Updates to the Handbook

Detailed guidance on vaccinating adults and children taking corticosteroids.

Removal of Menitorix as vaccine was discontinued in July 2020.

Minor changes to guidance for women planning pregnancy in Variations from product information.

Clarification of advice regarding the minimum interval between a dTpa-containing vaccine after a dT-containing vaccine. See vaccination after tetanus containing vaccines.

Guidance for doses of 23vPPV required after a haematopoietic stem cell transplant updated.

Minor editorial corrections.

Updated Table. Components of vaccines used in Australia.

Minor editorial corrections.

Recommendations have been updated to allow intradermal vaccination and accelerated schedules for rabies pre-exposure prophylaxis.

Recommendations for people at ongoing exposure risk in selected high-risk occupations have been updated to specify a booster dose 1 year after completing the 1st course of pre-exposure prophylaxis, and every 3 years after that.

For post-exposure prophylaxis, recommendations have been updated to specify the number of vaccine doses and the need for human rabies immunoglobulin for people who are mildly immunocompromised and people who are severely immunocompromised.

Guidance on vaccination after the age cut-off expanded.

NCIRS editorial changes.

More detailed guidance provided on the use of Zostavax in people who are immunocompromised or on immunosuppressive therapy, including:

• more details on pre-vaccination screening, including serological testing for past varicella-zoster virus (VZV) infection when relevant
• expanded list of immunosuppressive therapies that are considered safe for administration of Zostavax

Adverse events section updated to include:

• detailed information on VZV-like rash that could rarely occur following Zostavax administration
• relevant advice to vaccine recipients
• management and reporting of these episodes 

2021 Influenza seasonal updates.

Updates to influenza information in line with the ATAGI annual statement for seasonal influenza vaccines. Flucelvax Quad is now registered for use in Australia and is indicated in children and adults ≥9 years of age. 

Editorial changes to content to reflect closure of National HPV Vaccination Program Register. 

Section on reporting to immunisation registers updated to reflect closure of National HPV Vaccination Program Register.

Changes to catch-up recommendations for children receiving pneumococcal and/or Hepatitis A vaccines. Guidance on concomitant and sequential administration of vaccines has been updated.

Changes to the vaccination schedule for Aboriginal and Torres Strait Islander children in Northern Territory, Queensland, South Australia and Western Australia.

Recommendations for Aboriginal and Torres Strait Islander children in Northern Territory, Queensland, South Australia and Western Australia have changed. Aboriginal and Torres Strait Islander children in these states and territories are now recommended to receive Hepatitis A vaccine in a 2-dose schedule at 18 months and 4 years of age.

Recommendations have changed for people with risk conditions, Aboriginal and Torres Strait Islander people, and older adults.

The following changes have been made to recommendations for people with risk conditions:

• Category A and Category B conditions have been consolidated into a single list of risk conditions for pneumococcal disease.
• The recommended vaccines and number of doses — 1 extra dose of 13vPCV and 2 doses of 23vPPV — are now the same for all people with risk conditions.
• The number of lifetime doses of 23vPPV recommended for people with risk conditions is now limited to 2 doses.

The following changes have been made to recommendations for Aboriginal and Torres Strait Islander people:

• Aboriginal and Torres Strait Islander children in the Northern Territory, Queensland, South Australia and Western Australia are now recommended to receive 2 doses of 23vPPV in addition to the 4 doses of 13vPCV.
• Aboriginal and Torres Strait Islander adults without risk conditions for pneumococcal disease are now recommended to receive 1 dose of 13vPCV and 2 doses of 23vPPV at age ≥50 years.
• Aboriginal and Torres Strait Islander adults <50 years with risk conditions for pnuemococcal disease are to receive vaccines as per recommendations for people with risk conditions.

The following changes have been made to recommendations for healthy non-Indigenous adults:

• Healthy non-Indigenous adults are now recommended to receive a single dose of 13vPCV at age ≥70 years. Healthy non-Indigenous adults who do not have risk conditions for pneumococcal disease are no longer recommended to receive 23vPPV.

Changes to Hepatitis A and pneumococcal vaccine recommendations for Aboriginal and Torres Strait Islander people.

Editorial update to reflect changes to pneumococcal vaccine recommendations for older adults and people with medical risk factors.

Changes to pneumococcal vaccine recommendations for people who are immunocompromised.