The Australian Immunisation Handbook 10th Edition 2013

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DT a vaccine that protects against diphtheria and tetanus. The acronym DT, using capital letters, signifies the child formulation of diphtheria and tetanuscontaining vaccine, and denotes the substantially larger amounts of diphtheria toxoid in this formulation than in the adolescent/adult formulation. dT reduced antigen content formulation of diphtheria-tetanus vaccine, which contains substantially lower concentrations of diphtheria toxoid, and approximately half the tetanus antigen content, than the child formulation (which is signified by using capital letters DT). This vaccine is most commonly administered to adolescents/adults. DTP/DTPa/DTPw a vaccine that protects against diphtheria, tetanus and pertussis (whooping cough). The DTP used in Australia and many other industrialised countries is DTPa, which contains an acellular pertussis component made of refined pertussis extracts instead of inactivated whole pertussis bacteria (DTPw). The acronym DTPa, using capital letters, signifies child formulations of diphtheria, tetanus and acellular pertussis-containing vaccines, and denotes the substantially larger amounts of diphtheria toxoid and pertussis antigens in these formulations than in the adolescent/adult formulations. dTpa reduced antigen content formulation of diphtheria-tetanus-acellular pertussis vaccine, which contains substantially lower concentrations of diphtheria toxoid and pertussis antigens, and approximately half the tetanus antigen content, than the child formulations (which are signified by using all capital letters [DTPa]). This vaccine is most commonly administered to adolescents/adults. Effectiveness the extent to which a vaccine produces a benefit in a defined population in uncontrolled or routine circumstances Efficacy the extent to which a vaccine produces a benefit in a defined population in controlled or ideal circumstances, for example, in a randomised controlled trial Encephalitis inflammation of the brain Encephalopathy a general term to describe a variety of illnesses that affect the brain, including encephalitis Endemic endemic infections are present all the time in a community 490 The Australian Immunisation Handbook 10th edition
Enzootic enzootic infections are present all the time in animals of a specific geographic area Epidemic epidemic infections are those that spread rapidly in a community; measles and influenza viruses are common causes of epidemics in Australia; small epidemics are often called outbreaks Extensive limb swelling swelling of the limb, with or without redness, which: » extends from the joint above to the joint below the injection site, or beyond a joint (above or below the injection site), or » results in the circumference of the limb being twice the normal size. Febrile related to a fever, as in febrile illness and febrile convulsions Hepatitis an inflammation of the liver; can be caused by viral infections Hypotonic-hyporesponsive episode (shock, collapse) the sudden onset of pallor or cyanosis, limpness (muscle hypotonia), and reduced responsiveness or unresponsiveness occurring after vaccination, where no other cause is evident, such as a vasovagal episode or anaphylaxis. The episode usually occurs 1 to 48 hours after vaccination and resolves spontaneously. Immunisation the process of inducing immunity to an infectious agent by administering a vaccine Immunity the ability of the body to fight off certain infections; immunity can result from natural (‘wild’) infections or from vaccination Immunogenicity the ability (or the degree) to which a particular substance, in this context a vaccine, may provoke an immune response Immunoglobulin a protein extract from blood, sometimes called ‘antibody’, that fights off infection; injection of immunoglobulins provides temporary immunity against certain infections APPENDIX 5 491 APPENDIX 5
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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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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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4.20.13 Variations from product inf
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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
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-
Page 465 and 466: diagnosis. In addition, the risk of
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
Page 501 and 502: A4.5 Questions about the need for i
Page 503: APPENDIX 5: GLOSSARY OF TECHNICAL T
Page 507 and 508: Rotavirus a virus that is a common
Page 509 and 510: APPENDIX 6: COMMONLY USED ABBREVIAT
Page 511 and 512: OPV oral poliomyelitis vaccine PCEC
Page 513 and 514: Year Vaccine 2003 Varicella 2003 Me
Page 515 and 516: identifying the injection site, 79-
Page 517 and 518: Australian Capital Territory advers
Page 519 and 520: and travellers, 119 vaccines, 177-1
Page 521 and 522: abies and other lyssaviruses (inclu
Page 523 and 524: HPV Vaccination Program, 234 human
Page 525 and 526: interferon-gamma release assays (IG
Page 527 and 528: mercury, in vaccines. see thiomersa
Page 529 and 530: Northern Territory ACIR reporting,
Page 531 and 532: and Haemophilus influenzae type b (
Page 533 and 534: espiratory syncytial virus monoclon
Page 535 and 536: Therapeutic Goods Administration (T
Page 537 and 538: varicella-zoster immunoglobulin, 45
Page 539 and 540: INDEX 525 INDEX
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