1-3 The Terrace
P.O Box 5013
Wellington
Date:
May 2014
To:
General Practitioners, Practice Nurses, Practice Managers, Health Professionals
From:
Rayoni Keith, Manager, Immunisation
Subject:
Pages: 1 of 3
Target update, Rotavirus, Transition to Prevenar 13, Changes to
targeted (high risk) programmes for special groups, Ordering the new
vaccines, Immunisation Handbook 2014, Updated resources, NIR and
PMS changes, Vaccinator Schedule Updates, Changes to serology
testing, Seasonal influenza programme, Measles, Rheumatic fever
campaign
Target update
We are committed to ensuring 95% of all eight month olds are fully immunised by December 2014.
Working together we can achieve remarkable increases in this health target and with only seven
months to go. Congratulations to all those whose practice level coverage is over 95%. For
everyone else, if you haven’t already, now is the time to pre-call and recall your patients, or refer
children who are missed or late for their immunisation events to outreach services.
Results for the last three quarters remain on 91% nationwide. The Ministry is updating DHBs
weekly about their progress, and is now providing PHOs with coverage information for their
enrolled patients. There is a noticeable gap between babies’ immunisation status at six months
and at eight months – ensuring babies are immunised on time at six weeks, three months and five
months will reduce the amount of effort needed later.
Rotavirus vaccine on the National Immunisation Schedule from 1 July 2014
The introduction of rotavirus vaccine to the National Immunisation Schedule means that parents
are likely to seek further information. The most important points are as follows:

RotaTeq is given at 6 weeks, 3 months and 5 months of age. The first dose must be given
before 15 weeks of age (i.e. by 14 weeks and 6 days old at the latest).
 As the vaccine is a live attenuated oral vaccine, all contacts of vaccinated infants should
observe standard careful hygiene measures when changing nappies.
 There may be a small additional risk of intussusception from receiving rotavirus vaccination
particularly in the first week after the first dose (estimated between 1 and 6 infants in every
100,000 infants vaccinated). This is extremely low in comparison to the hundreds of infants
who are hospitalised annually because of rotavirus gastroenteritis. The possible increase in
risk of intussusception is the reason why the rotavirus vaccine has upper age limits at which
it can be given.
The Ministry has developed a resource to support the rotavirus vaccine discussion with parents.
This resource (code HE2425) is available at www.healthed.govt.nz/resource/immunise-againstrotavirus-protect-your-child.
A rotavirus vaccine factsheet for vaccinators and health professionals is available on the Ministry of
Health website at www.health.govt.nz/system/files/documents/pages/factsheet-vaccinators-healthprofessionals-about-rotavirus-rotateq-may2014.pdf
Transition to Prevenar 13
Prevenar 13 (PCV13) protects against 13 strains of pneumococcal disease – which includes the 10
strains offered by the current vaccine, Synflorix, and three further strains. Prevenar 13 will be
distributed once existing stocks of Synflorix have been used – this is likely to be in late July or
August.
If a child is due for a pneumococcal vaccine and they have previously received Synflorix they can
transition to Prevenar 13 for their remaining immunisation schedule without requiring additional
doses. Where this occurs the child should develop full protection against the ten strains covered
by both vaccines, and they are likely to have partial protection against the additional strains
covered by Prevenar 13.
Changes to targeted (high risk) programmes for special groups
There are new programmes and changes to the vaccines for special groups for the following
vaccines from 1 July 2014:
 Hepatitis A vaccine
 Hepatitis B vaccine
 Human papillomavirus (HPV)
 Meningococcal conjugate vaccines, MenCCV and MCV4-D
 Varicella.
For the most up to date information on the eligibility criteria and vaccines for special groups please
refer to the New Zealand Pharmaceutical Schedule and the online version of the Immunisation
Handbook 2014, at www.health.govt.nz/publication/immunisation-handbook-2014
Ordering the new vaccines
Changes are being made to the ProPharma online vaccine order form and you will be able to order
the new vaccines from 16 June 2014 so you can start vaccinating on 1 July 2014.
The funded vaccines Menactra, NeisVac-C and Varilrix will only be available on an ‘as needed
basis’. Please do not stockpile doses of these vaccines in your fridge.
Immunisation Handbook 2014
The Immunisation Handbook 2014 is now available and copies
are being sent to practices this week. Extra copies can be
ordered from Wickliffe. The Handbook is available online at the
link above, and an e-book version will be available for download
for use on tablets or e-readers by the end of this week.
