Updates to the Handbook

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.

Addition of text and evidence of immunogenicity in haematopoietic stem cell transplant recipients vaccinated with yellow fever vaccine.

Amendment of text to clarify yellow fever vaccines were 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 yellow fever vaccination for “people who are mildly or moderately immunocompromised” to align with the updated guidance in Vaccination for people who are immunocompromised chapter.

Updates to reflect the removal of Zostavax.

Updates to reflect inclusion of monoclonal antibodies as a form of passive immunisation. 

Updates to reflect the removal of Zostavax. 

Updates to reflect the removal of Zostavax.

Updates to reflect the new National RSV Mother & Infant Protection Program (RSV-MIPP).

Removal of Trumenba vacccine throughout the chapter due to discontinuation. Clinical guidance added for scenarios where Trumenba primary series was not completed or a booster is required. Clinical guidance added for adolescents who have previously received MenACWY or MenB vaccine. Variation from product information added for interval and number of doses for Bexsero in infants aged 2-5 months.

Removal of Trumenba from Table. Components of immunisation products used in Australia (under vaccine components aluminium compounds and polysorbate or sorbitol). Removal of mpox vaccine from the list of live vaccines. 

Removal of Trumenba information from Table. Recommendations for revaccination after haematopoietic stem cell transplant in children and adults. Change the mpox vaccine from the list of live vaccines to the list of inactivated vaccines.  

Updates throughout the chapter to remove outdated formulations (Comirnaty Original [Pfizer] 6 months to ≤5 years formulation, Comirnaty bivalent Original/Omicron BA.4/5 [Pfizer] ≥12 years formulation and Spikevax Omicron XBB.1.5 [Moderna] pre-filled syringe formulation) and added information about updated strain vaccine formulation that is Comirnaty JN.1. 

Minor factual updates in relation to individual product (Comirnaty JN.1 formulation) shelf life and registration for use as a primary and further dose vaccine have been made to align with updated production information. Minor updates made to reflect epidemiology of current SARS-CoV-2 circulating variants and effectiveness of Comirnaty JN.1 formulation.
 

Update to reflect recent changes in eligibility for zoster vaccination under the National Immunisation Program (NIP), including a new Table. Risk conditions and immunosuppressive therapies for zoster vaccination and eligibility for NIP funding.