{"id": "de14b5d1bbc9-0", "text": "The cold chain describes the system of transporting and storing vaccines within the manufacturer\u2019s recommended temperatures. It begins from when the vaccine is manufactured, transported through vaccine distribution centres, on to immunisation service providers and ends when the vaccine is administered.\nMost vaccines are also sensitive to UV and fluorescent light and must be stored in their original packaging.\nFailure to store and handle vaccines properly can result in reduced vaccine potency and inadequate immune responses in vaccine recipients as well as poor protection against disease.\nTraditional vaccine storage\nMost vaccines must be transported and stored within the traditional cold chain temperatures of between +2\u00b0C and +8\u00b0C. \u00a0The optimal temperature is +5\u00b0C.\nPurpose-built vaccine refrigerators are preferred for storing vaccines because they are designed and constructed specifically for vaccine storage within these temperatures. Domestic refrigerators are not suitable for vaccine storage.\nFor mobile or outreach immunisation clinics, vaccines can be transported in high quality coolers. Coolers must be appropriately packed using ice or gel packs and reliable temperature monitoring used throughout. Coolers are not intended for long term vaccine storage (more than 8 hours) or in extreme weather conditions.\nFurther information regarding traditional vaccine storage and management can be found at National Vaccine Storage Guidelines: Strive for 5.\nUltra-cold chain storage\nUltra-low temperatures are required for the storage of some COVID-19 vaccines.\nComirnaty\u2122\u00a0(Pfizer/BioNTech) requires ultra-cold chain storage in purpose-built freezers at temperatures between -90\u00b0C and -60\u00b0C. Thermal shippers with cartons of vaccine submerged in dry ice are required for transport.\nSpikevax (elasomeran) requires ultra-cold chain storage of between -25\u00b0C and -15\u00b0C. Once defrosted, Spikevax can be stored and transported at temperatures of between +2\u00b0C and +8\u00b0C for up to 30 days.", "source": "mvec.mcri.edu.au/references/cold-chain-helpful-resources/index.html"}
{"id": "de14b5d1bbc9-1", "text": "Ultra-cold chain handling equipment must be used as per manufacturer\u2019s advice when handling frozen vaccines. Once frozen vaccines are defrosted, they cannot be refrozen.\nFor further information, refer to the\u00a0Victorian COVID-19 vaccination guidelines.\nCommunity pharmacy\u2013acquired vaccines\nThe cold chain needs to be maintained, not only for vaccines provided as part of the National Immunisation Program but also for vaccines that a person buys from a pharmacy with a prescription. Doctors who provide a prescription for a vaccine should advise individuals that it is important to only purchase the vaccine from the pharmacy immediately before attending the practice or clinic appointment for vaccine administration. The pharmacist also has a responsibility to advise on the importance of maintaining the cold chain. On arrival to the clinic, the individual should notify reception that they have a vaccine to put in the vaccine refrigerator.\nIf an immunisation service provider has any concern that a vaccine provided by an individual may have been stored outside the recommended ranges, the vaccine should not be administered.\nCold chain breaches\nA cold chain breach occurs when vaccines are exposed to temperatures outside the manufacturers recommended range.\nA cold chain breach also includes the exposure of vaccines to light.\nIf a cold chain breach is suspected it is important to isolate the affected vaccines. Do not use affected vaccines until further clarification from the appropriate bodies is sought. It is important to report any cold chain breaches so that individuals can be revaccinated (if required) or unused vaccines can be recalled, if needed.\nCold chain breaches of National Immunisation Program (NIP) vaccines, influenza and travel vaccines must be reported to the Department of Health as soon as possible using the\u00a0Cold Chain Breach Report form. DH will outline recommendations for the next steps to take.\nCold chain breaches of COVID-19 vaccines should be reported to the Commonwealth Vaccine Operations Centre (VOC) on 1800 318 208. The VOC will provide advice on how cold chain breaches must be managed.", "source": "mvec.mcri.edu.au/references/cold-chain-helpful-resources/index.html"}
{"id": "de14b5d1bbc9-2", "text": "\ufeff\ufeff\nResources \nNational Vaccine Storage Guidelines: Strive for 5\nDepartment of Health \u2013 Cold Chain Management\nDepartment of Health \u2013 Victorian COVID-19 vaccination guidelines\nAuthor: Georgie Lewis (SAEFVIC Clinical Manager, Murdoch Children\u2019s Research Institute)\nReviewed by:\u00a0Rachael McGuire (MVEC Education Nurse Coordinator)\nDate:\u00a0September 2021\nMaterials in this section are updated as new information and vaccines become available. The Melbourne Vaccine Education Centre (MVEC) staff regularly reviews materials for accuracy.\nYou should not consider the information in this site to be specific, professional medical advice for your personal health or for your family\u2019s personal health. For medical concerns, including decisions about vaccinations, medications and other treatments, you should always consult a healthcare professional.\nA B C D E F G H I J K L M N O P Q R S T U V W X Y Z", "source": "mvec.mcri.edu.au/references/cold-chain-helpful-resources/index.html"}
{"id": "f32a118056d5-0", "text": "What is it?\nTyphoid and paratyphoid fever are bacterial infections, collectively known as enteric fever and are caused by the bacterias Salmonella enterica subspecies serovars Typhi and Paratyphi A, B and C. Enteric fever is different to the gastroenteritis that can be caused by Salmonella. Symptoms of enteric fever can range from mild to severe, and if left untreated can lead to serious complications or death. Typhoid fever presents more commonly than paratyphoid fever and is associated with higher rates of severe complications and poorer outcomes.\nWhat to look for\nInfections caused by typhoid and paratyphoid often present with prolonged fever and fatigue, headache, splenomegaly (enlargement of the spleen), and abdominal symptoms such as pain, lack of appetite, constipation or diarrhoea; often with bacteremia (bacteria in the bloodstream). A rash appearing as small pink clusters on the skin known as \u2018rose spots\u2019 can be seen in up to 30% of individuals with enteric fever. In severe cases, complications can include septic shock, gastrointestinal bleeding with perforation, altered conscious state, and death.\nHow is it transmitted?\nTyphoid fever is transmitted via the faecal-oral route and via contaminated food and water sources, most commonly in developing countries with untreated drinking water and poorer sanitation and food handling practices. The incubation period is usually 7-14 days.\nApproximately 1 in 20 infected individuals who do not receive treatment for typhoid fever will become an asymptomatic carrier of the disease.\nEpidemiology", "source": "mvec.mcri.edu.au/references/typhoid/index.html"}
{"id": "f32a118056d5-1", "text": "Epidemiology\nWhilst not as prevalent in Australia, typhoid fever is a common infective illness in many parts of the world, especially Asia, southeast Asia and sub-Saharan Africa. There were 14.3 million cases of typhoid and paratyphoid fever in 2017, with an estimated global case fatality of 0.95%. Children are disproportionately affected by infection.\nPrevention\nPrevention of enteric fever includes both vaccination and undertaking food and water precautions whilst travelling in developing countries where typhoid is endemic. There is no specific vaccine for paratyphoid fever however there is some evidence to suggest that administration of the oral typhoid fever vaccine can provide some cross protection against paratyphoid fever.\nVaccines\nThere are 3 vaccines available in Australia for protection against typhoid fever:\nVaccine Age Platform Antigen Route Volume Primary course Booster Typhim Vi\u00ae \u2265 2 years Inactivated Typhoid IM 0.5ml 1 dose Due in 3 years Vivaxim\u00ae\u00a7 \u2265 16 years Inactivated Typhoid/hepatitis A IM 1.0ml 2 doses, 6 months apart Typhoid only due in 3 years Vivotif\u00ae* \u2265 6 years Live-attenuated^ Typhoid Oral 1 capsule 3 doses (day 1, 3 & 5) 3-dose primary course- booster dose required after 3 years 4 doses (day 1, 3, 5 & 7) 4-dose primary course- booster dose required after 4 years", "source": "mvec.mcri.edu.au/references/typhoid/index.html"}
{"id": "f32a118056d5-2", "text": "\u00a7Whilst not registered for use in this age group, a number of travel medicine practitioners routinely administer Vivaxim\u00ae to children aged 2-15 years. Refer to Lau C. et al The tolerability of a combined hepatitis A and typhoid vaccine in children aged 2-16 years: an observational study Journal of Travel Medicine 2016: 15, 23 (2) for more information.\n*If a patient is taking both Vivotif\u00ae oral and the oral cholera vaccine (Dukoral\u00ae), these should be administered 8 hours apart due to the risk of components of the cholera vaccine impacting how the typhoid vaccine is absorbed in the gut.\n^Not to be given to people who are immunocompromised, taking immunosuppressive medications, pregnant women, or those taking oral antibiotics.\nOther precautions\nIn addition to vaccination, travellers should also maintain the following precautions to limit exposure to infections:\nundertaking effective hand washing practices\ndrinking bottled or boiled water\navoiding high-risk foods and drinks including:\nraw (or undercooked) shellfish\ncold meats\nsalads\nuntreated water and ice in drinks.\nResources\nAustralian Immunisation Handbook: Typhoid fever\nThe blue book: guidelines for the control of infectious diseases \nWorld Health Organization: Typhoid\nAuthors: Rachael Purcell (RCH Immunisation Fellow), Francesca Machingaifa (MVEC Education Nurse Coordinator) and Rachael McGuire (MVEC Education Nurse Coordinator)\nDate: September 15, 2022\nMaterials in this section are updated as new information and vaccines become available. The Melbourne Vaccine Education Centre (MVEC) staff regularly reviews materials for accuracy.", "source": "mvec.mcri.edu.au/references/typhoid/index.html"}
{"id": "f32a118056d5-3", "text": "You should not consider the information in this site to be specific, professional medical advice for your personal health or for your family\u2019s personal health. For medical concerns, including decisions about vaccinations, medications and other treatments, you should always consult a healthcare professional.\nA B C D E F G H I J K L M N O P Q R S T U V W X Y Z", "source": "mvec.mcri.edu.au/references/typhoid/index.html"}
{"id": "0815aa2cc67b-0", "text": "Background\nOne in 30 children will have a febrile seizure at some point during their childhood. They are typically triggered by a sudden rise in temperature, often as a result of a febrile illness. Febrile seizures more commonly occur in children between the ages of six months and six years, with a peak incidence identified between 14-18 months of age.\nFebrile seizures can be classified as simple or complex. Simple febrile seizures are most common and are generalised tonic-clonic, lasting less than 15 minutes\u2019 duration, do not recur within 24 hours and there is complete recovery within 1 hour. Complex febrile seizures include seizures with any of the following features: duration longer than 15 minutes, focal or partial features, recurrence within 24hrs or incomplete recovery within 1 hour [see Table 1 below for more details].\nAfter one febrile seizure from any cause, around 1 in 3 children will go on to experience further febrile seizures during childhood. Overall outcomes are excellent and the majority of children who experience febrile convulsions do not experience seizures beyond the age of five.\nSeizures following vaccination\nSeizures have been described following a number of childhood vaccines, including both inactivated (e.g. influenza) and live attenuated (e.g. measles-mumps-rubella [MMR]) vaccines.\nSeizures that occur within 14 days of vaccination are called vaccine-proximate seizures. Vaccine-proximate febrile seizures should be differentiated from vaccine-proximate afebrile seizures and vaccine-proximate status epilepticus.\nVaccine-proximate febrile seizures", "source": "mvec.mcri.edu.au/references/febrile-seizures-febrile-convulsions/index.html"}
{"id": "0815aa2cc67b-1", "text": "Vaccine-proximate febrile seizures\nFever is a common side effect following vaccination with certain vaccines eg. meningococcal B, COVID-19, MMR, MMRV and influenza. Fever generally occurs within 48hrs of inactivated vaccines and 5-14 days after administration of live-attenuated vaccines.\nAlthough vaccines can cause fevers, febrile seizures are not common after vaccination. Vaccine-proximate febrile seizures are not more severe than febrile seizures from other causes and the neurodevelopmental outcomes are the same.\nIt is important to note that infection with vaccine-preventable illnesses can also cause febrile seizures.\nVaccine-proximate status epilepticus and afebrile seizures\nVaccine-proximate status epilepticus and vaccine-proximate afebrile seizures are uncommon. Status epilepticus is a seizure lasting \u2265 30 minutes or multiple seizures over \u226530 minutes without recovery of consciousness between each seizure. Afebrile seizures are seizures occurring in the absence of fever. Children who experience vaccine-proximate status epilepticus or afebrile seizures should be referred to a specialist immunisation clinic. Some children with epilepsy including Dravet syndrome \u00a0or genetic epilepsy with febrile seizures (GEFS+) may present with their first seizure in this way.\nFor further information please refer to MVEC: Epilepsy.\nRecommendations\nProphylactic paracetamol", "source": "mvec.mcri.edu.au/references/febrile-seizures-febrile-convulsions/index.html"}
{"id": "0815aa2cc67b-2", "text": "Recommendations\nProphylactic paracetamol\nIt is widely recognised that children receiving Bexsero (meningococcal B vaccine) are more likely to experience fevers following vaccination. It is for this reason that children < 4 years of age are recommended to receive prophylactic paracetamol prior to vaccination, as well as 2 subsequent doses (6 hours apart) to reduce the likelihood and severity of fever. This should be administered regardless of whether the child is experiencing a fever or not.\nMMRV\nMeasles-mumps-rubella-varicella (MMRV) vaccines are not recommended as a first dose of an MMR- containing vaccine in children < 4 years of age due to the increased risk of fever and febrile seizures. Should MMRV vaccines be inadvertently administered as the first dose of an MMR-containing vaccine, the child\u2019s parent should be counselled to monitor for fevers and administer paracetamol as required. This vaccine administration error should also be reported to SAEFVIC.\nVaccine setting\nChildren with a history of vaccine-proximate simple febrile seizures or seizures from other causes can be safely vaccinated in the community. \u00a0A referral to a specialist immunisation clinic may be considered on a case-by-case basis. [See Table 1 below for different types of vaccine-proximate seizures and vaccine management plans]\nChildren with vaccine-proximate complex febrile seizures, vaccine-proximate status epilepticus and vaccine-proximate afebrile seizures should be referred to a specialist immunisation clinic for assessment before receiving further vaccinations. These seizures should also be reported to your local vaccine safety service, in Victoria, this is SAEFVIC.\nTable 1: Vaccine-proximate seizures and plan for future vaccines\nVaccine-proximate seizure type\nFeatures\nVaccination recommendations\nSimple febrile seizure", "source": "mvec.mcri.edu.au/references/febrile-seizures-febrile-convulsions/index.html"}
{"id": "0815aa2cc67b-3", "text": "Features\nVaccination recommendations\nSimple febrile seizure\nDocumented fever and all of the following:\ngeneralised tonic-clonic seizure\n\u2264\u00a015 minutes duration\nno recurrence within 24 hours of initial seizure\ncomplete recovery within 1 hour\nno evidence of central nervous system infection\nno previous neonatal or afebrile seizures, or progressive neurological conditions.\nSafe to receive future vaccines in the community setting.\nComplex febrile seizure\nDocumented fever and one or more of the following:\nduration > 15 minutes\nfocal features\nrecurrence within 24hrs of initial seizure\nincomplete recovery within 1 hour.\nRefer to specialist immunisation clinic for assessment.\nAfebrile seizures\nseizure (any type) in the absence of fever.\nRefer to specialist immunisation clinic for assessment.\nStatus epilepticus\nseizure lasting \u2265 30 minutes OR multiple seizures over \u2265\u00a030 minutes without return to normal level of consciousness between each seizure.\nRefer to specialist immunisation clinic for assessment and vaccination under medical supervision, likely inpatient admission.\n*Table adapted from Deng, L et. al, Seizures Following Vaccination in Children AJGP Vol 49, No 10, October 2020\nSummary\nFebrile seizures are common in childhood and less commonly occur following vaccination. Children with vaccine-proximate simple febrile seizures and febrile seizures from other causes can safely continue to receive vaccines in the community. Children with vaccine-proximate complex febrile seizures, status epilepticus or afebrile seizures should be referred to a specialist immunisation clinic prior to receiving further vaccinations. In any child with a history of seizures, referral to a specialist immunisation clinic can be considered when there are questions or concerns about the safety of vaccination.\nResources\nCDC: Febrile seizures follwoing childhood vaccinations, including influenza vaccination", "source": "mvec.mcri.edu.au/references/febrile-seizures-febrile-convulsions/index.html"}
{"id": "0815aa2cc67b-4", "text": "Resources\nCDC: Febrile seizures follwoing childhood vaccinations, including influenza vaccination\nEpilepsy Foundation: Febrile seizures\nDeng, L et. al, Seizures Following Vaccination in Children AJGP Vol 49, No 10, October 2020\nRCH Clinical Practice Guidelines: Febrile seizure\nRCH Kids Health Information: Febrile seizures\nDeng L, et. al, Postvaccination Febrile Seizure Severity and Outcome AAP Vol 143, Issue 5, May 2019\nAuthors: Raffaela Armiento, (Paediatrician, Victorian Specialist Immunisation Service), Francesca Machingaifa (MVEC Education Nurse Coordinator) and Rachael McGuire (MVEC Education Nurse Coordinator).\nDate: August 16, 2022\nMaterials in this section are updated as new information becomes available. The Melbourne Vaccine Education Centre (MVEC) staff regularly review materials for accuracy.\nYou should not consider the information in this site to be specific, professional medical advice for your personal health or for your family\u2019s personal health. For medical concerns, including decisions about vaccinations, medications and other treatments, you should always consult a healthcare professional.\nA B C D E F G H I J K L M N O P Q R S T U V W X Y Z", "source": "mvec.mcri.edu.au/references/febrile-seizures-febrile-convulsions/index.html"}
{"id": "71414bc584d9-0", "text": "There are a variety of factors that need to be considered in relation to the vaccination of the older population. A gradual decline of the immune system occurs as people age (known as immunosenescence), impacting how the immune system responds to new infections, as well as the effectiveness of long-term immune memory. It is for this reason that some vaccines are specifically designed for the older population and aim to enhance the immune response by using higher immunogenicity formulations or by containing adjuvants. Providing optimal protection can also be complicated due to the increasing prevalence of multiple co-morbidities in the ageing population. Specific medical conditions or targeted therapies (eg. chronic renal conditions, chemotherapy for cancers etc) can also cause older adults to be more vulnerable to infections and their complications. Further to this, relying on patient recall, as well as a lack of awareness for the recommended vaccines for the older population, can result in either missed vaccines or additional unnecessary doses being administered.\nThere are multiple vaccines recommended for the older population as outlined below.\nHerpes zoster (Shingles) vaccines\nShingles is caused by a reactivation of the varicella virus and will occur in approximately 20-30% of people in their lifetime. Older people (> 70 years of age) are more likely to suffer post-herpetic neuralgia (PHN) following a shingles infection than younger people. PHN is a chronic neuropathic pain which can affect 1 in 4 cases of shingles diagnosed in those > 80 years. It can persist for months to years with pain control being difficult to manage, impacting quality of life.\nThere are currently 2 vaccines available in Australia for the prevention of shingles:\nZostavax\u00ae- a live-attenuated vaccine\nShingrix\u00ae- an adjuvanted recombinant varicella zoster virus glycoprotein E (gE) subunit (non-live) vaccine", "source": "mvec.mcri.edu.au/references/immunisation-recommendations-for-the-older-population/index.html"}
{"id": "71414bc584d9-1", "text": "Zostavax\u00ae\nZostavax\u00ae has been shown to reduce the incidence of developing shingles by up to 50%, as well as the incidence of PHN in those \u2265 60 years of age by 66%. It is currently funded under the National Immunisation Program (NIP) for persons aged 70 years, with a catch-up program for those aged 71\u201379 years also funded (until October 2023). As it is a live-attenuated vaccine, it is contraindicated for use in those who are immunosuppressed, or on immunosuppressive medications (eg; Rituximab, Azathioprine, Prednisolone, chemotherapy etc). Prior to administering Zostavax\u00ae it is important to take a thorough patient history to determine suitability for immunisation.\nShingrix\u00ae\nShingrix\u00ae is preferred over Zostavax\u00ae for the prevention of shingles due to a higher efficacy, particularly in the older population. In those aged \u2265 50 years, Shingrix\u00ae provided 97% protection against shingles in immunocompetent individuals and 91% protection in those aged > 70 years. Clinical trials have demonstrated high efficacy up to 4 years following vaccination with immunogenicity data indicating this is likely to persist beyond 10 years.\nShingrix\u00ae is registered for use in adults aged \u2265 50 years. It is only available through private prescription and supplies are currently limited. It\u00a0is a non-live vaccine and as such can safely be administered to immunocompromised individuals. ATAGI recommends a 7 day interval between the administration of COVID-19 vaccines and Shingrix\u00ae, and prefers that FluadQuad and Shingrix\u00ae are not co-administered on the same day.", "source": "mvec.mcri.edu.au/references/immunisation-recommendations-for-the-older-population/index.html"}
{"id": "71414bc584d9-2", "text": "Further guidance can be provided by reviewing the Australian Immunisation Handbook: Table. Live shingles vaccine (Zostavax) screening for contraindications or by contacting SAEFVIC prior to immunisation.\nPneumococcal vaccines\nInvasive pneumococcal disease (IPD) can manifest as meningitis, pneumonia and bacteremia, with severe disease requiring hospitalisation, causing significant morbidity and even death. The elderly (along with infants) are at the highest risk of developing IPD. Recommendations for pneumococcal vaccines in adults vary according to age and medical condition [refer to ATAGI clinical advice on vaccination recommendations for people with risk conditions from 1 July 2020]. Pneumococcal vaccines are currently provided for free on the NIP for the following people:\nAboriginal and Torres Strait Islander adults with NO risk condition \u2013 1 dose of Prevenar 13\u00ae at 50 years of age, followed 8 weeks later by 2 doses of Pneumovax\u00ae\u00a023, given 5 years apart\nNon-indigenous adults with NO risk condition \u2013 1 dose of Prevenar 13\u00ae at >70 years\nNon-indigenous adolescents/adults diagnosed with a risk condition \u2013 1 dose of Prevenar 13\u00ae at diagnosis, followed by 2 doses of Pneumovax\u00ae\u00a023, given 5 years apart\nIn adults, injection site reactions may occur > 3 days following the Prevenar 13\u00ae dose given at > 70 years, particularly in those who have previously received Pneumovax\u00ae23. A history of large local injection site reactions following previous pneumococcal vaccines is not a contraindication to further doses.\nRefer to MVEC: Pneumococcal for more information.\nInfluenza vaccines", "source": "mvec.mcri.edu.au/references/immunisation-recommendations-for-the-older-population/index.html"}
{"id": "71414bc584d9-3", "text": "Influenza vaccines\nFor older adults, and those with certain medical conditions (eg. chronic lung disease, cardiac disease, immunosuppression), influenza disease can cause serious morbidity and mortality. Annual influenza vaccination is strongly encouraged and it is available for free on the NIP for those \u2265 65 years of age and/or adults with certain medical conditions. Due to a reduced immune response to routine influenza vaccines, those aged \u2265 65 years should receive higher-immunogenicity influenza vaccines.\nRefer to MVEC: Influenza for specific information on brands and dosing.\nCOVID-19 vaccines\nOlder people and those with comorbidities (eg. hypertension, diabetes, chronic lung disease etc) are much more likely to suffer from severe COVID-19 disease if infected. Of those who are > 80 years of age and have COVID-19 disease, approximately 1 in 3 will die from it.\nCOVID-19 vaccination requires a 2-dose primary course for immunocompetent individuals, or a 3 -dose primary course for those with immunocompromise. A primary course shoulod be followed by a booster dose \u2265 3 months later, and a further \u201cwinter booster\u201d dose \u2265 3 months after that for select individuals.\nFor more information on COVID-19 vaccination for older people please refer to COVID-19 vaccination \u2013 COVID-19 vaccination decision guide for frail older people, including those in residential aged care facilities.\nConsiderations for residents of residential aged care facilities (RACF)", "source": "mvec.mcri.edu.au/references/immunisation-recommendations-for-the-older-population/index.html"}
{"id": "71414bc584d9-4", "text": "Considerations for residents of residential aged care facilities (RACF)\nWhilst every effort should be made to immunise residents of RACF at risk of vaccine preventable diseases like COVID-19 and influenza, it is important to monitor for adverse events following immunisation (AEFIs). Due to a high incidence of cognitive impairment, elderly residents may not have capacity to self-report any side effects. Any AEFIs experienced within 5 days of vaccination should be reported to SAEFVIC. It is important to monitor for non-specific symptoms seen in the elderly population when unwell such as falls, delirium, functional decline, decrease/loss of appetite or changes in mood/behaviour.\nFor further information on additional cares that may be required and management of symptoms following vaccination in residents of RACF refer to Guidance for vaccination care of residents of Victorian Residential Aged Care Facilities.\nReporting to the Australian Immunisation Register (AIR)\nThe AIR provides a record of all vaccine doses given, the date of administration as well as the specific brands used.\u00a0Since 2016 vaccines administered to Australians of any age have been recorded onto the AIR. Patient recall, particularly in the older population, is not reliable and as such it important that immunisation records are accurately maintained and reviewed regularly.\nFrom March 2021, new legislation came into effect making reporting vaccines to AIR mandatory. This includes all COVID-19 vaccines, influenza vaccines and all National Immunisation Program vaccines.\nResources\nAustralian Government Department of Health: Immunisation for Seniors\nMVEC: Influenza\nMVEC: Zoster\nMVEC: Pneumococcal disease and vaccines\nMVEC: COVID-19 vaccines: Frequently asked questions\nMVEC: Australian Immunisation Register\nCOVID-19 vaccination \u2013 COVID-19 vaccination decision guide for frail older people, including those in residential aged care facilities", "source": "mvec.mcri.edu.au/references/immunisation-recommendations-for-the-older-population/index.html"}
{"id": "71414bc584d9-5", "text": "Guidance for vaccination care of residents of Victorian Residential Aged Care Facilities\nAw D. Silva B. and Palmer D. Immunosenescence: emerging challenges for an ageing population Immunology 2007 Apr; 120(4): 435\u2013446\nGustafson C. Kim C. Weyand C. Goronzy J Influence of immune aging on vaccine responses Journal of Allergy and Clinical Immunology 2020 May; 145(5): 1309\u20131321\nAuthors: Daryl Cheng (Paediatrician, The Royal Children\u2019s Hospital), Francesca Machingaifa (MVEC Education Nurse Coordinator) and Rachael McGuire (MVEC Education Nurse Coordinator)\nReviewed by: Francesca Machingaifa (MVEC Education Nurse Coordinator)\nDate: August 5, 2022\nMaterials in this section are updated as new information and vaccines become available. The Melbourne Vaccine Education Centre (MVEC) staff regularly reviews materials for accuracy.\nYou should not consider the information in this site to be specific, professional medical advice for your personal health or for your family\u2019s personal health. For medical concerns, including decisions about vaccinations, medications and other treatments, you should always consult a healthcare professional.\nA B C D E F G H I J K L M N O P Q R S T U V W X Y Z", "source": "mvec.mcri.edu.au/references/immunisation-recommendations-for-the-older-population/index.html"}
