The Australian Immunisation Handbook 10th Edition 2013

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Healthcare workers All healthcare workers should receive dTpa vaccine because of the significant risk of nosocomial transmission of pertussis to vulnerable patients. 15-18 (See also 3.3 Groups with special vaccination requirements, Table 3.3.7 Recommended vaccinations for persons at increased risk of certain occupationally acquired vaccinepreventable diseases.) A booster dose of dTpa is recommended if 10 years have elapsed since a previous dose. 39,40 Vaccinated healthcare workers who develop symptoms compatible with pertussis should still be investigated for pertussis. <strong>The</strong>re have been cases of nosocomial transmission of pertussis to infants from healthcare workers who have previously received dTpa vaccine. 17 Staff working in early childhood education and care Adults working with infants and young children aged
(see ‘Women who are planning pregnancy, pregnant or post-partum’ in 4.12.7 Recommendations above). Recently, it has been recommended in the United States, the United Kingdom and New Zealand that dTpa vaccine administered in the last trimester of pregnancy be preferred to post-partum maternal immunisation, for various reasons, including difficulties in implementation of the latter strategy, theoretical reasons why vaccination during pregnancy might be more effective, and the favourable safety profile of maternal vaccination. 53 <strong>The</strong>oretical reasons for effectiveness are: 1) that administration of dTpa during the third trimester of pregnancy results in high maternal pertussis antibody levels and transplacental transfer of antibodies to the infant; 54,55 and 2) that the levels of pertussis antibodies measured in cord blood in such infants are similar to those observed in infants at 12 months of age following a 3-dose DTPa course. 56 This is likely to provide protection against pertussis in the 1st month of an infant’s life, prior to commencement of the primary DTPa schedule. In addition, a woman vaccinated with dTpa during pregnancy will herself be protected against pertussis during the third trimester and will be less likely to transmit pertussis to the infant after delivery. Although specific safety data are limited, dTpa is an inactivated vaccine and there is evidence for the safety of this and other inactivated vaccines, such as tetanus and influenza, in pregnancy. 53,57 Safety of dTpa vaccines in pregnancy was not studied specifically during pre-market evaluations, but review of the available data from pregnancy registries, small studies and the United States Vaccine Adverse Event Reporting System did not indicate a higher frequency or unusual pattern of adverse events in pregnant women who received dTpa. 53 A potential disadvantage of giving dTpa in the third trimester of pregnancy is that maternal pertussis antibodies may interfere with an infant’s immune response following the primary 3-dose DTPa course at 2, 4 and 6 months of age, 53 a phenomenon referred to as ‘blunting’. 27,53,58 However, because correlates of protection are not fully understood, the clinical importance of this is uncertain. Although severe morbidity and mortality from pertussis is rare after 6 months of age, it is possible that a reduced immune response to the infant’s primary course of DTPa-containing vaccine could result in less protection against pertussis in the 2nd year of life. This provides the rationale for provision of an additional booster dose of a pertussis-containing vaccine (DTPa) in the 2nd year of life to children born to mothers who received dTpa during pregnancy (see ‘Infants and children’ in 4.12.7 Recommendations above). Refer to 3.3 Groups with special vaccination requirements, Table 3.3.1 Recommendations for vaccination in pregnancy for more information. PART 4 VACCINE-PREVENTABLE DISEASES 311 4.12 PERTUSSIS
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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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• Chronic respiratory conditions,
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Residents of residential aged care
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influenza vaccine prior to administ
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Page 281 and 282: 4.9 MEASLES 4.9.1 Virology Measles
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Page 299 and 300: 4.10.4 Vaccines There are different
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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
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: in the previous 10 years. 19,45 Adu
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Page 331 and 332: 4.13 PNEUMOCOCCAL DISEASE 4.13.1 Ba
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Page 339 and 340: Table 4.13.1: Recommendations for p
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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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Page 367 and 368: 4.16 RABIES AND OTHER LYSSAVIRUSES
Page 369 and 370: 4.16.4 Rabies vaccines • Mérieux
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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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The Australian Immunisation Handbook 10th Edition 2013

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