Updates to the Handbook

Guidance on co-administration of hepatitis B-containing vaccines with quadrivalent meningococcal vaccines has been added.

Information about the seroconversion rate after a standard 3-dose schedule has been added.

Editorial changes to recommendations for preterm infants, people travelling in the influenza season, and co-administration with other vaccines.

Wording of recommendation for preterm infants updated to include recommended age for vaccination.

Recommendation for people travelling in the influenza season updated to include more specific guidance on vaccinating returning travellers who have received the Northern Hemisphere vaccine.

Guidance under Co-administration with other vaccines updated.

Editorial update of guidance on the age at 1st MMR dose for children, to correct typographical error.

Recommendation for travellers updated to provide more information about the age group of travellers who require 2 doses of MMR vaccine.

Guidance under Co-administration with other vaccines updated.

Nature of the disease section updated to define the prodromal period.

Vaccine information section updated to clarify WHO vaccine effectiveness estimate.

Editorial changes to advice on use of Menveo and co-administration with other vaccines.

Recommendations and Variations from product information updated to include advice on use of Menveo in infants travelling to areas with high meningococcal A activity. Advice on Menveo dose schedule for infants travelling to areas with high meningococcal A activity has been added. Three primary doses should be given with an interval of 8 weeks between doses, followed by a 4th dose at 12 months age.

Guidance on concomitant and sequential administration of Menactra and Nimenrix with other vaccines has been updated.

Editorial changes to guidance about co-administration with other vaccines and timing of vaccination for women during pregnancy.

• Guidance under Co-administration with other vaccines updated.
• Guidance on timing of vaccination for women who did not receive pertussis vaccine during pregnancy updated.

Editorial changes to the recommendations for people with medical risk factors and guidance for co-administration with other vaccines.

Recommendations for people with medical risk factors updated to provide greater clarity on the number and timing of 23vPPV doses.

Guidance under Co-administration with other vaccines updated.

Guidance on co-administration of IPV-containing vaccines with other vaccines, including quadrivalent meningococcal vaccines, has been added.

Pre-vaccination screening section updated to include guidance on appropriate spacing of inactivated and live parenteral vaccines.

Guidance on administration of rotavirus vaccine to infants exposed to bDMARDs in utero updated.

Guidance under Co-administration with other vaccines updated.

Guidance on concomitant and sequential administration of tetanus-containing vaccines with Menactra and Nimenrix has been added.

Editorial changes to 'Table. Recommended timing of live vaccine doses in adults and children taking corticosteroids' in the ‘Use of live vaccines in people who are immunocompromised' section, to correct prednisone-equivalent doses for children and adolescents aged <16 years who weigh >10 kg.

Guidance on assessing the level of immunocompromise in children and adults with HIV updated.

Guidance on vaccination of infants born to mothers who received bDMARDs during pregnancy updated.

Guidance on vaccination of infants exposed to bDMARDs (biological disease-modifying anti-rheumatic drugs) in utero has been updated. Infants born to mothers who received bDMARDs during pregnancy are not recommended to receive rotavirus vaccine. Drug levels may be measured to guide decision-making.

Guidance on international travel requirements updated.

Contraindications for people who are immunocompromised updated.

Editorial change in Adverse events section to correct placement of references for the rate of immediate hypersensitivity reactions after yellow fever vaccination.

Guidance on risk to travellers updated.

Guidance on vaccination of travellers against measles, mumps and rubella updated to reflect advice in the Measles chapter.

Changes to catch-up recommendations for infants receiving MMR vaccines. The recommended age at which infants can receive MMR vaccine in special circumstances has been lowered from 9 months to 6 months. For additional details refer to MMR and MMRV vaccines and Measles.

The recommended age at which infants can receive MMR vaccine in special circumstances has been lowered from 9 months to 6 months. Infants as young as 6 months of age can receive MMR vaccine for travel to highly endemic areas during outbreaks and as post-exposure prophylaxis.

For post-exposure prophylaxis, infants from 6 months can be offered MMR vaccine in place of normal human immunoglobulin.

Updates to influenza information in line with the ATAGI annual statement for seasonal influenza vaccines

ATAGI annual statement for seasonal influenza vaccines is available here: https://health.gov.au/resources/publications/atagi-advice-on-seasonal-influenza-vaccines-in-2019

• The  indicated ages for Fluarix Tetra and Afluria Quad have been extended. Fluarix Tetra can be used as a 0.5 mL dose in children aged 6 months and older, down from 3 years.
• The recommendation for administration during pregnancy has been updated. Pregnant women can receive influenza vaccine during any stage of pregnancy. The timing of vaccination should be considered in relation to the influenza season and vaccine availability. Please refer to the recommendation for further details.
• 'People who are travelling during the influenza season are strongly recommended to receive influenza vaccine, especially if influenza is circulating in the destination region or in settings with increased risk of influenza circulation during the trip. Please refer to the recommendations for travellers for further details.

Updates to the recommendation for pertussis vaccination during pregnancy.

The recommendation for pertussis vaccination during pregnancy has been updated. The optimal timing for vaccination has been updated to 20 (previously 28) to 32 weeks gestation (mid 2nd trimester to early 3rd trimester). Please refer recommendations for Women who are pregnant or breastfeeding.

Changes to dose schedule for Bexsero, and Variations from product information.

• The recommended dose schedule for Bexsero has been updated for healthy infants aged 6 weeks to 5 months. Two primary doses should be given with an 8 week interval between doses, followed by a 3rd dose at 12 months of age.
• Based on various changes to product information Nimenrix, Menactra, Bexsero and Trumenba, updates have been made, particularly in the Variations from product information.

Editorial changes to 'Table. Monovalent hepatitis B vaccines for adolescents and adults' in the 'Vaccines, dosage and administration' section to include paediatric formulations.

Corrected text in table describing monovalent hepatitis B vaccines for adolescents and adults.

No supporting evidence required. Editorial update due to error in table – paediatric formulations omitted.