{"id": "ad3f5b5a39b6-0", "text": "What is it?\nThe Western Health Immunisation Service at Joan Kirner Women and Children\u2019s Hospital was established in July 2017. Run by immunisation nurses with the support of specialist paediatricians and infectious disease consultants, it is a walk-in clinic for patients and families of the hospital and local area. The clinic provides opportunistic paediatric immunisations for inpatients and outpatients according to the National Immunisation Program (NIP) and antenatal immunisations.\nThe Western Health immunisation service\u00a0is part of the VicSIS network. The VicSIS network provides specialist vaccination services for people who have experienced an adverse event following immunisation (AEFI) with a COVID-19 vaccine, or those who are identified as at risk of an AEFI (for example, people with a history of anaphylaxis). For further information refer to MVEC: The VicSIS network.\nOpen Monday to Friday 9am \u2013 4pm, excluding public holidays.\nLocation:\nGround Floor, Sunshine Hospital, Joan Kirner Women and Children\u2019s Hospital\nFirst Floor, Sunshine Hospital, Joan Kirner Women and Children\u2019s Hospital\nWestern Health: Sunshine Hospital\u00a0\nResources:\nMVEC: Vaccines in pregnancy\nMVEC: Influenza vaccine recommendations\nMVEC: Pertussis\nMVEC: The VicSIS network\nAuthors: Michelle Giles (Infectious Diseases Consultant, Western Health) and Francesca Machingaifa (MVEC Education Nurse Coordinator).\nReviewed by: Francesca Machingaifa (MVEC Education Nurse Coordinator)\nDate: March 2021\nMaterials in this section are updated as new information and vaccines become available. The Melbourne Vaccine Education Centre (MVEC) staff regularly reviews materials for accuracy.", "source": "mvec.mcri.edu.au/references/western-health-immunisation-service/index.html"}
{"id": "ad3f5b5a39b6-1", "text": "You should not consider the information in this site to be specific, professional medical advice for your personal health or for your family\u2019s personal health. For medical concerns, including decisions about vaccinations, medications and other treatments, you should always consult a healthcare professional.\nA B C D E F G H I J K L M N O P Q R S T U V W X Y Z", "source": "mvec.mcri.edu.au/references/western-health-immunisation-service/index.html"}
{"id": "244faa855c2f-0", "text": "MVEC is supportive of breastfeeding at the time of childhood immunisations as well as the immunisation of breastfeeding mothers when vaccines are indicated.\nIn this reference page, we detail the different types of vaccines recommended for breastfeeding women and describe when a more detailed discussion with your healthcare provider is warranted.\nImmunising breastfeeding mothers will not impact their ability to produce breastmilk. Inactivated (e.g. seasonal influenza and whooping cough) and live-attenuated vaccines (e.g. measles-mumps-rubella) are generally safe to administer to women who are breastfeeding.\nIn some instances, antibodies created by the mother in response to a vaccine can be passed onto the infant via breastmilk (passive immunity) to be absorbed orally and provide short term protection. Any maternal antibodies passed onto a baby via breastmilk does not interfere with a baby\u2019s immune response to their own vaccines.\nIn addition, there are no concerns for a breastfeeding mother to have contact with someone who has recently received either a live-attenuated or an inactivated vaccine.\nInfluenza\nAnnual influenza immunisation is safe and recommended for breastfeeding mothers. Babies less than 6-months of age are at greatest risk from disease yet cannot receive influenza vaccines until they are 6-months of age. Maternal immunisation will provide protection for mothers as well as providing some passive protection for babies through the secretion of antibodies until they are old enough to receive their own influenza vaccine [refer to MVEC: Influenza vaccine recommendations].\nMeasles-mumps-rubella (MMR)\nThe MMR vaccine is a live-attenuated vaccine and therefore immunisation should be avoided in the 28 days prior to a pregnancy and is contraindicated during pregnancy. However, it is safe for immunisation to occur at any time following delivery including whilst breastfeeding with no concerns for the mother or the breastfed infant.\nCOVID-19 vaccines", "source": "mvec.mcri.edu.au/references/breastfeeding-and-immunisations/index.html"}
{"id": "244faa855c2f-1", "text": "COVID-19 vaccines\nWomen who are breastfeeding can receive COVID-19 vaccines. They do not need to stop breastfeeding before or after being vaccinated. Antibodies have been detected in breastmilk and therefore this may also offer some protection to the infant via passive immunity.\nHepatitis B\nIt is safe for mothers who are positive for the hepatitis B virus to breastfeed their baby as long as the infant receives a dose of hepatitis B immunoglobulin (HBIG) at birth as well as all scheduled doses of hepatitis B vaccine commencing with the birth dose.\nYellow fever vaccines\nThe live-attenuated yellow fever vaccination should be avoided in breastfeeding mothers. Anyone travelling to a yellow fever endemic area should have a specialist travel consultation to provide individual travel advice and discuss immunisation recommendations. There is some evidence to suggest that yellow fever vaccine virus can be transmitted to infants via breastmilk. Infants are not recommended to receive the yellow fever vaccine until a minimum of 9 months of age due to its side effects profile [refer to Australian Immunisation Handbook: Yellow fever].\nResources\nThere are a lot of excellent resources that review the evidence and support the administration of routine vaccines to breastfeeding mothers.\nAustralian Breastfeeding Association: Breastfeeding and immunity\nCOVID-19 vaccination \u2013 COVID-19 vaccination decision guide for women who are pregnant, breastfeeding, or planning pregnancy\nCOVID-19 vaccination \u2013 ATAGI clinical guidance on COVID-19 Vaccine in Australia in 2021\nCenters for Disease Control and Prevention: Vaccination safety for breastfeeding mothers\nImmunisation Advisory Centre: Immunisation and breastfeeding\nAustralian Immunisation Handbook: Vaccination for women who are planning pregnancy, pregnant or breastfeeding\nMVEC: Maternal vaccination during pregnancy\nMVEC: Influenza vaccine recommendations\nMVEC: COVID-19 vaccine FAQs: women\u2019s health", "source": "mvec.mcri.edu.au/references/breastfeeding-and-immunisations/index.html"}
{"id": "244faa855c2f-2", "text": "MVEC: COVID-19 vaccine FAQs: women\u2019s health\nAuthors: Dr Nigel Crawford (Director SAEFVIC, Murdoch Children\u2019s Research Institute), Rachael McGuire (MVEC Education Nurse Coordinator) and Georgina Lewis (Clinical Manager SAEFVIC, Murdoch Children\u2019s Research Institute)\nReviewed by: Rachael McGuire (MVEC Education Nurse Coordinator)\nDate: July 2021\nMaterials in this section are updated as new information becomes available. The Melbourne Vaccine Education Centre (MVEC) staff regularly review materials for accuaracy.\nYou should not consider the information in this site to be specific, professional medical advice for your personal health or for your family\u2019s personal health. For medical concerns, including decisions about vaccinations, medications and other treatments, you should always consult a healthcare professional.\nA B C D E F G H I J K L M N O P Q R S T U V W X Y Z", "source": "mvec.mcri.edu.au/references/breastfeeding-and-immunisations/index.html"}
{"id": "fa0ba89f3d2c-0", "text": "Background\nVaccines work by activating an individual\u2019s immune system to form antibodies and memory cells in response to a pathogen (disease-causing organism), without the individual having to be infected with that pathogen. This means that if or when that pathogen is encountered in the future, the immune system will be able to respond effectively to fight infection, either minimising the symptoms experienced or preventing disease altogether.\nVaccines can be categorised into types based on the technology that they use to initiate an immune response. This technology is referred to as a \u2018vaccine platform\u2019.\n\ufeff\ufeff\nInactivated vaccines\nInactivated vaccines are created by using killed or deactivated pathogens or parts of pathogens that are unable to replicate and cause symptoms of disease. This approach to vaccine manufacturing has been used for decades to produce vaccines such as those for hepatitis A and B, polio and the polysaccharide pneumoccal (Pneumovax 23) vaccine. Nuvaxovid (Novavax) is an example of an inactivated protein-based COVID-19 vaccine which utilises only part of the virus (the spike protein).\nA benefit of these vaccines is that they are safe to administer to most people including pregnant or breastfeeding women or those with immunocompromise. However, the immune response induced by this mechanism alone may not be as strong or long-lasting compared with that from vaccines using other platforms. To overcome this challenge, booster doses or an adjuvant (ingredient added to vaccines during their manufacture to promote a stronger immune response and better disease protection) may be required.\nLive-attenuated vaccines\nLive-attenuated vaccines contain a whole pathogen that has been weakened (attenuated) in a laboratory making it less capable of replicating and causing disease. Examples of live-attenuated vaccines include the measles, mumps, rubella, varicella (chickenpox) and rotavirus vaccines.", "source": "mvec.mcri.edu.au/references/vaccine-platforms/index.html"}
{"id": "fa0ba89f3d2c-1", "text": "Live-attenuated vaccines typically induce a strong immune response and provide long-lasting immunity meaning fewer doses are required. The main disadvantage of using this platform is that these vaccines are not recommended for use in people who are immunocompromised due to the theoretical risk of causing vaccine-associated disease or to pregnant women due to the potential harm to the unborn baby. In addition, they take longer and are more difficult to mass produce because the pathogen needs to be grown under enhanced biosafety protocols in specialised laboratories.\nGenetic vaccines\nGenetic vaccines use one or more of a pathogen\u2019s genes (DNA or mRNA) to invoke an immune response. The COVID-19 vaccines Corminaty (Pfizer) and Spikevax (Moderna) are examples of mRNA vaccines and they contain the genetic code specific to the spike protein portion of the virus.\nGenetic vaccines can be produced faster than traditional manufacturing methods as development can begin as soon as the genetic sequence of a pathogen is available. Genetic vaccines are only capable of producing proteins and are unable to modify the host\u2019s (vaccine recipient) own genetic material (DNA or mRNA).\nViral vector vaccines\nNon-replicating and replicating viral vector vaccines are types of genetic vaccines. They work by using a modified virus (viral vector), which doesn\u2019t cause disease in humans, to carry a portion of the pathogen\u2019s genetic code into human cells.\nIn non-replicating viral vector vaccines, the individual\u2019s cells will then produce proteins (antigens) specific to the pathogen to trigger an immune response. The COVID-19 vaccine Vaxzevria (AstraZeneca) is an example of a non-replicating viral vector vaccine.", "source": "mvec.mcri.edu.au/references/vaccine-platforms/index.html"}
{"id": "fa0ba89f3d2c-2", "text": "Replicating viral vector vaccines have a similar mechanism but will also create new viral particles to enter further human cells, allowing a quicker and stronger immune response. Replicating viral vector vaccines best mimic natural infection and hence produce a strong immune response and can be used in lower doses.\nWhile viral vectors are well tolerated and highly immunogenic in most people, pre-existing immunity to the viral vector used may hamper the immune response to the vaccine.\nNanoparticle-based vaccines\nNanoparticle-based vaccines have received increasing interest in recent years due to their good safety profile and high immunogenic potential.\nNanoparticle vaccines are constructed by attaching selected key components of a pathogen (such as the COVID-19 spike protein or viral DNA) to an engineered nanoparticle (nanocarrier). This nanoparticle is commonly an engineered virus-like particle (a molecule that mimics the virus but is not infectious). These nanoparticles are highly stable and less prone to degradation than traditional protein vaccines. Gardasil 9 (human papillomavirus) and Nuvaxovid (Novavax COVID-19) vaccines are examples of this approach.\nResources\nAustralian Immunisation Handbook: Types of vaccines\nChildren\u2019s Hospital of Philadelphia, Vaccine Education Centre: Making vaccines: How are vaccines made\nFrontiers in Immunology: Progress and Pitfalls in the Quest for Effective SARS-CoV-2 (COVID-19) Vaccines\nAuthors: Daniela Say (MVEC Immunisation Fellow) and Nigel Crawford (Director SAEFVIC, Murdoch Children\u2019s Research Institute)\nReviewed by: Rachael McGuire (MVEC Education Nurse Coordinator) and Francesca Machingaifa (MVEC Education Nurse Coordinator)\nDate: April 1, 2023\nMaterials in this section are updated as new information and vaccines become available. The Melbourne Vaccine Education Centre (MVEC) staff regularly reviews materials for accuracy.", "source": "mvec.mcri.edu.au/references/vaccine-platforms/index.html"}
{"id": "fa0ba89f3d2c-3", "text": "You should not consider the information in this site to be specific, professional medical advice for your personal health or for your family\u2019s personal health. For medical concerns, including decisions about vaccinations, medications and other treatments, you should always consult a healthcare professional.\nA B C D E F G H I J K L M N O P Q R S T U V W X Y Z", "source": "mvec.mcri.edu.au/references/vaccine-platforms/index.html"}
{"id": "c12b3f5d1b5d-0", "text": "What is it?\nVaricella (chickenpox) is a highly contagious infection caused by the varicella-zoster virus (VZV).\nWhat to look for\nInfection usually begins with 1-2 days of fever, runny nose and lethargy.\nAn itchy rash follows, involving fluid filled vesicles (blisters) that can cover any part of the body including inside the mouth, eyelids and genital area. Severe complications can include pneumonia, meningitis and encephalitis.\nVaricella in pregnancy can result in skin scarring, ocular anomalies, limb defects and neurological malformations for the infant.\nThe virus can be reactivated later in life and cause Zoster (Shingles).\nHow is it transmitted?\nVaricella can be transmitted by coughing or sneezing, or from direct contact with the fluid inside the vesicles.\nPrevention\nImmunisation is the most effective form of prevention. A single dose of the live-attenuated vaccine is currently funded on the National Immunisation Program (NIP) for children at age 18 months of age, however giving a 2nd dose (not funded) provides greater protection. For those \u2265 14 years of age, 2 doses (administered 4 weeks apart) are required for the protection on non-immune individuals.\nPost-exposure prophylaxis\nIf a non-immune individual is exposed to disease, immunisation is recommended within 3-5 days (provided immunisation is not contraindicated). This can reduce the likelihood of varicella infection developing.", "source": "mvec.mcri.edu.au/references/chickenpox/index.html"}
{"id": "c12b3f5d1b5d-1", "text": "Neonates (whose mother develops infection up to 7 days prior to delivery or within 2 days after delivery), infants < 1-month of age (if mother is seronegative), pregnant women, premature infants (while still hospitalised, regardless of maternal serology) or immunosuppressed individuals who are exposed to varicella disease should receive Zoster Immunoglobulin (ZIG).\nRepeat doses of ZIG may be given if a person is exposed to varicella again > 3-weeks after the first dose of ZIG.\nResources\nRCH Kids health info Varicella fact sheet\nAustralian Immunisation Handbook: Varicella\nMVEC: Zoster\nMVEC: Live-attenuated vaccines and immunoglobulins or blood products\nAuthor: Rachael McGuire (Research Nurse, SAEFVIC, Murdoch Children\u2019s Research Institute)\nReviewed by: Rachael McGuire (Research Nurse, SAEFVIC, Murdoch Children\u2019s Research Institute)\nDate: July 2020\nMaterials in this section are updated as new information and vaccines become available. The Melbourne Vaccine Education Centre (MVEC) staff regularly reviews materials for accuracy.\nYou should not consider the information in this site to be specific, professional medical advice for your personal health or for your family\u2019s personal health. For medical concerns, including decisions about vaccinations, medications and other treatments, you should always consult a healthcare professional.\nA B C D E F G H I J K L M N O P Q R S T U V W X Y Z", "source": "mvec.mcri.edu.au/references/chickenpox/index.html"}
{"id": "facf2e288bc7-0", "text": "What is it?\nHerpes zoster (shingles) is caused by a reactivation of the varicella zoster virus (VZV), the same virus that causes\u00a0varicella (chickenpox) infection. After a person recovers from a varicella infection, the virus stays dormant (inactive) within the dorsal root ganglia of the spinal nerves but can later be reactivated, presenting as zoster.\nWhat to look for\nZoster is a painful, vesicular rash. It usually presents on one side of the face or body, typically appearing in a dermatomal distribution (an area of skin supplied by a spinal nerve). Prior to the emergence of the rash, there is often pain, itching, or tingling in the area where the rash will develop. This may happen anywhere from 1 to 5 days before the rash appears. Other symptoms of zoster can include fever, headache, chills, and malaise (generally feeling unwell). The blisters will typically scab over in 7\u201310 days after onset and resolve completely within 2\u20134 weeks.\nPost-herpetic neuralgia (PHN) is the most common complication of zoster and is more likely to occur in older people (> 70 years of age) than younger people. PHN is a chronic neuropathic pain which can affect 1 in 4 cases of zoster diagnosed in those aged > 80 years. It can persist for months to years with pain control being difficult to manage, impacting quality of life.\nOther complications of zoster include skin pigmentation and scarring, secondary bacterial infections, as well as herpes zoster opthalmicus (eye involvement with differing degrees of symptoms including conjunctivitis, ocular-cranial nerve palsies, loss of vision and debilitating pain).\nHow is it transmitted?", "source": "mvec.mcri.edu.au/references/shingles/index.html"}
{"id": "facf2e288bc7-1", "text": "How is it transmitted?\nZoster cannot be passed from one person to another as it is the reactivation of that person\u2019s previous VZV infection.\nExposure to the fluid-filled vesicles of a zoster rash can result in a VZV infection (as varicella infection) in a seronegative person (a person with no immunity to VZV). Zoster is less contagious than varicella and the risk of a person with zoster spreading the virus is low if the rash is covered.\nEpidemiology\nZoster can only develop in people who have previously been infected with VZV. It more commonly presents in adults aged > 50 years, those who are immunocompromised, and those who were diagnosed with a varicella infection when < 1 year of age.\nThe lifetime risk of a reactivation of the VZV virus to cause zoster is 20-30% and will affect half of all people who live to 80 years. Repeated presentations of zoster occur in around 6-8% of immunocompetent people, with higher rates affecting those who are immune suppressed.\nPrevention\nThe only way to reduce the risk of developing zoster in individuals who have previously been infected with VZV is through vaccination.\nThere are currently 2 vaccines available in Australia for the prevention of zoster:\nZostavax\u00ae- a live-attenuated vaccine\nShingrix\u00ae- an adjuvanted recombinant varicella zoster virus glycoprotein E (gE) subunit (non-live) vaccine.\nZoster vaccines are not interchangeable with varicella vaccines as they are very different. Zoster vaccines are much more potent than varicella vaccines and are not registered for use in younger people.\nIndications for use", "source": "mvec.mcri.edu.au/references/shingles/index.html"}
{"id": "facf2e288bc7-2", "text": "Indications for use\nZostavax\u00ae is registered for use in adults aged \u2265 50 years and is provided on the National Immunisation Program (NIP) at 70 years of age (with a catch up program for those 71-79 years, ending 31st of October 2023). As it is a live-attenuated vaccine, Zostavax\u00ae is contraindicated in immunocompromised individuals and pregnant women.\nShingrix\u00ae is registered for use in immune competent adults from \u2265 50 years of age and immunocompromised adults from \u2265 18 years. It is currently only available via a private prescription.\nZostavax\u00ae\nAdministrationImmunisation with Zostavax\u00ae requires a single dose only of 0.65ml to be administered subcutaneously.\u00a0It can be co-administered with other vaccines (given on the same day), including pneumococcal, influenza and COVID-19.\nZostavax\u00ae is a live-attenuated vaccine and its use is contraindicated in immunocompromised individuals due to the risk of vaccine-related disease.\nEfficacyZostavax\u00ae has been shown to reduce the incidence of zoster by approximately 50% and the incidence of PHN by 66%.\nEvidence suggests that efficacy decreases with increasing age and immunogenicity declines rapidly by 5-10 years after vaccination.\nSide effectsZostavax\u00ae has been demonstrated to be safe and well tolerated, with the most common side effect being injection site reactions. A localised varicella-like rash can also occurr in the first 72 hours after vaccination.", "source": "mvec.mcri.edu.au/references/shingles/index.html"}
{"id": "facf2e288bc7-3", "text": "Rarely, a non-localised VZV-like rash can occur 2-4 weeks following receipt of Zostavax\u00ae. Should this occur, medical attention is recommended for advice and management of symptoms which may include diagnostic testing and antiviral treatment. This event must also be reported to the relevant vaccine safety service (SAEFVIC\u00a0in Victoria).\nContraindications and precautionsZostavax\u00ae is live-attenuated vaccine and is therefore\u00a0contraindicated in immunocompromised individuals and pregnant women. Pre-immunisation screening of patients\u00a0with the Australian Immunisation Handbook: Table. Live shingles vaccine (Zostavax) screening for contraindications\u00a0prior to\u00a0administering Zostavax\u00ae is essential.\nIf there is uncertainty about how severely a person is immunocompromised and whether it is safe for them to receive a vaccine, do not vaccinate them. Seek expert advice from their treating physician or an immunisation specialist.\nMore information can be found via the following TGA alert regarding the use of Zostavax\u00ae in people with compromised immune function:\nTGA: Safety advisory- risk of infection with a vaccine virus.\nInadvertent administration of Zostavax\u00ae in immunocompromised individualsIf an immunocompromised patient is inadvertently administered a dose of Zostavax\u00ae,\u00a0prompt action\u00a0is required. Medical review by an infectious diseases specialist or immunisation expert must be facilitated and the appropriate anti-viral therapy and monitoring commenced.\nThe error must also be reported to the relevant authority to ensure appropriate follow up and support can be provided. In Victoria, this service is\u00a0SAEFVIC.\nIf the error occurs out of hours, seek specialist advice from the patient\u2019s treating specialist or an infectious diseases specialist at your local tertiary hospital.\nShingrix\u00ae", "source": "mvec.mcri.edu.au/references/shingles/index.html"}
{"id": "facf2e288bc7-4", "text": "Shingrix\u00ae\nAdministrationImmunisation with Shingrix\u00ae requires a course of 2 dose course of 0.5ml given intramuscularly. Doses should be administered 2-6 months apart for immune competent individuals aged 50 years and over and 1-2 months apart for immunocompromised individuals \u2265 18 years of age.\nShingrix\u00ae can be co-administered with other vaccines including pneumococcal, influenza and COVID-19 vaccines.\nEfficacyShingrix\u00ae is preferred over Zostavax\u00ae for the prevention of zoster due to its higher efficacy, particularly in the older population. In those aged \u2265 50 years, Shingrix\u00ae provided 97% protection against zoster in immunocompetent individuals and 91% protection in those aged > 70 years.\nClinical trials have demonstrated high efficacy up to 4 years following vaccination with immunogenicity data indicating this is likely to persist beyond 10 years.\nSide effectsExpected side effects of Shingrix\u00ae include\u00a0injection site reactions, fatigue, myalgia, headaches and fever and last 1-3 days. These occur at slightly higher rates than following Zostavax\u00ae.\nAn additional 3-6 cases of\u00a0Guillain Barre Syndrome (GBS)\u00a0per million doses of Shingrix\u00ae administered have been\u00a0estimated to occur.\nContraindications and precautionsShingrix\u00ae should not be administered for the treatment of varicella, acute shingles disease or PHN.\nDocumentation\nReporting of all NIP vaccines, including zoster vaccination, to the Australian Immunisation Register (AIR) is mandatory.\nIt is important that immunisation records are accurately maintained and reviewed\u00a0prior to vaccine administration to avoid any dosing errors. Patient recall is not always reliable and as such, reviewing an individual\u2019s immunisaition history is essential.\nCommonly asked questions", "source": "mvec.mcri.edu.au/references/shingles/index.html"}
{"id": "facf2e288bc7-5", "text": "Commonly asked questions\nCan patients receive Shingrix\u00ae if they have previously been immunised with Zostavax\u00ae?Yes. An minimum interval of 12 months is recommended between receiving Zostavax\u00ae and the administration of Shingrix\u00ae. A 2 dose course of Shingrix\u00ae is still required.\nCan patients receive Zostavax\u00ae if they have previously received Shingrix\u00ae?No. Zostavax\u00ae is not recommended for people who have previously received a zoster vaccine.\nShould patients with a clinical history of zoster receive zoster vaccines?Yes. People can experience zoster more than once in a lifetime. Approximately 6-8% of immune competent people will have a repeat episode of zoster within 8 years of their first diagnosis. Further episodes are even more common for individuals with immune compromise.\nImmune competent individuals should wait at least 12 months following a zoster diagnosis before receiving an age-appropriate zoster vaccine (either Shingrix\u00ae or Zostavax\u00ae) as risk of a further episode is low in the initial time period.\nImmunocompromised individuals are at an increased risk of further episode of zoster compared with immune competent people. It is recommended that they receive a 2 dose course of Shingrix\u00ae a minimum of 3 months after acute illness.\nResources\nAustralian Government Department of Health and Aged Care: Statement on the clinical use of Zoster vaccine in older adults in Australia\nNCIRS: Zoster vaccines GRADE assessments\nAustralian Immunisation Handbook: Table. Live shingles vaccine (Zostavax) screening for contraindications\nAustralian Immunisation Handbook: Zoster\nNCIRS: Zoster vaccines- FAQs\nAuthors:\u00a0Nigel Crawford (Director, SAEFVIC, Murdoch Children\u2019s Research Institute) and Georgina Lewis (Clinical manager, SAEFVIC, Murdoch Children\u2019s Research Institute)", "source": "mvec.mcri.edu.au/references/shingles/index.html"}
{"id": "facf2e288bc7-6", "text": "Reviewed by: Rachael McGuire (MVEC Education Nurse Coordinator)\nDate: April 4, 2023\nMaterials in this section are updated as new information and vaccines become available. The Melbourne Vaccine Education Centre (MVEC) staff regularly reviews materials for accuracy.\nYou should not consider the information in this site to be specific, professional medical advice for your personal health or for your family\u2019s personal health. For medical concerns, including decisions about vaccinations, medications and other treatments, you should always consult a healthcare professional.\nA B C D E F G H I J K L M N O P Q R S T U V W X Y Z", "source": "mvec.mcri.edu.au/references/shingles/index.html"}
