Immunise Australia Program
Australian Government Department of Health and Ageing
Australian Government Department of Health and Ageing. Immunise Australia Program. Information Line 1800 671 811
Immunise Australia Program. Information Line 1800 671 811

Health Professionals

Information for Health Professionals on various immunisation-related topics.


This page contains information for Health Professionals on various immunisation and vaccination-related topics. Disease-specific publications for Health Professionals can be accessed from the Publications & Resources page.

Seasonal Influenza Vaccine

2014 Seasonal Influenza Vaccination Program

The 2014 program starts on 15 March. Annual influenza vaccination is provided free through the National Immunisation Program (NIP) to groups who are at an increased risk of influenza complications, including:

Influenza vaccination in children

Since late 2010, bioCSL Fluvax® has not been registered for use in children aged less than 5 years because it causes unacceptably high rates of adverse events, specifically fevers and febrile convulsions, in children of this age.

BioCSL Fluvax® is approved for use in persons aged 5 years and older; however, the TGA and the Product Information for bioCSL Fluvax® advise that this vaccine should only be used in children aged 5 to under 9 years based on careful consideration of potential benefits and risks to the individual. ATAGI recommends it not be used in this age group because there are readily available alternative trivalent inactivated influenza vaccines which are much less likely to induce fever. Only if an alternative vaccine is not available should bioCSL Fluvax® be used. Thus, use of bioCSL Fluvax® in children aged 5 to 9 years should only be considered after careful review of the potential benefits and risks.

The available data indicate that there is a very low risk of fever, which is usually mild and transient, following vaccination with the other vaccine brands: Agrippal®; Fluarix®; Influvac®; and Vaxigrip®. Any of these vaccines can be used in children aged 6 months and older.

The following table shows which flu vaccines are suitable for different age groups of children.

Table 1. Summary of seasonal trivalent influenza vaccines available for use in Australia in the 2014 southern hemisphere influenza season, by brand, recommended age and availability under the NIP

Vaccine brand name
Vaccine sponsor
6 months to <5 years
5 years to <10 years
10 years and older
Formulation
Route
Available through the NIP
Aggripal® Novartis
Yes
Yes
Yes
0.5 mL pre-filled syringe
IM
No
Fluarix® GSK
Yes
Yes
Yes
0.5 mL pre-filled syringe
IM
Yes
Fluvax® bioCSL
Not approved for use
X
See Note 1
Yes
0.5 mL pre-filled syringe
IM
Yes
Influvac® Abbott
Yes
Yes
Yes
0.5 mL pre-filled syringe
IM
No
Influvac® Junior Abbott
See Note 2
Not approved for use
Not approved for use
0.25 mL pre-filled syringe
IM
No
Intanza® Sanofi Pasteur
Not approved for use
Not approved for use
18–59 years
See Note 3
0.1 mL pre-filled microinjection system
ID
No
Vaxigrip® Sanofi Pasteur
Yes
Yes
Yes
0.5 mL pre-filled syringe
IM
Yes
Vaxigrip® Junior Sanofi Pasteur
See Note 2
Not approved for use
Not approved for use
0.25 mL prefilled syringe
IM
Yes

Abbreviations: NIP – National Immunisation Program; GSK – GlaxoSmithKline; IM – intramuscular; ID – intradermal


Vaccine composition

The 2014 trivalent vaccine differs from the 2013 seasons trivalent vaccine as it contains two new strains. Therefore it is especially important for those who are at risk to be vaccinated.

The H1N1 pandemic influenza virus strain, A(H1N1)pdm09, remains in the vaccine. The second influenza A strain and the influenza B strain, however, are different from previous years. The in the 2014 southern hemisphere trivalent seasonal influenza vaccine are:

For information about the composition of the vaccine visit the Therapeutic Goods Administration (TGA) website.

