Chief Medical Officer Advice
Important information about seasonal influenza vaccination and the National Immunisation Program for 2012
23 April 2012: Seasonal Influenza VaccinationI am writing to provide you important information about seasonal influenza vaccination and the National Immunisation Program for 2012. Free seasonal influenza vaccine is provided under the National Immunisation Program (NIP) for children aged 6 months and over with medical conditions predisposing them to severe influenza. Influenza vaccine is available from general practitioners or other immunisation providers.
Three influenza vaccines are available on the NIP: Fluvax® (CSL), Vaxigrip® (Sanofi) and Fluarix® (GSK). The Australian Technical Advisory Group on Immunisation (ATAGI) recommends the use of Fluarix, Vaxigrip, Influvac® or Agrippal® in children between 6 months to less than 10 years of age. Fluvax is not registered for use in children less than 5 years of age and should not be given to children in this age group. You should contact your state or territory health department for supplies of Vaxigrip and Fluarix if there are none currently available in the practice.
There has been a number of verified reports from the Australian Childhood Immunisation Register where children under the age of five have been given Fluvax. I urge you to ensure that Fluvax is not inadvertently administered to children less than five years of age and for you to have processes in place to prevent this occurring.
The influenza strains in the seasonal influenza vaccine selected by the Australian Influenza Vaccine Committee for 2012 are the same as in 2011. Patients should be advised that, even if they had the seasonal influenza vaccine in 2011, annual vaccination is necessary as immunological evidence indicates that immunity following influenza vaccination is not long term.
The primary focus of the 2012 seasonal influenza immunisation campaign is on pregnant women, as they are at increased risk of severe disease or complications from infection. The Royal Australian and New Zealand College of Obstetricians and Gynaecologists (RANZCOG) strongly endorse routine vaccination of pregnant women against influenza. RANZCOG stated that immunisation is estimated to prevent 1 to 2 hospitalisations per 1000 pregnant women vaccinated during the second or third trimester. The full statement can be accessed at the RANZCOG website (ref C-Obs 45).
Children aged 6 months and over with medical conditions predisposing them to severe influenza are eligible to receive either Fluarix or Vaxigrip under the NIP. ATAGI advises that there is a strong preference for the use of Vaxigrip, Fluarix Influvac or Agrippal for children aged 5 years to less than 10 years of age. Fluvax may be used in children aged 5 to less than 10 years if no other influenza vaccine is available. If Fluvax is administered, parents should be informed of the potential increased risk of fever noting that febrile convulsions are rare in this age group.
ATAGI has also advised that there may be a small increase in the risk of fever and febrile convulsions with the concurrent administration of trivalent influenza vaccine and Prevenar 13® in children aged six months to less than five years, especially those aged 12–24 months of age. Providers should discuss this risk with parents. If there are strong parental concerns, the option of administering these two vaccines separately, with an interval of at least three days between them should be offered.
A copy of the full ATAGI statement which includes information about all seasonal influenza vaccines registered for 2012 and the rationale for these recommendations is available from the Immunise Australia website.
A factsheet and an information brochure about seasonal influenza immunisation will be sent to you separately. At the same time brochures will be available for download from the Immunise Australia website or ordered through the Immunise Australia Information Line on 1800 671 811.
To ensure accurate monitoring of influenza vaccine usage in children I would remind you to notify the ACIR if you administer influenza vaccine to a child aged up to 7 years. I also encourage you to report any adverse events following influenza vaccination to the Therapeutic Goods Administration through the ‘report a problem’ link on its website or through the usual reporting mechanisms in your State or Territory.
Professor Chris Baggoley
BVSc (Hons), BM BS, BSocAdmin, FACEM
23 April 2012
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Page last modified: 21 June, 2012