{"id": "dccb8a406be1-0", "text": "What is it?\nRespiratory syncytial virus (RSV) is one of the leading causes of respiratory tract infections in young children. While for some it can cause the common cold, for others, it may lead to more severe infection.\u00a0Children < 1 year of age, individuals with underlying medical conditions (e.g., chronic cardiac and lung disease), the older population, and immunocompromised people are more likely to experience serious disease and hospitalisation. \u00a0\u00a0\nWhat to look for\nCold-like symptoms such as rhinorrhea (runny nose), fever, wheeze, headache and cough are common. Symptoms generally appear 1-5 days after exposure and can last 8-15 days.\u00a0\nWhilst most infections are mild, bronchiolitis (inflammation of the small airways) and pneumonia (lung infection) can occur in severe presentations and may lead to hospitalisation for supportive measures such as oxygen therapy and rehydration. \u00a0\nHow can it be transmitted?\nRSV is highly contagious and can be transmitted via the inhalation of droplets containing the virus. RSV can also be transmitted when a person touches a contaminated surface and then touches their face.\u00a0\nPeople with RSV are generally considered infectious for 3-8 days. However, some people continue to spread the virus for up to 4 weeks.\u00a0\nEpidemiology\nRSV infections are commonly seasonal, with a peak in cases usually seen over autumn and winter. Almost all children will have experienced infection by the age of 2 years.\u00a0\u00a0\nPrevention\nPracticing good hand hygiene is important in preventing infections.\u00a0\nThere are currently no vaccines registered for use within Australia. However, there are many RSV vaccines under development in clinical trials. Previous infection with RSV can provide some immunity but this protection is not long term.", "source": "mvec.mcri.edu.au/references/respiratory-syncytial-virus-rsv/index.html"}
{"id": "dccb8a406be1-1", "text": "Synagis\u00ae (palivizumab) is an immunoglobulin (a blood product offering donated antibodies) currently available to some infants considered to be at higher risk of severe RSV disease (due to medical conditions such as prematurity, chronic lung disease, and specific cardiac conditions). It is not routinely available to all infants. Doses are calculated according to weight and given monthly over the winter period (usually May to October). \u00a0\nResources\nHealth direct: Respiratory syncytial virus (RSV)\nRCH Kids Health Information: Respiratory syncytial virus (RSV)\nSarah McNab and others, Changing Epidemiology of Respiratory Syncytial Virus in Australia\u2014Delayed Re-Emergence in Victoria Compared to Western Australia/New South Wales (WA/NSW) After Prolonged Lock-Down for Coronavirus Disease 2019 (COVID-19),\u00a0Clinical Infectious Diseases, Volume 73, Issue 12, 15 December 2021, Pages 2365\u20132366\nAuthors: Georgina Lewis (Clinical Manager SAEFVIC, Murdoch Children\u2019s Research Institute) and Rachael McGuire (MVEC Education Nurse Coordinator)\nDate: June 20, 2023\nMaterials in this section are updated as new information and vaccines become available. The Melbourne Vaccine Education Centre (MVEC) staff regularly reviews materials for accuracy.\nYou should not consider the information in this site to be specific, professional medical advice for your personal health or for your family\u2019s personal health. For medical concerns, including decisions about vaccinations, medications and other treatments, you should always consult a healthcare professional.\nA B C D E F G H I J K L M N O P Q R S T U V W X Y Z", "source": "mvec.mcri.edu.au/references/respiratory-syncytial-virus-rsv/index.html"}
{"id": "a775c6e83aa8-0", "text": "Background\nImmunosuppression (also known as immunocompromise) occurs when a person\u2019s immune system is weakened, resulting in a decreased ability to fight infections. Causes of immunosuppression may include having certain medical conditions (e.g., autoimmune disease, cancer, transplants, functional or anatomical asplenia, advancing age and HIV) or taking specific medications (e.g., corticosteroids, disease-modifying antirheumatic drugs [DMARDs] or cancer therapies).\nVaccination is particularly important for those who are\u00a0immunosuppressed\u00a0due to the increased risk of developing severe disease (hospitalisation/intensive care admission, death) if exposed to vaccine-preventable diseases. Protection from vaccines can be suboptimal in this patient group and therefore additional doses of vaccines may be recommended. Conversely, some vaccines (live-attenuated vaccines) may be contraindicated due to the potential risk of vaccine-related disease.\nTaking a thorough patient history prior to vaccination is recommended to determine an individual\u2019s degree of immunosuppression and to formulate their individual vaccination strategy.\nVaccination timing\nVaccination may need to be planned with the treating specialist. In some instances, the timing of immunosuppressive therapies may be altered to increase the response to vaccines. In other circumstances, the intervals between vaccine doses may be altered to accommodate treatment regimes.\nIn some instances, vaccines can be given pre-emptively to people who anticipate immunosuppression in the future (e.g., a patient undergoing a planned splenectomy should be immunised prior to surgery).\nRecommended vaccines\nInactivated vaccines are safe to administer to the immunocompromised individual but efficacy may be reduced.\nInfluenza\nAnnual influenza vaccination is recommended for all immunosuppressed patients.", "source": "mvec.mcri.edu.au/references/immunosuppression-and-vaccines/index.html"}
{"id": "a775c6e83aa8-1", "text": "Influenza\nAnnual influenza vaccination is recommended for all immunosuppressed patients.\nThose < 9 years of age are recommended to receive 2 doses of influenza vaccine, administered a minimum of 4 weeks apart, in the first year of receiving an influenza vaccine. Transplant recipients (solid organ or haematopoietic stem cell) should also receive 2 doses of influenza vaccine, a minimum of 4 weeks apart, in the first year following their transplant. This is regardless of age or previous influenza vaccine history.\nWhere a major shift in the circulating influenza virus occurs, such as in an influenza pandemic situation, 2 doses a minimum of 4 weeks apart, could be considered regardless of patient age or immunisation history to ensure optimal immune response.\nPneumococcal\nThe timing of vaccination, the number of doses recommended, and the type of vaccine (conjugate or polysaccharide) depends on a person\u2019s age and underlying risk for invasive pneumococcal disease (IPD).\nMeningococcal\nThose taking certain therapies or with specific medical conditions (particularly those with asplenia) are recommended to receive a primary course of meningococcal B and ACWY vaccines. Following this, booster doses are recommended for some individuals with specified medical conditions or treatment that increase their risk of invasive meningococcal disease (IMD).\nCOVID-19", "source": "mvec.mcri.edu.au/references/immunosuppression-and-vaccines/index.html"}
{"id": "a775c6e83aa8-2", "text": "COVID-19\nCOVID-19\u00a0vaccination is strongly recommended for all immunosuppressed individuals aged 6 months and over due to an increased risk of developing severe disease. A 3-dose primary course\u00a0 is recommended for optimal protection (compared with a 2-dose course for those who are immune competent). Following a primary course, booster doses\u00a0are also recommended in those aged \u2265 18 years. Children and adolescents aged 5-17 years of age with comorbidities that increase their risk of severe COVID-19 disease (including immunosuppression) should also consider a booster dose.\nContraindicated vaccines\nLive-attenuated vaccines are contraindicated for most immunosuppressed individuals due to the risk of adverse events or vaccine-related disease. In some instances, an alternate inactivated vaccine may be available for use (see table 1).\nTable 1: Contraindicated vaccines in immunosuppressed patients and alternative options to consider\nDisease Contraindicated vaccine brands (live-attenuated vaccines) Alternate vaccine brands (inactivated vaccines) Japanese encephalitis\u00a5Imojev\u00ae JEspect\u00ae MMR (measles-mumps-rubella)^Priorix\u00ae, M-M-R II\u00ae N/A MMRV (measles-mumps-rubella-varicella)^Priorix-tetra\u00ae, ProQuad\u00ae N/A Mpox\u00a5ACAM2000\u2122 JYNNEOS Rotavirus^Rotarix\u00ae N/A Tuberculosis#\u00a5BCG (varying brands) N/A Typhoid\u00a5Vivotif\u00ae Typhim\u00ae, Vivaxim\u00ae (in combination with hepatitis A) Varicella\u00a5Varivax\u00ae, Varilrix\u00ae N/A Yellow fever\u00a5Stamaril\u00ae N/A Zoster^Zostavax\u00ae Shingrix\u00ae\u00a7", "source": "mvec.mcri.edu.au/references/immunosuppression-and-vaccines/index.html"}
{"id": "a775c6e83aa8-3", "text": "^routinely administered on the National Immunisation Program (NIP)\n#recommended vaccine for select patient group only\n\u00a5available vaccine for those at higher risk of infection (eg. travel)\n\u00a7not on NIP but available at cost\nN/A no alternate vaccine available\nInadvertent administration of a live-attenuated vaccine\nIf an immunosuppressed patient is inadvertently administered a live-attenuated vaccine prompt action is required. Medical review by an infectious diseases specialist or immunisation expert must be facilitated and the appropriate management commenced (e.g., anti-viral therapy, monitoring etc.).\nThe patient must be informed of the incident and have a clear understanding of its implications, including any signs and symptoms to monitor for [refer to resources for guidance]. The error must also be reported to the relevant authority to ensure appropriate follow up and support can be provided. In Victoria, this service is SAEFVIC.\nIf the error occurs out of hours, seek specialist advice from the patient\u2019s treating specialist or an infectious diseases specialist at your local tertiary hospital.\nPrecautions\nMothers who are receiving immunosuppressive therapy and breastfeeding (or those who received immunosuppressive medication during pregnancy) should seek advice from a Specialist Immunisation Clinic around the safety of live-attenuated vaccines for their child (e.g., oral rotavirus vaccine or BCG).\nHousehold contacts\nHousehold contacts of immunosuppressed individuals should be up to date with all vaccines and are recommended to receive annual influenza vaccination as well as COVID-19 vaccines.", "source": "mvec.mcri.edu.au/references/immunosuppression-and-vaccines/index.html"}
{"id": "a775c6e83aa8-4", "text": "It is safe for household contacts to receive live-attenuated vaccines (including rotavirus and varicella). Thorough hand hygiene should always be performed when handling soiled nappies of rotavirus vaccine recipients to minimise the risk of vaccine-virus transmission. Any varicella-like blisters that occur on the vaccinee following varicella vaccination should be covered until they crust over.\nResources\nMVEC: Asplenia\nMVEC: Zoster\nMVEC: Solid organ transplant recipient: pre-transplant immunisation recommendations\nMVEC Cancer immunisation guideline: vaccine recommendations following chemotherapy and haematopoietic stem cell transplant\nMVEC: Immunisation recommendations for the older population\nAustralian Immunisation Handbook: Vaccination for people who are immunocompromised\nMVEC eLearning course: Vaccine errors: Prevention, management and open disclosure [for providers]\nAuthors: Georgina Lewis (Clinical Manager, SAEFVIC, Murdoch Children\u2019s Research Institute), Francesca Machingaifa (MVEC Education Nurse Coordinator) and Rachael McGuire (MVEC Education Nurse Coordinator)\nReviewed: Rachael McGuire (MVEC Education Nurse Coordinator) and Georgina Lewis (Clinical Manager, SAEFVIC, Murdoch Children\u2019s Research Institute)\nDate: May 3, 2023\nMaterials in this section are updated as new information and vaccines become available. The Melbourne Vaccine Education Centre (MVEC) staff regularly reviews materials for accuracy.\nYou should not consider the information in this site to be specific, professional medical advice for your personal health or for your family\u2019s personal health. For medical concerns, including decisions about vaccinations, medications and other treatments, you should always consult a healthcare professional.\nA B C D E F G H I J K L M N O P Q R S T U V W X Y Z", "source": "mvec.mcri.edu.au/references/immunosuppression-and-vaccines/index.html"}
{"id": "7bb21e75c25f-0", "text": "The Paediatric Active Enhanced Disease Surveillance (PAEDS) network is a hospital-based active surveillance system employing prospective case ascertainment for selected serious childhood conditions, particularly vaccine preventable diseases and potential adverse events following immunisation (AEFI). PAEDS data is used to better understand these conditions, inform policy and practice under the National Immunisation Program, and enable rapid public health responses for certain conditions of public health importance. PAEDS enhances data available from other Australian surveillance systems by providing prospective, detailed clinical and laboratory information on children with selected conditions.\nPAEDS consists of a network of clinicians and public health researchers in 7 tertiary paediatric hospitals across Australia.\nThe Royal Children\u2019s Hospital, Melbourne, Victoria\nMonash Children\u2019s Hospital, Clayton, Victoria\nThe Children\u2019s Hospital at Westmead, Sydney, New South Wales\nWomen\u2019s and Children\u2019s Hospital, Adelaide, South Australia\nPerth Children\u2019s Hospital, Perth, Western Australia\nQueensland Children\u2019s Hospital, Brisbane, Queensland\nThe Royal Darwin Hospital, Darwin, Northern Territory\nThe PAEDS group is jointly funded by the Commonwealth and State Departments of Health, with some grant funding for specific conditions.\nThe current conditions under surveillance by the PAEDS network are:\nAcute Flaccid Paralysis (A condition causing paralysis and loss of tone in one or more limbs, which can be caused by the polio virus)\nIntussusception (A rare type of bowel obstruction seen in infants)\nVaricella (chicken pox) and herpes zoster (shingles) requiring hospitalisation\nPertussis (Whooping cough)\nAcute Childhood Encephalitis (Inflammation and/or infection of the brain)\nInfluenza (Seasonal flu)\nInvasive Meningococcal Disease (Severe bacterial sepsis and/or meningitis)\nInvasive Group A Streptococcus (A severe bacterial infection)", "source": "mvec.mcri.edu.au/references/paeds-paediatric-active-enhanced-disease-surveillance/index.html"}
{"id": "7bb21e75c25f-1", "text": "Invasive Group A Streptococcus (A severe bacterial infection)\nKawasaki Disease (rare disease in which blood vessels throughout the body become inflamed)\nGram Negative Bloodstream Infections (serious bacterial infections in the bloodstream)\nCOVID-19\u00a0(SARS-CoV-2)\nPIMS-TS\u00a0(Paediatric Inflammatory Multisystem Syndrome temporally associated with SARS-CoV-2)\nContact Information\nFor more information about the PAEDS group in Melbourne, please contact the study team on:\nThe Royal Children\u2019s Hospital\n(03) 9345 5066 [email\u00a0protected]\nMonash Children\u2019s Hospital\n(03) 8572 3581\nInvestigators\nA/Professor\u00a0Nigel Crawford [email\u00a0protected]\nA/Professor Jim Buttery [email\u00a0protected]\nPAEDS Network Website\nwww.paeds.edu.au\nAuthor: Alissa McMinn (Research Manager, SAEFVIC, Murdoch Children\u2019s Research Institute)\nReviewed by: Alissa McMinn (Research Manager, SAEFVIC, Murdoch Children\u2019s Research Institute)\nDate: October 2020\nMaterials in this section are updated as new information and vaccines become available. The Melbourne Vaccine Education Centre (MVEC) staff regularly reviews materials for accuracy.\nYou should not consider the information in this site to be specific, professional medical advice for your personal health or for your family\u2019s personal health. For medical concerns, including decisions about vaccinations, medications and other treatments, you should always consult a healthcare professional.\nA B C D E F G H I J K L M N O P Q R S T U V W X Y Z", "source": "mvec.mcri.edu.au/references/paeds-paediatric-active-enhanced-disease-surveillance/index.html"}
{"id": "c7ddbe0ab158-0", "text": "Background\nGuillain-Barre Syndrome (GBS) is an autoimmune condition whereby the body\u2019s own immune system can attack the nerves, damaging the myelin (insulating layer) and sometimes the axon (nerve fiber). This damage can result in symptoms of muscle weakness, altered sensation, numbness and paralysis.\nThe rate of GBS is approximately 2 in every 100,000 people per year. The syndrome is often triggered following a viral or bacterial illness usually occurring 1-3 weeks prior to symptoms developing. As an example, \u2018wild-type\u2019 influenza and campylobacter are infections known to be associated with GBS.\nSymptoms usually start in the lower extremities and progress up the body over a few days or weeks. There is no known cure but therapies include intravenous immunoglobulin. Most cases spontaneously recover although this may take from 6 months to 2 years. Approximately 10-15 percent of GBS cases can result in permanent disability.\nGBS and influenza vaccines\nInfluenza vaccination has been identified as a possible cause following H1N1 containing vaccines, but the evidence is variable and at a very low rate, definitely lower than the rate of GBS caused by \u2018wild type\u2019 influenza. As per the AusVaxSafety clinical resources flow chart\u00a0 [see resources], influenza immunisation is generally not recommended for people with a history of GBS occurring within 6 weeks of receiving a previous influenza vaccine. However specialist immunisation advice should be sought to discuss the potential benefit of vaccination and the risk for GBS recurrence post vaccination or GBS recurrence post influenza disease. There are no concerns administering influenza vaccines to patients who have a history of developing GBS more than 6 weeks following an influenza vaccine.\nGBS and meningococcal vaccines", "source": "mvec.mcri.edu.au/references/guillain-barre-syndrome/index.html"}
{"id": "c7ddbe0ab158-1", "text": "GBS and meningococcal vaccines\nThere is no increased risk of developing GBS after receiving meningococcal vaccinations. People with a history of GBS can safely receive meningococcal vaccines. It is also safe for them to receive all of the other routine National Immunisation Program (NIP) and travel vaccines as required.\nGBS and COVID-19 vaccines\nGBS has been reported to occur in individuals following both COVID-19 infection and COVID-19 vaccination.\u00a0Intensive post-licensure surveillance and investigations by the TGA and other international vaccine regulators, has shown a growing body of evidence of a possible link between GBS and Vaxzevria (AstraZeneca). In response to this, GBS has been listed as a precaution\u00a0for those receiving Vaxzevria.\nIndividuals who have previously been diagnosed with GBS can receive COVID-19 vaccines. Specialist advice from a treating neurologist or immunisation specialist may be considered to discuss the benefits and risks of vaccination.\nGBS and Shingrix\u00ae\nPreliminary data from the US suggests that there is a very rare risk of GBS ocurring in individuals who have received the shingles (herpes zoster) vaccine, Shingrix\u00ae (an additional 3-6 cases of GBS per million doses of vaccine administered). GBS has also been reported following shingles disease. The benefits of vaccination outweigh the risk of GBS.\nResources\nAusVaxSafety Clinical Resources: Approach to influenza vaccination in patients with a history of Guillain-Barre Syndrome\nAustralian Immunisation Handbook: Influenza chapter \nBetter Health Channel: Guillain-Barre Syndrome\nCDC: Vaccine Considerations for People with Underlying Medical Conditions\nAuthors:\u00a0Rachael McGuire (SAEFVIC Research Nurse, Murdoch Children\u2019s Research Institute) and Nigel Crawford (Director SAEFVIC, Murdoch Children\u2019s Research Institute)", "source": "mvec.mcri.edu.au/references/guillain-barre-syndrome/index.html"}
{"id": "c7ddbe0ab158-2", "text": "Reviewed by: Rachael McGuire (MVEC Education Nurse Coordinator)\nDate: November 29, 2022\nMaterials in this section are updated as new information and vaccines become available. The Melbourne Vaccine Education Centre (MVEC) staff regularly reviews materials for accuracy.\nYou should not consider the information in this site to be specific, professional medical advice for your personal health or for your family\u2019s personal health. For medical concerns, including decisions about vaccinations, medications and other treatments, you should always consult a healthcare professional.\nA B C D E F G H I J K L M N O P Q R S T U V W X Y Z", "source": "mvec.mcri.edu.au/references/guillain-barre-syndrome/index.html"}
{"id": "dfeb85b926d1-0", "text": "What is it?\nMeasles, also known as rubeola, is a highly contagious viral illness. It is caused by the measles virus which belongs to the Morbillivirus family.\nWhat to look for\nInfection usually begins with 3-4 days of fever, malaise, cough, coryza (runny nose) and conjunctivitis. Small white spots, known as Koplik spots, are also present on the buccal mucosa (mucosal surface of the cheeks) of an infected person.\n3-4 days later a maculopapular rash (red with a combination of flat and raised areas) then develops, often beginning on the face before becoming more generalised and can last up to 7 days. Very rarely does a measles infection occur in the absence of a rash.\nComplications of a measles infection include pneumonia and otitis media (ear infection). Approximately 1 in 1000 people will develop encephalitis (brain inflammation) which carries a mortality rate of 10-15%. Sub-acute sclerosing panencephalitis (SSPE) is a rare progressive neurological disorder that can develop 2-10 years after an initial measles infection. It is characterised by encephalitis and demyelination (loss of the protective covering of the nerve fibres) causing behaviour changes, seizures and muscle rigidity. SSPE is fatal in all cases.\nMeasles infections during pregnancy can result in miscarriage and prematurity.\nHow is it transmitted?\nMeasles can be spread by an infected person coughing or sneezing respiratory droplets or through the direct contact with infected nasal or throat secretions. An environment can remain infectious for up to 2 hours after an infectious person has been present.", "source": "mvec.mcri.edu.au/references/measles/index.html"}
{"id": "dfeb85b926d1-1", "text": "The incubation period is 7 to 18 days (more commonly 10 days), with a person able to transmit disease for up to 5 days prior to the onset of the rash, and as long as 4 days after the rash develops.\nHumans are the only reservoirs for the measles virus.\nEpidemiology\nPrior to the introduction of vaccination in 1963, measles infections contributed to 2.6 million deaths globally each year. Despite extensive vaccination campaigns worldwide, measles infection still carries a significant burden in some countries contributing to 142 000 deaths globally in 2018.\nWithin Australia, however, high rates of vaccine coverage led to the WHO declaring Australia \u201cmeasles-free\u201d in 2014. Measles infections are still seen in non-immune individuals travelling internationally, placing unimmunised Australians at risk of infection.\nPrevention\nLive-attenuated measles-containing vaccines are highly effective in protecting against disease. A 2-dose course of vaccination is routinely provided on the National Immunisation Program (NIP) for children as combination vaccines at:\n12 months of age \u2013 Priorix\u00ae/M-M-R\u00aeII (measles- mumps- rubella (MMR))\n18 months of age \u2013 Priorix-Tetra\u00ae/ProQuad\u00ae (measles-mumps-rubella-varicella (MMRV))\nIn addition, babies aged between 6 months and 11 months travelling overseas, non-immune women planning pregnancy or non-immune women after delivery, and any person born since 1966 who does not have evidence of 2 doses of vaccination/is seronegative is eligible to receive funded measles-containing vaccines.\nDue to high rates of circulating measles virus in the years preceding 1966 and the life-long immunity invoked by natural infection, those born during this time are considered already immune and generally do not require vaccination.\nContraindications", "source": "mvec.mcri.edu.au/references/measles/index.html"}
{"id": "dfeb85b926d1-2", "text": "Contraindications\nLive-attenuated vaccines such as measles-containing vaccines are contraindicated in individuals with immune compromise due to the risks of adverse events and the chance of developing vaccine-related disease.\nAdditionally, pregnant women should not receive measles-containing vaccines due to the potential risks to the unborn baby. Instead, vaccination at least 4 weeks prior to pregnancy or vaccination in the postnatal period is recommended.\nPrecautions\nSpecific intervals between the administration of immunoglobulins or other blood products and administration of measles-containing vaccines are recommended. This is due to the potential for any circulating donated antibodies affecting the immune response to vaccination.\nSide effects\n7-10 days following MMR vaccination, individuals may experience fever, malaise, and a non-infectious rash lasting 2-3 days.\nMMRV vaccines are\u00a0not recommended\u00a0as a first dose of a measles-containing vaccine in children < 4 years of age due to the increased risk of fever and febrile seizures.\nPost-exposure prophylaxis\nIf a non-immune individual is exposed to measles, immunisation with MMR or MMRV is recommended to occur within 72 hours of exposure to reduce the likelihood of infection (provided immunisation is not a contraindication).\nInfants \u2264 5 months of age born to non-immune mothers or mothers with < 2 documented doses of measles vaccination, individuals of any age with immune compromise, and pregnant women, may be recommended to receive Normal Human Immunoglobulin (NHIG) if exposed to disease [refer to resources].\nResources\nAustralian Academy of Science: measles- everything you need to know\nAustralian Immunisation Handbook: Table: Post-exposure prophylaxis needed within 72 hours of 1st exposure for people exposed to measles", "source": "mvec.mcri.edu.au/references/measles/index.html"}
{"id": "dfeb85b926d1-3", "text": "Australian Immunisation Handbook: Table: Recommended intervals between immunoglobulins or blood products, and measles-mumps-rubella, measles-mumps-rubella-varicella or varicella vaccination\nWorld Health Organization: measles\nMVEC: MMR vaccine and autism\nRCH Clinical Practice Guideline: illness in the returned traveller\nBetter Health Channel: measles\nAuthor: Rachael McGuire (SAEFVIC Research Nurse, Murdoch Children\u2019s Research Institute)\nReviewed by: Rachael McGuire (MVEC Education Nurse Coordinator) and Francesca Machingaifa (MVEC Education Nurse Coordinator)\nDate: December 8, 2022\nMaterials in this section are updated as new information and vaccines become available. The Melbourne Vaccine Education Centre (MVEC) staff regularly reviews materials for accuracy.\nYou should not consider the information in this site to be specific, professional medical advice for your personal health or for your family\u2019s personal health. For medical concerns, including decisions about vaccinations, medications and other treatments, you should always consult a healthcare professional.\nA B C D E F G H I J K L M N O P Q R S T U V W X Y Z", "source": "mvec.mcri.edu.au/references/measles/index.html"}
{"id": "c1a0f6c164a5-0", "text": "AEFI-CAN (Adverse Events Following Immunisation \u2013 Clinical Assessment Network) is a formal collaboration between Australian state and territory-based vaccine safety clinics and their adult and paediatric immunisation/infectious diseases/allergy specialists. It also includes representatives from the Therapeutic Goods Administration (TGA), most state/territory health departments and the immunisation branch of the Australian Government Department of Health (DoH).\nAs a national network, AEFI-CAN works collaboratively to clinically assess and manage individual patients following serious or unexpected adverse events after immunisation. The network is also involved in:\ndeveloping a consistent robust national approach to serious and/or severe AEFI with the creation of standardised protocols\nstandardising AEFI and clinical follow up reporting\nenhancing community and health/vaccine provider knowledge and practice about AEFI\nproviding expert advice to health professionals as required.\nAEFI-CAN bridges the important link between surveillance and clinical assessment and management. As such, AEFI-CAN assists in determining patient outcomes and supports investigation of possible safety signals in a real-time integrated way.\nAuthors:\u00a0Adele Harris (SAEFVIC Research Nurse, Murdoch Children\u2019s Research Institute) and Annette Alafaci (SAEFVIC Research Assistant, Murdoch Children\u2019s Research Institute)\nReviewed by: Annette Alafaci (SAEFVIC Research Assistant, Murdoch Children\u2019s Research Institute)\nDate: December 2020\nMaterials in this section are updated as new information and vaccines become available. The Melbourne Vaccine Education Centre (MVEC) staff regularly reviews materials for accuracy.\nYou should not consider the information in this site to be specific, professional medical advice for your personal health or for your family\u2019s personal health. For medical concerns, including decisions about vaccinations, medications and other treatments, you should always consult a healthcare professional.\nA B C D E F G H I J K L M N O P Q R S T U V W X Y Z", "source": "mvec.mcri.edu.au/references/aefi-can-adverse-events-following-immunisation-clinical-assessment-network/index.html"}
