FIM) antigens are also included. Pertussis vaccines provide good protection against severe and typical pertussis, but substantially less against milder coughing illness. 29,30 Vaccine efficacy of DTPa vaccines with three or more antigens has been reported as 71 to 78% for preventing milder symptoms of pertussis and 84% for preventing typical disease. 30 Epidemiological data suggest that receipt of the 1st dose of the primary DTPa course significantly reduces the incidence of severe pertussis disease in young infants, as measured by hospitalisation rates. 31-33 Data on the duration of immunity following DTPa vaccine indicate that waning occurs 5 to 6 years after the last dose of vaccine. 2,34 However, these studies could not control for levels of circulating pertussis in the population, which may boost the level of immunity and lead to over-estimation of the duration of protection against symptomatic disease. 29,30 Reduced antigen content formulation, dTpa, vaccines are immunogenic. 35-38 A randomised trial in adults reported a point estimate of 92% efficacy against culture/nucleic acid test-positive disease within 2.5 years of vaccination with a 3-component monovalent pertussis vaccine. 4 Data on the duration of immunity to pertussis following a single booster dose of dTpa are limited. Longterm follow-up of adults vaccinated with dTpa has shown a rapid decline in levels of pertussis antibodies within the first 2 years after vaccination, with a continued steady decline out to 10 years after vaccination, although antibody levels remained above baseline. 39 A similar long-term follow-up of adolescents 304 The Australian Immunisation Handbook 10th edition
demonstrated a more rapid decline, with pertussis antibody levels decreasing to or approaching pre-vaccination levels after 10 years. 40 The rate of decline in clinical protection is unknown, but some protection against clinical disease is likely to persist for up to 10 years. Recent studies have indicated that dTpa vaccine is immunogenic in the elderly. 38 Vaccines containing DTPa are available in various combinations with inactivated poliomyelitis, hepatitis B and Haemophilus influenzae type b vaccines. Formulations for children aged
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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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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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Page 269 and 270: Residents of residential aged care
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Page 273 and 274: 4.8 JAPANESE ENCEPHALITIS 4.8.1 Vir
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Page 277 and 278: When using JEspect in children aged
Page 279 and 280: 4.8.8 Pregnancy and breastfeeding I
Page 281 and 282: 4.9 MEASLES 4.9.1 Virology Measles
Page 283 and 284: 4.9.4 Vaccines Monovalent measles v
Page 285 and 286: 4.9.6 Dosage and administration The
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Page 289 and 290: increase in adverse events from vac
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Page 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 317: acquired from healthcare workers. 1
Page 321 and 322: • Boostrix-IPV - GlaxoSmithKline
Page 323 and 324: in the previous 10 years. 19,45 Adu
Page 325 and 326: (see ‘Women who are planning preg
Page 327 and 328: an HHE. An HHE may last from a few
Page 329 and 330: The product information for Quadrac
Page 331 and 332: 4.13 PNEUMOCOCCAL DISEASE 4.13.1 Ba
Page 333 and 334: non-Indigenous children (88%). 19,2
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Page 339 and 340: Table 4.13.1: Recommendations for p
Page 341 and 342: Category B: Conditions associated w
Page 343 and 344: Children aged >5 years to 15 years)
Page 345 and 346: Non-Indigenous adults A single dose
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Page 349 and 350: 4.13.11 Adverse events 10-valent pn
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Page 357 and 358: 4.14.8 Pregnancy and breastfeeding
Page 359 and 360: 4.15 Q FEVER 4.15.1 Bacteriology Q
Page 361 and 362: 4.15.4 Vaccine • Q-Vax - CSL Limi
Page 363 and 364: individuals, which can be accessed
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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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4.21.8 Pregnancy and breastfeeding
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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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4.23.8 Pregnancy and breastfeeding
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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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