Report influenza vaccinations and adverse events

Immunisation providers are encouraged to report all influenza vaccines given to children up to seven years of age to the Australian Childhood Immunisation Register. Any adverse events following immunisation at any age should be reported to the TGA through the ‘reporting problems’ link at the TGA website or through the usual reporting mechanisms in the relevant state or territory.

A number of seasonal influenza resources are available for ordering and printing including posters and fact sheets.

Meningococcal B Vaccine

From 5 March 2014, the recombinant multicomponent meningococcal B vaccine Bexsero® (4CMenB) will be available through purchase on the private market. 4CMenB is registered for use in persons ≥2 months of age for the prevention of invasive disease caused by serogroup B meningococci.

For infants aged <6 months of age, 3 primary doses of 4CMenB plus a booster at age 12 months are recommended. 4CMenB may be given at the same time as other infant vaccines administered under the NIP, but must be given at separate injection sites. The first dose of 4CMenB may be administered as early as 6 weeks of age to align with the NIP infant schedule. For older infants, adolescents and adults who the vaccine is recommended for, the dosing schedule varies based on age of first dose.

In clinical trials systemic reactions, including fever, were more common when 4CMenB was given concurrently with other infant vaccines, compared to when 4CMenB or other routine vaccines were administered alone. Therefore ATAGI recommends the prophylactic use of paracetamol with every dose of 4CMenB administered to children <2 years of age, to reduce the probability and severity of fever. The first dose of paracetamol (15mg/kg per dose) is recommended within the 30 min period prior to vaccination or as soon as practicable afterwards, regardless of the presence of fever. This can be followed by 2 more doses of paracetamol given 6 hours apart.

More detailed information regarding dosage and administration, recommendations for use and adverse events, including the use of prophylactic paracetamol, are provided in the full clinical advice.

Pneumococcal Vaccine

Program providing an additional dose of 13vPCV (a 13-valent pneumococcal conjugate vaccine) for at risk Aboriginal and Torres Strait Islander children

A fourth dose of Prevenar 13®, (13vPCV, a 13-valent pneumococcal conjugate vaccine) for Aboriginal and Torres Strait Islander children residing in Queensland, South Australia, Western Australia and the Northern Territory will be listed on the National Immunisation Program from 1 October 2012. This will replace the booster dose of Pneumovax23®, (23vPPV, a 23-valent pneumococcal polysaccharide vaccine) currently administered between 18 and 24 months of age for Aboriginal and Torres Strait Islander children residing in these jurisdictions.

The booster dose is required after a primary course of 13vPCV at 2, 4 and 6 months of age due to an increased risk of pneumococcal disease in Aboriginal and Torres Strait Islander children residing in these jurisdictions.

The Australian Technical Advisory Group on Immunisation (ATAGI) advises that following the availability of 13vPCV in Australia, existing evidence does not support the continuing role of 23vPPV for Aboriginal and Torres Strait Islander children.

Conjugate vaccines, such as 13vPCV are more effective than polysaccharide vaccines, such as 23vPPV, in children under two years of age.

Moving this fourth dose forward to the 12-18 month old cohort aligns the provision of the fourth dose for medically at risk children at 12 months of age.

This program does not apply to Aboriginal or Torres Strait Islander children living in New South Wales, Victoria, Tasmania or the Australian Capital Territory where the rate of IPD is similar to that of non-Indigenous children.

Program providing a supplementary dose of 13vPCV (a 13-valent pneumococcal conjugate vaccine)

A program providing a supplementary does of 13vPDV commenced on 1 October 2011 and concluded on 30 September 2012. Children who were aged between 12 months and 35 months and had completed a primary pneumococcal vaccination course with 7vPCV were eligible to receive a free supplementary dose of 13vPCV.

For more information, refer to: Childhood Pneumococcal Immunisation - Provider Guidelines Program Providing a Supplementary Dose.

