What changes have been made to the Vaccine Schedule
Since July 2018, the Vaccination schedule for NSW has been changed for a number of Vaccines, our dedicated and experienced Nurse Immunisers at the Madison Medical Practice have been aware of the changes and have since implemented this government initiative to provide the best protection for your child. Please read the below information about the diseases and the vaccines designed to inoculate against them to ensure you and your family are protected. Naturally if you have any questions or concerns please contact our friendly reception staff to make an appointment with our dedicated Nurse immunisers.
Pneumococcal
What is pneumococcal disease?
Pneumococcal disease is caused by infection with the bacteria Streptococcus pneumoniae. Infection can cause a variety of diseases including: pneumonia (infection of the lungs), otitis media (infection of the middle ear) and meningitis (infection of the membranes around the brain and spinal cord).
What has changed in regards to the pneumococcal vaccine from 1 July 2018?
The third dose of pneumococcal vaccine (Prevenar 13) previously given at 6 months of age will now be given at 12 months of age from 1 July 2018 – Prevenar 13 is now given at 6 weeks, 4 months and 12 months.
Children with medical conditions associated with an increased risk of invasive pneumococcal disease will still receive the 6 month dose as an additional dose – now given at 6 weeks, 4 months, 6 months and 12 months. A list of these conditions is available from The Australian Immunisation Handbook
Why has the schedule changed in relation to the pneumococcal vaccine for children?
The Australian Technical Advisory Group on Immunisation (ATAGI) has recommended a change in the timing of the pneumococcal vaccine (Prevenar 13) doses to ensure that the National Immunisation Program (NIP) is aligned with disease patterns. Since the introduction of the pneumococcal vaccine there has been a large reduction in cases of invasive pneumococcal disease (IPD), however in recent years there has been an increase in the number of cases of IPD in children beyond 12 months of age. A dose of pneumococcal vaccine in the second year of life is expected to improve the protection provided by the childhood vaccination program, and reducing the primary course from three to two doses is not expected to increase the risk of IPD in infants under 12 months of age.
Should children who have received a third dose of pneumococcal vaccine at 6 months (previous schedule) receive a booster dose at 12 months?
Yes. All children who are due for their 12 month vaccinations from 1 July 2018 onwards are recommended to receive a funded dose of pneumococcal vaccine at 12 month of age.
Children born between 1 July 2017 and 31 December 2017 without increased risk of IPD can receive a total of 4 doses of pneumococcal vaccine during the transition. Parents should be reassured that this is safe. For this group of children, the 12 month vaccine is funded, but is not required to be considered fully immunised for the purposes of https://beta.health.gov.au/resources/publications/no-jab-no-pay-new-requirements-fact-sheet Children with conditions that have an increased risk of IPD should receive 4 doses of the vaccine (6 weeks, 4 months, 6 months and 12 months).
Where can I get more information about pneumococcal disease?
Go to https://www.health.nsw.gov.au/Infectious/factsheets/Pages/pneumococcal-disease.aspx for more information , or please make an appointment with our Madison Medical Practice Nurse Immunisers.
Meningococcal ACWY
What is meningococcal disease?
Invasive meningococcal disease (IMD) is a rare but serious infection caused by the bacteria Neisseria meningitidis that usually causes meningitis (inflammation of the lining of the brain and spinal cord) and/or septicemia (blood poisoning). Up to 10 per cent of IMD infections are fatal even with appropriate antibiotic treatment and survivors may be left with long-term complications. There are several serogroups of Neisseria meningitidis which cause invasive disease in Australia: A, B, C, W and Y.
What has changed from 1 July 2018 for meningococcal vaccine?
Before 1 July 2018 children received a combination meningococcal C, Haemophilus influenzae type b (Hib) vaccine at 12 months of age. To broaden the protection of children against the bacteria that causes meningococcal infection, a vaccine (Nimenrix) that protects against 4 serogroups of the bacteria will be given to children at 12 months of age from 1 July 2018. These serogroups are A, C, W and Y. The Hib component of the previous vaccine will be given as a monovalent vaccination (Act-HIB) at 18 months.
Why has the meningococcal vaccine changed?
Prior to 1 July 2018 the meningococcal containing vaccine given to children at 12 months of age only provided protection against serogroup C of the bacteria that causes meningococcal infection.
In recent years there has been an increase in the number of cases of meningococcal infection caused by serogroups of the bacteria other than the C serogroup. Therefore from 1 July 2018 children will receive a meningococcal vaccine at 12 months of age which protects against an additional 3 serogroups of the bacteria. The vaccine (Nimenrix) protects against serogroups A, C, W and Y serogroups.
Who is eligible for the meningococcal ACWY vaccine?
Meningococcal ACWY will be given to all children who are eligible for their 12 month vaccinations from 1 July 2018 onwards.
Children who have received their 12 month vaccines (including meningococcal C-Hib) before 1 July 2018 are not eligible to receive the meningococcal ACWY vaccine under the National Immunisation Program (NIP). Meningococcal ACWY-containing vaccines can be purchased from the private market however there should be a minimum interval of 8 weeks between the meningococcal C vaccination and administration of the meningococcal ACWY vaccine.
Can Nimenrix be administered before 12 months of age?
