The Australian Immunisation Handbook 10th Edition 2013

Catch-up schedules for persons ≥10 years of age
Catch-up is much less commonly required for this age group than for young
children. Nevertheless, issues surrounding booster doses or revaccinations are
common, particularly in adults. Persons who did not have natural infection
as children but were not vaccinated remain at unnecessary risk of vaccinepreventable
diseases.
In general, the same principles for catch-up vaccination apply as for younger
children. For example, if a vaccine course is incomplete, do not start the course
again, regardless of the interval since the last dose. One exception to this rule is
for oral cholera vaccine (see 4.1 Cholera).
Catch-up vaccination for adults can be less straightforward than for children and
adolescents. A useful principle to consider when planning which vaccines to give
to adults is the HALO principle, which allows for assessment of vaccines needed
depending on risk factors:
• Health
• Age
• Lifestyle
• Occupation
The schedule for each individual adult may differ because of the risk factors
identified when applying the HALO principle. Some examples of how the HALO
principle can be used:
• Health: the person to be vaccinated has a medical condition(s) that places
them at increased risk of acquiring a particular vaccine-preventable disease
or experiencing complications from that disease, for example, influenza.
• Age: older age groups may require extra vaccines, such as influenza or
pneumococcal vaccination, or certain age groups may be targeted for
immunisation against a particular vaccine-preventable disease, such as HPV.
Another example is young to middle-aged adults who may have missed out
on vaccine doses due to schedule changes, such as the 2nd dose of MMR
vaccine.
• Lifestyle: the person may have missed vaccines because they moved location
of residence, may require extra vaccines because they travel frequently, or
have other lifestyle risk factors that increase their risk of acquiring a vaccinepreventable
disease, for example, smoking or injecting drugs.
• Occupation: the person may be employed in an occupation for which certain
vaccines are recommended because of the increased risk of acquiring a
vaccine-preventable disease and/or transmitting it to others, such as in
healthcare or early childhood education and care.
The HALO principle is also incorporated, to some extent, into questions used in
the pre-vaccination screening checklist (see Tables 2.1.1 and 2.1.2).
PART 2 VACCINATION PROCEDURES 61
2.1 PRE-VACCINATION