The Australian Immunisation Handbook 10th Edition 2013

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• Table 2.1.6 can be used to assess the number of doses a child should have received if they were on schedule. Check under the current age of the child to see how many doses they should have already received and use that number of doses as the starting point for calculating a catch-up schedule. For example, a child who is 18 months old now should have received 3 doses of DTPa, 3 doses of IPV, etc. • Table 2.1.7 lists the minimum acceptable interval between doses under special circumstances, such as catch-up vaccination. Vaccine doses should not be administered at less than the acceptable minimum interval. 16 In the majority of instances, doses administered earlier than the minimum acceptable interval should not be considered as valid doses and should be repeated, as appropriate, using Table 2.1.6. • Tables 2.1.8 to 2.1.11 are for calculating catch-up for Haemophilus influenzae type b (Hib) and pneumococcal vaccination of children. • Table 2.1.12 can be used to calculate a catch-up schedule for persons aged ≥10 years. In addition, the following principles should generally be applied when planning catch-up vaccination: • When commencing the catch-up schedule, the standard scheduled interval between doses may be reduced or extended, and the numbers of doses required may reduce with age. For example, from 15 months of age, only 1 dose of (any) Hib vaccine is required. • As a child gets older, the recommended number of vaccine doses may change (or even be omitted from the schedule), as the child becomes less vulnerable to specific diseases. • For incomplete or overdue vaccinations, build on the previous documented doses. In almost every circumstance, it is advisable to not start the schedule again, regardless of the interval since the last dose, but to count previous doses. One exception to this rule is for oral cholera vaccine (see 4.1 Cholera). • If more than one vaccine is overdue, 1 dose of each due or overdue vaccine should be given at the first catch-up visit. Further required doses should be scheduled after the appropriate minimum interval (see Table 2.1.7). • A catch-up schedule may require multiple vaccinations at a visit. Give all the due vaccines at the same visit – do not defer. See 2.2.9 Administering multiple vaccine injections at the same visit. • The standard intervals and ages recommended in the NIP schedule should be used once the child or adult is up to date with the schedule. • Some persons will require further doses of antigens that are available only in combination vaccines. In general, the use of the combination vaccine(s) is acceptable, even if this means the number of doses of another antigen administered exceeds the required number. 42 The Australian Immunisation Handbook 10th edition
• For some vaccines, catch-up vaccination is not recommended. For example, rotavirus vaccination is not recommended if the 1st (and subsequent) vaccine doses are not able to be provided within the prescribed upper age limits (see ‘Catch-up guidelines for individual vaccines for children
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The Australian Immunisation Handboo
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FOREWORD Since 1932, when Governmen
Page 5 and 6: TABLE OF CONTENTS PART 1 INTRODUCTI
Page 7 and 8: LIST OF TABLES Table 2.1.1: Pre-vac
Page 9 and 10: List 4.13.1: Conditions associated
Page 11 and 12: PREFACE The 10th edition of The Aus
Page 13 and 14: Secretariat support, Australian Tec
Page 15 and 16: PART 1 INTRODUCTION TO THE AUSTRALI
Page 17 and 18: 1.2 DEVELOPMENT OF THE 10TH EDITION
Page 19 and 20: 1.3 HOW TO USE THE 10TH EDITION HAN
Page 21 and 22: 1.4 WHAT’S NEW All chapters have
Page 23 and 24: 2.2 Administration of vaccines •
Page 25 and 26: • The section on vaccination of p
Page 27 and 28: 4.6 Human papillomavirus • HPV va
Page 29 and 30: • For Aboriginal and Torres Strai
Page 31 and 32: Part 5 Passive immunisation • Inf
Page 33 and 34: without the harmful consequences of
Page 35 and 36: (vaccine failure). Often such infec
Page 37 and 38: will occur following receipt of a s
Page 39 and 40: cases, both the doctor issuing the
Page 41 and 42: Should a child or adolescent refuse
Page 43 and 44: • check that the correct time int
Page 45 and 46: Note: Please discuss this informati
Page 47 and 48: Condition or circumstance of person
Page 49 and 50: Condition or circumstance of person
Page 51 and 52: Table 2.1.3: Live attenuated parent
Page 53 and 54: An online ‘catch-up calculator’
Page 55: Use of serological testing to guide
Page 59 and 60: Figure 2.1.1: Catch-up worksheet fo
Page 61 and 62: Vaccine Minimum age for 1st dose in
Page 63 and 64: Table 2.1.6: Number of vaccine dose
Page 65 and 66: Catch-up guidelines for individual
Page 67 and 68: If 13vPCV is not available, and 10v
Page 69 and 70: Previous vaccination history 2 prev
Page 71 and 72: PART 2 VACCINATION PROCEDURES 57 Ta
Page 73 and 74: PART 2 VACCINATION PROCEDURES 59 Ta
Page 75 and 76: Catch-up schedules for persons ≥1
Page 77 and 78: For additional details on these rec
Page 79 and 80: 2.2 ADMINISTRATION OF VACCINES 2.2.
Page 81 and 82: • Never freeze a vaccine after it
Page 83 and 84: PART 2 VACCINATION PROCEDURES 69 In
Page 85 and 86: 2.2.5 Vaccine injection techniques
Page 87 and 88: Interruption to a vaccination If th
Page 89 and 90: 2.2.7 Positioning for vaccination I
Page 91 and 92: Children ≥12 months of age Cuddle
Page 93 and 94: 2.2.8 Identifying the injection sit
Page 95 and 96: • Place the palm over the greater
Page 97 and 98: 2.2.9 Administering multiple vaccin
Page 99 and 100: 2.3 POST-VACCINATION 2.3.1 Immediat
Page 101 and 102: Management of an immediate adverse
Page 103 and 104: Management of anaphylaxis Rapid IM
Page 105 and 106: 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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In developed countries, typhoid fev
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A 4th capsule taken on day 7 has be
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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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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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