{"id": "8e0196e42c23-0", "text": "Myocarditis is an inflammatory disease of the heart muscle, whilst pericarditis is an inflammatory disease of the lining of the heart muscle. They are rare conditions, most commonly associated with viral infections (including SARS-CoV-2) but can also be triggered by other factors such as medications and autoimmune conditions.\nGlobally, an increased number of cases above an expected population rate of myocarditis and pericarditis have been reported in individuals who have received COVID-19 vaccines, with the highest rates occurring following administration of COVID-19 mRNA vaccines (eg. Comirnaty (Pfizer)\u00a0and Spikevax (Moderna)).\n\ufeff\ufeff\nInformation specific to myocarditis and pericarditis can be found via the below buttons. In addition, frequently asked questions relating to vaccination are also addressed.\nMyocarditisPericarditisFrequently asked questions\nMyocarditis\nHow is myocarditis following COVID-19 vaccination triggered?The exact mechanism behind cardiac inflammation temporally associated with COVID-19 vaccines is currently being investigated. Clinical causes from international and local surveillance data suggest an immune-mediated or hypersensitivity trigger. There are ongoing studies examining the role of the SARS-CoV-2 spike protein, impact of certain cardiac biomarkers and genetic predispositions to this adverse event of special interest (AESI).\nWho is at risk of myocarditis?Myocarditis from any cause, occurs more commonly in males than females. It is also more likely to affect younger adults.\nReported rates of myocarditis occurring following administration of COVID-19 vaccines vary; however, they are above expected background rates for both sexes. The peak risk group for COVID-19 vaccine related myocarditis is young adult males aged 16-17 years, with a smaller increased risk for males aged between 12-24 years.", "source": "mvec.mcri.edu.au/references/pericarditis-and-myocarditis-following-covid-19-vaccines/index.html"}
{"id": "8e0196e42c23-1", "text": "International and local vaccine safety surveillance data have found that it is more commonly associated with administration of a\u00a0second\u00a0dose of COVID-19 mRNA vaccine. Myocarditis following other COVID-19 vaccines, third doses or booster doses have also been identified, although reported cases have occurred at\u00a0lower rates\u00a0than those identified following either dose of a primary course.\nAlthough myocarditis AESI has been associated with all of the COVID-19 vaccines used in Australia, there is a higher risk of myocarditis following administration of COVID-19 mRNA vaccines compared to non-mRNA vaccines. Surveillance data from multiple countries have also demonstrated a greater risk with Spikevax (Moderna) compared to Comirnaty (Pfizer).\nAre children more likely to experience myocarditis following COVID-19 vaccination?Available safety data from\u00a0local\u00a0and\u00a0international sources\u00a0suggest there is a significantly lower risk of children developing myocarditis following vaccination. Thus far, data shows that the risk of COVID-19 vaccine myocarditis decreases as age decreases.\nATAGI recommends an interval of 8 weeks between vaccine doses in a primary course for age-eligible children (\u2264 11 years) for maximum efficacy and safety. This extended interval is based on international data suggesting a longer time interval between dose 1 and 2 may reduce the risk of myocarditis. This extended interval also allows more time to observe international vaccine safety data and identify any signals for rare adverse events.\nVery few cases of myocarditis in children <6 years of age have been reported in available worldwide surveillance data to date.\nFor more information on COVID-19 vaccination in individuals < 18 years please refer to\u00a0COVID-19 vaccination in children and adolescents.\nPre-existing cardiac conditions and COVID-19 vaccinationIndividuals with the following cardiac conditions can safely receive COVID-19 vaccines without the need for additional monitoring or precautions:\ncoronary artery disease\nmyocardial infarction\nstable heart failure", "source": "mvec.mcri.edu.au/references/pericarditis-and-myocarditis-following-covid-19-vaccines/index.html"}
{"id": "8e0196e42c23-2", "text": "coronary artery disease\nmyocardial infarction\nstable heart failure\narrhythmias\nrheumatic fever\nrheumatic heart disease\nkawasaki disease\nmost congenital heart disease\nthose with implanted cardiac devices\ncongenital heart disease\ncardiac transplant\ncardiomyopathy.\nThose with a history of the following conditions can also receive COVID-19 vaccines; however should consult their treating specialist to determine the appropriate timing for vaccination:\nrecent (within 3 months) or current inflammatory cardiac conditions (including myocarditis, pericarditis and endocarditis)\nacute rheumatic fever or acute rheumatic heart disease\nacute decompensated heart failure.\nPatients with ongoing cardiac inflammation should have vaccination deferred. In some instances, vaccination with\u00a0Vaxzevria (AstraZeneca)\u00a0or\u00a0Nuvaxovid (Novavax)\u00a0may be considered due to the lower associated risk of developing myocarditis.\nWhat are the symptoms of myocarditis?Myocarditis presents similarly to pericarditis, with a range of symptoms including:\nchest pain, pressure or discomfort\npain with breathing (pleuritic chest pain)\nshortness of breath\npalpitations\nsyncope (faint)\nother non-specific symptoms such as fatigue, dizziness, abdominal pain.\nIn individuals who have received COVID-19\u00a0 vaccines, symptoms of myocarditis have most commonly been reported within 2-7 days of\u00a0second\u00a0dose vaccination.\nHow is myocarditis after COVID-19 vaccination diagnosed and investigated?If there is suspicion of myocarditis, particularly in the first week following vaccination, timely medical review is important. Those who appear unwell should be referred to an emergency department for examination and the following primary investigations:\nblood tests for cardiac biomarkers, such as troponin\nelectrocardiogram (ECG).", "source": "mvec.mcri.edu.au/references/pericarditis-and-myocarditis-following-covid-19-vaccines/index.html"}
{"id": "8e0196e42c23-3", "text": "electrocardiogram (ECG).\nOther tests should be considered if the patient is unwell or the tests above are abnormal:\nchest X-ray (CXR)\nother tests related to investigating differential diagnoses such as inflammatory markers (C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR)\nbedside or formal ultrasound/echo\ncardiac MRI.\nConsistent findings of myocarditis may include elevated troponin, ECG changes (ST or T-wave abnormalities, premature atrial or ventricular complexes) as well as abnormal echocardiogram or cardiac MRI.\nIndividuals who are investigated for myocarditis following vaccination should avoid high-intensity exercise until symptoms have resolved is recommended.\nCardiologist advice and followup is strongly recommended.\nHow is myocarditis after COVID-19 vaccination treated?Current data shows that most cases of myocarditis following COVID-19 vaccination have mild symptoms and recover well. Information on long term sequelae is not yet available.\nTreatment of these conditions is managed by a cardiologist and include in-patient supportive therapies. In the rare severe or complicated cases, specific management for arrythmias, decreased cardiac function or congestive cardiac failure with pharmacological agents such as ACE-inhibitors and beta-blockers or mechanical support may be necessary.\nI have specific questions around my risk of myocarditis following COVID-19 vaccination. Help!Although uncommon, myocarditis is most often seen after COVID-19 mRNA vaccines. Please refer to our specific\u00a0FAQs on COVID-19 mRNA vaccines\u00a0for further information. This includes answers on:\nimpact of dose intervals between 1st\u00a0and 2nd\u00a0doses of vaccine\nrisk of developing myocarditis from COVID-19 disease vs the vaccine\nexercise after COVID-19 vaccination\nimpacts of medications and drugs such as clozapine, stimulants, amphetamines on developing myocarditis.", "source": "mvec.mcri.edu.au/references/pericarditis-and-myocarditis-following-covid-19-vaccines/index.html"}
{"id": "8e0196e42c23-4", "text": "What are the implications for future doses (including third and booster doses)?For individuals where the cause of inflammation is attributed to COVID-19 vaccination, a report to\u00a0SAEFVIC\u00a0is indicated and a referral to a cardiologist and/or specialist immunisation service (eg.\u00a0VicSIS) is recommended.\nPlease refer to the below algorithm for recommendations relating to further doses of COVID-19 vaccines in patients who have been diagnosed with myocarditis following vaccination.\n*Brighton Level refers to Brighton Collaboration criteria for classifying myocarditis\nPDF version of the above diagram available here.\nATAGI currently recommends that individuals diagnosed with myocarditis following vaccination defer any further doses and are referred to a specialist immunisation clinic.\nWhat is the risk/benefit ratio for vaccination for the young adult age group?It is important to discuss your individual circumstances with a health care provider in order to make an informed decision.\nThe level of COVID-19 community transmission in Australia can change quickly. Factors to consider include age, potential for exposure to the virus (including in the workplace), high rates of global transmission, the emergence of new variants of the virus, as well as the potential for future changes to Australia\u2019s border controls.\nWhilst COVID-19 infection can sometimes result in myocarditis, its incidence following COVID-19 vaccination is comparatively extremely rare. Most individuals diagnosed with myocarditis following COVID-19 vaccination have responded well to treatment.\nPericarditis\nHow is pericarditis following COVID-19 vaccination triggered?The exact mechanism behind cardiac sac inflammation temporally associated with COVID-19 vaccination is currently being investigated. Clinical causes from international surveillance data suggest an immune-mediated or hypersensitivity trigger.\nWho is at risk of pericarditis?Pericarditis from any cause occurs in similar rates amongst males and females. It is also more likely to affect younger adults.", "source": "mvec.mcri.edu.au/references/pericarditis-and-myocarditis-following-covid-19-vaccines/index.html"}
{"id": "8e0196e42c23-5", "text": "Reported rates of pericarditis occurring following administration of a COVID-19 vaccine vary; however, they are above expected background population rates. Available surveillance data suggests the risks for pericarditis after a mRNA vaccine are higher than non-mRNA vaccines.\nInternational and local data indicate that pericarditis following COVID-19 vaccines is more common in the 18-39 year old age group for both males and females. Pericarditis following third doses or booster doses have also been identified in a small number of individuals. Reported cases have occurred at\u00a0significantly lower rates\u00a0than those identified following either dose of a primary course.\nAre children more likely to experience pericarditis following COVID-19 vaccination?Available safety data from\u00a0local\u00a0and\u00a0international sources\u00a0suggest there is a significantly lower risk of children developing pericarditis following COVID-19 vaccination.\nATAGI recommends an interval of 8 weeks between vaccine doses in a primary course for age-eligible children (\u2264 11 years) for maximum efficacy and safety. This extended interval is based on international data suggesting a longer time interval between dose 1 and 2 may reduce the risk of myocarditis \u2013 which in principle may also extend to pericarditis. This extended interval also allows more time to observe international vaccine safety data and identify any signals for rare adverse events.\nFor more information on COVID-19 vaccination in individuals < 18 years please refer to\u00a0COVID-19 vaccination in children and adolescents.\nPre-existing cardiac conditions and COVID-19 vaccinationIndividuals with the following cardiac conditions can safely receive COVID-19 vaccines without the need for additional monitoring or precautions:\ncoronary artery disease\nmyocardial infarction\nstable heart failure\narrhythmias\nrheumatic fever\nrheumatic heart disease\nkawasaki disease\nmost congenital heart disease\nthose with implanted cardiac devices\ncongenital heart disease\ncardiac transplant", "source": "mvec.mcri.edu.au/references/pericarditis-and-myocarditis-following-covid-19-vaccines/index.html"}
{"id": "8e0196e42c23-6", "text": "those with implanted cardiac devices\ncongenital heart disease\ncardiac transplant\ncardiomyopathy.\nThose with a history of the following conditions can also receive COVID-19 vaccines; however should consult their treating specialist to determine the appropriate timing for vaccination:\nrecent (within 3 months) or current inflammatory cardiac conditions (including myocarditis, pericarditis and endocarditis)\nacute rheumatic fever or acute rheumatic heart disease\nacute decompensated heart failure.\nPatients with ongoing cardiac inflammation should have vaccination deferred. In some instances, vaccination with\u00a0Vaxzevria (AstraZeneca)\u00a0or\u00a0Nuvaxovid (Novavax)\u00a0may be considered due to the lower associated risk of pericarditis.\nWhat are the symptoms of pericarditis?Pericarditis presents similarly to myocarditis, with a range of symptoms including:\nchest pain, pressure or discomfort\npain with breathing (pleuritic chest pain)\nshortness of breath\npalpitations\nsyncope (faint)\nother non-specific symptoms such as fatigue, dizziness, abdominal pain.\nHow is pericarditis after COVID-19 vaccination diagnosed and investigated?If there is suspicion of either of these conditions, particularly in the first 2-3 weeks following vaccination, timely medical review is important. Those who appear unwell should be referred to an emergency department for the following investigations:\nblood tests for cardiac biomarkers, such as troponin\nelectrocardiogram (ECG)\nOther tests should be considered if the patient unwell or the tests above are abnormal:\nchest X-ray (CXR)\nother tests related to investigating differential diagnoses such as inflammatory markers (C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR)).", "source": "mvec.mcri.edu.au/references/pericarditis-and-myocarditis-following-covid-19-vaccines/index.html"}
{"id": "8e0196e42c23-7", "text": "Consistent findings of pericarditis include a pericardial rub on auscultation, widespread ST-elevation or PR depression on ECG, as well as pericardial effusion on imaging.\nIndividuals who are investigated for pericarditis following vaccination should avoid high-intensity exercise until symptoms have resolved is recommended. Those experiencing ongoing symptoms should return for review in 1-2 days time. Cardiologist advice is recommended if clinical suspicion is high, regardless of normal investigations.\nHow is pericarditis after COVID-19 vaccination treated?Current data shows that most cases of pericarditis following COVID-19 vaccination have mild symptoms and recover well.\nIn some scenarios, there have been reports of pericarditis causing prolonged and recurrent symptoms but with functionally normal investigations including cardiac imaging. Information on long term sequelae is still being collected.\nTreatment of these conditions is managed by a cardiologist and include in-patient supportive therapies, often with anti-inflammatory medications or colchicine. In the rare severe or complicated cases, specific management for arrhythmias, decreased cardiac function or congestive cardiac failure with pharmacological agents such as ACE-inhibitors and beta-blockers or mechanical support may be necessary.\nWhat are the implications for future doses (including third and booster doses)?For individuals where the cause of inflammation is attributed to COVID-19 vaccination, a report to\u00a0SAEFVIC\u00a0is indicated and a referral to a cardiologist and/or specialist immunisation service (eg.\u00a0VicSIS) is recommended.\nPlease refer to the below algorithm for recommendations relating to further doses of COVID-19 vaccines in patients who have been diagnosed with pericarditis following vaccination.\n*Brighton Level refers to Brighton Collaboration criteria for classifying pericarditis\nAccess a pdf version of this guide here.", "source": "mvec.mcri.edu.au/references/pericarditis-and-myocarditis-following-covid-19-vaccines/index.html"}
{"id": "8e0196e42c23-8", "text": "Access a pdf version of this guide here.\nIn particular, the groups which are at lower risk (green in algorithm), could proceed with further doses of COVID-19 vaccination as per above suggested instructions.\nWhat is the risk/benefit ratio for vaccination for the young adult age group?It is important to discuss your individual circumstances with a health care provider in order to make an informed decision.\nThe level of COVID-19 community transmission in Australia can change quickly. Factors to consider include age, potential for exposure to the virus (including in the workplace), high rates of global transmission, the emergence of new variants of the virus, as well as the potential for future changes to Australia\u2019s border controls.\nWhilst COVID-19 infection can sometimes result in pericarditis, its incidence following COVID-19 vaccination is comparatively extremely rare. Most individuals diagnosed with pericarditis following COVID-19 vaccination have responded well to treatment.\nFrequently asked questions\nI am taking certain medications that have myocarditis listed as an uncommon side effect. Am I at greater risk of developing myocarditis/pericarditis after COVID-19 vaccination?Taking medications that have myocarditis listed as an uncommon side effect (e.g. antipsychotic drugs and biological chemotherapeutic agents) is not a contraindication to COVID-19 vaccination. Individuals taking these medications can be safely vaccinated in the community with no need for additional precautions or monitoring.\nAre there impacts of other substances on the development of myocarditis/pericarditis after COVID-19 vaccines?The use of recreational stimulants (particularly amphetamines) is discouraged especially in the week following vaccination to limit the potential for developing myocarditis/pericarditis.", "source": "mvec.mcri.edu.au/references/pericarditis-and-myocarditis-following-covid-19-vaccines/index.html"}
{"id": "8e0196e42c23-9", "text": "Should exercise be limited after receiving COVID-19 vaccines to reduce the chance of myocarditis/pericarditis?Exercise is not thought to increase the risk of developing myocarditis/pericarditis following COVID-19 vaccination. It is therefore not necessary to reduce or avoid exercise in the post-vacccination period.\nHowever, if patients develop myocarditis/pericarditis post vaccination there is a concern that exercise may be pro-arrhythmic (eg. will exacerbate) the condition.\nAs myocarditis/pericarditis following COVID-19 vaccination is thought to be immune mediated, would those with pre-existing autoimmune diseases be at an increased risk compared to the general public?Myocarditis/pericarditis following COVID-19 vaccination appears to be idiosyncratic at this stage, with no clear risk factors. Thus, there is no indication of increased risk in those with underlying autoimmune disease.\nResources\nInvestigation, management and treatment of myocarditis/pericarditis\nHealthPathways Myocarditis and Pericarditis after mRNA COVID-19 Vaccines (login required)\nPaediatric Research in Emergency Departments International Collaborative: Chest pain guideline\nGuidelines on Myocarditis/Pericarditis\nCOVID-19 vaccination \u2013 Guidance on myocarditis ad pericarditis after COVID-19 vaccines\nCDC Clinical Considerations: Myocarditis and Pericarditis after Receipt of mRNA COVID-19 Vaccines Among Adolescents and Young Adults\nCOVID-19 subcommittee of the WHO Global Advisory Committee on Vaccine Safety (GACVS) reviews cases of mild myocarditis reported with COVID-19 mRNA vaccines\nBrighton Collaboration: Myocarditis/Pericarditis Case Definition\nMVEC resources on COVID-19 vaccines and myocarditis/pericarditis\nThe MVEC Conversation: myocarditis/pericarditis following mRNA vaccination\nMVEC COVID-19 vaccine FAQs: mRNA vaccines: myocarditis/pericarditis", "source": "mvec.mcri.edu.au/references/pericarditis-and-myocarditis-following-covid-19-vaccines/index.html"}
{"id": "8e0196e42c23-10", "text": "MVEC COVID-19 vaccine FAQs: mRNA vaccines: myocarditis/pericarditis\nAuthors: Rachael McGuire (MVEC Education Nurse Coordinator), Francesca Machingaifa (MVEC Education Nurse Coordinator), Daryl Cheng (MVEC Medical Lead) and Nigel Crawford (Director SAEFVIC, Murdoch Children\u2019s Research Institute)\nReviewed by: Daryl Cheng (MVEC Medical Lead) and Julia Smith (Immunisation Fellow, Royal Children\u2019s Hospital)\nDate: October 27, 2022\nMaterials in this section are updated as new information and vaccines become available. The Melbourne Vaccine Education Centre (MVEC) staff regularly reviews materials for accuracy.\nYou should not consider the information in this site to be specific, professional medical advice for your personal health or for your family\u2019s personal health. For medical concerns, including decisions about vaccinations, medications and other treatments, you should always consult a healthcare professional.\nA B C D E F G H I J K L M N O P Q R S T U V W X Y Z", "source": "mvec.mcri.edu.au/references/pericarditis-and-myocarditis-following-covid-19-vaccines/index.html"}
{"id": "da63b7e17e68-0", "text": "Drive-through immunisation clinics are an alternative venue for supporting vaccine delivery. A drive-through clinic can assist members of the community to continue to receive recommended immunisations whilst maintaining physical distancing.\nA drive-through clinic may not be a setting that is recommended for all patients. It is important that patients be screened for their suitability to use a drive-through service prior to immunisation. Pre-screening of patients can identify previous immunisation reactions, history of vasovagal reactions or needle phobia.\nRunning sessions by appointment may allow for planning the type and amount of vaccines required and also allows the flow of patients to be staggered in order to prevent traffic congestion.\nPreparation for drive-through clinics\nThere are many different factors that need to be considered when setting up for this type of immunisation venue.\nThe location\nConsider a location within close proximity of the GP service or health care facility (if applicable). An ideal location would allow for a 1-directional flow of traffic in order to avoid congestion and ensure the safety of roaming staff members. Each individual parking bay should allow enough room for all 4 car doors to completely open without any obstructions (to ensure full access to each patient should AEFI occur).\nEquipment\nCarefully consider the equipment required to set up and maintain a drive-through clinic. Equipment should include clear signage, bed/chair to manage adverse events if required, an anaphylaxis response kit, essential paperwork, (such as pre-immunisation checklists and vaccine side effects forms), equipment to maintain the cold chain, as well as any equipment necessary to prepare and administer vaccines. Remote access to patient records and the Australian Immunisation Register (AIR) is recommended to allow for review of immunisation records. as well as appropriate documentation of any vaccines administered.\nStaff\nStaff may include nurse immunisers, as well as medical and administrative personnel.\nThe cold chain", "source": "mvec.mcri.edu.au/references/how-to-set-up-a-drive-through-immunisation-clinic/index.html"}
{"id": "da63b7e17e68-1", "text": "Staff may include nurse immunisers, as well as medical and administrative personnel.\nThe cold chain\nStorage of vaccines in a drive-through clinic setting must comply with the cold chain recommendations set out by the vaccine manufacturer. \u00a0The time between vaccines being removed from purpose-built vaccine fridges to being administered should be as short as possible.\nDuring a drive-through immunisation session\nImmunisation history, pre-immunisation checklist, possible vaccine side effects and suitability for immunisation must be reviewed and discussed prior to vaccination.\nEmergency equipment (anaphylaxis response kit) and a telephone must be readily available should they be required.\nCorrect injection technique is essential, ensuring that the entire limb is exposed and correct anatomical landmarks identified to locate the correct injection site. If a patient cannot be safely immunised in the car (eg: child seated in the middle car seat) or is not a suitable candidate for in-vehicle immunisation then they could be immunised out of the car in a chair, then returned to the car to wait for the recommended 15 minute waiting period. Patients should be advised not to get in and out of their cars whilst parked.\nPost-immunisation in a drive-though session\nFollowing immunisation, patients must remain at the vaccination venue for at least 15 minutes and should be advised to avoid driving for at least 15 minutes following vaccination. Patients waiting in their vehicles should be instructed to use the car horn to gain attention in their 15 minute observation period if required. All vaccines should be recorded on the AIR and appropriate documentation should be completed and provided to the patient.\nResources\nMVEC: Cold chain\nMVEC: Shoulder Injury Related to Vaccine Administration\nMVEC: Shoulder Injury Related to Vaccine Administration (SIRVA) eLearning package\nNational Vaccine Storage Guidelines \u2018Strive for 5\u2019\nMVEC: Administration of injected vaccines- correct technique\nATAGI Clinical Statement on Vaccination Observation Time", "source": "mvec.mcri.edu.au/references/how-to-set-up-a-drive-through-immunisation-clinic/index.html"}
{"id": "da63b7e17e68-2", "text": "ATAGI Clinical Statement on Vaccination Observation Time\nATAGI statement on considerations for establishing drive-through COVID-19 vaccination clinic sites\nAuthors: Francesca Machingaifa (SAEFVIC Research Nurse, Murdoch Children\u2019s Research Institute) and Rachael McGuire (SAEFVIC Research Nurse, Murdoch Children\u2019s Research Institute)\nReviewed by: Rachael McGuire (MVEC Education Nurse Coordinator)\nDate: May 31, 2022\nMaterials in this section are updated as new information and vaccines become available. The Melbourne Vaccine Education Centre (MVEC) staff regularly reviews materials for accuracy.\nYou should not consider the information in this site to be specific, professional medical advice for your personal health or for your family\u2019s personal health. For medical concerns, including decisions about vaccinations, medications and other treatments, you should always consult a healthcare professional.\nA B C D E F G H I J K L M N O P Q R S T U V W X Y Z", "source": "mvec.mcri.edu.au/references/how-to-set-up-a-drive-through-immunisation-clinic/index.html"}
{"id": "8321e1c062e2-0", "text": "Myocarditis is an inflammatory disease of the heart muscle, whilst pericarditis is an inflammatory disease of the lining of the heart muscle. They are rare conditions, most commonly associated with viral infections (including SARS-CoV-2) but can also be triggered by other factors such as medications and autoimmune conditions.\nGlobally, an increased number of cases above an expected population rate of myocarditis and pericarditis have been reported in individuals who have received COVID-19 vaccines, with the highest rates occurring following administration of COVID-19 mRNA vaccines (eg. Comirnaty (Pfizer)\u00a0and Spikevax (Moderna)).\n\ufeff\ufeff\nInformation specific to myocarditis and pericarditis can be found via the below buttons. In addition, frequently asked questions relating to vaccination are also addressed.\nMyocarditisPericarditisFrequently asked questions\nMyocarditis\nHow is myocarditis following COVID-19 vaccination triggered?The exact mechanism behind cardiac inflammation temporally associated with COVID-19 vaccines is currently being investigated. Clinical causes from international and local surveillance data suggest an immune-mediated or hypersensitivity trigger. There are ongoing studies examining the role of the SARS-CoV-2 spike protein, impact of certain cardiac biomarkers and genetic predispositions to this adverse event of special interest (AESI).\nWho is at risk of myocarditis?Myocarditis from any cause, occurs more commonly in males than females. It is also more likely to affect younger adults.\nReported rates of myocarditis occurring following administration of COVID-19 vaccines vary; however, they are above expected background rates for both sexes. The peak risk group for COVID-19 vaccine related myocarditis is young adult males aged 16-17 years, with a smaller increased risk for males aged between 12-24 years.", "source": "mvec.mcri.edu.au/references/myocarditis-and-pericarditis-following-covid-19-vaccines/index.html"}
