Updates to the Handbook
A list of updates made to the Handbook is provided below by the date they were published. The Handbook will be reviewed 3 times per year following ATAGI meetings in February, May and August. Urgent updates to the content will be made as required.
Recently added
This page was added on 06 June 2018.
Updates made
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6 June 2018
The following pages were updated:
Rabies and other lyssaviruses
Advice regarding HRIG delay following high-risk situations of potential lyssavirus exposure has been updated. For bites to the head and neck, give post-exposure prophylaxis as soon as possible and no later than 48 hours after exposure, even if the animal has been sent for testing.
5 June 2018
The following pages were updated:
Haemophilus influenzae type b (Hib)
The Hib (Haemophilus influenzae type b) booster dose previously given in combination with Hib-MenC (combined Hib and meningococcal C vaccine) at 12 months of age has been replaced with a monovalent Hib dose at 18 months of age.
9 April 2018
The following pages were updated:
Influenza (flu)
2018 Influenza seasonal updates. 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:
- 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).
- 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):
- Aboriginal and Torres Strait Islander children living in the NT, QLD, SA and WA
- 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.
1 August 2017
The following pages were updated:
Diphtheria
Changes to 4.2.4 Vaccines and 4.2.12 Variations from product information.
4.2.4 Vaccines and 4.2.12 Variations from product information
Amendment of text due to the discontinuation of a vaccine type, Pediacel. (Refer also Chapters, 4.2 Diphtheria, 4.3 Haemophilus influenzae type b, 4.14 Polio and 4.19 Tetanus).
4.2.7 Recommendations
Addition of text clarifying vaccination in laboratory workers.
Haemophilus influenzae type b (Hib)
Changes to 4.3.4 Vaccines, 4.3.7 Recommendations, and 4.3.12 Variations from product information
4.3.4 Vaccines
Addition of text to clarify situations in which vaccine interchangeability will now need to be considered.
4.3.4 Vaccines, 4.3.7 Recommendations, 4.3.12 Variations from product information
Amendment of text due to the discontinuation of the Haemophilus b conjugate (PRP-OMP) vaccine (PedvaxHIB) (Refer also Chapter 2.1 Pre-vaccination).
Amendment of text due to the discontinuation of a vaccine type, Pediacel (Refer also Chapters, 4.2 Diphtheria, 4.12 Pertussis, 4.14 Polio and 4.19 Tetanus).
Hepatitis A
Changes to 4.4.4 Vaccines and 4.4.6 Dosage and administration
4.4.4 Vaccines
Amendment of text to align with new product information.
4.4.6 Dosage and administration
Correction of incorrect text, replacing ELISA units with antigen units and changing 12 months to 36 months.
Measles
Changes to 4.9.4 Vaccines; 4.9.5 Transport, storage and handling; 4.11 Mumps and 4.18 Rubella); 4.9.10 Precautions; and 4.9.11 Adverse events
4.9.4 Vaccines
Correction of text due to incorrect nomenclature (Refer also Chapters, 4.11 Mumps and 4.18 Rubella and 4.22 Varicella).
Updating of text for consistency with new product information. In particular, the source of animal derived gelatin was updated to specify porcine gelatin. (Refer also Chapters, 4.11 Mumps, 4.18 Rubella, 4.21 Typhoid, 4.22 Varicella and Appendices 3 & 4).
4.9.5 Transport, storage and handling
Amendment of text to align with new product information on storage of vaccine at various temperatures (Refer also Chapters, 4.11 Mumps and 4.18 Rubella).
4.9.10 Precautions, 4.9.11 Adverse events
Moving text on egg allergy from Precautions to Adverse Events to be consistent with other chapters (Refer also Chapters, 4.11 Mumps, 4.18 Rubella and 4.22 Varicella).
4.9.11 Adverse events
Addition of text on ovalbumin quantity in vaccine.
Mumps
Changes to 4.11.4 Vaccines; 4.11.5 Transport, storage and handling; and 4.11.11 Adverse events
4.11.4 Vaccines
Correction of text due to incorrect nomenclature (Refer also Chapters, 4.9 Measles, 4.18 Rubella and 4.22 Varicella).
Updating of text for consistency with new product information. In particular, the source of animal derived gelatin was updated to specify porcine gelatin. (Refer also Chapters, 4.9 Measles, 4.18 Rubella, 4.21 Typhoid, 4.22 Varicella and Appendices 3 & 4).
4.11.5 Transport, storage and handling
Amendment of text to align with new product information on storage of vaccine at various temperatures (Refer also Chapters, 4.9 Measles and 4.18 Rubella).
4.11.11 Adverse events
Addition of text on egg allergy to Adverse Events to be consistent with other chapters. (Refer also Chapters, 4.9 Measles, 4.18 Rubella and 4.22 Varicella).