Ongoing pneumococcal program

On 1 July 2011, a 13-valent pneumococcal conjugate vaccine (13vPCV, Prevenar 13®) replaced the 7-valent pneumococcal conjugate vaccine (7vPCV, Prevenar®) on the NIP in all states and territories except the Northern Territory. The Northern Territory will start using 13vPCV in its program on 1 October 2011. The vaccine, 13vPCV provides protection against an additional six serotypes, which can cause invasive pneumococcal disease (IPD), that were not previously covered by 7vPCV. This includes disease associated with the increasingly predominant serotype 19A.

For more information, refer to: Childhood Pneumococcal Immunisation - Provider Guidelines.

Changes to recommendations for the revaccination of adults with Pneumovax 23®

In April 2011, following an increase in the notification of adverse events following revaccination of adults Pneumovax 23®, the Therapeutic Goods Administration (TGA) recommended that revaccination with Pneumovax 23® should not occur pending the outcome of further investigation and a review of previous advice on its use by the Australian Technical Advisory Group on Immunisation (ATAGI).

The outcome of this investigation has led to the formulation of new advice on the safety, efficacy and effectiveness of Pneumovax 23® and its place within the National Immunisation Program.

ATAGI recommends that revaccination with Pneumovax 23® should only be considered for patients at high risk of serious disease.

For further information refer to Pneumococcal immunisation for older Australians.

Rotavirus and Intussusception

An investigation has been undertaken into the link between rotavirus vaccine and intussusception. The current recommendation is that Rotarix and RotaTeq still be administered to infants according to the guidelines in the Australian Immunisation Handbook 9th Edition. ATAGI does also however recommend that parents be well-informed of the risk of intussusception.

Vaccine preparation, administration, storage and handling

Only persons suitably trained and qualified are permitted to administer vaccines.

For further information on vaccine procedures, refer to the Australian Immunisation Handbook 10th Edition 2013 (NHMRC).

Vaccines that are transported, stored, prepared and administered safely will minimise harm to individuals, health care professionals and the community.

It is important to ensure vaccines are prepared according to manufacturers’ instructions. Providers should be vigilant in correctly preparing vaccines that require reconstitution prior to administration.

National vaccine storage guidelines: Strive for 5 outlines the basic principles for safe vaccine management. It is a concise, practical, user-friendly guide to vaccine storage and is aimed at Australian vaccination service providers.

The technology for vaccine storage is changing rapidly. If you are purchasing equipment it is recommended that you thoroughly investigate the item. The material in Strive for 5 may help you with your investigations. For further information contact your State or Territory Health Department.

Due to the Australian context and an evolution in technology, knowledge and vaccines, there are differences between the National vaccine storage guidelines: Strive for 5 and the World Health Organization’s documents and the Australian Immunisation Handbook 10th Edition 2013 (NHMRC).

Schedule splitting and catch-up doses

Schedule splitting

Schedule splitting, where one or more vaccines are not administered at the age schedule point as recommended, is not encouraged in Australia.

Research shows vaccines that have been delayed due to schedule splitting do not achieve as high coverage as vaccines administered at the appropriate age point.

Vaccines that have been scheduled to be given at the same age schedule point have been demonstrated to be safe and effective when given at the same visit.

Catch-up doses

Some children may miss doses of routine childhood vaccines and they should be vaccinated using an appropriate catch up schedule as soon as possible. For technical information please refer to the Australian Immunisation Handbook 10th Edition 2013 (NHMRC).

Clinical advice for immunisation providers regarding the use of Menitorix® in delivering catch-up vaccinations

From 1 July 2013, the combined Haemophilus influenzae type b (Hib) and meningococcal serogroup C (MenC) vaccine, Menitorix®, was added to the National Immunisation Program (NIP) schedule at 12 months of age. This combination vaccine replaces the single dose of monovalent meningococcal C conjugate vaccine (MenCCV) and booster dose of monovalent Hib vaccine previously scheduled at 12 months of age, which means one less injection is required at this schedule point. However, due to the use of the combination vaccine, issues may arise when planning catch-up vaccinations for either MenC or Hib. ATAGI recommendations for planning catch-up vaccination schedules using the Hib-MenCCV combination vaccine, Menitorix®, are provided in the full clinical advice. Examples of acceptable approaches to a catch-up schedule for one catch-up scenario are provided in Table 1.

