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Updates on 09/04/2018

Influenza (flu)

Updating the text to reflect the 2018 influenza season (Refer to Chapter 4.7 Influenza)

Pneumococcal disease

Recommendations

The following replaces the existing Recommendations for infant pneumococcal vaccination schedule listed in Chapter 4.6 Pneumococcal disease:

  1. All children, except those specified in (b) below, should receive three doses of 13vPCV at 2, 4 and 12 months of age (called ‘2+1’ schedule) instead of the current schedule with doses at 2, 4 and 6 months of age (called ‘3+0’ schedule).
  2. The following population groups at increased risk of pneumococcal infection should continue to receive four doses of 13vPCV at 2, 4, 6 and 12 months^ of age (called ‘3+1’ schedule):
    1. Aboriginal and Torres Strait Islander children living in the NT, QLD, SA and WA
    2. Children with underlying medical conditions associated with an increased risk of IPD.

^ Note the preferred schedule point for the fourth (last) 13vPCV dose is age 12 months rather than 18 months.

Table 1: Comparison of current and proposed ATAGI recommendations for 13vPCV schedules in children

Cohort

Schedule in previous recommendation*

Schedule in current recommendation

Children without underlying medical conditions associated with increased risk of IPD

All children in ACT, NSW, TAS or VIC

3+0

(2, 4 and 6 months)

2+1

(2, 4 and 12 months)

Non-Indigenous children in NT, QLD, SA or WA

Aboriginal and Torres Strait Islander children in NT, QLD, SA or WA

3+1

(2, 4, 6 and 12–18 months)

3+1

(2, 4, 6 and 12 months)

All children with underlying medical conditions associated with increased risk of IPD (Attachment A)

3+1

(2, 4, 6 and 12 months)

3+1

(2, 4, 6 and 12 months)

* Refer to The Australian Immunisation Handbook Chapter 4.13 Pneumococcal disease, section 4.13.7 ‘Recommendations’.

Schedules for catch-up doses of 13vPCV for children aged <5 years who have not received any pneumococcal conjugate vaccine (PCV) doses or who have only received incomplete courses of PCVs are covered in Tables 2 (for all children with medical condition(s) increasing IPD risk and Aboriginal and Torres Strait Islander children in NT, QLD, SA or WA) and 3 (for all other children).

Table 2: Catch-up schedule for 13vPCV for Aboriginal and Torres Strait Islander children living in NT, QLD, SA or WA ONLY, and all children with any medical condition(s)* associated with an increased risk of invasive pneumococcal disease (IPD), aged <5 years

Number of doses given previously

Age at presentation

Age when previous dose of any PCV was given

Recommendations‡

1st dose

2nd dose

3rd dose

Number of further dose(s) required

No previous doses

<12 months

4§

12–59 months

2

1 previous dose

<12 months

Any age

3§

12–59 months

<12 months

2§

≥12 months

1

2 previous doses

<12 months

Any age

Any age

2§

12–59 months

<12 months

<12 months

2§

≥12 months

1

≥12 months

≥12 months

None

3 previous doses

<12 months

Any age

Any age

Any age

1§

12–59 months

<12 months

<12 months

Any age

1

≥12 months

≥12 months

None

* Recommendations for vaccination of haematopoietic stem cell transplant (HSCT) recipients differ: a separate table for revaccination following HSCT in children and adults will be included in upcoming updates to The Australian Immunisation Handbook.
 Prior PCV doses may have been given as 7vPCV (e.g. from overseas), 10vPCV or 13vPCV. Use 13vPCV as the vaccine formulation for catch-up doses, regardless of which formulation of PCV the child received previously.
 Where possible, align doses with the standard schedule points at 2, 4 and 6 months of age for infants. The minimum interval between dose(s) is 1 month if aged <12 months, and 2 months if aged ≥12 months.
§ The last dose should be given after the child reaches 12 months of age (as a booster dose) with a minimum interval of 2 months after the previous dose of PCV.

Table 3: Catch-up schedule for 13vPCV for all other children aged <5 years (not covered in Table 2a)

Number of doses given previously

Age at presentation

Age when previous dose of any PCV* was given

Recommendation

1st dose

2nd dose

3rd dose

Number of further dose(s) required

No previous doses

<12 months

3

12–59 months

1

1 previous dose

<12 months

<12 months

2

12–59 months

<12 months

1

≥12 months

None

2 previous doses

<12 months

<12 months

<12 months

1

12–59 months

<12 months

<12 months

1

≥12 months

None

3 previous doses

<12 months

<12 months

<12 months

<12 months

1

12–59 months

Any age

Any age

≥12 months

None

* Prior PCV doses may have been given as 7vPCV (e.g. from overseas), 10vPCV or 13vPCV. Use 13vPCV as the vaccine formulation for catch-up doses, regardless of which formulation of PCV the child received previously.
 Where possible, align doses with the standard schedule points at 2 months and 4 months of age for infants aged <5 months. The minimum interval between dose(s) is 1 month if aged <12 months, and 2 months if aged ≥12 months.
 The last dose should be given after the child reaches 12 months of age (as a booster dose) with a minimum interval of 2 months after the previous dose of 13vPCV.