{"id": "8321e1c062e2-1", "text": "International and local vaccine safety surveillance data have found that it is more commonly associated with administration of a\u00a0second\u00a0dose of COVID-19 mRNA vaccine. Myocarditis following other COVID-19 vaccines, third doses or booster doses have also been identified, although reported cases have occurred at\u00a0lower rates\u00a0than those identified following either dose of a primary course.\nAlthough myocarditis AESI has been associated with all of the COVID-19 vaccines used in Australia, there is a higher risk of myocarditis following administration of COVID-19 mRNA vaccines compared to non-mRNA vaccines. Surveillance data from multiple countries have also demonstrated a greater risk with Spikevax (Moderna) compared to Comirnaty (Pfizer).\nAre children more likely to experience myocarditis following COVID-19 vaccination?Available safety data from\u00a0local\u00a0and\u00a0international sources\u00a0suggest there is a significantly lower risk of children developing myocarditis following vaccination. Thus far, data shows that the risk of COVID-19 vaccine myocarditis decreases as age decreases.\nATAGI recommends an interval of 8 weeks between vaccine doses in a primary course for age-eligible children (\u2264 11 years) for maximum efficacy and safety. This extended interval is based on international data suggesting a longer time interval between dose 1 and 2 may reduce the risk of myocarditis. This extended interval also allows more time to observe international vaccine safety data and identify any signals for rare adverse events.\nVery few cases of myocarditis in children <6 years of age have been reported in available worldwide surveillance data to date.\nFor more information on COVID-19 vaccination in individuals < 18 years please refer to\u00a0COVID-19 vaccination in children and adolescents.\nPre-existing cardiac conditions and COVID-19 vaccinationIndividuals with the following cardiac conditions can safely receive COVID-19 vaccines without the need for additional monitoring or precautions:\ncoronary artery disease\nmyocardial infarction\nstable heart failure", "source": "mvec.mcri.edu.au/references/myocarditis-and-pericarditis-following-covid-19-vaccines/index.html"}
{"id": "8321e1c062e2-2", "text": "coronary artery disease\nmyocardial infarction\nstable heart failure\narrhythmias\nrheumatic fever\nrheumatic heart disease\nkawasaki disease\nmost congenital heart disease\nthose with implanted cardiac devices\ncongenital heart disease\ncardiac transplant\ncardiomyopathy.\nThose with a history of the following conditions can also receive COVID-19 vaccines; however should consult their treating specialist to determine the appropriate timing for vaccination:\nrecent (within 3 months) or current inflammatory cardiac conditions (including myocarditis, pericarditis and endocarditis)\nacute rheumatic fever or acute rheumatic heart disease\nacute decompensated heart failure.\nPatients with ongoing cardiac inflammation should have vaccination deferred. In some instances, vaccination with\u00a0Vaxzevria (AstraZeneca)\u00a0or\u00a0Nuvaxovid (Novavax)\u00a0may be considered due to the lower associated risk of developing myocarditis.\nWhat are the symptoms of myocarditis?Myocarditis presents similarly to pericarditis, with a range of symptoms including:\nchest pain, pressure or discomfort\npain with breathing (pleuritic chest pain)\nshortness of breath\npalpitations\nsyncope (faint)\nother non-specific symptoms such as fatigue, dizziness, abdominal pain.\nIn individuals who have received COVID-19\u00a0 vaccines, symptoms of myocarditis have most commonly been reported within 2-7 days of\u00a0second\u00a0dose vaccination.\nHow is myocarditis after COVID-19 vaccination diagnosed and investigated?If there is suspicion of myocarditis, particularly in the first week following vaccination, timely medical review is important. Those who appear unwell should be referred to an emergency department for examination and the following primary investigations:\nblood tests for cardiac biomarkers, such as troponin\nelectrocardiogram (ECG).", "source": "mvec.mcri.edu.au/references/myocarditis-and-pericarditis-following-covid-19-vaccines/index.html"}
{"id": "8321e1c062e2-3", "text": "electrocardiogram (ECG).\nOther tests should be considered if the patient is unwell or the tests above are abnormal:\nchest X-ray (CXR)\nother tests related to investigating differential diagnoses such as inflammatory markers (C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR)\nbedside or formal ultrasound/echo\ncardiac MRI.\nConsistent findings of myocarditis may include elevated troponin, ECG changes (ST or T-wave abnormalities, premature atrial or ventricular complexes) as well as abnormal echocardiogram or cardiac MRI.\nIndividuals who are investigated for myocarditis following vaccination should avoid high-intensity exercise until symptoms have resolved is recommended.\nCardiologist advice and followup is strongly recommended.\nHow is myocarditis after COVID-19 vaccination treated?Current data shows that most cases of myocarditis following COVID-19 vaccination have mild symptoms and recover well. Information on long term sequelae is not yet available.\nTreatment of these conditions is managed by a cardiologist and include in-patient supportive therapies. In the rare severe or complicated cases, specific management for arrythmias, decreased cardiac function or congestive cardiac failure with pharmacological agents such as ACE-inhibitors and beta-blockers or mechanical support may be necessary.\nI have specific questions around my risk of myocarditis following COVID-19 vaccination. Help!Although uncommon, myocarditis is most often seen after COVID-19 mRNA vaccines. Please refer to our specific\u00a0FAQs on COVID-19 mRNA vaccines\u00a0for further information. This includes answers on:\nimpact of dose intervals between 1st\u00a0and 2nd\u00a0doses of vaccine\nrisk of developing myocarditis from COVID-19 disease vs the vaccine\nexercise after COVID-19 vaccination\nimpacts of medications and drugs such as clozapine, stimulants, amphetamines on developing myocarditis.", "source": "mvec.mcri.edu.au/references/myocarditis-and-pericarditis-following-covid-19-vaccines/index.html"}
{"id": "8321e1c062e2-4", "text": "What are the implications for future doses (including third and booster doses)?For individuals where the cause of inflammation is attributed to COVID-19 vaccination, a report to\u00a0SAEFVIC\u00a0is indicated and a referral to a cardiologist and/or specialist immunisation service (eg.\u00a0VicSIS) is recommended.\nPlease refer to the below algorithm for recommendations relating to further doses of COVID-19 vaccines in patients who have been diagnosed with myocarditis following vaccination.\n*Brighton Level refers to Brighton Collaboration criteria for classifying myocarditis\nPDF version of the above diagram available here.\nATAGI currently recommends that individuals diagnosed with myocarditis following vaccination defer any further doses and are referred to a specialist immunisation clinic.\nWhat is the risk/benefit ratio for vaccination for the young adult age group?It is important to discuss your individual circumstances with a health care provider in order to make an informed decision.\nThe level of COVID-19 community transmission in Australia can change quickly. Factors to consider include age, potential for exposure to the virus (including in the workplace), high rates of global transmission, the emergence of new variants of the virus, as well as the potential for future changes to Australia\u2019s border controls.\nWhilst COVID-19 infection can sometimes result in myocarditis, its incidence following COVID-19 vaccination is comparatively extremely rare. Most individuals diagnosed with myocarditis following COVID-19 vaccination have responded well to treatment.\nPericarditis\nHow is pericarditis following COVID-19 vaccination triggered?The exact mechanism behind cardiac sac inflammation temporally associated with COVID-19 vaccination is currently being investigated. Clinical causes from international surveillance data suggest an immune-mediated or hypersensitivity trigger.\nWho is at risk of pericarditis?Pericarditis from any cause occurs in similar rates amongst males and females. It is also more likely to affect younger adults.", "source": "mvec.mcri.edu.au/references/myocarditis-and-pericarditis-following-covid-19-vaccines/index.html"}
{"id": "8321e1c062e2-5", "text": "Reported rates of pericarditis occurring following administration of a COVID-19 vaccine vary; however, they are above expected background population rates. Available surveillance data suggests the risks for pericarditis after a mRNA vaccine are higher than non-mRNA vaccines.\nInternational and local data indicate that pericarditis following COVID-19 vaccines is more common in the 18-39 year old age group for both males and females. Pericarditis following third doses or booster doses have also been identified in a small number of individuals. Reported cases have occurred at\u00a0significantly lower rates\u00a0than those identified following either dose of a primary course.\nAre children more likely to experience pericarditis following COVID-19 vaccination?Available safety data from\u00a0local\u00a0and\u00a0international sources\u00a0suggest there is a significantly lower risk of children developing pericarditis following COVID-19 vaccination.\nATAGI recommends an interval of 8 weeks between vaccine doses in a primary course for age-eligible children (\u2264 11 years) for maximum efficacy and safety. This extended interval is based on international data suggesting a longer time interval between dose 1 and 2 may reduce the risk of myocarditis \u2013 which in principle may also extend to pericarditis. This extended interval also allows more time to observe international vaccine safety data and identify any signals for rare adverse events.\nFor more information on COVID-19 vaccination in individuals < 18 years please refer to\u00a0COVID-19 vaccination in children and adolescents.\nPre-existing cardiac conditions and COVID-19 vaccinationIndividuals with the following cardiac conditions can safely receive COVID-19 vaccines without the need for additional monitoring or precautions:\ncoronary artery disease\nmyocardial infarction\nstable heart failure\narrhythmias\nrheumatic fever\nrheumatic heart disease\nkawasaki disease\nmost congenital heart disease\nthose with implanted cardiac devices\ncongenital heart disease\ncardiac transplant", "source": "mvec.mcri.edu.au/references/myocarditis-and-pericarditis-following-covid-19-vaccines/index.html"}
{"id": "8321e1c062e2-6", "text": "those with implanted cardiac devices\ncongenital heart disease\ncardiac transplant\ncardiomyopathy.\nThose with a history of the following conditions can also receive COVID-19 vaccines; however should consult their treating specialist to determine the appropriate timing for vaccination:\nrecent (within 3 months) or current inflammatory cardiac conditions (including myocarditis, pericarditis and endocarditis)\nacute rheumatic fever or acute rheumatic heart disease\nacute decompensated heart failure.\nPatients with ongoing cardiac inflammation should have vaccination deferred. In some instances, vaccination with\u00a0Vaxzevria (AstraZeneca)\u00a0or\u00a0Nuvaxovid (Novavax)\u00a0may be considered due to the lower associated risk of pericarditis.\nWhat are the symptoms of pericarditis?Pericarditis presents similarly to myocarditis, with a range of symptoms including:\nchest pain, pressure or discomfort\npain with breathing (pleuritic chest pain)\nshortness of breath\npalpitations\nsyncope (faint)\nother non-specific symptoms such as fatigue, dizziness, abdominal pain.\nHow is pericarditis after COVID-19 vaccination diagnosed and investigated?If there is suspicion of either of these conditions, particularly in the first 2-3 weeks following vaccination, timely medical review is important. Those who appear unwell should be referred to an emergency department for the following investigations:\nblood tests for cardiac biomarkers, such as troponin\nelectrocardiogram (ECG)\nOther tests should be considered if the patient unwell or the tests above are abnormal:\nchest X-ray (CXR)\nother tests related to investigating differential diagnoses such as inflammatory markers (C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR)).", "source": "mvec.mcri.edu.au/references/myocarditis-and-pericarditis-following-covid-19-vaccines/index.html"}
{"id": "8321e1c062e2-7", "text": "Consistent findings of pericarditis include a pericardial rub on auscultation, widespread ST-elevation or PR depression on ECG, as well as pericardial effusion on imaging.\nIndividuals who are investigated for pericarditis following vaccination should avoid high-intensity exercise until symptoms have resolved is recommended. Those experiencing ongoing symptoms should return for review in 1-2 days time. Cardiologist advice is recommended if clinical suspicion is high, regardless of normal investigations.\nHow is pericarditis after COVID-19 vaccination treated?Current data shows that most cases of pericarditis following COVID-19 vaccination have mild symptoms and recover well.\nIn some scenarios, there have been reports of pericarditis causing prolonged and recurrent symptoms but with functionally normal investigations including cardiac imaging. Information on long term sequelae is still being collected.\nTreatment of these conditions is managed by a cardiologist and include in-patient supportive therapies, often with anti-inflammatory medications or colchicine. In the rare severe or complicated cases, specific management for arrhythmias, decreased cardiac function or congestive cardiac failure with pharmacological agents such as ACE-inhibitors and beta-blockers or mechanical support may be necessary.\nWhat are the implications for future doses (including third and booster doses)?For individuals where the cause of inflammation is attributed to COVID-19 vaccination, a report to\u00a0SAEFVIC\u00a0is indicated and a referral to a cardiologist and/or specialist immunisation service (eg.\u00a0VicSIS) is recommended.\nPlease refer to the below algorithm for recommendations relating to further doses of COVID-19 vaccines in patients who have been diagnosed with pericarditis following vaccination.\n*Brighton Level refers to Brighton Collaboration criteria for classifying pericarditis\nAccess a pdf version of this guide here.", "source": "mvec.mcri.edu.au/references/myocarditis-and-pericarditis-following-covid-19-vaccines/index.html"}
{"id": "8321e1c062e2-8", "text": "Access a pdf version of this guide here.\nIn particular, the groups which are at lower risk (green in algorithm), could proceed with further doses of COVID-19 vaccination as per above suggested instructions.\nWhat is the risk/benefit ratio for vaccination for the young adult age group?It is important to discuss your individual circumstances with a health care provider in order to make an informed decision.\nThe level of COVID-19 community transmission in Australia can change quickly. Factors to consider include age, potential for exposure to the virus (including in the workplace), high rates of global transmission, the emergence of new variants of the virus, as well as the potential for future changes to Australia\u2019s border controls.\nWhilst COVID-19 infection can sometimes result in pericarditis, its incidence following COVID-19 vaccination is comparatively extremely rare. Most individuals diagnosed with pericarditis following COVID-19 vaccination have responded well to treatment.\nFrequently asked questions\nI am taking certain medications that have myocarditis listed as an uncommon side effect. Am I at greater risk of developing myocarditis/pericarditis after COVID-19 vaccination?Taking medications that have myocarditis listed as an uncommon side effect (e.g. antipsychotic drugs and biological chemotherapeutic agents) is not a contraindication to COVID-19 vaccination. Individuals taking these medications can be safely vaccinated in the community with no need for additional precautions or monitoring.\nAre there impacts of other substances on the development of myocarditis/pericarditis after COVID-19 vaccines?The use of recreational stimulants (particularly amphetamines) is discouraged especially in the week following vaccination to limit the potential for developing myocarditis/pericarditis.", "source": "mvec.mcri.edu.au/references/myocarditis-and-pericarditis-following-covid-19-vaccines/index.html"}
{"id": "8321e1c062e2-9", "text": "Should exercise be limited after receiving COVID-19 vaccines to reduce the chance of myocarditis/pericarditis?Exercise is not thought to increase the risk of developing myocarditis/pericarditis following COVID-19 vaccination. It is therefore not necessary to reduce or avoid exercise in the post-vacccination period.\nHowever, if patients develop myocarditis/pericarditis post vaccination there is a concern that exercise may be pro-arrhythmic (eg. will exacerbate) the condition.\nAs myocarditis/pericarditis following COVID-19 vaccination is thought to be immune mediated, would those with pre-existing autoimmune diseases be at an increased risk compared to the general public?Myocarditis/pericarditis following COVID-19 vaccination appears to be idiosyncratic at this stage, with no clear risk factors. Thus, there is no indication of increased risk in those with underlying autoimmune disease.\nResources\nInvestigation, management and treatment of myocarditis/pericarditis\nHealthPathways Myocarditis and Pericarditis after mRNA COVID-19 Vaccines (login required)\nPaediatric Research in Emergency Departments International Collaborative: Chest pain guideline\nGuidelines on Myocarditis/Pericarditis\nCOVID-19 vaccination \u2013 Guidance on myocarditis ad pericarditis after COVID-19 vaccines\nCDC Clinical Considerations: Myocarditis and Pericarditis after Receipt of mRNA COVID-19 Vaccines Among Adolescents and Young Adults\nCOVID-19 subcommittee of the WHO Global Advisory Committee on Vaccine Safety (GACVS) reviews cases of mild myocarditis reported with COVID-19 mRNA vaccines\nBrighton Collaboration: Myocarditis/Pericarditis Case Definition\nMVEC resources on COVID-19 vaccines and myocarditis/pericarditis\nThe MVEC Conversation: myocarditis/pericarditis following mRNA vaccination\nMVEC COVID-19 vaccine FAQs: mRNA vaccines: myocarditis/pericarditis", "source": "mvec.mcri.edu.au/references/myocarditis-and-pericarditis-following-covid-19-vaccines/index.html"}
{"id": "8321e1c062e2-10", "text": "MVEC COVID-19 vaccine FAQs: mRNA vaccines: myocarditis/pericarditis\nAuthors: Rachael McGuire (MVEC Education Nurse Coordinator), Francesca Machingaifa (MVEC Education Nurse Coordinator), Daryl Cheng (MVEC Medical Lead) and Nigel Crawford (Director SAEFVIC, Murdoch Children\u2019s Research Institute)\nReviewed by: Daryl Cheng (MVEC Medical Lead) and Julia Smith (Immunisation Fellow, Royal Children\u2019s Hospital)\nDate: October 27, 2022\nMaterials in this section are updated as new information and vaccines become available. The Melbourne Vaccine Education Centre (MVEC) staff regularly reviews materials for accuracy.\nYou should not consider the information in this site to be specific, professional medical advice for your personal health or for your family\u2019s personal health. For medical concerns, including decisions about vaccinations, medications and other treatments, you should always consult a healthcare professional.\nA B C D E F G H I J K L M N O P Q R S T U V W X Y Z", "source": "mvec.mcri.edu.au/references/myocarditis-and-pericarditis-following-covid-19-vaccines/index.html"}
{"id": "93b91d5f33dc-0", "text": "Each local council throughout Victoria offers regular immunisation sessions for the administration of all funded National Immunisation Program (NIP) vaccines. Sessions are free to attend and people of all ages requiring NIP vaccines can be vaccinated. Sessions are run by accredited nurse immunisers with medical support. Some councils may also choose to have additional vaccines such as meningococcal (Nimenrix\u00ae or Bexsero\u00ae), influenza and chickenpox vaccines available for purchase for those who do not meet the eligibility criteria for funded vaccines [see resources]. All vaccines administered are recorded on the Australian Immunisation Register (AIR).\nPlease refer to the tables below for contact details of your local council to obtain further information regarding session times.\nMetropolitan councils\nCouncil\nTelephone number\nImmunisation sessions\nBanyule City Council\n(03) 9490 4222\nBanyule immunisation session times\nBayside City Council\n(03) 9599 4444\nBayside immunisation session times\nBoroondara City Council\n(03) 9278 4444\nBoroondara immunisation session times\nBrimbank City Council\n(03) 9248 4000\nBrimbank immunisation session times\nCardinia Shire Council\n1300 787 624\nCardinia immunisation session times\nCity of Casey\n(03) 9705 5200\nCasey immunisation session times\nDarebin City Council\n(03) 8470 8562\nDarebin immunisation session times\nFrankston City Council\n1300 322 322\nFrankston immunisation session times\nGlen Eira City Council\n(03) 9524 3333\nGlen Eira immunisation session times\nGreater Dandenong City Council\n(03) 8571 1000\nDandenong immunisation session times\nHobsons Bay City Council", "source": "mvec.mcri.edu.au/references/victorian-council-immunisation-sessions/index.html"}
{"id": "93b91d5f33dc-1", "text": "Dandenong immunisation session times\nHobsons Bay City Council\n(03) 9932 1000\nHobsons Bay immunisation session times\nHume City Council\n(03) 9205 2200\nHume immunisation session times\nKingston City Council\n1300 653 356\nKingston immunisation session times\nKnox City Council\n(03) 9298 8000\nKnox immunisation session times\nManningham City Council\n(03) 9840 9333\nManningham immunisation session times\nMaribyrnong City Council\n(03) 9688 0145\nMaribyrnong immunisation session times\nMaroondah City Council\n(03) 9298 4598\nMaroondah immunisation session times\nMelbourne City Council\n(03) 9340 1451\nMelbourne immunisation session times\nMelton City Council\n(03) 9747 7200\nMelton immunisation session times\nMonash City Council\n(03) 9518 3555\nMonash immunisation session times\nMoonee Valley City Council\n(03) 9243 8888\nMoonee Valley immunisation session times\nMoreland City Council\n(03) 9240 1111\nMoreland immunisation session times\nMornington Peninsula Shire\n(03) 5950 1000\nMornington immunisation session times\nNillumbik Shire Council\n(03) 9433 3111\nNillumbik immunisation session times\nPort Phillip City Council\n(03) 9209 6383\nPort Phillip immunisation session times\nStonnington City Council\n(03) 8290 1333\nStonnington immunisation session times\nWhitehorse City Council", "source": "mvec.mcri.edu.au/references/victorian-council-immunisation-sessions/index.html"}
{"id": "93b91d5f33dc-2", "text": "Stonnington immunisation session times\nWhitehorse City Council\n(03) 9262 6197\nWhitehorse immunisation session times\nWhittlesea City Council\n(03) 9217 2170\nWhittlesea immunisation session times\nWyndham City Council\n(03) 9742 0777\nWyndham immunisation session times\nYarra City Council\n(03) 9205 5555\nYarra City immunisation session times\nYarra Ranges Shire Council\n1300 368 333\nYarra Ranges immunisation session times\nRegional councils\nCouncil\nTelephone number\nImmunisation sessions\nAlpine Shire Council\n(03) 5755 0555\nAlpine immunisation session times\nArarat Rural City Council\n(03) 5355 0200\nArarat immunisation session times\nBallarat City Council\n(03) 5320 5850\nBallarat immunisation session times\nBass Coast Shire Council\n(03) 5671 2211\nBass Coast immunisation session times\nBaw Baw Shire Council\n(03) 5624 2411\nBaw Baw immunisation session times\nBenalla Rural City Council\n(03) 5760 2600\nBenalla immunisation session times\nBuloke Shire Council\n1300 520 520\nBuloke immunisation session times\nCampaspe Shire Council\n(03) 5481 2200\nCampaspe immunisation session times\nCentral Goldfields Shire Council\n(03) 5461 0610\nCentral Goldfields immunisation session times\nColac Otway Shire Council\n(03) 5232 9400\nColac-Otway immunisation session times\nCorangamite Shire Council\n(03) 5232 7100", "source": "mvec.mcri.edu.au/references/victorian-council-immunisation-sessions/index.html"}
{"id": "93b91d5f33dc-3", "text": "Corangamite Shire Council\n(03) 5232 7100\nCorangamite immunisation session times\nEast Gippsland Shire Council\n(03) 5153 9500\nEast Gippsland immunisation session times\nGannawarra Shire Council\n(03) 5450 9333\nGannawarra immunisation session times\nGlenelg Shire Council\n(03) 5522 2211\nGlenelg immunisation session times\nGolden Plains Shire Council\n(03) 5220 7111\nGolden Plains immunisation session times\nGreater Bendigo City Council\n(03) 5434 6000\nBendigo immunisation session times\nCity of Greater Geelong\n(03) 4215 6962\nGeelong immunisation session times\nGreater Shepparton City Council\n(03) 5832 9700\nShepparton immunisation session times\nHepburn Shire Council\n(03) 53482306\nHepburn immunisation session times\nHindmarsh Shire Council\n(03) 5391 4444\nHindmarsh immunisation session times\nHorsham Rural City Council\n(03) 5382 9777\nHorsham immunisation session times\nIndigo Shire Council\n1300 365 003\nIndigo immunisation session times\nLatrobe City Council\n1300 367 700\nLatrobe immunisation session times\nLoddon Shire Council\n(03) 5494 1200\nLoddon immunisation session times\nMacedon Ranges Shire Council\n(03) 5422 0333\nMacedon Ranges immunisation session times\nMansfield Shire Council\n(03) 5775 8555\nMansfield immunisation session times", "source": "mvec.mcri.edu.au/references/victorian-council-immunisation-sessions/index.html"}
{"id": "93b91d5f33dc-4", "text": "(03) 5775 8555\nMansfield immunisation session times\nMildura Rural City Council\n(03) 5018 8100\nMildura immunisation session times\nMitchell Shire Council\n(03) 5734 6200\nMitchell immunisation session times\nMoira Shire Council\n(03) 5871 9222\nMoira immunisation session times\nMoorabool Shire Council\n(03) 5366 7100\nMoorabool immunisation session times\nMount Alexander Shire Council\n(03) 5472 1364\nMount Alexander immunisation session times\nMoyne Shire Council\n1300 656 564\nMoyne immunisation session times\nMurrindindi Shire Council\n(03) 5772 0333\nMurrindindi immunisation session times\nNorthern Grampians Shire Council\n(03) 5358 8700\nNorthern Grampians immunisation session times\nPyrenees Shire Council\n(03) 5349 1100\nPyrenees immunisation session times\nSouth Gippsland Shire Council\n(03) 5662 9200\nSouth Gippsland immunisation session times\nSouthern Grampians Shire Council\n(03) 5573 0444\nSouthern Grampians immunisation session times\nStrathbogie Shire Council\n(03) 5795 0000\nStrathbogie immunisation session times\nSurf Coast Shire Council\n1300 610 600\nSurf Coast immunisation session times\nSwan Hill Rural City Council\n(03) 5036 2333\nSwan Hill immunisation session times\nTowong Shire Council\n(02) 6071 5100\nTowong immunisation session times", "source": "mvec.mcri.edu.au/references/victorian-council-immunisation-sessions/index.html"}
{"id": "93b91d5f33dc-5", "text": "(02) 6071 5100\nTowong immunisation session times\nRural City of Wangaratta\n(03) 5722 0888\nWangaratta immunisation session times\nWarrnambool City Council\n(03) 5559 4855\nWarrnambool immunisation session times\nWellington Shire Council\n1300 366 244\nWellington immunisation session times\nWest Wimmera Shire Council\n(03) 5585 9900\nWest Wimmera immunisation session times\nCity of Wodonga\n(02) 6022 9300\nWodonga immunisation session times\nYarriambiack Shire Council\n(03) 5398 0100\nYarriambiack immunisation session times\nFor any feedback relating to this page please contact us here.\nResources\nDHHS: Victorian immunisation schedule and eligibility criteria for free vaccines\nMVEC: Australian Immunisation Register\nAuthor:\u00a0Rachael McGuire (SAEFVIC Research Nurse, Murdoch Children\u2019s Research Institute)\nReviewed by: Francesca Machingaifa (MVEC Education Nurse Coordinator)\nDate: February 2022\nMaterials in this section are updated as new information and vaccines become available. The Melbourne Vaccine Education Centre (MVEC) staff regularly reviews materials for accuracy.\nYou should not consider the information in this site to be specific, professional medical advice for your personal health or for your family\u2019s personal health. For medical concerns, including decisions about vaccinations, medications and other treatments, you should always consult a healthcare professional.\nA B C D E F G H I J K L M N O P Q R S T U V W X Y Z", "source": "mvec.mcri.edu.au/references/victorian-council-immunisation-sessions/index.html"}
{"id": "0abbcb462246-0", "text": "Background\nThe International Network of Special Immunization Services (INSIS) is a coordinated international collaboration of vaccine safety surveillance systems. By collaborating on a global scale, rare serious adverse events following immunisation (occurring in < 1 per 10,000 vaccine recipients) are more likely to be identified, thoroughly investigated and better understood. The international leads are Karina Top (Canada) and Bob Chen (United States).\nObjectives\nINSIS aims to promote confidence in the safety of vaccines. Implementing standardised case definitions and protocols can assist with identifying unique molecular signatures and biomarkers associated with rare adverse events following immunisation (AEFI) and improve our understanding of the genetic basis for adverse events (eg. thrombosis with thrombocytopenia syndrome and myocarditis/pericarditis following COVID-19 vaccines). By determining the causes of AEFI and identifying individual risk factors for experiencing AEFIs, it can develop recommendations for the safest way to immunise individuals with a history of or those identified as at higher risk of experiencing an AEFI. This improved understanding will also help in vaccine safety communication and the development of resources through leading websites such as MVEC.\nSAEFVIC, in collaboration with AEFI-CAN, leads Australia\u2019s involvement with INSIS.\nFunding\nINSIS is funded by the Coalition for Epidemic Preparedness Innovations (CEPI), the Canadian Institutes of Health Research (CIHR) and IWK Health Centre.\nResources\nInternational Network of Special Immunization Services\nMVEC: SAEFVIC\nMVEC: AusVaxSafety\nMVEC: AEFI-CAN\nMVEC: Adverse event reporting Australia\nAuthors: Rachael McGuire (MVEC Education Nurse Coordinator) and Nigel Crawford (Director, SAEFVIC, Murdoch Children\u2019s Research Institute)\nDate: March 9, 2023", "source": "mvec.mcri.edu.au/references/international-network-of-special-immunization-services/index.html"}
