The Australian Immunisation Handbook 10th Edition 2013

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7 days after dose 1, and 2-fold in the first 7 days after dose 2 of either vaccine. 74 The baseline risk of intussusception for Australian infants is around 80 cases per 100 000 infants. 75 The increased risk of IS following rotavirus vaccination, from the most recent Australian study, is estimated as approximately 6 additional cases of intussusception among every 100 000 infants vaccinated, or 18 additional cases per year in Australia. 74 This estimate assumes that infants in which an episode of IS occurs shortly after vaccination would not have otherwise experienced a ‘natural’ episode of intussusception; however, this cannot be determined from current data. Importantly, studies from both Australia14-17 and overseas57 have demonstrated the substantial impact of vaccination in preventing rotavirus morbidity and mortality (see also 4.17.3 Epidemiology above). Rotavirus vaccines continue to be recommended for use on the basis of this positive benefit to risk profile. 76 Immunisation providers should inform parents and carers of the rare risk of intussusception and how to be alert for the signs and symptoms of the condition. Rotavirus vaccine should not be given to an infant who has had a confirmed intussusception because there may be an increased risk of the condition recurring (see 4.17.9 Contraindications above). Other adverse events No significant increase in post-vaccination vomiting, diarrhoea or fever has been reported during follow-up of several thousand recipients of Rotarix compared to those who were unvaccinated. 39,77 Detailed follow-up of 11 700 recipients of RotaTeq or placebo reported no increase in fever or irritability in the week after vaccination among vaccinated infants, but a small increase in the incidence of vomiting (7% versus 5%) and diarrhoea (10% versus 9%). 78 Vomiting and diarrhoea have not emerged as important adverse events following immunisation in post-marketing surveillance of rotavirus vaccines. Infants who report an episode of diarrhoea or vomiting following vaccination should still receive subsequent rotavirus vaccine doses, as required and age eligible. The potential causes of diarrhoea/vomiting following vaccination include: gastroenteritis unrelated to rotavirus vaccination or infection (e.g. another viral agent); natural rotavirus infection (as vaccination is neither immediately protective nor 100% protective against all disease); or symptoms from vaccine virus replication (less likely). If rotavirus is detected by routine stool testing on a recently vaccinated infant, a positive test result can represent either natural infection or vaccine virus (as vaccine virus shedding occurs commonly after vaccination (see 4.17.4 Vaccines above). Specific testing is required to differentiate between vaccine virus and natural infection; however, this is rarely clinically indicated. 382 The Australian Immunisation Handbook 10th edition
4.17.12 Variations from product information The product information for Rotarix states that the vaccine should not be administered to subjects with any chronic gastrointestinal disease. The ATAGI recommends instead that pre-existing chronic gastrointestinal disease is not a contraindication to rotavirus vaccination, with the exception of those conditions that may predispose to IS (see 4.17.9 Contraindications and 4.17.10 Precautions above). The product information for RotaTeq states that in the event that a dose of vaccine is spat out or vomited post vaccination, a replacement dose should not be given. The ATAGI recommends instead that if most of a dose is spat out or vomited then a single replacement dose may be given (see 4.17.6 Dosage and administration above.) References A full reference list is available on the electronic Handbook or website www.immunise.health.gov.au PART 4 VACCINE-PREVENTABLE DISEASES 383 4.17 ROTAVIRUS
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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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4.8 JAPANESE ENCEPHALITIS 4.8.1 Vir
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28 days following vaccination with
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When using JEspect in children aged
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4.8.8 Pregnancy and breastfeeding I
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4.9 MEASLES 4.9.1 Virology Measles
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4.9.4 Vaccines Monovalent measles v
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4.9.6 Dosage and administration The
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Table 4.9.1: Recommendations for me
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increase in adverse events from vac
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Immunoglobulin or blood product adm
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approximately 5%. 2,25 There is als
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Table 4.9.2: Post-exposure prophyla
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4.10 MENINGOCOCCAL DISEASE 4.10.1 B
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4.10.4 Vaccines There are different
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Polysaccharide vaccines Quadrivalen
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Interchangeability of meningococcal
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• Children (aged ≥9 months) and
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Appendix 1 Contact details for Aust
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4.11 MUMPS 4.11.1 Virology Mumps is
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Trivalent measles-mumps-rubella (MM
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4.11.7 Recommendations Infants aged
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Vaccination with other live attenua
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acquired from healthcare workers. 1
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demonstrated a more rapid decline,
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• Boostrix-IPV - GlaxoSmithKline
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in the previous 10 years. 19,45 Adu
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(see ‘Women who are planning preg
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an HHE. An HHE may last from a few
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The product information for Quadrac
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4.13 PNEUMOCOCCAL DISEASE 4.13.1 Ba
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non-Indigenous children (88%). 19,2
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10-valent pneumococcal conjugate va
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lesser antibody responses to 2nd or
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Table 4.13.1: Recommendations for p
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Category B: Conditions associated w
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Children aged >5 years to 15 years)
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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
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Page 367 and 368: 4.16 RABIES AND OTHER LYSSAVIRUSES
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Page 387 and 388: age group11,12 and affecting 3.8% o
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Page 401 and 402: zoster virus [Oka strain]). Lyophil
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Page 409 and 410: case. Seronegative women of child-b
Page 411 and 412: 4.19 TETANUS 4.19.1 Bacteriology Te
Page 413 and 414: Formulations for children aged
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Page 419 and 420: studies indicate that the adverse r
Page 421 and 422: The product information for Adacel
Page 423 and 424: of MDR-TB cases identified has incr
Page 425 and 426: BCG vaccination procedures BCG vacc
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Page 429 and 430: 4.20.13 Variations from product inf
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Page 435 and 436: 4.21.8 Pregnancy and breastfeeding
Page 437 and 438: 4.22 VARICELLA 4.22.1 Virology Vari
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Page 441 and 442: Reconstituted Varivax Refrigerated
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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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4.24.12 Variations from product inf
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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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