Immunisation update

Rosemary Morey Immunisation Nurse September 2014

Age Birth

Immunisation Schedule: Birth to 6 months

Vaccine preventable disease (VPD)

Hepatitis B

Vaccine brand ®

H-B-Vax II Paediatric

2, 4 and 6 months

Can be given from 6 weeks of age

Diphtheria, Tetanus, Pertussis, Polio, Hib, Hepatitis B Pneumococcal Rotavirus Infanrix hexa Prevenar 13 RotaTeq

Notes

• • • • 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

Age

Immunisation Schedule: 12 months to 4 years

12 months 18 months Vaccine preventable disease (VPD)

Measles, Mumps, Rubella

Vaccine brand ®

M-M-R II / Priorix

Haemophilus influenzae

type b (Hib), Meningococcal C Menitorix Measles, Mumps, Rubella, Chickenpox Priorix-Tetra

4 years

Can be given from 3.5 years of age

Diphtheria, Tetanus, Pertussis, Poliomyelitis Infanrix IPV Measles, Mumps, Rubella (until end 2015) M-M-R II / Priorix

Notes

Additional vaccines for prematurity and increased medical risk The risk of febrile seizures is greatly reduced by giving MMR only at 12 months of age From 2016 MMR will cease at 4 years as this cohort of children will have had MMRV vaccine at 18 months of age 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

12 months of age premature babies

<32 weeks gestation or <2000g birth weight

12 months of age

With underlying medical risk factors and/or <28 weeks gestation

4-5 years of age

With underlying medical risk factors and/or <28 weeks gestation Influenza Hepatitis B Pneumococcal Pneumococcal 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

H-B-Vax II Paediatric 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) Single booster dose Prevenar 13 Pneumovax 23 Single booster dose See the current edition The Australian Immunisation recommendations

Australian Childhood Immunisation Register Coverage Victoria, 30 June 2014

Age in months 12 - <15 24 - <27 60 - <63 (5 yrs) Provider split Total Victoria Victoria Indigenous Total Australia 91% 93% 92% 87% 93% 89% 91% 93% 92% 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 1 st dose before 12 months of age, unless given specific advice from the Department of Health confirming contact with an infectious case. • A funded early 2 nd dose can be given on parental request • For measles alert updates see: http://health.vic.gov.au/chiefhealthofficer/alerts/alert 2014-09-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-advice bexsero

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: Fax: Email: www.saefvic.org.au

Telephone: 9345 4143 9345 4163 [email protected]

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: [email protected]

• 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