Updates to the Handbook

Addition of a recommendation on the use of Japanese encephalitis vaccines in target groups in Japanese encephalitis risk regions of mainland Australia. Addition of a booster recommendation for JEspect in children, with supporting evidence.

Updates to Japanese encephalitis epidemiology in Australia and Torres Strait Islands, to include detail on the 2022 mainland Australian outbreak and ongoing transmission risk.

Updates to the text on intradermal administration of Imojev with an external link to the ATAGI 2022 statement on use of intradermal Imojev.

Addition of new evidence on the vaccine immunogenicity, duration of protection and booster effects of Imojev and JEspect. Updates to remove studies on JE-Vax.

Updates to the variations from product information to include the co-administration of Imojev and other vaccines, intradermal administration of Imojev and administration of Imojev in breastfeeding.

Updates to include detail on multidose vials, removal of vaccines no longer available, guidance on vaccination under sedation, and addition of advice on vaccine administration errors.

Updates to advice for adrenaline autoinjectors, myocarditis, GBS and rash following VZV vaccination.

Link added to Vaccination for people who are immunocompromised chapter and figure describing types of medical conditions and immunosuppressive therapy and associated levels of immunocompromise.

Addition of tables in recommendations section to improve clarity of guidance, updating of immunocompromising and medical conditions list to align with other chapters, removal of information for outdated products.

Guidance on the minimum interval (i.e. 4 weeks) between each Hib dose updated for haematopoietic stem cell transplant recipients to ensure consistency with recommendations in “Haematopoietic stem cell transplant: recommendations for vaccination” in the Vaccination for people who are immunocompromised chapter.

Addition of text on coadministration with monoclonal antibodies.

Link added to Vaccination for people who are immunocompromised chapter and figure describing types of medical conditions and immunosuppressive therapy and associated levels of immunocompromise.

Amendment of text to clarify MMR vaccines are contraindicated mainly for people who are severely immunocompromised to align with the updated guidance in Vaccination for people who are immunocompromised chapter.

Addition of text and guidance to clarify precautions of MMR vaccination for people who are mildly or moderately immunocompromised” to align with the updated guidance in Vaccination for people who are immunocompromised chapter.

Addition of text describing coadministration of MMR vaccine with RSV monoclonal antibody.

Amendment of text to clarify MMR vaccines are contraindicated mainly for people who are severely immunocompromised to align with the updated guidance in Vaccination for people who are immunocompromised chapter.

Addition of text and guidance to clarify precautions of MMR vaccination for people who are mildly or moderately immunocompromised” to align with the updated guidance in Vaccination for people who are immunocompromised chapter.

Addition of text describing coadministration of MMR vaccine with RSV monoclonal antibody.

Updates to remove any references to products no longer available (NeisVac-C, Cervarix, Spikevax, Zostavax, Nuvaxovid and Fluarix Tetra) and updates to the pre-vaccination screening checklist.

Link added to Vaccination for people who are immunocompromised chapter and figure describing types of medical conditions and immunosuppressive therapy and associated levels of immunocompromise.

Amendment of definitions of level of immunocompromise to align with the updated definitions in Vaccination for people who are immunocompromised chapter.

Addition of text to provide guidance on rotavirus administration to infants born to mothers who received biological immunosuppressive therapies during pregnancy to align with the updated guidance in “Infants exposed to immunosuppressive therapy in utero or through breastmilk” in Vaccination for people who are immunocompromised chapter.

Addition of text describing coadministration of rotavirus vaccine with RSV monoclonal antibody.

Amendment of text to clarify MMR vaccines are contraindicated mainly for people who are severely immunocompromised to align with the updated guidance in Vaccination for people who are immunocompromised chapter.

Addition of text and guidance to clarify precautions of MMR vaccination for people who are mildly or moderately immunocompromised” to align with the updated guidance in Vaccination for people who are immunocompromised chapter.

Addition of text describing coadministration of MMR vaccine with RSV monoclonal antibody.

Addition of text on contraindications of BCG vaccine to include other immunocompromised populations, such as solid organ transplant and HSCT, and updated advice for people with inborn errors of immunity, HIV and secondary immunodeficiency due to immunosuppressive therapies.

New text providing advice on precautions for administering the oral live typhoid vaccine to close contacts of immunocompromised people, to avoid the theoretical risk of transmitting the vaccine strain virus.

Link added to Vaccination for people who are immunocompromised chapter and figure describing types of medical conditions and immunosuppressive therapy and associated levels of immunocompromise.

An updated immunocompromised chapter offers comprehensive information and recommendations for people who are immunocompromised. The chapter provides clear immunocompromise definitions and categorises the level of immunocompromise across various types of conditions, including inborn errors of immunity, secondary immunodeficiencies due to medical conditions or therapies, asplenia, infants exposed to immunosuppression in utero, immunocompromised close contacts, and immunocompromised travellers. This chapter will serve as a primary reference for detailed information and vaccination guidance tailored to each immunocompromising condition, in alignment with specific disease chapters.

Addition of text to clarify guidance of non-live vaccine administration to infants born to mothers receiving immunosuppressive therapies during pregnancy to align with the updated guidance in “Infants exposed to immunosuppressive therapy in utero or through breastmilk” in Vaccination for people who are immunocompromised chapter.

Addition of text to provide guidance on live vaccine administration to infants born to mothers who received biological immunosuppressive therapies during pregnancy, particularly to rotavirus vaccine recommendations, to align with the updated guidance in “Infants exposed to immunosuppressive therapy in utero or through breastmilk” in Vaccination for people who are immunocompromised chapter.

Amendment of text to clarify varicella vaccines are contraindicated mainly for people who are severely immunocompromised to align with the updated guidance in Vaccination for people who are immunocompromised chapter.

Addition of text and guidance to clarify precautions of varicella vaccination for people who are mildly or moderately immunocompromised” to align with the updated guidance in Vaccination for people who are immunocompromised chapter.

Addition of text describing coadministration of varicella vaccine with RSV monoclonal antibody.