The Handbook has been updated to include the National
Immunisation Schedule changes that take effect from 1 July
2014. It has been reordered so disease chapters are in
alphabetical order, and there is a new chapter on immunisation
for high risk groups.
The online version of the Handbook will be updated to reflect any
changes made by PHARMAC to the Pharmaceutical Schedule
about publicly funded vaccines and the eligibility criteria.
Updated immunisation resources
Key resources for the public about the Schedule have been revised and rebranded; these are
currently being printed. These include a pamphlet Immunise your child on time, post vaccination
advice sheet, schedule card including photos of the vaccine boxes, and booklet Childhood
Immunisation. The new resources will be available to order from mid to late June from
www.healthed.govt.nz . A detailed list of these new resources is available on
www.health.govt.nz/schedule.
NIR and PMS changes
The National Immunisation Register (NIR) and your local practice management systems (PMS) are
being updated for the Schedule changes.
From 1 July the following vaccines will be able to be recorded on the NIR for both children and
adults who meet the eligibility criteria for these publically funded vaccines:
Rotavirus (RV5)
Influenza
MMR
dTap - pregnant woman
Meningococcal A, C, Y and W135 (MCV4-D)
Meningococcal C (MenCCV)
Varicella (VV)
Hepatitis A
Hepatitis B
Your PMS vendor has made changes to their software so that adult ‘opt-off’ messages are not sent
to the NIR. Opt-off messages will continue to go to the NIR for children born since 2005. Your
PMS vendor will advise you when their software has been updated and what changes they have
made.
Vaccinator Schedule update sessions
Vaccinator update sessions will be offered during June in all DHBs and we encourage you to
participate in these sessions. For information on when these updates are being given in your area,
please contact your local immunisation coordinator.
Changes to serology testing for babies born to mothers with chronic hepatitis B infection
Babies who are born to mothers who are HBsAg positive require serological testing at around 9
months of age. This is a change from the previous recommendation for serological testing at age 5
months. These babies should still receive a birth dose of hepatitis B vaccine and hepatitis B
immunoglobulin as well as the vaccines given at ages 6 weeks, 3 months and 5 months.
Changes will be made to record the outcome of the serological testing on the NIR but these will not
be completed by 1 July.
2014 seasonal influenza programme
We have distributed just over 1.15 million doses of vaccine. This year the aim is to reach 1.25
million doses by 31 July. In order for us to do this, your help is needed to ensure that everyone
who is eligible is vaccinated, including pregnant women who can also receive Tdap and influenza
vaccine together. Ideally all flu vaccine pre-calls for the eligible population will be complete by 1
July, as it is likely that rotavirus vaccine may be very popular for babies fast approaching 14 weeks
and 6 days.
Measles
Between December 2013 and 28 May 2014 there have been 133 cases of measles reported in
New Zealand. 110 cases in Auckland, 15 in Bay of Plenty/Lakes, 4 in Wellington, 2 in Hawke’s
Bay and 2 in Waikato.
Further cases linked to the two Waikato cases would not be unexpected. One attended the
Armageddon Expo popular culture event at Claudelands Event Centre on Sunday 25 May. Owing
to the size of the event the Waikato DHB has issued a media release to alert attendees to be
mindful of the signs and symptoms of measles.
To protect your patients and to help prevent outbreaks in New Zealand, please continue to
encourage vaccination for patients who have not previously received two doses of measles
containing vaccine.
Rheumatic fever campaign
Rheumatic fever TV advertising begins on Saturday 7 June and runs until late August. The ads
focus on raising awareness of the link between sore throats, rheumatic fever and possible heart
damage. Healthline contact details are promoted in the ads, allowing callers at greatest risk of
rheumatic fever to be identified and directed to appropriate medical care. You may notice an
increase in the number of children and young people presenting with sore throats after 7 June.
The Ministry of Health advises that antibiotic treatment is recommended for all suspected Group A
Strep sore throat infections in those children and young people at the greatest risk of developing
rheumatic fever (Māori and Pacific people living in high risk areas of the North Island). The
recommended first-line treatment is 10 days of amoxicillin given once daily (750mg daily for
those under 30kg, and 1000mg daily for those over 30kg).
If you have any queries about anything in this update, please email
immunisation@moh.govt.nz