National HPV Vaccination Program-catch-up doses

Department of Health Chief Medical Officer advice for immunisation providers in making a decision on whether to revaccinate a person who has received doses of HPV vaccine at less than the recommended minimum intervals. The guidance has been developed in consultation with the National Centre for Immunisation Research and Surveillance and other immunisation experts, based on available evidence.

South Australian Immunisation Calculator

Developed by the South Australian Government, SA Immunisation Calculator is a national resource for health care providers to work out an appropriate catch-up schedule for Australian children up to their seventh birthday, according to the National Immunisation Program (NIP) Schedule.

Using a child's immunisation history record to enter required information, the Calculator generates a 'catch-up' vaccination schedule appropriate for the state or territory of residence of the child.

Adverse Events Following Immunisation (AEFI)

An adverse event following immunisation (AEFI) is an unwanted or unexpected event occurring after the administration of vaccine(s). Such an event may be caused by the vaccine(s) or may occur by chance after vaccination (i.e. it would have occurred regardless of vaccination). Most vaccines can cause minor adverse events such as low-grade fever, pain or redness at the injection site and parents/patients should be counselled on how to manage these events should they occur.

Vaccines are extensively tested for safety and efficacy before being made available by suppliers. Nevertheless, careful surveillance must be maintained to improve knowledge about adverse reactions.

Several sections of the Australian Immunisation Handbook 10th Edition 2013 (NHMRC) contains information on AEFI including post-vaccination procedures and an information sheet on adverse events following vaccination (refer to link Front Cover).

Immunisation Registers

The Australian Childhood Immunisation Register (ACIR) is a national register administered by Medicare Australia that records details of vaccinations given to children under seven years of age who live in Australia. It was established in 1996 in response to a decline in childhood immunisation in Australia and an increase in preventable childhood diseases.

The National HPV Vaccination Program Register is administered by the Victorian Cytology Service (VCS). It records details of HPV vaccine doses given, sends completion of vaccination statements to all individuals who have received the vaccine and sends reminders to individuals who are overdue for vaccination within the school-based program. Because the Australian Childhood Immunisation Register only accepts vaccination data for children aged up to 7 years, the HPV Register is administered as a separate entity.

Vaccination and disease surveillance data

The Department of Health, Medicare Australia and the National Centre for Immunisation Research and Surveillance (NCIRS) collate information about vaccination coverage surveillance data and Vaccine preventable disease surveillance data, including historical trends.

Medicare Australia operates the Australian Childhood Immunisation Register (ACIR), which is tasked with:

For more information about vaccination coverage surveillance data, refer to Immunisation Coverage Data.

Secure site reports can be accessed by authorised immunisation providers through the ACIR statistics website.

Immunisation for Health Care Workers

People in certain occupations should consider vaccination to protect them from occupationally acquired vaccine-preventable diseases. For more information refer to the Australian Immunisation Handbook 10th Edition 2013 (NHMRC).

National Guidelines for Immunisation Education for Registered Nurses and Midwives

The National Guidelines for Immunisation Education Registered Nurses & Midwives (2001) are under review by the National Immunisation Committee.

For more information, refer to: National Guidelines for Immunisation Education for Registered Nurses and Midwives.

For further information on this contact NIC (nic.ohp@health.gov.au).

The Department of Health gives no assurance to the accuracy or relevance of any of the information contained in this publication nor assumes legal liability or responsibility for errors or omissions contained within this publication.

If you are having difficulty downloading any documents please email OHP Webmaster (ohp.webmaster@health.gov.au) and we will arrange for an alternative format or a copy to be sent to you.


Page last modified: 18 March, 2014