Immunisation update
Rosemary Morey
Immunisation Nurse
September 2014
Immunisation Schedule:
Birth to 6 months
Age
Vaccine
preventable
disease (VPD)
Vaccine brand ®
Notes
Birth
Hepatitis B
H-B-Vax II Paediatric
•
Ideally given within 24 hours or up to
7 days of birth
•
No catch-up for missed dose
•
Early start = early pertussis
protection
•
All vaccines due on same day
•
First dose before 13 weeks of age;
third dose before 33 weeks of age
•
Virus shedding -1st dose
•
Intussusception (contraindication &
AEFI)
•
Note additional contraindications
2, 4 and 6
months
Can be given
from 6 weeks
of age
Diphtheria, Tetanus,
Pertussis, Polio, Hib,
Hepatitis B
Infanrix hexa
Pneumococcal
Prevenar 13
Rotavirus
RotaTeq
Immunisation Schedule:
12 months to 4 years
Age
Vaccine
preventable
disease (VPD)
Vaccine brand ®
Notes
12 months
Measles, Mumps,
Rubella
M-M-R II / Priorix
Additional vaccines for prematurity and
increased medical risk
Haemophilus influenzae
type b (Hib),
Meningococcal C
Menitorix
18 months
Measles, Mumps,
Rubella, Chickenpox
Priorix-Tetra
The risk of febrile seizures is greatly
reduced by giving MMR only at 12
months of age
4 years
Can be given
from 3.5 years
of age
Diphtheria, Tetanus,
Pertussis, Poliomyelitis
Infanrix IPV
From 2016 MMR will cease at 4 years as
this cohort of children will have had
MMRV vaccine at 18 months of age
Measles, Mumps,
Rubella (until end 2015)
M-M-R II / Priorix
Additional vaccines for prematurity and
increased medical risk
Extra recommended and funded vaccines for
babies and children with increased risk categories
Age
VPD
Vaccine brand ®
Notes
From 6 months of age
With underlying medical
risk factors
Influenza
Fluarix/Vaxigrip/Fluvax*
*bioCSL's Fluvax brand
not registered for use for
children <5 years of age and not
recommended in children 5 to 9
years
Annually
From 6 months to 9 years inclusive, give 2
doses of influenza vaccine a minimum of
1 month apart, in the first year of
administration.
Paediatric dose 6 months to <3 years
(From 2015? - ATSI aged 6mths to 5yrs)
12 months of age
premature babies
<32 weeks gestation or
<2000g birth weight
Hepatitis B
H-B-Vax II Paediatric
Single booster dose
12 months of age
With underlying medical
risk factors and/or <28
weeks gestation
Pneumococcal
Prevenar 13
Single booster dose
4-5 years of age
With underlying medical
risk factors and/or <28
weeks gestation
Pneumococcal
Pneumovax 23
See the current edition The Australian
Immunisation recommendations
Australian Childhood Immunisation Register
Coverage Victoria, 30 June 2014
Age in months
Total Victoria
Victoria
Total Australia
Indigenous
12 - <15
91%
87%
91%
24 - <27
93%
93%
93%
60 - <63 (5 yrs)
92%
89%
92%
Provider split
GP 56% / Local council 42%
Measles notifications in Victoria
Measles cases in Melbourne
People at risk of measles:
• Australian born during or since 1966 with no documentation of either 2 doses of a
measles-containing vaccine or laboratory-confirmed measles
• immunocompromised
The current Chief Health Officer measles alert recommendations include:
• No active recall for early doses
• Do not give the 1st dose before 12 months of age, unless given specific advice from
the Department of Health confirming contact with an infectious case.
• A funded early 2nd dose can be given on parental request
• For measles alert updates see: http://health.vic.gov.au/chiefhealthofficer/alerts/alert2014-09-measles-cases.htm
Invasive meningococcal disease notifications
Bexsero® Vaccine – Meningococcal B
•
Available from March 2014 on the private market (prescription)
•
Recommended for children aged <5 years, particularly infants aged <1 year
•
Doses recommended depend on the age of commencement.
•
Prophylactic use of paracetamol recommended with every dose administered to children
<2 years of age
•
Can be administered from 6 weeks of age
•
Summary clinical advice:
www.immunise.health.gov.au/internet/immunise/publishing.nsf/Content/atagi-advicebexsero
Pertussis notifications for Victoria
Pertussis cases aged <6mo and % hospitalised
True contraindications to vaccination
•
•
Absolute (extremely rare)
–
Anaphylaxis to the previous vaccine dose
–
Anaphylaxis to a component of the vaccine
–
Severe allergic reaction
–
Fever ≥38.5°C
Precaution (usually with ‘live’ virus vaccines)
–
Pregnancy
–
Impaired immunity &/or immunosuppressive therapy
–
Recent Immunoglobulins or blood products
•
check dose and intervals between administration
SAEFVIC
•
Surveillance of Adverse Events Following Vaccination in the Community
•
Monitoring vaccine safety in children and adults
•
Rapidly detect & research vaccine safety concerns
•
Immunisation providers and parents can report a significant or unexpected
adverse event following vaccination:
–
Online:
www.saefvic.org.au
–
Telephone:
9345 4143
–
Fax:
–
Email:
9345 4163
saefvic@mcri.edu.au
Health care workers:
Be an advocate for vaccination
Rationale:
• You are at increased risk of exposure to
vaccine preventable diseases
• You can transmit infections to susceptible
patients and your own family / friends
Recommendations:
• Pertussis (10 yearly)
• Measles, Mumps, Rubella (if born since 1966)
• Varicella (if non-immune)
• Hepatitis B
• Influenza (annually)
Source: Australian Immunisation Handbook, 10th Ed.
Health Professional Resources
•
Immunise Australia: immunise.health.gov.au
•
Immunisation Section: www.health.vic.gov.au/immunisation
•
–
Ph: 1300 882 008
–
M – F: 9am to 12pm & 2pm to 3 pm
–
Email: immunisation@health.vic.gov.au
Local council immunisation service
Additional Information
•
National Centre for Immunisation Research & Surveillance
www.ncirs.usyd.edu.au/
•
‘Communicating with parents about vaccination: a framework for health
professionals’, Leask J, Kinnersley P, Jackson C, Cheater F, Bedford HE,
Rowles G 2012, ‘Communicating with parents about vaccination: a
framework for health professionals’, BMC Pediatrics 12(154):1471–2431:
www.biomedcentral.com/1471-2431/12/154.
Parent Resources
• Immunise Australia: immunise.health.gov.au
• Better Health Channel fact sheets:
www.betterhealth.vic.gov.au
• Royal Children’s Hospital and Monash Medical Centre:
GP referral to Paediatrician. Phone: 1300 882 924
Additional Information
• The Science of Immunisation – Questions and Answers:
www.science.org/immunisation.html
• National Centre for Immunisation Research & Surveillance:
www.ncirs.edu.au/consumer-resources/index.php
• Chain of Protection: www.chainofprotection.org
Resources
• Posters available to order from the Commonwealth and
Victorian Immunisation websites
Acknowledgements:
Vaccine preventable graphs: Communicable Diseases
Epidemiology & Surveillance, Department of Health