{"id": "0abbcb462246-1", "text": "Date: March 9, 2023\nMaterials in this section are updated as new information and vaccines become available. The Melbourne Vaccine Education Centre (MVEC) staff regularly reviews materials for accuracy.\nYou should not consider the information in this site to be specific, professional medical advice for your personal health or for your family\u2019s personal health. For medical concerns, including decisions about vaccinations, medications and other treatments, you should always consult a healthcare professional.\n\u00a0\n\u00a0\n\u00a0\nA B C D E F G H I J K L M N O P Q R S T U V W X Y Z", "source": "mvec.mcri.edu.au/references/international-network-of-special-immunization-services/index.html"}
{"id": "f67ab234adbf-0", "text": "There are a number of neurological conditions that are associated with an increased risk of vaccine preventable diseases. These include:\nEpilepsy and seizure disorders\nDevelopmental delay and intellectual disability\nCerebral palsy\nNeuromuscular disorders\nHydrocephalus and children with ventricular-peritoneal shunts\nChildren with any of these underlying conditions should have routine vaccinations according to the Australian National Immunisation Program Schedule.\nIn children where epilepsy is unstable, or there is a progressive neurological disorder of unclear aetiology, specialist consultation is recommended to advise on the appropriate vaccination course. In Victoria, referrals for this service should be made to SAEFVIC.\nInfluenza vaccination\nAll children with neurologic and neurodevelopmental conditions are at high risk of severe and complicated influenza infection.\nThis includes disorders that do not have an obvious compromise in respiratory function such as intellectual disability and epilepsy. Influenza infection can also markedly increase seizures in children with epilepsy.\nThese children should all be offered annual influenza vaccination from 6 months of age. Two doses are required in the first year the vaccine is received if less than 9 years of age [see Resources].\nPneumococcal vaccination\nChildren with CSF leaks and intracranial shunts are at higher risk of invasive pneumococcal disease. This includes brain inflammation (meningitis) and blood infection (bacteraemia). These children should be offered additional vaccines, including an extra pneumococcal conjugate vaccine to optimise protection.\u00a0 See the Pneumococcal chapter in the Australian Immunisation Handbook for the latest recommendations [see Resources]\nHuman Papillomavirus (HPV) Vaccination\nTransmission of the HPV virus is primarily through sexual intercourse and can also occur via non- penetrative sexual contact.\nThere is some evidence for potential virus transmission via viral particles on hands.", "source": "mvec.mcri.edu.au/references/neurologic-and-neurodevelopmental-conditions/index.html"}
{"id": "f67ab234adbf-1", "text": "There is some evidence for potential virus transmission via viral particles on hands.\nHPV infection is associated with the potential development of serious disease such as cervical and anogenital cancers. The infection is also the primary cause of anogenital warts.\nAs transmission can be varied, children with neurodevelopmental conditions should be offered HPV vaccination as per the routine secondary school program.\nResources\nThe Australian Immunisation Handbook: Pneumococcal chapter\nHPV Cancer Council\nMVEC: Influenza Vaccine Recommendations\nMVEC: Human Papilloma Virus (HPV)\nMVEC: SAEFVIC\nAuthor: Teresa Lazzaro (Paediatrician, Immunisation Service, Royal Children\u2019s Hospital Melbourne)\nDate: September 2018\nMaterials in this section are updated as new information and vaccines become available. The Melbourne Vaccine Education Centre (MVEC) staff regularly reviews materials for accuracy.\nYou should not consider the information in this site to be specific, professional medical advice for your personal health or for your family\u2019s personal health. For medical concerns, including decisions about vaccinations, medications and other treatments, you should always consult a healthcare professional.\nA B C D E F G H I J K L M N O P Q R S T U V W X Y Z", "source": "mvec.mcri.edu.au/references/neurologic-and-neurodevelopmental-conditions/index.html"}
{"id": "b543c4224852-0", "text": "The Victorian Specialist Immunisation Services (VicSIS) network was established in 2021 to help support the COVID-19 vaccine rollout in Victoria. It was coordinated and funded by the Victorian Department of Health (DH) with clinical support provided by SAEFVIC (the Victorian vaccine safety service). \u00a0\nVicSIS provided specialist vaccination services for adults and children who had experienced an adverse event following immunisation (AEFI) with a COVID-19 vaccine, or for those who were identified as at-risk of experiencing an AEFI. \u00a0\nVicSIS services were discontinued in early 2023. If you have experienced an AEFI following vaccination with a COVID-19 vaccine, please speak to your local health provider for further advice or contact SAEFVIC. \u00a0\nResources\nMVEC: SAEFVIC\nMVEC: COVID-19 vaccines and allergy\nMVEC: COVID-19\nMVEC: COVID-19 vaccine adverse events\nMVEC: COVID-19 vaccines in people with immunocompromise\nMVEC: Immunisation recommendations for the older population\nAuthors: Francesca Machingaifa (MVEC Education Nurse Coordinator) and Rachael McGuire (MVEC Education Nurse Coordinator)\nDate:\u00a0February 2, 2023\nMaterials in this section are updated as new information and vaccines become available. The Melbourne Vaccine Education Centre (MVEC) staff regularly reviews materials for accuracy.\nYou should not consider the information in this site to be specific, professional medical advice for your personal health or for your family\u2019s personal health. For medical concerns, including decisions about vaccinations, medications and other treatments, you should always consult a healthcare professional.\nA B C D E F G H I J K L M N O P Q R S T U V W X Y Z", "source": "mvec.mcri.edu.au/references/the-vicsis-victorian-specialist-immunisation-services-network/index.html"}
{"id": "bedabf4fe3c8-0", "text": "What is it?\nIndividuals that are at higher risk of vaccine preventable diseases (VPD) are classified as \u2018special risk\u2019 groups in the Australian Immunisation Handbook.\nThis includes populations at special risk (e.g. Aboriginal and Torres Straight Islanders) and those with additional vaccine requirements (e.g. maternal vaccination; preterm infants). It also has detailed sections on those at special risk because of immune suppression (disease and/or therapy) e.g. Asplenia, cancer/chemotherapy.\nThe chapter is updated online using the latest available scientific evidence\nThe Handbook is endorsed by:\nThe Australian Technical Advisory Group on Immunisation [ATAGI] and \nThe National Health and Medical Research Council [NHMRC]\nResources\nAustralian Immunisation Handbook: Vaccination for Special Risk Groups\nMVEC: Australian Technical Advisory Group on Immunisation\nReviewed by: Nigel Crawford (Director, SAEFVIC, Murdoch Children\u2019s Research Institute)\nDate:\u00a0September 2018\nMaterials in this section are updated as new information and vaccines become available. The Melbourne Vaccine Education Centre (MVEC) staff regularly reviews materials for accuracy.\nYou should not consider the information in this site to be specific, professional medical advice for your personal health or for your family\u2019s personal health. For medical concerns, including decisions about vaccinations, medications and other treatments, you should always consult a healthcare professional.\n\u00a0\nA B C D E F G H I J K L M N O P Q R S T U V W X Y Z", "source": "mvec.mcri.edu.au/references/special-risk-chapter-in-the-australian-immunisation-handbook/index.html"}
{"id": "5f18c03c265a-0", "text": "What is it?\nKawasaki disease (KD) is the second most common form of vasculitis (inflammation of blood vessels) in childhood, affecting 200-300 Australian children every year. It mostly occurs in children aged under 5, with some rare cases affecting older children or adults. KD is a collection of symptoms including persistent fever, conjunctival infection, rash, painful oedema of the hands and feet, lymphadenopathy and oral symptoms such as strawberry tongue, erythema and cracking and bleeding of the lips. Children with KD are at risk of developing coronary artery aneurysms, and in some cases damage to the heart valves or muscle, if prompt treatment is not initiated. Up to 10% of children with KD will go on to develop problems with the coronary arteries, and it is the most common form of acquired heart disease in children in developed nations.\nTreatment\nMorbidity and mortality is reduced by the prompt initiation of treatment with the administration of intravenous immunoglobulin (IVIg). IVIg prevents damage to large arteries of the heart in 80% of cases. Low dose aspirin is prescribed for a few weeks following diagnosis to prevent cardiac complications.\u00a0\nKawasaki disease and immunisation\nThere is no evidence that vaccination can lead to KD. Whilst a diagnosis of KD may be made following immunisation, this association is temporal and research has not identified a causal association.\nDue to the inflammation that occurs with KD, BCG administration sites can become during the illness if BCG was administered in the 6 months prior.\u00a0\nVaccine precautions\nInactivated routine vaccines can be administered as per the National Immunisation Program (NIP) once a child has recovered from the acute illness.", "source": "mvec.mcri.edu.au/references/kawasaki-disease-and-vaccines/index.html"}
{"id": "5f18c03c265a-1", "text": "Live-attenuated vaccines such as measles-mumps-rubella-varicella and measles-mumps-rubella must be delayed 11 months following the administration of intravenous immunoglobulin (IVIg) as the transfusion of IVIg can affect the immune response to the vaccine.\nResources\nMVEC: Live-attenuated vaccines and immunoglobulins or blood products\nMVEC: Children with cardiac disease\nRCH Kids Health Information: Kawasaki disease\u00a0\nRCH Clinical practice guidelines: Kawasaki disease\nKawasaki Disease Foundation\nAuthor: Adele Harris (SAEFVIC Research Nurse, Murdoch Children\u2019s Research Institute).\nReviewed by: Francesca Machingaifa (MVEC Education Nurse Coordinator) and Rachael McGuire (MVEC Education Nurse Coordinator)\nDate: June 2022\nMaterials in this section are updated as new information and vaccines become available. The Melbourne Vaccine Education Centre (MVEC) staff regularly reviews materials for accuracy.\nYou should not consider the information in this site to be specific, professional medical advice for your personal health or for your family\u2019s personal health. For medical concerns, including decisions about vaccinations, medications and other treatments, you should always consult a healthcare professional.\n\u00a0\n\u00a0\nA B C D E F G H I J K L M N O P Q R S T U V W X Y Z", "source": "mvec.mcri.edu.au/references/kawasaki-disease-and-vaccines/index.html"}
{"id": "1403e2188b38-0", "text": "The development of a nodule at the injection site is a known but rare adverse event following immunisation (AEFI). Nodules are defined as the presence of a palpable, firm, discrete or well-demarcated soft tissue lump at the site of immunisation in the absence of heat, erythema (redness) or signs of abscess.\nNodules can occur following any vaccine. \u00a0They usually present in the days or weeks following immunisation and are most often reported following vaccines given in infancy or childhood. A nodule can persist for weeks and sometimes months. They are usually asymptomatic but can be tender and/or itchy. They are often reported by parents to feel like a \u2018pea\u2019 size lump under the skin. They usually resolve spontaneously without treatment or investigation.\nIt is unclear what causes a nodule however, vaccine components (e.g. aluminium), local inflammatory reactions or immune-mediated responses have been implicated as possible contributing factors.\nVery rarely, a nodule may persist and become symptomatic for the vaccinee (see rare or persisting subcutaneous nodules below).\nImplications and considerations for future vaccines\nIt is recommended that future vaccines continue to be given according to the immunisation schedule. The history of, or presence of, a nodule is not a contraindication to future vaccines.\nEnsure correct vaccine administration for both intramuscular and subcutaneous vaccines. Deep intramuscular (IM) injection for IM vaccines should be considered to minimise the risk of potential recurrence of a nodule. Where possible, avoid vaccination at a site of an existing nodule.\nRare or persisting subcutaneous nodules", "source": "mvec.mcri.edu.au/references/injection-site-nodules/index.html"}
{"id": "1403e2188b38-1", "text": "Rare or persisting subcutaneous nodules\nSome nodules can become symptomatic and last for months or even years and are referred to as persisting subcutaneous nodules. Pruritus (itch) is the most concerning symptom that motivates parents to seek medical attention. Ongoing pruritus can alter the appearance of the skin leading to excoriation, hair growth and pigmentation changes. Intensified itching and a change in size of the nodule has been reported when a child is unwell with a viral infection or even following subsequent vaccinations given at a different anatomical site.\nTreatment of persisting subcutaneous nodules\nA conservative approach to treatment is recommended and is usually to provide symptomatic relief of pruritus. Any treatments would need to be provided following medical review and can include topical corticosteroids or dressings to protect the area from rigorous scratching. Referral to a Specialist Immunisation Clinic should be considered for specialist consultation.\nAny AEFI should be reported to the vaccine safety service in your state. In Victoria reports can be made to SAEFVIC.\nResources\nRothstein. E, et al Nodule at injection site as an adverse event following immunization: case definition and guidelines for data collection, analysis and presentation, Vaccine 2004 (22): 575-585\nSilcock, R. et al Subcutaneous nodules following immunization in children; in Victoria, Australia from 2007 to 2016, Vaccine 2020 (38): 3169-3177\nSilcock, R. et al Subcutaneous nodules: an important adverse event following immunization, Expert Review of Vaccines 2019 (18): 405-410", "source": "mvec.mcri.edu.au/references/injection-site-nodules/index.html"}
{"id": "1403e2188b38-2", "text": "Bergfors, E. Lundmark, K. Kronander, U. A child with a long-standing, intensely itching subcutaneous nodule on a thigh: an uncommon (?) reaction to commonly used vaccines, BMJ Case Reports 2013:bcr2012007779\nMVEC: Injection site reactions\nAuthors: Mel Addison (SAEFVIC Research Nurse, Murdoch Children\u2019s Research Institute), Rachael McGuire (SAEFVIC Research Nurse, Murdoch Children\u2019s Research Institute) and Georgina Lewis (Clinical Manager, SAEFVIC, Murdoch Children\u2019s Research Institute)\nReviewed by:\u00a0Mel Addison (SAEFVICResearch Nurse, Murdoch Children\u2019s Research Institute)\nDate: October 18, 2022\nMaterials in this section are updated as new information and vaccines become available. The Melbourne Vaccine Education Centre (MVEC) staff regularly reviews materials for accuracy.\nYou should not consider the information in this site to be specific, professional medical advice for your personal health or for your family\u2019s personal health. For medical concerns, including decisions about vaccinations, medications and other treatments, you should always consult a healthcare professional.\nA B C D E F G H I J K L M N O P Q R S T U V W X Y Z", "source": "mvec.mcri.edu.au/references/injection-site-nodules/index.html"}
{"id": "975e7566ee29-0", "text": "Background\nPneumococcal disease is caused by Streptococcus Pneumoniae (pneumococcus), a bacteria that can live in the nose and throat (nasopharynx) of healthy people and in most cases does not cause illness or disease. However, in some cases the bacteria may grow and spread to other parts of the body.\u00a0 Invasive pneumococcal disease (IPD) can manifest as meningitis, pneumonia, sinusitis, otitis media (ear infections), osteomyelitis (bone infection), joint infections and septicaemia (blood infection). The severity of illness can vary, with severe disease requiring hospitalisation, causing significant morbidity and even death. Certain individuals with specific medical conditions (advancing age, identifying as Aboriginal and Torres Strait Islander, Asplenia etc) may be considered at increased risk of IPD and therefore require additional protection.\nPneumococcal vaccines\nThere are currently two multivalent pneumococcal vaccines available for free on the National Immunisation Program (NIP).\nPrevenar 13\u00ae (13vPCV) \u2013 a conjugate vaccine, providing protection against 13 different serotypes of pneumococcal (1, 3, 4, 5, 6A, 7F, 9V, 14, 18C, 19A, 19F, 23F). It is available on the NIP for individuals >6 weeks of age.", "source": "mvec.mcri.edu.au/references/pneumococcal-disease-and-vaccines/index.html"}
{"id": "975e7566ee29-1", "text": "Pneumovax 23\u00ae (23vPPV) \u2013 a polysaccharide vaccine, providing protection against 23 serotypes of pneumococcal (1, 2, 3, 4, 5, 6B, 7F, 8, 9N, 9V, 10A, 11A, 12F, 14, 15B, 17F, 18C, 19F, 19A, 20, 22F, 23F and 33F). It is available on the NIP as an additional recommendation for individuals >4-years of age who are at increased risk of IPD (it is not recommended for those <2 years of age due to poor immunogenicity in this population).\nCo-administration with other vaccines\n13vPCV and 23vPPV may be co-administered with other vaccines on the NIP, including the quadrivalent influenza vaccine (QIV), live attenuated vaccines (MMR/Varicella/Zostavax\u00ae) and COVID-19 vaccines.\nConsider where possible, different injection sites when co-administering pneumococcal and QIV in adults due to the increased risk of injection site reactions.\nCommon side effects of pneumococcal vaccines\nfever\nirritability\nlethargy\npain at the injection site\ninjection site reactions (redness, heat, swelling and tenderness)\nbody aches", "source": "mvec.mcri.edu.au/references/pneumococcal-disease-and-vaccines/index.html"}
{"id": "975e7566ee29-2", "text": "injection site reactions (redness, heat, swelling and tenderness)\nbody aches\nNote \u2013 In children, injection site reactions are more commonly reported as occurring within 24-48 hours following immunisation. In adults, injection site reactions may occur >3 days following the 13vPCV dose given at >70years, particularly in those who have previously received 23vPPV [see resources]. In both age groups a history of large local injection site reactions following previous pneumococcal vaccines is not a contraindication to further doses.\nCurrent pneumococcal recommendations as of July 2020\nSpecific population groups are at an increased risk of IPD. Updated ATAGI advice relating to these population groups include:\nChildren and adults with conditions that increase their risk from pneumococcal disease\nAll Aboriginal and Torres Strait Islander older adults (age \u226550 years)\nAll non-Indigenous older adults (age \u226570 years)\nIt is important for immunisation providers to familiarise themselves with the pneumococcal vaccine recommendations specific to each patient, recognising the variations to recommendations for different age groups, at-risk medical conditions, and Aboriginal and Torres Strait Islander status.\nTable 1: Summary of pneumococcal vaccine recommendations for all age groups and risk-categories\nAge and risk category\nCurrent age/Age at diagnosis of risk-condition\nPrevenar 13\u00ae (13vPCV) schedule\nPneumovax 23\u00ae (23vPPV) schedule*\nInfants and children with NO medical risk conditions (including Aboriginal and Torres Strait Islander children living in Vic, ACT, Tas and NSW)\n< 12-months\nAs per NIP (2, 4 & 12-months)^\nN/A\nInfants and children WITH a medical risk condition (including Aboriginal and Torres Strait Islander children) living in NT, QLD, SA and WA)", "source": "mvec.mcri.edu.au/references/pneumococcal-disease-and-vaccines/index.html"}
{"id": "975e7566ee29-3", "text": "< 12-months\nAs per NIP (2, 4 & 12-months) + 1 additional dose at 6-months^ (total 4 doses in a lifetime)\nDose 1 at 4-years of age\nDose 2 \u2265 5-years following dose 1*\n\u2265 12-months\nAs per NIP (2, 4 & 12-months) + 1 additional dose at age of diagnosis,^ given a minimum of 2-months after dose 3 (total 4 doses in a lifetime)\nDose 1 > 4-years of age (minimum 2- months after 4th dose of 13vPCV)\nDose 2 \u2265 5-years after dose 1*\nAboriginal and Torres Strait Islander adults with NO risk condition\nAdults > 50-years\n1 dose at > 50-years\u00a7\n2 doses* at least 5-years apart (minimum of 2-months after dose of 13vPCV)\nNon-indigenous adults with NO risk condition\nAdults\u00a0> 70-years\n1 dose at > 70-years#\u00a7\n(catch up for all adults > 70-years)\nN/A\nNon-indigenous adolescents/adults diagnosed with a\u00a0risk condition\nAny age\n1 dose at age of diagnosis#\n2 doses* at least 5-years apart (minimum of 2-months after dose of 13vPCV)\n*Maximum amount of 23vPPV in a lifetime is 2 doses", "source": "mvec.mcri.edu.au/references/pneumococcal-disease-and-vaccines/index.html"}
{"id": "975e7566ee29-4", "text": "*Maximum amount of 23vPPV in a lifetime is 2 doses\n^ Refer to specific pneumococcal catch up advice if commencing immunisations late/delayed including Table. Catch-up schedule for 13vPCV for Aboriginal and Torres Strait Islander children living in NSW, Vic, Tas or ACT, and all children who do not have risk condition(s) for pneumococcal disease, aged <5 years and Table. Catch-up schedule for 13vPCV for Aboriginal and Torres Strait Islander children living in NT, Qld, SA or WA ONLY, and all children with risk condition(s) for pneumococcal disease, aged <5 years\n\u00a7 For those individuals who have already received a dose 23vPPV, 13vPCV must be given \u226512-months after the 23vPPV\n# In July 2020, 13vPCV replaced the 23vPPV that was previously funded at > 65-years. 13vPCV should still be given even if 23vPPV has been administered previously. In scenarios where 23vPPV was administered first, there should be a minimum interval of 12-months before giving 13vPCV\nResources\nAustralian Immunisation Handbook: Pneumococcal disease\nAustralian Immunisation Handbook: List. Risk conditions for pneumococcal disease\nATAGI clinical advice on changes to recommendations for the use and funding of pneumococcal vaccines from 1 July 2020\u00a0\nNCIRS: Pneumococcal vaccines- frequently asked questions\nBetter Health Channel: Pneumococcal disease\nHuman Vaccines and Immunotherapeutics: Coadministration of 13-valent pneumococcal conjugate and quadrivalent inactivated influenza vaccines in adults previously immunized with polysaccharide pneumococcal vaccine 23: a randomized clinical trial", "source": "mvec.mcri.edu.au/references/pneumococcal-disease-and-vaccines/index.html"}
{"id": "975e7566ee29-5", "text": "Authors: Mel Addison (SAEFVIC Research Nurse, Murdoch Children\u2019s Research Institute), Georgina Lewis (Clinical Manager SAEFVIC, Murdoch Children\u2019s Research Institute), Rachael McGuire (MVEC Education Nurse Coordinator), Teresa Lazzaro (Paediatrician, the Royal Children\u2019s Hospital)\nReviewed by:\u00a0Mel Addison (SAEFVIC Research Nurse, Murdoch Children\u2019s Research Institute)\nDate: May 9, 2022\nMaterials in this section are updated as new information and vaccines become available. The Melbourne Vaccine Education Centre (MVEC) staff regularly reviews materials for accuracy.\nYou should not consider the information in this site to be specific, professional medical advice for your personal health or for your family\u2019s personal health. For medical concerns, including decisions about vaccinations, medications and other treatments, you should always consult a healthcare professional.\nA B C D E F G H I J K L M N O P Q R S T U V W X Y Z", "source": "mvec.mcri.edu.au/references/pneumococcal-disease-and-vaccines/index.html"}
{"id": "5b3b195af40e-0", "text": "Did you know there are additional vaccines recommended by vaccine experts that are available for private purchase? They are not free as they are not listed on the National Immunisation Program (NIP) or funded by the government. Most councils will offer some additional vaccines for purchase or alternatively all these vaccines are available for purchase with a prescription from your GP.\nInfluenza vaccine\nInfluenza vaccine is recommended annually for everyone from the age of 6-months.\nWho is eligible for the free vaccine?\nInfluenza vaccine is routinely funded for all children aged 6-months to less than 5-years of age, all Aboriginal & Torres Strait Islander people \u2265 6-months of age, pregnant women and for people with specific medical risk factors who are at risk of complications from influenza, regardless of age.\nRecommended but not funded:\nFor children (> 5-years), adolescents and adults. Influenza vaccines can be purchased and administered at most council community immunisation sessions or alternatively with a prescription from your GP or from pharmacist immunisers for people aged 10-years and over.\nChildren less than 9-years of age require 2 doses, 1 month apart, in the first year they receive the vaccine.\nResources:\nMVEC influenza vaccine recommendations\nMeningococcal vaccines\nMeningococcal ACWY\nMeningococcal ACWY (MenACWY) vaccine is recommended for any person who wants to protect themselves against invasive meningococcal disease (IMD) and can be administered from as early as 6-weeks of age. MenACWY provides protection against four strains of meningococcal disease, A, C, W and Y.\nWho is eligible for the free vaccine?\nA single dose of Nimenrix\u00ae is currently provided at 12-months of age on the National Immunisation Program (NIP)", "source": "mvec.mcri.edu.au/references/recommended-additional-vaccines-for-purchase-up-to-20-years-of-age-unfunded/index.html"}
{"id": "5b3b195af40e-1", "text": "Catch-up dose for any person aged under 20 years who did not receive a meningococcal C containing vaccine at 12-months of age\nYoung people aged 15 to 16-years or in Year 10 of secondary school as a school based vaccine program\nAll young people aged 15-19 years of age who have not received the vaccine at secondary school\nPeople of all ages with some specified medical conditions that increase the risk of IMD (complement deficiency, current or future treatment with eculizumab, asplenia) [see resources].\nRecommended but not funded:\nSome local councils offer Nimenrix\u00ae (Meningococcal ACWY) as a fee for service if patients wish to be protected but do not meet the criteria on the NIP. Alternatively, this vaccine is available at the GP on private prescription.\nMeningococcal B\nMeningococcal B (MenB) vaccine provides protection against B strain meningococcal disease and can be administered from as early as 6-weeks of age.\nWho is eligible for the free vaccine?\nPeople of all ages with some specified medical conditions that increase the risk of IMD (complement deficiency, current or future treatment with eculizumab, asplenia) [see resources]\nAboriginal and Torres Strait Islander infants from 2-months of age [see resources]\nThere are currently 2 vaccines available on the\u00a0private\u00a0market for the protection of meningococcal B disease.\nBexsero\u00ae is for use from 6-weeks of age\nTrumenba\u00ae is licensed for use in \u2265 10-years of age\nMeningococcal B vaccines brands are not interchangeable.", "source": "mvec.mcri.edu.au/references/recommended-additional-vaccines-for-purchase-up-to-20-years-of-age-unfunded/index.html"}
{"id": "5b3b195af40e-2", "text": "Meningococcal B vaccines brands are not interchangeable.\nSome local councils offer Bexsero\u00ae as a fee for service if patients wish to be protected but do not meet the criteria on the NIP. Alternatively, this vaccine is available at the GP on private prescription.\nResources:\nMVEC Meningococcal disease and vaccines\nMVEC: Meningococcal vaccines in special risk and immunosuppressed patients\nATAGI: Clinical advice on changes to recommendations for the use and funding of meningococcal vaccines from 1 July 2020\nChickenpox (varicella) vaccine\n2 doses of varicella-containing vaccine provide 15-20% more protection against (mild) breakthrough varicella (chickenpox) in children <14 years of age, however a 2nd dose is not included on the National Immunisation Program schedule.\nWho is eligible for the free vaccine?\nA single dose of the live-attenuated varicella vaccine is currently funded on the NIP for children at age 18 months of age in a combined measles-mumps-rubella-chickenpox (MMRV) vaccine.\nFor those \u2265 14 years of age, 2 doses (administered 4 weeks apart) are required for the protection of non-immune individuals.\nMMRV combination vaccine is not recommended for use in people from >14 years of age.\nRecommended but not funded \nIf parents or carers wish to minimise the risk of breakthrough varicella in children <14 years of age, a 2nd dose of varicella-containing vaccine is recommended and can be purchased at some council community immunisation sessions or purchased by prescription from the GP.", "source": "mvec.mcri.edu.au/references/recommended-additional-vaccines-for-purchase-up-to-20-years-of-age-unfunded/index.html"}
