Clinical Updates

This page contains clinical updates for health professionals.

Page last updated: 08 June 2016

National Immunisation Program Influenza Vaccine

Fact sheet for vaccination providers - 2016 National Immunisation Program influenza vaccine.

Practice and clinic resources: Get the flu shot before the flu gets you poster, poster for Aboriginal and Torres Strait Islander people; vaccine fridge sticker and flyer reminders to assist in administration of the correct vaccines.

Australian Technical Advisory Group on Immunisation (ATAGI) advice for immunisation providers regarding the administration of seasonal influenza vaccines in 2016.

Australian Immunisation Handbook 10th Edition (updated June 2015).

Pertussis  booster for 18 month olds

A pertussis (whooping cough) booster has been added to the NIP for children at 18 months of age. The booster dose complements pertussis containing vaccinations given at two, four and six months with booster doses given at four years and 10 to 15 years. Supplies of the vaccine will be available from March 2016.

The Australian Technical Advisory Group on Immunisation (ATAGI) considers the re-introduction of a pertussis booster dose at 18 months necessary from a public health perspective to improve pertussis control. This is due to waning immunity following primary immunisation and an increase in the number of infections in the two to nine age group in recent years.

Targeted, enhanced surveillance of adverse events will be undertaken as part of the program roll-out.  Any adverse events following immunisation at any age should be reported to the Therapeutic Goods Administration (TGA). Go to the ‘report a problem’ link via the TGA's website at ( or report adverse events through the usual reporting mechanisms in your state or territory.

In order to maintain a complete immunisation history, all vaccines administered to children should be notified to the Australian Childhood Immunisation Register (ACIR) via usual methods.

Catch-up: Incentives for vaccination providers

From 1 January 2016, an additional $6 incentive payment will be made to vaccination providers and GPs who follow up and vaccinate children who are more than two months overdue for their childhood vaccinations. A fact sheet explaining this payment is available.

Fact sheets addressing commonly held concerns regarding vaccination

These resources can help frame discussion about immunisation with parents and provide evidence-based answers to commonly held concerns and myths surrounding vaccination.

Expansion of Australia’s Immunisation Registers

Expansion of Australia’s Immunisation Registers: Work has begun to expand the scope of Australia’s two existing immunisation registers; the Australian Childhood Immunisation Register and the National HPV Vaccination Program Register, to improve vaccination coverage across the whole community. Further information regarding the scheduled changes can be obtained by referring to the Expansion of Australia’s Immunisation Registers factsheet below.

No Jab, No Pay

The Australian Government is extending childhood immunisation arrangements for family assistance payments to increase immunisation rates of children residing in Australia. As an immunisation provider you will be key to providing catch-up vaccinations to children up to 19 years of age under the Australian Government’s No Jab, No Pay measure.

The list of current early childhood vaccines required for Family Tax Benefit part A Supplement (FTB Part A supplement), Child Care Rebate (CCR) and Child Care Benefit (CCB) is available from the Department of Social Services website.

Vaccines which are not required to receive family assistance payments are still recommended for some age groups. For example, meningococcal C and varicella are clinically recommended and funded by the Government for young individuals between the ages of 10-19 years of age. These vaccines are not linked to family assistance payments.

An overview for health professionals, with initial details is available.

In addition, you may find the following resources helpful for your discussions with parents:

Medical exemptions

From 1 January 2016, notifications of medical contraindications and natural immunity will NOT be accepted on practice/GP letterhead and must be provided on the approved ACIR Immunisation Medical Exemption Form.

The form includes guidance for general practitioners on what is, and is not, considered a valid reason for a medical exemption.

Medical contraindications to vaccination are rare. The medical basis for vaccination exemption is based on guidance in the Australian Immunisation Handbook 10th edition.

Natural immunity to hepatitis B, measles, mumps, rubella and varicella must be confirmed via laboratory testing or physician based clinical diagnosis. Exemption to a combination vaccine on the bases of natural immunity is only valid if immunity is confirmed for all vaccine antigens.

Conscientious objection (vaccination objection on non-medical grounds) is no longer a valid exemption from the immunisation requirements.


Zostavax® has been approved to be placed on the NIP, to be provided free of charge from 1 November 2016 to people aged 70 years, subject to vaccine supply. There will also be a five year catch-up program for people aged 71 – 79 years. The Department is working to progress the provision of the Zostavax® vaccine to all eligible Australians as rapidly as possible.

The implementation of new vaccination programs under the NIP is a major task that takes approximately 12-18 months from receipt of Government funding approval. This time is required for activities such as the procurement of vaccine; vaccine safety surveillance planning; development of appropriate communications; and negotiation with states and territories regarding implementation requirements and timing. In the case of the Zostavax® vaccine, time is also required to develop and roll out an adult vaccination register.

For more information about Zostavax®, refer to the Zoster section of the Australian Immunisation Handbook 10th edition 2015.

Changes to recommendations in the administration of pertussis containing vaccine

The Pertussis Chapter, 4.12, of the 10th Edition of the Australian Immunisation Handbook has been updated and approved by the National Health and Medical Research Council CEO on 27 March 2015.

The Pertussis Chapter includes two changes to recommendations in the administration of pertussis containing vaccine:

  • a DTPa (diphtheria, tetanus, pertussis) booster at age 18 months to reduce pertussis notifications in the 1 - 3 year age group and to reduce transmission to younger siblings; and
  • a preference for pertussis vaccination (the reduced content dTpa formulation) in pregnant women (third trimester) to improve protection against pertussis in young infants.

The chapter also contains amendments which provide updated information and evidence.

Australian Immunisation Handbook Pertussis Chapter 4.12.

Pertussis posters and brochures

Meningococcal B vaccine and clinical advice for immunisation providers regarding the use of Bexsero® (4CMenB)

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

For infants aged < six months of age, three 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 National Immunisation Program, but must be given at separate injection sites. The first dose of 4CMenB may be administered as early as six weeks of age to align with the National Immunisation Program 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 Australian Technical Advisory Group on Immunisation recommends the prophylactic use of paracetamol with every dose of 4CMenB administered to children

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

Australian Technical Advisory Group on Immunisation (ATAGI) advice on non National Immunisation Program vaccines

Information about vaccines that are available in Australia but not included on the National Immunisation Program, such as yellow Fever and rabies, is also available in the Australian Immunisation handbook (10th edition 2013).

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