The Australian Immunisation Handbook 10th Edition 2013

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should be tested for varicella-zoster antibodies following contact with a person with confirmed varicella. However, testing should not delay ZIG administration after initial exposure to a case. 84-86 ZIG administration (preferably within 96 hours and up to 10 days after exposure) is required for the following groups and should not be delayed by testing (if indicated below): • Pregnant women who are presumed to be susceptible to varicella infection. If practicable, they should be tested for varicella-zoster antibodies before ZIG is given. 5 • Neonates whose mothers develop varicella from 7 or fewer days before delivery to 2 days after delivery. ZIG must be given, as the neonatal mortality without ZIG is up to 30% in this setting. 1,7 ZIG must be given as early as possible in the incubation period. • Neonates exposed to varicella in the 1st month of life, if the mother has no personal history of infection with VZV and is seronegative. 27 ZIG should be given, due to the increased risk of severe varicella in newborns of seronegative women. • Premature infants (born at
high-dose intravenous NHIG are likely to be protected and probably do not require ZIG if the last dose of NHIG was given 3 weeks or less before exposure. Vaccination for post-exposure prophylaxis If VV is not contraindicated, it can be offered to non-immune age-eligible children and adults who have a significant exposure to varicella or HZ and wish to be protected against primary infection with VZV (see ‘Post-exposure vaccination’ in 4.22.7 Recommendations above). 51-55 Vaccination has the added benefit of reducing the likelihood of varicella infection, particularly moderate to severe disease, following exposure, and also provides long-term protection. Vaccination of exposed persons during outbreaks has also been shown to prevent further cases and to control outbreaks. 55 If MMR vaccination is also indicated, MMRV vaccine can be used in children
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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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Non-Indigenous adults A single dose
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Adults who have a condition listed
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4.13.11 Adverse events 10-valent pn
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5 years with a condition(s) associa
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virtually eradicated in India, but
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formaldehyde, glutaraldehyde, polys
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4.14.8 Pregnancy and breastfeeding
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4.15 Q FEVER 4.15.1 Bacteriology Q
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4.15.4 Vaccine • Q-Vax - CSL Limi
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individuals, which can be accessed
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Refer to 3.3 Groups with special va
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4.16 RABIES AND OTHER LYSSAVIRUSES
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4.16.4 Rabies vaccines • Mérieux
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of an even more accelerated schedul
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Pre-exposure prophylaxis for rabies
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The relevant state/territory health
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Although data are limited on the ef
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Table 4.16.2: Post-exposure prophyl
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Figure 4.16.2: Post-exposure prophy
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Figure 4.16.3: Booster algorithm fo
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allergic reaction occurs following
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age group11,12 and affecting 3.8% o
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of age, the risk of IS was increase
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Interchangeability of rotavirus vac
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gestational age; median 34 weeks) w
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Infants living in households with p
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4.17.12 Variations from product inf
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Page 401 and 402: zoster virus [Oka strain]). Lyophil
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Page 405 and 406: A number of commercial assays for t
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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
Page 415 and 416: 4.19.5 Transport, storage and handl
Page 417 and 418: foreign bodies (especially wood spl
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
Page 427 and 428: Occupational groups There is some e
Page 429 and 430: 4.20.13 Variations from product inf
Page 431 and 432: In developed countries, typhoid fev
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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 445 and 446: eceived varicella vaccine while bre
Page 447 and 448: immunoglobulin and other blood prod
Page 449: eported in a 9-year follow-up of 70
Page 453 and 454: 4.23 YELLOW FEVER 4.23.1 Virology Y
Page 455 and 456: Co-administration with other vaccin
Page 457 and 458: 4.23.8 Pregnancy and breastfeeding
Page 459 and 460: Vaccine-associated neurotropic adve
Page 461 and 462: 1000 cases per 100 000 population i
Page 463 and 464: administration of Zostavax with 23-
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Page 467 and 468: Laboratory testing to check for an
Page 469 and 470: 4.24.12 Variations from product inf
Page 471 and 472: the immunoglobulin preparations con
Page 473 and 474: Prevention of measles Measles vacci
Page 475 and 476: who are being treated with immunosu
Page 477 and 478: limb with a separate syringe, and a
Page 479 and 480: APPENDIX 1: CONTACT DETAILS FOR AUS
Page 481 and 482: APPENDIX 2: LITERATURE SEARCH STRAT
Page 483 and 484: APPENDIX 3: COMPONENTS OF VACCINES
Page 485 and 486: Vaccine component* Vaccine brand
Page 487 and 488: APPENDIX 4: COMMONLY ASKED QUESTION
Page 489 and 490: When should preterm infants be vacc
Page 491 and 492: If a parent decides not to have a c
Page 493 and 494: Should vaccines be given to persons
Page 495 and 496: eason not to vaccinate. Asthma, ecz
Page 497 and 498: Does MMR vaccine cause inflammatory
Page 499 and 500: (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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