{"id": "5b3b195af40e-3", "text": "Children can receive a chickenpox vaccine from as young as 12 months of age. This can provide earlier protection against varicella, which may be appropriate in the context of childcare, travel or a varicella outbreak. There is no safety concern if the child still receives the dose scheduled at 18 months of age.\nThe minimum interval between doses of varicella-containing vaccine is 4 weeks.\nResources:\nMVEC: Varicella\nSpecial risk groups\nIndividuals that are at higher risk of vaccine preventable diseases (VPD) are classified as \u2018special risk\u2019 groups in the Australian Immunisation Handbook.\nThis includes populations at special risk (e.g. Aboriginal and Torres Straight Islanders) and those with additional vaccine requirements (e.g. maternal vaccination; preterm infants). It also has detailed sections on those at special risk because of immune suppression (disease and/or therapy) e.g. Asplenia, cancer/chemotherapy.\nResources:\nAustralian Immunisation Handbook: Vaccination for Special Risk Groups\nAdditional resources\nFurther information about childhood vaccination can be found at:\nThe Better Health Channel: Healthy Living: Immunisation\nATAGI: Clinical advice on changes to recommendations for the use and funding of meningococcal vaccines from 1 July 2020\nATAGI: Clinical advice on changes to vaccine recommendations and funding for people with risk conditions from 1 July 2020\nNational Immunisation Program Schedule\nMVEC: Victorian council immunisation sessions\nAuthors: Georgina Lewis (SAEFVIC Clinical Manager, Murdoch Children\u2019s Research Institute), Francesca Machingaifa (SAEFVIC Research Nurse, Murdoch Children\u2019s Research Institute) and DHHS Immunisation Nurses (Immunisation Section, Health Protection Branch, Department of Health and Human Services).", "source": "mvec.mcri.edu.au/references/recommended-additional-vaccines-for-purchase-up-to-20-years-of-age-unfunded/index.html"}
{"id": "5b3b195af40e-4", "text": "Reviewed by:\u00a0Francesca Machingaifa (SAEFVIC Research Nurse, Murdoch Children\u2019s Research Institute) and\u00a0Georgina Lewis (SAEFVIC Clinical Manager, Murdoch Children\u2019s Research Institute)\nDate: July 2020\nMaterials in this section are updated as new information and vaccines become available. The Melbourne Vaccine Education Centre (MVEC) staff regularly reviews materials for accuracy.\nYou should not consider the information in this site to be specific, professional medical advice for your personal health or for your family\u2019s personal health. For medical concerns, including decisions about vaccinations, medications and other treatments, you should always consult a healthcare professional.\nA B C D E F G H I J K L M N O P Q R S T U V W X Y Z", "source": "mvec.mcri.edu.au/references/recommended-additional-vaccines-for-purchase-up-to-20-years-of-age-unfunded/index.html"}
{"id": "70d1bcc1c15d-0", "text": "Vaccines are medications and like any medication, there are possible side effects or adverse events. Serious adverse events from immunisation are extremely rare. If you or your child has experienced an adverse event it should be reported to your local government health authority for follow up and management.\nPlease see the list below for the appropriate body to report to, according to your state or territory.\nSouth Australia Health\u00a01300 232 272\u00a0http://www.sahealth.sa.gov.au/\nTasmania (Direct to the TGA) 1800 044 114 http://www.tga.gov.au/\nVictoria (SAEFVIC) 1300 882 924\u00a0 (Option 1) https://www.safevac.org.au/Home/Info/VIC\nWestern Australia State Health Department WAVVS\u00a0(08) 9321 1312\u00a0 https://www.safevac.org.au/Home/Info/WA\nAustralian Capital Territory Health Department\u00a0(02) 6205 2300 http://www.health.act.gov.au/\nNew South Wales Public Health Units\u00a01300 066 055\u00a0http://www.health.nsw.gov.au/\nNorthern Territory Department of Health\u00a0(08) 8922 8044 NT AEFI form\nQueensland Health\u00a0(07) 3328 9888 http://www.health.qld.gov.au/\nIt is important to note that these services do not provide emergency care and are reporting services only.\nIf you require medical assistance please see your GP, local emergency department or dial 000 if immediate support is required.\nAuthor: Rachael McGuire (MVEC Education Nurse Coordinator)\nReviewed by: Francesca Machingaifa (MVEC Education Nurse Coordinator)\nDate: February 2022\nMaterials in this section are updated as new information and vaccines become available. The Melbourne Vaccine Education Centre (MVEC) staff regularly reviews materials for accuracy.", "source": "mvec.mcri.edu.au/references/adverse-events-reporting-australia/index.html"}
{"id": "70d1bcc1c15d-1", "text": "You should not consider the information in this site to be specific, professional medical advice for your personal health or for your family\u2019s personal health. For medical concerns, including decisions about vaccinations, medications and other treatments, you should always consult a healthcare professional.\nA B C D E F G H I J K L M N O P Q R S T U V W X Y Z", "source": "mvec.mcri.edu.au/references/adverse-events-reporting-australia/index.html"}
{"id": "6c269f10a856-0", "text": "Hypersensitivity/allergic reactions following immunisation can be classified as:\nurticarial- a red, itchy skin rash often referred to as hives, which characteristically has a central raised white wheal surrounded by an area of redness\nnon-urticarial rash- skin changes that don\u2019t involve hives\nangioedema- swelling in the deeper layers of the skin\ngeneralised allergic reaction- involving symptoms like vomiting and diarrhoea\nanaphylaxis- a sudden onset and rapid progression of symptoms involving the skin, respiratory and/or cardiovascular systems.\nSuspected hypersensitivity reactions, particularly non-urticarial skin rashes following immunisation, are common, however true vaccine allergy, where a person is contraindicated from being immunised with the same vaccine in the future, is rare (less than 1 case per million doses).\nA true vaccine allergy can only be diagnosed after specialist consultation with a vaccine allergy specialist, often after specific testing is carried out.\nFor future vaccine advice in the setting of immunisation hypersensitivity/allergic reactions, referrals should be made to SAEFVIC. SAEFVIC staff may direct the referral to an immunisation specialist or alternatively to a vaccine allergy specialist.\n\ufeff\ufeff\nInfluenza vaccine and egg allergy\nBased on prospective and retrospective studies of influenza vaccination in those with and without egg allergy (including egg anaphylaxis), the presence of egg allergy does not increase the risk of allergic reactions to the influenza vaccine.\nThe influenza vaccine can be administered in community vaccination clinics (which may or may not have direct medical practitioner supervision), General Practitioner surgeries or Immunisation clinics, as a single dose followed by the recommended 15 minute observation period.\nMMR vaccine and egg allergy", "source": "mvec.mcri.edu.au/references/allergy-and-immunisation/index.html"}
{"id": "6c269f10a856-1", "text": "MMR vaccine and egg allergy\nAlthough measles and mumps vaccine viruses are cultivated in eggs, these vaccines (MMR or MMR-Varicella vaccines) contain negligible amounts of egg protein/allergen. Therefore individuals with allergy/anaphylaxis to egg can be safely immunised in the community setting without any need for extra monitoring or additional observation.\nYellow fever vaccine and egg allergy\nCurrently, many guidelines advise that egg anaphylaxis is a contraindication to receiving a yellow fever vaccine (YFV), with the Australian Immunisation Handbook recommending people requiring the vaccine discuss this with an immunologist or allergist due to the YFV containing egg ovalbumin.\nDue to the serious nature of the disease, some countries requiring proof of immunisation as an entry requirement and the widely varying guidelines pertaining to YFV in egg-allergic people; researchers from the National Centre for Immunisation Research and Surveillance (NCIRS), and the Royal Children\u2019s Hospital in Melbourne, have published a case series proposing that skin testing may not be required for patients with mild egg allergy, and that a 2-step graded challenge under medical supervision is a safe alternative.\nCOVID-19 vaccines and allergy\nAdditional precautions are recommended for individuals with possible allergic reactions to a previous dose of a COVID-19 vaccine; allergic reactions to ingredients in the COVID-19 vaccine to be administered (including Polysorbate 80 in Vaxzevria (AstraZeneca) and Nuvaxovid (Novavax), and PEG in Comirnaty (Pfizer)\u00a0and Spikevax (Moderna)); prior anaphylactic reactions to other vaccines or medications where PEG or Polysorbate 80 may have been the cause; or a known systemic mast cell activation disorder with raised mast cell tryptase that has required treatment.", "source": "mvec.mcri.edu.au/references/allergy-and-immunisation/index.html"}
{"id": "6c269f10a856-2", "text": "In these instances a specialist review by an immunology/allergy/vaccination specialist to undertake a risk/benefit assessment to assess suitability for vaccination should be undertaken.\nFor all other allergies, including those with a history of anaphylaxis to food, drugs, venom or latex, it is recommended a routine observation period of 15 minutes following COVID-19 vaccination is observed.\nResources\nMVEC: Gelatin allergy and vaccines\nMVEC: COVID-19 vaccines and allergy\nNCIRS fact sheet- Vaccines, allergy and asthma\nThe Pediatric Infectious Diseases Journal: Yellow fever vaccination in EGG-allergic children\nMVEC: SAEFVIC\nAustralasian Society of Clinical Immunology and Allergy (ASCIA): Vaccination of the egg-allergic individual\u00a0\nJournal of Allergy and Clinical Immunology: Vocal cord dysfunction/inducible laryngeal obstruction(s) mimicking anaphylaxis during SARS-CoV-2 (COVID-19) vaccination\nAuthor:\u00a0Kirsten Perrett (Clinician Scientist Fellow, Murdoch Children\u2019s Research Institute)\nReviewed by: Rachael McGuire (MVEC Education Nurse Coordinator)\nDate: May 31, 2022\nMaterials in this section are updated as new information and vaccines become available. The Melbourne Vaccine Education Centre (MVEC) staff regularly reviews materials for accuracy.\nYou should not consider the information in this site to be specific, professional medical advice for your personal health or for your family\u2019s personal health. For medical concerns, including decisions about vaccinations, medications and other treatments, you should always consult a healthcare professional.\nA B C D E F G H I J K L M N O P Q R S T U V W X Y Z", "source": "mvec.mcri.edu.au/references/allergy-and-immunisation/index.html"}
{"id": "948e1d70b254-0", "text": "What is tetanus?\nTetanus is a bacterial infection caused by the bacteria Clostridium Tetani. It commonly lives in dirt, dust and animal waste and the spores are usually introduced into the body via lacerations or puncture wounds. The spores can survive in a wound for as long as 3 months before becoming active. The most common time frame for presentation of tetanus is around 14 days, but it can also be delayed (up to months), after the injury. Unlike other vaccine preventable diseases, tetanus is not transmissible from person to person.\nExamples of wounds that are considered tetanus prone include:\nbites, either animal or human\ndeep penetrating wounds\nwounds with foreign bodies i.e. splinters\nburns\nopen fractures\ncuts or lacerations with outdoor equipment\ntooth reimplantation post avulsion\nIV drug use sites.\nTetanus can occur following trivial or even unnoticed wounds. Tetanus prophylaxis should be strongly considered for all unimmunised or partially immunised persons, regardless of the nature of the wound.\nSigns and Symptoms\nPeople infected with tetanus commonly show signs of muscle spasm, mainly around the face and neck, including lock jaw. Spasms can last for significant amounts of time, requiring large amounts of analgesia.\nSevere cases can lead to breathing difficulties, respiratory infections and heart attack. 1 in 10 people with tetanus will die despite receiving prompt medical treatment.\nPrevention\nVaccination is the most effective way to prevent tetanus.\nAs per the National Immunisation Program (NIP), a primary course of tetanus vaccination is given at 6-weeks, 4-months, and 6-months of age (Infanrix\u00ae hexa/Vaxelis\u00ae).\nBoosters doses are then scheduled to be administered at:", "source": "mvec.mcri.edu.au/references/tetanus-prone-wounds-management/index.html"}
{"id": "948e1d70b254-1", "text": "Boosters doses are then scheduled to be administered at:\n18 months (Infanrix\u00ae/Tripacel\u00ae)\n4 years (Infanrix-IPV\u00ae/Quadracel\u00ae)\n12 to 13 years of age/Year 7 high school program (Boostrix\u00ae)\nA further booster dose as dTpa (Boostrix\u00ae/Adacel\u00ae) is recommended but not funded, for adults aged \u2265 50 years who have not received a dose of tetanus-containing vaccine in the last 10 years.\nRegular booster doses every 10 years are no longer recommended. However immunisation advice regarding the management of a tetanus prone wound varies from this (see below).\nTetanus prone wounds\nThe correct management of a tetanus prone wound is vital in the prevention of tetanus (see resources: RCH Clinical Practice Guideline).\nKey messages include:\nwhere applicable, wounds should be cleaned, disinfected, and surgically treated if required\nin paediatric patients, a full immunisation history should be taken, ensuring that a primary course of tetanus vaccination has been completed\nif a patient is > 5 years post a tetanus vaccine, then a booster is recommended\nan important age group to consider for a booster are those aged between 9-13 years, as they are 5 years post their 4 year old vaccine, and may not have yet received their Year 7 booster.\nChildren or adults who are unimmunised or only partially\nEvery person will receive an injury at some point in their life. Whether it is tetanus prone, will depend on medical assessment. Even the most superficial wounds could be at risk of tetanus depending on the mechanism of injury.", "source": "mvec.mcri.edu.au/references/tetanus-prone-wounds-management/index.html"}
{"id": "948e1d70b254-2", "text": "An unimmunised or partially immunised person is at greatest risk of contracting tetanus. The elderly population are often included in this group due to timing of their last booster, most commonly being exposed whilst gardening.\nA partially immunised person is one who has not yet completed a primary course, or has received < 3 doses of a tetanus containing vaccine. These people require not only a tetanus-containing vaccine but also tetanus immunoglobulin (TIG) (refer to resources for specific advice).\nIf immunisation history is in doubt, TIG and a tetanus-containing vaccine should be administered.\nImmunoglobulin provides protection for up to 1 month after administration. Vaccination provides protection against the toxin and not the bacteria. A full course of 3 doses of a tetanus-containing vaccine should be completed to ensure ongoing immunity. If individual advice is required consider a referral to a Specialist Immunisation Clinic.\nADT\u00ae vaccine\nThe use of ADT\u00ae in children aged < 10 years is not recommended as it does not contain enough antigen to promote an adequate immune response in the unimmunised, however there are unlikely to be safety issues. Parents requesting this option should be made aware of the increased risk of contracting tetanus.\nManagement of immunosuppressed patients with a tetanus prone-wound\nImmunosuppressive medications are becoming more common place in the management of particular medical conditions. Patients who may be immunosuppressed include:\nautoimmune conditions ie: IBD, lupus, rheumatologocial conditions\nsolid organ transplant recipients, Haematopoietic stem cell transplant recipients\nall oncology patients.\nPatients who are immunosuppressed should be considered unimmunised and treated accordingly with immunoglobulin and a vaccine.\nResources\nAustralian Immunisation Handbook: Tetanus\nThe Royal Children\u2019s Hospital Clinical Practice Guideline: Management of tetanus prone wound", "source": "mvec.mcri.edu.au/references/tetanus-prone-wounds-management/index.html"}
{"id": "948e1d70b254-3", "text": "The Royal Children\u2019s Hospital Clinical Practice Guideline: Management of tetanus prone wound\nAustralian Government Department of Health and Aged Care: Changes to the National Immunisation Program schedule from July 1 2023\nAuthor: Lynne Addlem (Immunisation Nurse, The Royal Children\u2019s Hospital) and Rachael McGuire (Education Nurse Coordinator)\nReviewed by: Rachael McGuire (Education Nurse Coordinator)\nDate: July 4, 2023\nMaterials in this section are updated as new information becomes available. The Melbourne Vaccine Education Centre (MVEC) staff regularly review materials for accuracy.\nYou should not consider the information in this site to be specific, professional medical advice for your personal health or for your family\u2019s personal health. For medical concerns, including decisions about vaccinations, medications and other treatments, you should always consult a healthcare professional.\n\u00a0\nA B C D E F G H I J K L M N O P Q R S T U V W X Y Z", "source": "mvec.mcri.edu.au/references/tetanus-prone-wounds-management/index.html"}
{"id": "dd90b7f5e821-0", "text": "At MVEC we strongly encourage people to seek answers to their questions and to be well informed with evidence-based information. We know that nearly half of all parents have some concerns about immunising their children, ranging from minor concerns to more serious degrees of vaccine hesitancy. Many people also have questions about COVID-19 vaccines for themselves and their families.\nThere is a lot of information available to people, particularly on the internet, which can be quite overwhelming. There is also a lot of misinformation, and conspiracy theories, and it can be hard to know which information sources to trust and what is true. Research suggests that information alone is not enough to address people\u2019s concerns about immunisation, even when it comes from recommended sources. That is because vaccine conversations matter, and how we discuss vaccines is often just as important as what information is shared.\nTalking to people who have questions about vaccines\nOne of the most effective strategies to address people\u2019s questions and concerns about vaccines is through a discussion with a trusted health care provider like a GP, nurse, paediatrician or midwife. Effective conversations are non-judgemental and help guide people towards accepting vaccination.\nHaving a combative conversation with a person who has questions about vaccines is never helpful. If possible, try to work out where the person may sit on the vaccine hesitency spectrum. They may have only minor concerns, more serious concerns or they may refuse vaccines all together. This often becomes apparent quite quickly as you start the conversation and helps you tailor your conversation accordingly.\nHere are the key steps to have an effective vaccine conversation:\n1. Find out all of the person\u2019s questions and concerns\nStart with an open-ended question, like \u201cWhat concerns do you have?\u201d\nTry to just listen and not jump in and correct their beliefs straight away. This is what we call \u201cresisting the righting reflex\u201d", "source": "mvec.mcri.edu.au/references/vaccine-confidence/index.html"}
{"id": "dd90b7f5e821-1", "text": "Encourage them to share all their concerns before you start responding. They may even mention their most important concern last.\nAt this point, once they have had a chance to list their concerns, summarise them to check your understanding.\n2. Acknowledge concerns and share knowledge\nNot everyone is \u201cvaccine hesitant\u201d. Having questions is very normal, especially with the newer COVID-19 vaccines. People are likely to be more receptive to what you have to say if you acknowledge their concerns without judgement.\nIt is helpful to ask if you can share what you know about vaccine safety and effectiveness and provide some good resources and information. Try to keep your explanations clear and check for understanding.\nAt this point, it is good to reinforce their motivation to accept vaccination.\n3. Discuss disease severity\nIt is always good to bring the discussion back to centre on disease severity, rather than focusing exclusively on the vaccines. This reminds people why we are vaccinating and reinforces the benefit.\n4. Recommend vaccination\nLastly, make a clear and strong recommendation to have the vaccine(s). This reinforces the importance of vaccination and clearly shows that you believe this is the best way to protect the person against vaccine preventable diseases.\nIf it is possible and the person is willing, deliver the vaccine(s) or explain where they need to go to receive them.\n5. Continue the conversation\nIf the person is not yet ready to accept vaccination, keep the communication open and invite them back at a later time to continue the conversation.\nTalking with friends and family can also have an influence on people\u2019s vaccine hesitancy. If you\u2019re someone who wants to encourage others to vaccinate, you can take some of the strategies we recommend for healthcare providers into your discussions with people in your life.", "source": "mvec.mcri.edu.au/references/vaccine-confidence/index.html"}
{"id": "dd90b7f5e821-2", "text": "This seems obvious, but the best approach is not to judge people, correct them, or jump into battle. This just entrenches people\u2019s beliefs and makes them defensive. And they probably won\u2019t trust you or want to talk to you openly about this topic anymore!\n\u00a0\n\ufeff\n\u00a0\nHow to tackle misinformation\nWe\u2019ve all heard people spreading misinformation and myths about vaccines. While it can be tempting to try to correct misinformation whenever you hear it, this can actually give the issue more oxygen. But if you notice that misinformation is spreading widely and beginning to affect people\u2019s vaccination behaviour, it may be time to step in.\nIf an individual is spreading misinformation, try to speak with them privately. It\u2019s not effective to have a public debate, either in person or online. Acknowledge the emotion and try to look for the truth together.\nIf you are debunking a particular myth, start by clearly restating the truth. Then, explain why the myth is untrue, and provide an alternative explanation for what the person is experiencing.\nFor example, if someone believes that the flu vaccine gives them the flu because they feel sick after the vaccine, it\u2019s not enough to simply tell them that is untrue. Explain why this is untrue \u2013 the vaccine contains a killed virus that cannot cause the flu. Then follow this with an alternative explanation for the person\u2019s symptoms \u2013 this is your body generating an immune response to the vaccine, and these symptoms are much more mild and brief than actual flu symptoms.\nFinally, end by restating the truth. People remember what we say first and last, and what we say more than once. Make sure it\u2019s the truth and not the myth that sticks in their minds.\n\u00a0\n\ufeff\n\u00a0\nResources\nTalking to people who have concerns\nNCIRS Sharing Knowledge About Immunisation (SKAI) project\nMumBubVax: Talking about immunisation for mothers and babies", "source": "mvec.mcri.edu.au/references/vaccine-confidence/index.html"}
{"id": "dd90b7f5e821-3", "text": "MumBubVax: Talking about immunisation for mothers and babies\nThe Conversation: Everyone can be effective advocate for vaccination- here\u2019s how\nCommunicating about COVID-19 vaccines and vaccine safety\nWorld Health Organization: COVID-19 vaccines- safety surveillance manual\nPre print MJA: Communicating with patients and the public about COVID-19 vaccine safety: recommendations from the Collaboration on Social Science in Immunisation\nCOSSI: A COVID-19 vaccine strategy to support uptake amongst Australians: Working Paper November 2020\nABC news: How to talk to friends and family feeling unsure about COVID-19 vaccines\nThe COVID-19 Vaccine Communication Handbook\nAddressing misinformation or talking about vaccination in online forums\nWorld Health Organization: How to respond to vocal vaccine deniers in public\nBMC Public Health: How organisations promoting vaccination respond to misinformation on social media: a qualitative investigation\nUNICEF: Vaccine misinformation management guide\nTips on countering conspiracy theories and misinformation\nAuthors: Margie Danchin (Senior Research Fellow, Murdoch Children\u2019s Research Institute) and Rachael McGuire (SAEFVIC Research Nurse, Murdoch Children\u2019s Research Institute)\nReviewed by: Margie Danchin (Group Leader, Vaccine Uptake Group, Murdoch Children\u2019s Research Institute) and Jess Kaufman (Research Fellow, Vaccine Uptake Group, Murdoch Children\u2019s Research Institute)\nDate: June 2021\nMaterials in this section are updated as new information and vaccines become available. The Melbourne Vaccine Education Centre (MVEC) staff regularly reviews materials for accuracy.\nYou should not consider the information in this site to be specific, professional medical advice for your personal health or for your family\u2019s personal health. For medical concerns, including decisions about vaccinations, medications and other treatments, you should always consult a healthcare professional.\nA B C D E F G H I J K L M N O P Q R S T U V W X Y Z", "source": "mvec.mcri.edu.au/references/vaccine-confidence/index.html"}
{"id": "5e1c73d5365a-0", "text": "Background\nSwelling, redness (erythema), pain and itch at the site of injection can be a common side effect from any vaccine. Symptoms are usually mild and localised to the site of vaccination, with onset commonly occurring within the first 48 hours of vaccination and symptoms lasting 1-2 days. In some cases however, injection site reactions (ISRs) can be more significant, last up to a week, or have delayed onset.\nSevere injection site reactions\nSevere ISRs can present with pain, erythema and induration (hard, tight swelling) which extends from \u201cjoint to joint\u201d (e.g., from the shoulder joint to the elbow joint) or \u201ccrossing joints\u201d (e.g., swelling that passes over at least one joint). Localised itch is also often reported. Resolution of these symptoms usually occur within 5-7 days with no long-term sequelae. Most affected individuals do not experience a high grade fever and remain systemically well.\nDelayed injection site reactions following COVID-19 vaccines\nDelayed ISRs have been reported to occur following COVID-19 vaccination. Symptoms commonly present within 4-11 days of vaccination, with a median onset of 8 days and can last 4-5 days.\nInjection site reactions following pneumococcal vaccines\nPneumococcal vaccines are administered to both children and adults via the National Immunisation Program (NIP). In children, ISRs are more commonly reported as occurring within 24-48 hours following immunisation. In adults, ISRs may occur >3 days following the 13vPCV dose given at >70years.\nTreatment of injection site reactions\nISRs can generally be managed at home with symptomatic relief such as oral analgesia and a cold compress. Immobilising the affected limb should be avoided as movement will enhance lymphatic drainage. Antibiotics and antihistamines are generally not required.", "source": "mvec.mcri.edu.au/references/injection-site-reactions/index.html"}
{"id": "5e1c73d5365a-1", "text": "Implications for future doses\nIn any age group, previous experience of an ISR is not a contraindication to future doses of vaccines and vaccine recipients are encouraged to complete the recommended vaccine schedules. Recurrence of symptoms following future vaccination may occur in some individuals but severity is not likely to be worsened.\nAny event felt to be significant following vaccination, including any symptoms which have not gone away after a few days should be reported to SAEFVIC. Providing a photograph of the ISR can assist with SAEFVIC management and advice.\nResources\nMVEC: Adverse Event Reporting Australia\nMVEC: SAEFVIC\nMVEC: Injection site nodules\nAustralian Immunisation Handbook: Common AEFIs and how to manage them\nAuthor: Rachael McGuire (SAEFVIC Research Nurse, Murdoch Children\u2019s Research Institute)\nReviewed by: Rachael McGuire (MVEC Education Nurse Coordinator)\nDate: May 30, 2023\nMaterials in this section are updated as new information and vaccines become available. The Melbourne Vaccine Education Centre (MVEC) staff regularly reviews materials for accuracy.\nYou should not consider the information in this site to be specific, professional medical advice for your personal health or for your family\u2019s personal health. For medical concerns, including decisions about vaccinations, medications and other treatments, you should always consult a healthcare professional.\nA B C D E F G H I J K L M N O P Q R S T U V W X Y Z", "source": "mvec.mcri.edu.au/references/injection-site-reactions/index.html"}
