Updates to the Handbook

Addition of intranasal route of administration and intranasal administration technique.

Updated advice on LAIV for people living or working in close contact with severely immunocompromised people.

Updated to include LAIV and to indicate it as a contraindication as necessary for specific immunocompromised groups.

Updates were made throughout the chapter to include intranasally administered live attenuated influenza vaccine (LAIV; FluMist) as an alternative to inactivated influenza vaccine in children aged 2 to <18 years, except where contraindicated.

Additional updates have been made to reflect changes to the recommendation for influenza vaccine doses. Most individuals should receive one dose of influenza vaccine each year. When receiving influenza vaccine for the first time, healthy children aged 6 months to <2 years and only those with medical risk conditions aged 6 months to <9 years should receive 2 doses, given 4 weeks apart. People of any age receiving influenza vaccine for the first time after haematopoietic stem cell or solid organ transplant or CAR T-cell therapy should also receive 2 doses, given 4 weeks apart.

Updates were made throughout the chapter to indicate that people aged from 50 years may receive adjuvanted influenza vaccine (Fluad) as an alternative to standard-dose influenza vaccine.

Updates were made throughout the chapter to reflect that all quadrivalent influenza vaccine formulations have been transitioned to trivalent influenza vaccine formulations.

Clarification included that pregnant women should receive inactivated influenza vaccine rather than live attenuated influenza vaccine (LAIV); however, there is no evidence of risk associated with LAIV receipt in pregnancy. 

Addition of a new table outlining recommended doses of influenza vaccine and vaccine type by age group.

Editorial update of vaccination in people with a history of GBS to better align with other handbook chapters. 

New sections in precautions describing use of LAIV for people living or working in close contact with severely immunocompromised people and children with cochlear implants.

Updates to ‘Variations from product information – egg allergy’ for FluMist (LAIV) and Fluzone. 

Updated to include LAIV and clarified live and non-live influenza vaccine use.

Updates to the ‘Table. Components of immunisation products used in Australia’ to include LAIV FluMist excipients, to update vaccine names to TIV versions to reflect 2026 updates, and to include previously omitted Shingrix components.

Updated to include LAIV and to indicate it as a contraindication as necessary for specific immunocompromised groups.

Updated to include LAIV and to indicate it as a contraindication as necessary for specific immunocompromised groups.

Updated to include LAIV for all relevant sections about live vaccine recommendations

Updated advice on the first dose of influenza vaccines in vaccine naïve and people with risk conditions to align with influenza chapter.

Updated to include new information regarding LAIV. Pregnant women should continue to receive IIV rather than.

Updated advice on revaccination with RSV Abrysvo in each pregnancy to align with RSV chapter.

Updates to reflect updated recommendation for RSV vaccine Abrysvo to be given in each pregnancy from 28 weeks gestation.

Removed all information related to NeisVac-C as it is no longer available.

Re-added Avaxim, reverting the previous change which removed it. This error occurred due to conflicting information regarding supply availability.

Re-added Avaxim, partially reverting elements of the previous change which removed it. This error occurred due to conflicting information regarding supply availability.

Updated to include ibuprofen for pain relief. 

Addition of ibuprofen to the section on managing pain and fever after vaccination.

Addition of epidemiological evidence on rates of GBS after RSV vaccination.

Updated hyperlink for Northern Territory AEFI form.

Updated pneumococcal catch-up table headings to improve clarity of who is included.

Updated the MMR/MMRV in minimum age catch-up table so that MMRV as a first dose can only be given after 4 years of age.

Updated to include details of how vaccine minimum intervals are described in the handbook and how a month is calculated for this purpose.

HepB, Hib and pneumococcal vaccine minimum intervals updated to align with language used for other vaccines for consistency across Handbook.

Removal of text describing booster doses for Hib as it was unclear and inconsistent with Hib catch up table.

Removed Avaxim as it is no longer available.

Hepatitis B vaccine minimum intervals updated to align with language used for other vaccines for consistency across Handbook.