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.
Program providing an additional dose of 13vPCV (a 13-valent pneumococcal conjugate vaccine) for at risk Aboriginal and Torres Strait Islander childrenA 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)From 1 October 2011 until 30 September 2012 children who are aged between 12 months and 35 months and have completed a primary pneumococcal vaccination course with 7vPCV are eligible to receive a free supplementary dose of 13vPCV.
Medically at risk childrenChildren with underlying medical conditions who have received a booster dose of 7vPCV at 12 months of age are also eligible to receive a supplementary dose of 13vPCV.
Aboriginal and Torres Strait Islander childrenAboriginal and Torres Strait Islander children residing in Queensland, South Australia and Western Australia receive a primary course of 13vPCV at 2, 4 and 6 months of age. In these states, a dose of 23vPPV is given between the ages 18 months to 24 months. These children do not require a booster dose of 23vPPV (Pneumovax 23®) if they receive the supplementary dose of 13vPCV between the ages of 12 months and 35 months.
In the Northern Territory, the Territory Government will fund 13vPCV at 18 months of age for Aboriginal and Torres Strait Islander children.
For more information, go to: Childhood Pneumococcal Immunisation - Provider Guidelines Program Providing a Supplementary Dose.
Ongoing pneumococcal programOn 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, go to: Childhood Pneumococcal Immunisation - Provider Guidelines.
Recent 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 see Pneumococcal immunisation for older Australians
Important information regarding adverse events following vaccinationFollowing the suspension of Fluvax for children in 2010, the former Chief Medical Officer Professor John Horvath AO was asked to review the management of Australia’s seasonal influenza vaccine program, and our system for reporting adverse events following vaccination. This Review is now available for viewing. Review of the management of adverse events associated with Panvax and Fluvax
Seasonal Influenza VaccineThe Australian Childhood Immunisation Register (ACIR) records all vaccines administered to children under the age of 7. Immunisation providers are encouraged to report all influenza vaccines given to children under 7 years to ACIR.
ATAGI’s clinical advice for immunisation providers regarding the administration of 2013 trivalent seasonal influenza vaccines (March 2013) Therapeutic Goods Administration (TGA) statement on the 2013 seasonal influenza vaccines TGA statement on 2013 seasonal influenza vaccines for use in children 2013 Fact sheet Reporting adverse events
Rotavirus and IntussusceptionAn 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. More information for immunisation providers. Link to CMO letter of 25 February 2011 to Immunisation Providers
Vaccine preparation, administration, storage and handlingOnly 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 splittingSchedule 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.
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 9th Edition 2008 (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 dosesDepartment of Health and Ageing 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.
- Chief Medical Officer Guidance on revaccination where HPV vaccine doses have been given at less than recommended minimum intervals January 2009. - Updated 19/2/2010
- Summary Advice Chief Medical Officer Re-vaccination following administration of HPV vaccine outside recommended dose intervals. - Updated 19/2/2010
South Australian Immunisation CalculatorDeveloped 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 7th 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.Top of Page
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 andá an information sheet on adverse events following vaccination (see link to Front Cover).
Observation after vaccinationRecipients of vaccines should remain under observation for a short interval to ensure that they do not experience an immediate adverse event. It is recommended that recipients remain in the vicinity of the place of vaccination for at least 15 minutes. Severe anaphylactic reactions usually have a rapid onset; most life-threatening adverse events begin within 10 minutes of vaccination.
The most serious immediate AEFI is anaphylaxis. However, in adults and older children, the most common immediate adverse event is a vasovagal episode (fainting), either immediately or soon after vaccination. Because fainting after vaccination can lead to serious consequences, anyone who complains of giddiness or light-headedness before or after vaccination should be advised to lie down until free of symptoms. Most faints following vaccination occur within 5 minutes, and 98% occur within 30 minutes. Adults should, therefore, be warned of the risk of driving or operating machinery for at least 30 minutes after vaccination.
