Immunisation update Rosemary Morey Immunisation Nurse September 2014

Immunisation Schedule: Birth to 6 months AgeVaccine preventable disease (VPD) Vaccine brand ®Notes BirthHepatitis BH-B-Vax II Paediatric Ideally given within 24 hours or up to 7 days of birth No catch-up for missed dose 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 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

Immunisation Schedule: 12 months to 4 years AgeVaccine preventable disease (VPD) Vaccine brand ®Notes 12 monthsMeasles, Mumps, Rubella Haemophilus influenzae type b (Hib), Meningococcal C M-M-R II / Priorix Menitorix Additional vaccines for prematurity and increased medical risk 18 monthsMeasles, Mumps, Rubella, Chickenpox Priorix-TetraThe 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 Measles, Mumps, Rubella (until end 2015) Infanrix IPV M-M-R II / Priorix 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

AgeVPDVaccine brand ®Notes From 6 months of age With underlying medical risk factors InfluenzaFluarix/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 BH-B-Vax II PaediatricSingle booster dose 12 months of age With underlying medical risk factors and/or <28 weeks gestation PneumococcalPrevenar 13Single booster dose 4-5 years of age With underlying medical risk factors and/or <28 weeks gestation PneumococcalPneumovax 23See the current edition The Australian Immunisation recommendations Extra recommended and funded vaccines for babies and children with increased risk categories

Age in monthsTotal Victoria Victoria Indigenous Total Australia 12 - <1591%87%91% 24 - <2793% 60 - <63 (5 yrs)92%89%92% Provider splitGP 56% / Local council 42% Australian Childhood Immunisation Register Coverage Victoria, 30 June 2014

Measles notifications in Victoria

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: measles-cases.htm Measles cases in Melbourne

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: bexsero bexsero

Pertussis notifications for Victoria

Pertussis cases aged <6mo and % hospitalised

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 True contraindications to vaccination

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: –Telephone: –Fax: – SAEFVIC

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 care workers: Be an advocate for vaccination

Immunise Australia: immunise.health.gov.auimmunise.health.gov.au Immunisation Section: –Ph: –M – F: 9am to 12pm & 2pm to 3 pm – Local council immunisation service Additional Information National Centre for Immunisation Research & Surveillance ‘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: Health Professional Resources

Immunise Australia: immunise.health.gov.auimmunise.health.gov.au Better Health Channel fact sheets: Royal Children’s Hospital and Monash Medical Centre: GP referral to Paediatrician. Phone: Additional Information The Science of Immunisation – Questions and Answers: National Centre for Immunisation Research & Surveillance: Chain of Protection: Parent Resources

Posters available to order from the Commonwealth and Victorian Immunisation websites Acknowledgements: Vaccine preventable graphs: Communicable Diseases Epidemiology & Surveillance, Department of Health Resources