Nimenrix is registered for use from 12 months of age however the Australian Technical Advisory Group on Immunisation (ATAGI) advise that it can be used from 6 weeks of age. In order to be considered fully immunised the 12 month dose should not be given before 11 months of age.
Is there a catch-up program for children who have received the meningococcal C vaccine to receive the meningococcal ACWY vaccine?
No. Children who have already received their meningococcal C vaccine at 12 months of age are not eligible for a meningococcal ACWY vaccine.
If a child who has not received their 12 month vaccinations presents for catch up after 1 July 2018 should they receive the meningococcal ACWY vaccine?
If a child presents for their 12 month vaccinations late, administer the vaccines according to the current schedule.
What if a parent wants to initiate meningococcal ACWY vaccination prior to 12 months of age?
Parents who wish to initiate meningococcal ACWY vaccination prior to their child’s first birthday can purchase this from the private market.
Should a child who commenced or completed a vaccination course for meningococcal ACWY prior to 12 months of age be vaccinated at 12 months? Is it funded?
Yes. A single dose of meningococcal ACWY vaccine is recommended and funded to be given at 12 months of age for all children regardless of whether they have previously received meningococcal ACWY vaccine prior to 12 months of age. However, there should be a minimum interval of 8 weeks from their last meningococcal ACWY dose before the 12 month dose is given.
Why is the meningococcal B vaccine not included on the schedule?
In contrast to vaccines for meningococcal serogroups A, C, W & Y, the cost-effectiveness of the meningococcal B vaccine has not been demonstrated. Further, year on year meningococcal B cases in Australia have been decreasing, and while still a very serious disease, the circulating strains of meningococcal B disease do not show the same levels of mortality as is seen with meningococcal W disease. Meningococcal B vaccine is however available for purchase from the private market.
Can a child receive the meningococcal ACWY vaccine at the same time as meningococcal B vaccine?
Yes. Meningococcal B vaccine (Bexsero or Trumenba) can be administered at the same time as meningococcal ACWY vaccine, however prophylactic administration of paracetamol is recommended before and after administration of Bexsero in children aged <2 years. Meningococcal B vaccine is not funded under the National Immunisation Program. If people wish to vaccinate their child against meningococcal B they will need to purchase it from the private market.
Where can I get more information about meningococcal disease?
Visit https://www.health.nsw.gov.au/Infectious/factsheets/Pages/Meningococcal_disease.aspx
For more information about meningococcal disease, or please make an appointment with our Madison Medical Practice Nurse Immunisers
Haemophilus Influenzae type b
What is Haemophilus influenzae type b?
Haemophilus Influenzae type b (Hib) disease is caused by infection with Haemophilus influenzae type b bacteria.
Infection can cause:
- meningitis (infection of the membranes around the brain and spinal cord)
- epiglottitis (severe swelling of the epiglottis at the back of the throat)
- pneumonia (infection of the lungs)
- osteomyelitis (infection of the bones and joints)
- cellulitis (infection of the tissue under the skin, usually on the face).
These conditions can develop quickly, and meningitis and epiglottitis can sometimes be fatal.
What has changed from 1 July 2018 for Haemophilus influenzae type b vaccine?
Before 1 July 2108 children received the fourth dose of Haemophilus influenzae type b (Hib) in a combination vaccine with meningococcal C at 12 months of age (Menitorix). From 1 July 2018 the Hib component of the vaccine will be given as a monovalent vaccination (Act-HIB) at 18 months.
Why has there been a change to the Haemophilus influenzae type b vaccine (Hib)?
In order to facilitate required changes to the Immunisation Schedule, the Australian Technical Advisory Group on Immunisation (ATAGI) has reviewed evidence regarding the Hib vaccine and recommended that the fourth dose be moved to 18 months of age as it is safe and effective to do so.
What If a child already received a Haemophilus influenzae type b vaccine at 12 months of age?
Children born between 1 January 2017 and 30 June 2017 do not require the additional dose of Hib to be considered fully immunised, including for the purposes of https://beta.health.gov.au/resources/publications/no-jab-no-pay-new-requirements-fact-sheet Children in this group can however receive the funded dose of Hib vaccine at 18 months (total of 5 doses of Hib) and parents should be reassured that this is safe.
Where can I get more information about Haemophilus influenzae type b disease?
See the haemophilus influenzae type b fact sheet for more information about Hib disease.
Pertussis
What is whooping cough (pertussis)?
Whooping cough (Pertussis) can be a life threatening infection in babies. Whooping cough in babies can lead to apnoea (pauses in normal breathing), pneumonia, feeding problems and weight loss, seizures, brain damage and, in some cases, death. Older children and adults can get whooping cough too and pass it on to babies.
What has changed from 1 July 2018 in relation to the whooping cough (pertussis) vaccine for pregnant women?
The whooping cough vaccine has been provided free of charge on the NSW Immunisation Schedule to all pregnant women in their third trimester. From 1 July 2018 this vaccine (Boostrix or Adacel) will continue to be provided for pregnant women in their third trimester but will be funded by the National Immunisation Program (NIP).
Where can I get more information about pertussis (whooping cough)?
See the https://www.health.nsw.gov.au/Infectious/factsheets/Pages/pertussis.aspx or more information about Pertussis disease or please make an appointment with our Madison Medical Practice Nurse Immunisers