Pertussis (whooping cough)
Changes to 4.12.4 Vaccines and 4.12.12 Variations from product information.
4.12.4 Vaccines and 4.12.12 Variations from product information
Amendment of text due to the discontinuation of a vaccine type, Pediacel. (Refer also Chapters, 4.2 Diphtheria, 4.3 Haemophilus influenzae type b, 4.14 Polio and 4.19 Tetanus).
Poliomyelitis
Changes to 4.14.4 Vaccines and 4.14.12 Variations from product information.
4.14.4 Vaccines and 4.14.12 Variations from product information
Amendment of text due to the discontinuation of a vaccine type, Pediacel. (Refer also to Chapters, 4.2 Diphtheria, 4.3 Haemophilus influenzae type b, 4.12 Pertussis and 4.19 Tetanus).
Rotavirus
Changes to 4.17.6 Dosage and administration
Amendment of text relating to the need for a third dose of vaccine.
Rubella
Changes to 4.18.4 Vaccines; 4.18.5 Transport, storage and handling; and 4.18.11 Adverse events
4.18.4 Vaccines
Amendment of text to align with new product information. In particular the source of animal derived gelatin was updated to specify porcine gelatin. (Refer also Chapters, 4.9 Measles, 4.11 Mumps, 4.21 Typhoid, 4.22 Varicella and Appendices 3 & 4).
Correction of text due to incorrect nomenclature (Refer also Chapter, 4.9 Measles, 4.11 Mumps and 4.22 Varicella).
4.18.5 Transport, storage and handling
Amendment of text to align with new product information on storage of vaccine at various temperatures (Refer also Chapters, 4.9 Measles and 4.11 Mumps).
4.18.11 Adverse events
Addition of text on egg allergy to Adverse Events to be consistent with other chapters (Refer also Chapters, 4.9 Measles, 4.11 Mumps, 4.18 Rubella and 4.22 Varicella).
Tetanus
Changes to 4.19.4 Vaccines and 4.19.12 Variations from product information
Amendment of text due to the discontinuation of a vaccine type, Pediacel. (Refer also Chapters, 4.2 Diphtheria, 4.3 Haemophilus influenzae type b, 4.12 Pertussis and 4.14 Polio).
Tuberculosis
Changes to 4.20.10 Precautions
4.20.10 Precautions
Addition of text to clarify when BCG vaccination should be deferred in people with skin conditions.
Typhoid fever
Changes to 4.21.4 Vaccines
4.21.4 Vaccines
Amendment of text to align with new product information. In particular the source of animal derived gelatin was updated to specify bovine gelatin. (Refer also Chapters, 4.9 Measles, 4.11 Mumps, 4.18 Rubella, 4.22 Varicella and Appendices 3 & 4).
Varicella (chickenpox)
Changes to 4.22.4 Vaccines; 4.22.11 Adverse events; and 4.22.12 Public health management of varicella.
4.22.4 Vaccines
Amendment of text to align with new product information. In particular the source of animal derived gelatin was updated to specify porcine gelatin. (Refer also Chapters, 4.9 Measles, 4.11 Mumps, 4.18 Rubella, 4.21 Typhoid and Appendices 3 & 4).
Correction of text due to incorrect nomenclature (Refer also Chapters, 4.9 Measles, 4.11 Mumps and 4.18 Rubella).
4.22.11 Adverse events
Addition of text on egg allergy to Adverse Events to be consistent with other chapters. (Refer also Chapters, 4.9 Measles, 4.11 Mumps and 4.18 Rubella).
4.22.12 Public health management of varicella
Addition of text to section regarding giving neonates zoster immunoglobulin (ZIG) to clarify it is after primary varicella-zoster virus (VZV) infection of the mother.
Zoster (herpes zoster)
Changes to 4.24.7 Recommendations, 4.24.9 Contraindications, 4.24.10 Precautions, and 4.24.11 Adverse events
4.24.7 Recommendations
Addition of text reiterating importance of obtaining a medical history in patients prior to vaccination, to reiterate the contraindications regarding use of Zostavax in immunocompromised people and to provide further detail on what constitutes immunocompromise and how to manage inadvertent vaccination in these people.
4.24.9 Contraindications
Addition of text and table to reiterate the contraindications regarding use of Zostavax in immunocompromised people and to provide further detail on what constitutes immunocompromise and how to manage inadvertent vaccination in these people.
4.24.10 Precautions
Addition of text providing more specific detail of CD4 levels at which a person infected with HIV can receive Zostavax. (Refer also Chapter 3.3 Groups with special vaccination requirements).
4.24.11 Adverse events
Addition of text providing details of select serious outcomes where immunocompromised people have received Zostavax.