The Australian Immunisation Handbook 10th Edition

22 June 2015

Page last updated: 08 April 2016

22 June 2015

Key updates made to the 10th edition Handbook in June 2015 are listed below by chapter, including chapter sections and subsections. In addition to the updates listed below, other minor amendments have been made to some chapters to improve clarity, consistency and accuracy; these changes are not specifically noted.

References have been removed, updated or introduced where required.

2.1 Pre-vaccination

2.1.4 Pre-vaccination screening

Information on vaccination of infants born to mothers receiving immunosuppressive therapy during pregnancy added to Table 2.1.1: Pre-vaccination screening checklist and Table 2.1.2: Responses to relevant conditions or circumstances identified through the pre-vaccination screening checklist.

2.1.5 Catch-up

Link to resource for international immunisation schedules updated.

Information added on the acceptable minimum intervals and age restrictions for primary hepatitis B vaccine doses in infants and appropriate action if these are not met, including in Table 2.1.7: Minimum acceptable dose intervals for children <10 years of age (refer also to 4.5 Hepatitis B).

Advice on catch-up vaccination for pertussis-containing vaccines updated, including in Table 2.1.6: Number of vaccine doses that should have been administered by the current age of the child and Table 2.1.7: Minimum acceptable dose intervals for children <10 years of age (refer also to 4.12 Pertussis).

Advice on catch-up vaccination for meningococcal vaccines updated, including in Table 2.1.5: Minimum acceptable age for the 1st dose of scheduled vaccines in infants in special circumstances and Table 2.1.7: Minimum acceptable dose intervals for children <10 years of age (refer also to 4.10 Meningococcal disease).

2.2 Administration of vaccines

2.2.2 Equipment for vaccination

Information on the need to shake vials, pre-filled syringes or reconstituted vaccines added.

2.2.3 Route of administration and 2.2.5 Vaccine injection techniques

Information on Intanza intradermal vaccine formulations removed, including from Table 2.2.1: Route of administration for vaccines used in Australia (refer also to 4.7 Influenza).

2.2.4 Preparation for vaccine administration

Advice on the prophylactic use of paracetamol added (refer also to 4.10 Meningococcal disease).

2.3 Post-vaccination

2.3.1 Immediate after-careand 2.3.2 Adverse events following immunisation

Advice on the prophylactic use of paracetamol updated (refer also to 4.10 Meningococcal disease).

Information on complex regional pain syndrome added.

3.1 Vaccination for Aboriginal and Torres Strait Islander people

3.1.1 Children

Recommendation for the use of influenza vaccines updated (refer to 4.7 Influenza).

3.2 Vaccination for international travel

3.2.2 Infections acquired by travellers, 3.2.4 Vaccines and 3.2.5 Vaccinating the traveller with special risk factors

Information on the risk of Japanese encephalitis to travellers added (refer also to 4.8 Japanese encephalitis).

3.2.3 Practical aspects of recommending vaccinations for travellers and 3.2.4 Vaccines

Information on international health regulations related to polio added (refer also to 4.14 Poliomyelitis).

3.2.4 Vaccines

Recommendations on the use of meningococcal vaccines updated (refer also to 4.10 Meningococcal disease).

Information on Intanza intradermal vaccine formulations removed from Table 3.2.1: Dose and routes of administration of commonly used vaccines in adult travellers (refer also to 4.7 Influenza). Advice on the ages at which to use Japanese encephalitis vaccines updated in Table 3.2.2: Recommended lower age limits of travel vaccines for children (refer also to 4.8 Japanese encephalitis).

3.2.4 Vaccines and 3.2.5 Vaccinating the traveller with special risk factors

Recommendations on the use of meningococcal vaccines updated (refer to 4.10 Meningococcal disease).

3.3 Groups with special vaccination requirements

3.3.2 Vaccination of women who are planning pregnancy, pregnant or breastfeeding, and preterm infants and 3.3.3 Vaccination of immunocompromised persons

Information on the vaccination of infants born to mothers receiving immunosuppressive therapy during pregnancy added.

Recommendations on the use of pertussis-containing vaccines in pregnant women updated, including in Table 3.3.1: Recommendations for vaccination in pregnancy (refer to 4.12 Pertussis).

3.3.3 Vaccination of immunocompromised persons

Information on Intanza intradermal influenza vaccine formulations removed from Table 3.3.5: Recommendations for vaccination in persons with functional or anatomical asplenia (refer also to 4.7 Influenza).

Number of doses of annual influenza vaccine required in persons with immunocompromising conditions clarified (refer also to 4.7 Influenza).

3.3.3 Vaccination of immunocompromised persons and 3.3.7 Vaccination of persons at occupational risk

Recommendations on the use of meningococcal vaccines updated (refer to 4.10 Meningococcal disease).

4.2 Diphtheria

4.2.4 Vaccines, 4.2.7 Recommendations and 4.2.8 Pregnancy and breastfeeding

Recommendations on the use of pertussis-containing vaccines updated (refer to 4.12 Pertussis).

4.3 Haemophilus influenzae type b

4.3.4 Vaccines, 4.3.6 Dosage and administration and 4.3.7 Recommendations

Information on the use of the Hib-MenCCV combination vaccine added.

4.4 Hepatitis A

4.4.7 Recommendations

Lifestyle risk factors for hepatitis A clarified.

4.5 Hepatitis B

4.5.4 Vaccines

Information on accelerated hepatitis B schedules added.

4.5.7 Recommendations

Clinical course of action for sexual contacts of persons with hepatitis B clarified.

4.5.4 Vaccines and 4.5.7 Recommendations

Acceptable minimum intervals and age requirements for primary hepatitis B vaccine doses and the appropriate action if these are not met has been clarified (refer also to 2.1 Pre-vaccination).