What to do to manage injection site discomfortMany vaccine injections may result in soreness, redness, itching, swelling or burning at the injection site for 1 to 2 days. Paracetamol might be required to ease the discomfort. Sometimes a small, hard lump may persist for some weeks or months. This should not be of concern and requires no treatment.
Managing fever after immunisationGive extra fluids to drink. Do not overdress an infant if hot. Although the routine use of paracetamol at the time of vaccination is no longer necessary, it may be required if, for example, an infant or child has a high fever following vaccination. The dose of paracetamol is 15 mg/kg of paracetamol liquid, up to a maximum daily dose of 90 mg/kg per day.
Reporting Adverse Events Following Immunisation (AEFI)AEFI are notifiable directly to the relevant health authority in Australian Capital Territory, New South Wales, Northern Territory, Queensland, South Australia, Victoria and Western Australia. These States and Territories then notify the Therapeutic Goods Administration (TGA). In Tasmania, AEFI should be reported directly to the TGA using the blue card or electronically via the TGA website.
The TGA receives reports of unexpected and serious adverse events for all medicines, including vaccines. Any person (medical or non-medical) can report an AEFI to the TGA.To report any serious or unexpected reactions refer to Reporting problems with medicines (Therapeutic Goods Administration).
Adverse event servicesServices for people who have experienced a serious adverse event following immunisation have been established in Australia.
The aim of these services is to:
- review people who have had a serious adverse event following immunisation to determine the relationship between vaccination and the event;
- determine whether or not remaining scheduled vaccinations should be administered; and
- provide an environment in which further vaccinations can be given, including:
- close observation;
- information about risk and benefits of vaccination; and
- specialist treatment in the event an adverse event recurs.
Vaccination of children who have had a serious AEFIChildren who have had a serious AEFI (other than a contraindication, such as anaphylaxis) may be subsequently vaccinated under close medical supervision. Not all States and Territories offer an adverse event immunisation clinic. However, in States or Territories where there are no clinics, there is often a paediatrician or infectious diseases specialist who will review families who have concerns regarding future vaccinations following a previous adverse event. For more information about adverse event services contact your State or Territory Health Department. Top of Page
Immunisation RegistersThe 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 dataThe Department of Health and Ageing, 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:
- providing an accurate measure of the immunisation coverage of children in Australia under 7 years of age
- providing an effective management tool for monitoring immunisation coverage and service delivery.
NCIRS conducts research and provides independent expert advice about all aspects of diseases which can be prevented by vaccination, particularly in children, including a national perspective on social and other issues related to immunisation. For more information see and NCIRS Fact Sheets and the NCIRS surveillance reports for vaccine preventable diseases and vaccination coverage in Australia and among Aboriginal and Torres Strait Islander People.Communicable Diseases Network Australia (Department of Health and Ageing) provides surveillance of notifiable communicable diseases. Data can be accessed via the National Notifiable Diseases Surveillance System (NNDSS) (Department of Health and Ageing).
More information about monitoring notifiable diseases can be found at Surveillance systems for communicable diseases in Australia (Department of Health and Ageing).
General Practice Immunisation Incentives (GPII) SchemeThe General Practice Immunisation Incentives (GPII) Scheme provides financial incentives to general practices for monitoring, promoting and providing appropriate immunisation services to children under the age of seven years.
The GPII aims to encourage at least 90 per cent of practices to fully immunise 90 per cent of children under seven years of age attending their practices.
The GPII is administered by Medicare Australia on behalf of the Australian Government Department of Health and Ageing.
For more information, see GPII Scheme on the Medicare Australia website.
Immunisation for Health Care WorkersPeople 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, go to: National Guidelines for Immunisation Education for Registered Nurses and Midwives
For further information on this contact NIC (firstname.lastname@example.org).
The Department of Health and Ageing 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.
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Page last modified: 21 November, 2013