4.6 Human papillomavirus

4.6.4 Vaccines

Information on next-generation HPV vaccines and schedules under development added.

4.7 Influenza

Terminology referring to the bioCSL brand of trivalent influenza vaccine has been changed throughout the influenza chapter and other chapters if required.

4.7.4 Vaccines and 4.7.11 Adverse events

Information on inactivated quadrivalent influenza vaccine formulations added (including in vaccine information box).

4.7.4 Vaccines and 4.7.6 Dosage and administration

Information on Intanza intradermal vaccine formulations removed.

4.7.6 Dosage and administration

Upper age limit for when children require 2 doses of inactivated influenza vaccine if receiving for the first time clarified.

4.7.7 Recommendations

Number of doses of annual influenza vaccine required in persons with immunocompromising conditions clarified (refer also to 3.3 Groups with special vaccination requirements).

Information on influenza vaccine recommendations for preterm infants added.

Recommendations on the use of influenza vaccines updated, including:

  • Persons at increased risk of complications from influenza infection for whom vaccination is recommended expanded to include individuals with a BMI ≥40 and individuals with chronic liver disease.
  • Annual influenza vaccine is now recommended for all Aboriginal and Torres Strait Islander children.

4.8 Japanese encephalitis

4.8.3 Epidemiology and 4.8.7 Recommendations

Information on the risk of Japanese encephalitis to travellers added (refer also to 3.2 Vaccination for international travel).

4.8.4 Vaccines

Information on accelerated schedule for JEspect added.

4.8.6 Dosage and administration

Information on the interchangeability of Japanese encephalitis vaccines added.

Recommendations on the use of Japanese encephalitis vaccines updated, including:

  • JEspect can now be given at the same time as quadrivalent meningococcal vaccine and rabies vaccine, and Imojev can be given at the same time as MMR vaccine.

4.8.4 Vaccines and 4.8.6 Dosage and administration

Advice on the age of use for Japanese encephalitis vaccines updated, including a new table, Table 4.8.1: Recommended doses of JE vaccines (refer also to 3.2 Vaccination for international travel).

4.8.4 Vaccines, 4.8.6 Dosage and administration and 4.8.7 Recommendations

Recommendations on the use of Japanese encephalitis vaccines updated, including:

  • A booster dose of Imojev is now recommended in children aged ≥9 months to <18 years and a booster dose of JEspect is recommended in adults aged ≥18 years.

4.8.4 Vaccines, 4.8.6 Dosage and administration and 4.8.13 Variations from product information

Recommendations on the use of Japanese encephalitis vaccines updated, including:

  • JEspect can now be given to children aged ≥2 months to <18 years in circumstances where an alternative is not available or contraindicated.

4.8.10 Precautions

Information on vaccination after immunoglobulin or blood product administration added.

4.9 Measles

4.9.10 Precautions and 4.9.11 Adverse events

Advice on the prophylactic use of paracetamol updated (refer also to 4.10 Meningococcal disease).

4.9.12 Public health management of measles

Advice on post-exposure management of measles clarified in Table 4.9.2: Post-exposure prophylaxis required within 72 hours of first exposure for persons exposed to measles.

4.10 Meningococcal disease

This entire Handbook chapter has been reviewed and updated including:

  • Addition of two new meningococcal vaccine formulations: meningococcal B vaccine (Bexsero) and quadrivalent meningococcal conjugate vaccine (Nimenrix).
  • Recommendations on the use of Bexsero.
  • Recommendations for the use of prophylactic administration of paracetamol with Bexsero as an exception to routine Handbook recommendations.
  • Recommendations for vaccination of groups at increased risk of meningococcal disease including men who have sex with men, college students, new military recruits and people with HIV.
  • Recommendations for vaccination of persons with certain medical conditions (including age of use and booster recommendations by vaccine brand).
  • Recommendations for vaccination of travellers (including age of use and booster recommendations by vaccine brand).

4.13 Pneumococcal disease

4.13.4 Vaccines, 4.13.6 Dosage and administration, 4.13.7 Recommendations, 4.13.11 Adverse events and 4.13.12 Variations from product information

Information on registration of 13vPCV for use from 6 weeks of age added.

4.13.6 Dosage and administration

Recommendation for the use of pneumococcal polysaccharide vaccine updated:

  • Co-administration of 23vPPV and Zostavax is acceptable (refer also to 4.24 Zoster).

4.14 Poliomyelitis

4.14.7 Recommendations

Information on international health regulations related to polio added (refer also to 3.2 Vaccination for international travel).

4.16 Rabies and other lyssaviruses (including Australian bat lyssavirus)

4.16.5 Rabies immunoglobulin

Information added on alternative products for use during potential shortages of rabies immunoglobulin.

4.16.8 Recommendations

Information added on appropriate post-exposure prophylaxis following a potential exposure to a terrestrial animal in an area where rabies is not enzootic.

4.19 Tetanus

4.19.4 Vaccines, 4.19.7 Recommendations, 4.19.8 Pregnancy and breastfeeding and 4.19.14 Variations from product information

Recommendations on the use of pertussis-containing vaccines updated (refer to 4.12 Pertussis).

4.22 Varicella

4.22.11 Adverse events

Advice on the prophylactic use of paracetamol updated (refer also to 4.10 Meningococcal disease).

4.23 Yellow fever

4.23.7 Recommendations

Information on booster dose requirements under International Health Regulations added.

4.24 Zoster (herpes zoster)

4.24.6 Dosage and administration

Recommendations on the use of zoster vaccine updated, including:

4.24.7 Recommendations

Recommendations on the use of zoster vaccine updated, including:

  • Zostavax recommendations now broken down by new age groups.