{"id": "901bf60bef76-0", "text": "Background\nPharmacist immunisers are registered pharmacists who have completed additional training that allows them to administer approved vaccines to specified patient groups. This improves vaccine accessibility for the community which is particularly important to limit the spread of vaccine preventable diseases.\nPharmacist immuniser requirements\nIn addition to completing an immunisation program recognised by the Chief Health Officer, pharmacist immunisers are required to display their certificate of completing said training, hold current First Aid and CPR certificates, and ensure that another suitably qualified staff member is on site when immunising in pharmacy settings. Completion of further training modules are required prior to administering some vaccines (COVID-19, monkeypox and Japanese encephalitis)\nPharmacist immunisers are bound by the policies and procedures of their local jurisdiction. For more information on requirements of pharmacists in Victoria, refer to the Victorian Pharmacist-Administered Vaccination Program Guidelines.\nWhich vaccines can pharmacist immunisers administer in Victoria?\nIn Victoria, pharmacist immunisers are authorised to administer the following vaccines:\ninfluenza vaccines to those aged \u2265 5 years\ndiphtheria\u2013 tetanus\u2013pertussis vaccines to those aged \u2265 12 years\nmeasles-mumps-rubella vaccines to those aged \u2265 15 years\nmeningococcal ACWY vaccines to those aged \u2265 15 years\nCOVID-19 vaccines under a time limited approval\nhuman papillomavirus vaccines to those aged \u2265 12 years\npneumococcal vaccines to those \u2265 50 years\nherpes zoster vaccines to those \u2265 50 years\nmpox vaccines to eligible individuals aged \u2265 5 years\nJapanese encephalitis vaccines to eligible individuals aged \u2265 5 years.\nResources\nPharmacist Immuniser Training Programs\nPharmaceutical Society of Australia:\u00a0Manage the delivery and administration of injections and immunisations- Victoria", "source": "mvec.mcri.edu.au/references/pharmacist-immunisers/index.html"}
{"id": "901bf60bef76-1", "text": "Pharmacy Guild of Australia, Victoria:\u00a0Delivering immunisation in a community pharmacy setting\nOther resources\nDHHS: Pharmacist immunisers\nDHHS: Pharmacist-administered vaccination services\nVictorian COVID-19 Vaccination Guidelines\nVictorian Pharmacist-Administered Vaccination Program Guidelines\nAuthors:\u00a0Rachael McGuire (SAEFVIC Research Nurse, Murdoch Children\u2019s Research Institute), Annie Cobbledick (Immunisation Pharmacist, The Royal Children\u2019s Hospital), Nigel Crawford (Director SAEFVIC, Murdoch Children\u2019s Research Institute), Helen Pitcher (Immunisation Section, Department of Health and Human Services) and Linny Nguy (Immunisation Section, Department of Health and Human Services)\nReviewed by: Rachael McGuire (MVEC Education Nurse Coordinator)\nDate: January 30, 2023\nMaterials in this section are updated as new information and vaccines become available. The Melbourne Vaccine Education Centre (MVEC) staff regularly reviews materials for accuracy.\nYou should not consider the information in this site to be specific, professional medical advice for your personal health or for your family\u2019s personal health. For medical concerns, including decisions about vaccinations, medications and other treatments, you should always consult a healthcare professional.\nA B C D E F G H I J K L M N O P Q R S T U V W X Y Z", "source": "mvec.mcri.edu.au/references/pharmacist-immunisers/index.html"}
{"id": "2d0927e368e3-0", "text": "What is it?\nJapanese encephalitis virus (JEV) is a rare but potentially serious infection caused by the flavivirus and is spread to humans through mosquito bites. It is a leading cause of vaccine-preventable encephalitis (brain infection) in Asia and the Western Pacific. It has recently been detected in piggeries in New South Wales, Queensland and Victoria and human cases have been reported.\nWhat to look for?\nMost people infected with JEV do not develop symptoms. Symptoms occur 5-15 days after exposure and can be non-specific or mild and can include fever, diarrhoea and rigors. Less than 1% of infected people develop encephalitis. Symptoms of encephalitis may include headache, confusion, vomiting, weakness, seizures or neck stiffness. In severe cases resulting in encephalitis there is a mortality rate of 20-30%, with permanent neurological disability occurring in 30-50% of survivors.\nHow is it transmitted?\nJEV is spread by mosquito bites. It mostly affects pigs, horses and water birds, but can also cause disease in humans. It cannot be transmitted from person to person, or through eating pork or pig products. When JEV occurs during pregnancy, infection can also be transmitted to the unborn baby.\nEpidemiology\nPeople with increased exposure to mosquitos may be at higher risk of infection, particularly those spending time outdoors or working with pigs. Children under 5 years of age and older people who are infected with JEV are at higher risk of more severe illness, including encephalitis.\nJEV is very common across Asia and the Western Pacific. As of March 4th, 2022 an outbreak in the eastern states of Australia was identified with a likely increased risk of transmission near the border of New South Wales and Victoria, particularly in the Murray River region.\nPrevention", "source": "mvec.mcri.edu.au/references/japanese-encephalitis/index.html"}
{"id": "2d0927e368e3-1", "text": "Prevention\nPreventing mosquito bites with physical barriers is the most effective way to avoid infection with JEV. Vaccines are also available to prevent the development of disease.\nPhysical barriers\nExposure to mosquito bites can be prevented in a number of ways including:\nwearing long, loose fitting clothes when outdoors\nusing mosquito repellents containing picaridin or DEET\nlimiting outdoor activity if there are lots of mosquitoes\nusing fly sprays, mosquito coils and plug-in repellent devices\nsleeping under mosquito nets treated with insecticides if you don\u2019t have flywire screens on your windows or are sleeping in an untreated tent/in the open outdoors.\nVaccines\nThere are currently three JEV vaccines available in Australia, Imojev, JEspect and Ixiaro.\nImojev\nImojev\nAge\nRoute\nDose\nPrimary course\nBooster doses\u03a9\n\u2265 9 months \u2013 < 18 years\nSC\n0.5ml\n1 dose\u00df\nSingle age- appropriate booster dose of either Ixiaro\u00a7/JEspect\u00a7/Imojev\u00df is recommended if \u2265 12 months has passed since the completion of the primary course and the individual has ongoing risk of JEV exposure.\n\u2265 18 years\nSC\n0.5ml\n1 dose\u00df\nIndividuals who received a primary course of Imojev\u00df at \u2265 18 years do not require a booster dose, regardless of ongoing risk of exposure.\n\u03a9 For further information on booster doses refer to\u00a0ATAGI clinical guidance on Japanese encephalitis virus vaccines.\n\u00df Imojev is a live-attenuated vaccine and therefore is contraindicated for pregnant women or people who are immunocompromised.\n\u00a7 Ixiaro/JEspect are inactivated vaccines and are therefore suitable for administration in pregnant women or immunocompromised individuals.", "source": "mvec.mcri.edu.au/references/japanese-encephalitis/index.html"}
{"id": "2d0927e368e3-2", "text": "JEspect\nJEspect\nAge\nRoute\nDose\nPrimary course\nBooster doses\u03a9\n\u2265 2 months\u00a0 \u2013 < 3 years\nIM\n0.25ml\n2 doses (28 days apart)\nSingle age- appropriate booster dose of either Ixiaro\u00a7/JEspect\u00a7/Imojev\u00df is recommended if \u2265 12 months has passed since the completion of the primary course and the individual has ongoing risk of JEV exposure.\n\u2265 3 years \u2013 < 18 years\nIM\n0.5ml\n2 doses (28 days apart)\nSingle age- appropriate booster dose of either Ixiaro\u00a7/JEspect\u00a7/Imojev\u00df is recommended if \u2265 12 months has passed since the completion of the primary course and the individual has ongoing risk of JEV exposure.\n\u2265 18 years\nIM\n0.5ml\n2 doses (28 days apart)\u03b4\nSingle age- appropriate booster dose of either Ixiaro\u00a7/JEspect\u00a7/Imojev\u00df is recommended if \u2265 12 months has passed since the completion of the primary course and the individual has ongoing risk of JEV exposure^.\n\u03a9 For further information on booster doses refer to\u00a0ATAGI clinical guidance on Japanese encephalitis virus vaccines.\n\u00df Imojev is a live-attenuated vaccine and therefore is contraindicated for\u00a0pregnant women\u00a0or people who are\u00a0immunocompromised.\n\u00a7 JEspect/Ixiaro are inactivated vaccines and are therefore suitable for administration in pregnant women or immunocompromised individuals.\n\u03b4 The interval can be shortened to 7 days for those aged \u2265 18 years if the individuals is at imminent risk of JEV exposure.", "source": "mvec.mcri.edu.au/references/japanese-encephalitis/index.html"}
{"id": "2d0927e368e3-3", "text": "^ booster doses are not required for individuals who received a primary course of Imojev at \u226518 years of age, regardless of ongoing risk of exposure.\nIxiaro\nIxiaro\nAge\nRoute\nDose\nPrimary course\nBooster doses\u03a9\n\u2265 2 months\u00a0 \u2013 < 3 years\nIM\n0.25ml\n2 doses (28 days apart)\nSingle age- appropriate booster dose of either Ixiaro\u00a7/JEspect\u00a7/Imojev\u00df is recommended if \u2265 12 months has passed since the completion of the primary course and the individual has ongoing risk of JEV exposure.\n\u2265 3 years \u2013 < 18 years\nIM\n0.5ml\n2 doses (28 days apart)\nSingle age- appropriate booster dose of either Ixiaro\u00a7/JEspect\u00a7/Imojev\u00df is recommended if \u2265 12 months has passed since the completion of the primary course and the individual has ongoing risk of JEV exposure.\n\u2265 18 years\nIM\n0.5ml\n2 doses (28 days apart)\u03b4\nSingle age- appropriate booster dose of either Ixiaro\u00a7/JEspect\u00a7/Imojev\u00df is recommended if \u2265 12 months has passed since the completion of the primary course and the individual has ongoing risk of JEV exposure^.\n\u03a9 For further information on booster doses refer to\u00a0ATAGI clinical guidance on Japanese encephalitis virus vaccines.\n\u00df Imojev is a live-attenuated vaccine and therefore is contraindicated for\u00a0pregnant women\u00a0or people who are\u00a0immunocompromised.\n\u00a7 JEspect/Ixiaro are inactivated vaccines and are therefore suitable for administration in pregnant women or immunocompromised individuals.", "source": "mvec.mcri.edu.au/references/japanese-encephalitis/index.html"}
{"id": "2d0927e368e3-4", "text": "\u03b4 The interval can be shortened to 7 days for those aged \u2265 18 years if the individuals is at imminent risk of JEV exposure.\n^ booster doses are not required for individuals who received a primary course of Imojev at \u226518 years of age, regardless of ongoing risk of exposure.\nSide effects following either vaccine are usually mild and short-lived. They can include injection site pain, redness and swelling, as well fever, headaches and muscle aches.\nVaccine recommendations\nJapanese encephalitis vaccination is recommended for individuals who are likely to be at greatest risk of infection with JEV. Routinely, this includes individuals who are travelling to areas in which Japanese encephalitis is endemic and residents of the Torres Strait Islands.\nIn the context of the current Australian outbreak of JEV, vaccination is recommenced for individuals aged \u22652 months who live in the local government areas of Campaspe, Gannawarra, Greater Shepparton, Indigo, Loddon, Mildura, Moira, Swan Hill, Wodonga, Towong, Benalla, Wangaratta, Strathbogie, Buloke, Greater Bendigo, Hindmarsh, Horsham, Northern Grampians, West Wimmera and Yarriambiack who:\nregularly spend time outdoor engaging in activities that place them at risk of mosquito bites\nare experiencing homelessness or are living in conditions with limited mosquito protection\u00a0(such as tents or exposed dwellings)\nare engaged in outdoor flood recovery efforts (this also applies to individuals from other areas who are deployed as part of flood recovery efforts).\nOthers who are eligible for vaccination not based on local government areas:\npeople who work at, reside at or are visiting:\na piggery, pork abattoir or pork rendering plant (including children \u2265 2 months of age), or transport workers, veterinarians or other individuals caring for pigs", "source": "mvec.mcri.edu.au/references/japanese-encephalitis/index.html"}
{"id": "2d0927e368e3-5", "text": "a property that has a confirmed JE infection\na property suspected to have a JE infection\npork abbatoir or pork rendering plant\npersonnel who work directly with mosquitoes through surveillance, control and management, and indirectly through management of vertebrate mosquito-borne disease surveillance systems\nall diagnostic and research laboratory workers who may be exposed to JEV.\nEligible individuals are encouraged to contact their GP, local public health unit or community immunisation provider to discuss access to vaccination.\nFurther information can be found via the common queries below:\nShould individuals travelling to the Murray River region receive the JEV vaccine?The current supply of JEV vaccine is currently being prioritised in Australia for high-risk groups as noted above.\nIndividuals travelling to regions associated with JEV cases for holiday purposes are recommended to take additional precautions to avoid mosquito contact.\nWhat is the difference between the three JEV vaccines and can individuals choose which JEV vaccine they receive?There are three JEV vaccines available in Australia:\nImojev is a live-attenuated vaccine which can be given as a single dose from \u2265 9 months of age. It cannot be administered in pregnant women or those with immunocompromise.\nJEspect and Ixiaro are the same vaccines, made by different manufacturers. They are an inactivated vaccines given in a two-dose schedule and registered for use in those \u2265 2 months of age. They are suitable for administration in immunocompromised individuals and pregnant women.\nVaccine choice will be determined by age, immune-status, pregnancy and availability.\nHow effective are JEV vaccines?Around 95% of people develop a protective immune response to the virus around 28 days after receiving their vaccine.\nOther measures such as physical barriers and effective mosquito repellent are also recommended to avoid exposure.", "source": "mvec.mcri.edu.au/references/japanese-encephalitis/index.html"}
{"id": "2d0927e368e3-6", "text": "Other measures such as physical barriers and effective mosquito repellent are also recommended to avoid exposure.\nCan pregnant women receive JEV vaccines?Women who are pregnant are recommended to receive either JEspect or Ixiaro as they are inactivated JEV vaccines.\nImojev is a live-attenuated vaccine and is therefore contraindicated in pregnancy. Women should be advised to avoid falling pregnant for 28 days following vaccination with Imojev. Pre-immunisation screening is essential to identify pregnant women.\nNB: JEV infection occurring in the first and second trimesters has been associated with miscarriage.\nCan women who are breastfeeding receive JEV vaccines?JEspect and Ixiaro are the preferred JEV vaccines for breastfeeding women.\nThere is minimal data on the safety of Imojev when administered to breastfeeding women and therefore it is not routinely recommended. In women with a high risk of mosquito exposure, Imojev may be considered in circumstances where JEspect or Ixiaro are unavailable and following consultation with a specialist immunisation service.\nCan immunocompromised individuals receive JEV vaccines?People who are immunocompromised can receive JEspect or Ixiaro.\nImojev is a live-attenuated vaccine and is therefore contraindicated in this patient group due to the risk of vaccine-associated disease.\nAre booster doses of JEV vaccines recommended?Yes. A single age-appropriate booster dose of either JEspect, Ixiaro or Imojev is recommended for individuals if \u2265 12 months has passed since the completion of the primary course and the individual has an ongoing risk of JEV exposure. This recommendation also applies to individuals who completed their primary course overseas with a brand not available in Australia (eg. JEvax).", "source": "mvec.mcri.edu.au/references/japanese-encephalitis/index.html"}
{"id": "2d0927e368e3-7", "text": "The only exception to this is individuals received a primary course of Imojev when the individual was \u2265 18 years of age. In these circumstances, further booster doses are not required.\nResources\nVictorian program information\nVictorian Department of Health: Japanese encephalitis in Victoria\nOther resources\nAustralian Immunisation Handbook: Japanese encephalitis\nAustralian Government Department of Health and Aged Care: Japanese encephalitis virus situation declared a Communicable Disease Incident of National Significance\nATAGI statement on Japanese encephalitis virus (JEV) vaccines\nATAGI clinical guidance on Japanese encephalitis virus vaccines\nCDNA advice regarding vaccination against Japanese encephalitis virus\nAuthors: Rachael Purcell (Immunisation Fellow, Royal Children\u2019s Hospital), Nigel Crawford (Director, SAEFVIC, Murdoch Children\u2019s Research Institute), Rachael McGuire (MVEC Education Nurse Coordinator) and Raffaela Armiento (Consultant Paediatrician, Victorian Immunisation Specialist Services)\nReviewed by: Rachael McGuire (MVEC Education Nurse Coordinator)\nDate: March 23, 2023\nMaterials in this section are updated as new information and vaccines become available. The Melbourne Vaccine Education Centre (MVEC) staff regularly reviews materials for accuracy.\nYou should not consider the information in this site to be specific, professional medical advice for your personal health or for your family\u2019s personal health. For medical concerns, including decisions about vaccinations, medications and other treatments, you should always consult a healthcare professional.\nA B C D E F G H I J K L M N O P Q R S T U V W X Y Z", "source": "mvec.mcri.edu.au/references/japanese-encephalitis/index.html"}
{"id": "0be329be93f5-0", "text": "What is it?\nCOVID-19 disease is caused by the highly contagious SARS-CoV-2 virus, a type of coronavirus discovered in 2019 that spread rapidly resulting in a global pandemic. Multiple strains of SARS-CoV-2 have since emerged and public health authorities continue to monitor these. The Omicron strain is currently the most dominant variant circulating and has been shown to be more transmissible than previous variants. \nCOVID-19 disease has had vast impacts on society. In addition to the public health implications, the economic, social and mental health effects have been and continue to be enormous.\u00a0\nWhat to look for?\nInfections can be asymptomatic or can result in a spectrum of symptoms, from mild respiratory symptoms to more serious disease affecting multiple organs and systems. Severe disease can lead to hospitalisation and mechanical ventilation, or even death.\u00a0\u00a0\nCommon symptoms of acute COVID-19 infection can include fever, cough, myalgia (body aches), dyspnoea (difficulty breathing), gastrointestinal symptoms (e.g., diarrhoea, nausea or vomiting), headache, sore throat, loss of smell or taste, and rhinorrhoea (runny nose).", "source": "mvec.mcri.edu.au/references/pfizer-biontech-covid-19-vaccine/index.html"}
{"id": "0be329be93f5-1", "text": "Some individuals can experience ongoing symptoms for weeks or months after their initial diagnosis, this is known as long COVID or post-COVID conditions. Symptoms can include extreme fatigue, post-exertional malaise, dyspnoea, chest pain, palpitations, fever, arthralgia (joint pain), paresthesia (pins and needles), rash, hoarse voice, problems with memory and concentration (brain fog), sleep problems, changes with taste or smell, gastrointestinal symptoms, changes in menstrual cycles, weight loss and poor appetite, mood changes (depression, anxiety), and difficulty completing activities of daily living. In addition, long COVID can have a huge impact on an individual\u2019s quality of life, mental health, and ability to participate in work or schooling. Long COVID is more common in people who have experienced severe COVID-19 disease, those who had underlying medical conditions prior to infection (e.g., hypertension, chronic lung disease, diabetes, obesity), and those who are unvaccinated.\nPaediatric Multisystem Inflammatory Syndrome Temporally associated with SARS-CoV-2 (PIMS-TS), or Multisystem Inflammatory Syndrome in Children associated with COVID-19 (MIS-C), is a newly described condition that has been reported in children in the first 2-6 weeks after COVID-19 infection. It is an inflammatory condition, similar to Kawasaki disease, and is characterised by rash, fever, shock and abdominal pain. Children experiencing PIMS-TS almost always require hospitalisation for treatment.\nHow is it transmitted?", "source": "mvec.mcri.edu.au/references/pfizer-biontech-covid-19-vaccine/index.html"}
{"id": "0be329be93f5-2", "text": "How is it transmitted?\nTransmission of COVID-19 is through the inhalation of virus particles which have been made airborne after an infected person coughs, sneezes, breathes, speaks or sings. Droplets or particles can contaminate surfaces and can be spread when a person touches these surfaces and then touches their nose, mouth or eyes. Poorly ventilated settings can also contribute to the spread of COVID-19 as it means aerosol particles can remain suspended in the air for minutes to hours.\nThe incubation period for the disease is 1-14 days, with most individuals displaying symptoms 5-6 days after being exposed. Individuals are thought to be infectious up to 48 hours before symptoms appear and are most infectious in this prodromal period and the early stages of their illness. People with asymptomatic disease can still infect others. \u00a0\nEpidemiology\nSince 2019, over 765 million infections have been reported worldwide contributing to almost 7 million deaths, with true figures likely to be much higher.\u00a0\nIndividuals with immune compromise (due to taking specific medications/therapies or due to a medical condition), advancing age (particularly > 70 years), obesity, respiratory conditions, pregnancy, heart disease, diabetes, renal disease, liver disease, neurological conditions and disability are more likely to experience severe symptoms if infected with SARS-CoV-2.\nCertain occupations, such as working in health care, carry a greater chance of exposure to SARS-CoV-2 and therefore infection.\nPrevention\nStrategies to reduce risk of transmission of COVID-19 disease include standard precautions such as hand hygiene, wearing a mask indoors when remaining socially distant is not possible, and ensuring good ventilation.\u00a0Vaccines can reduce the severity of COVID-19 symptoms and need for hospitalisation.\nPrimary course", "source": "mvec.mcri.edu.au/references/pfizer-biontech-covid-19-vaccine/index.html"}
{"id": "0be329be93f5-3", "text": "Primary course\nA primary course of vaccination is recommended for all individuals from 5 years of age. Immune competent (those with a functioning immune system) individuals should receive 2 doses given 8 weeks apart, whereas those with immunocompromise should receive 3 doses, with 8 weeks between each dose.\nChildren aged 6 months to \u2264 4 years with severe immunocompromise, disability, and those who have complex and/or multiple health conditions which increase the risk of severe COVID-19 should also receive a primary course of COVID-19 vaccination. In this age group a primary course consists of 3 doses of Comirnaty (Pfizer) [maroon cap] with 8 weeks between each dose, regardless of immune function.\nBooster doses\nIn 2023 ATAGI recommends a single COVID-19 booster dose for all adults aged 65 years and over, as well as adults aged 18-64 years with medical comorbidities that increase their risk of severe COVID-19 disease.\nAdults aged 18-64 years (without risk factors for severe COVID-19 disease), and children and adolescents aged 5-17 years (with medical comorbidities that increase their risk of severe disease or with disability or complex health needs) can consider a booster dose. Booster doses are not recommended in anyone less than 5 years of age.\nVaccines brands available for use by age group", "source": "mvec.mcri.edu.au/references/pfizer-biontech-covid-19-vaccine/index.html"}
{"id": "0be329be93f5-4", "text": "Vaccines brands available for use by age group\nAge group Vaccine brand Comirnaty (Pfizer- original) [maroon cap] Comirnaty (Pfizer- original) [orange cap] Comirnaty (Pfizer- original) [purple cap] Comirnaty (Pfizer bivalent- original/BA.1) [grey cap] Comirnaty (Pfizer bivalent- original/BA.4/5) [grey cap] Spikevax (Moderna bivalent- original/BA.1) [blue cap/green label] Spikevax (Moderna bivalent- original/BA.4/5) [pre-filled syringe] Nuvaxovid (Novavax) 6 months- \u2264 4 years \u2713 5 - \u2264 11 years \u2713 12 - \u2264 17 years \u2713 \u2713 \u2713 \u2713 \u2265 18 years \u2713 \u2713 \u2713 \u2713 \u2713 \u2713 \n shaded boxes indicate preferred vaccine type used in each age group.\n shaded boxes indicate that vaccine is not available for use in this age group.\nSide effects following vaccination\nCommon side effects\u00a0\nMost side effects following COVID-19 vaccination are mild and can include pain at the injection site, fatigue, headache, lymphadenopathy and fever.\u00a0\nRare side effects", "source": "mvec.mcri.edu.au/references/pfizer-biontech-covid-19-vaccine/index.html"}
{"id": "0be329be93f5-5", "text": "Rare side effects\u00a0\u00a0\nMyocarditis (inflammation of the heart muscle) and pericarditis (inflammation of the lining around the heart) are rare conditions that have been reported following administration of COVID-19 vaccines. They are most commonly associated with viral infections (including COVID-19 disease) but can also be triggered by other factors such as medications and autoimmune conditions. In the setting of vaccination, the peak risk group for myocarditis is young adult males aged between 16-24 years old following a second dose of vaccination. Pericarditis occurring after vaccination is more common in the 20-45 year old age group for both males and females.\u00a0\nThrombosis with thrombocytopenia (TTS) was a rare condition that was reported to occur in people who had previously received the COVID-19 vaccine Vaxzevria (AstraZeneca). From March 20, 2023 Vaxzevria is no longer available for use in Australia.\nCommonly asked questions\nCan pregnant or breastfeeding women receive COVID-19 vaccines?Yes it is safe to administer COVID-19 vaccines at any stage of pregnancy. Due to an increased risk of severe outcomes for pregnant women and their unborn babies it is recommended that pregnant women have received a primary course of COVID-19 vaccination. Administration of booster doses can also be considered if they are due.\nBreastfeeding women can receive COVID-19 vaccines. They do not need to stop breastfeeding before or after being vaccinated.\nReal world surveillance of international data on mRNA COVID-19 vaccine administration in pregnant women has shown no significant safety concerns for either the mother or the baby. Further to this, antibodies have been detected in the cord blood and breastmilk of vaccinated women, suggesting a transfer of protection to the baby.", "source": "mvec.mcri.edu.au/references/pfizer-biontech-covid-19-vaccine/index.html"}
{"id": "0be329be93f5-6", "text": "Where can I access COVID-19 vaccines?COVID-19 vaccines can be accessed through GP clinics, some pharmacies (for vaccine recipients aged \u2265 5 years) and hospital immunisation services at Monash Children\u2019s Hospital,\u00a0the Royal Children\u2019s Hospital\u00a0and\u00a0Joan Kirner Women\u2019s and Children\u2019s Hospital (Sunshine). To find your closest provider and make an appointment visit the\u00a0Health direct website or phone the coronavirus hotline on 1800 675 398.\nWhat is the recommended interval between COVID-19 infection and vaccination?An interval of 6 months between COVID-19 infection and COVID-19 vaccination (primary dose or booster dose) is recommended.\nCan COVID-19 vaccines be administered on the same day as other vaccines?In most instances COVID-19 vaccines can be co-administered (given on the same day) with other vaccines, and this includes influenza vaccines. The only exception to this is for children aged 6 months to < 5 years, where separating COVID-19 vaccines and other vaccines by 7-14 days is preferred. This recommendation aims to minimise adverse events such as fever, which can occur in the 3 days following inactivated vaccines and 7-10 days post vaccination with the live-attenuated MMR vaccine.", "source": "mvec.mcri.edu.au/references/pfizer-biontech-covid-19-vaccine/index.html"}
{"id": "0be329be93f5-7", "text": "How do we complete a primary course of vaccination for children aged 6 months - \u2264 4 years who commenced their course with Spikevax (Moderna) `{`original/ancestral`}` now that it is no longer available?Immune competent children who commenced their primary course with 1 dose of Spikevax (Moderna), can complete their primary course with 1 dose of age-appropriate Comirnaty (Pfizer) only. Severely immunocompromised children who received 1 dose of Spikevax (Moderna), should receive a further 2 doses of Comirnaty (Pfizer) 8 weeks apart to complete the primary course. Severely immunocompromised children who received 2 doses of Spikevax (Moderna) should receive 1 further dose of Comirnaty (Pfizer) 8 weeks later to complete the primary course.\nResources\nMVEC: Vaccine platforms\u00a0\nMVEC: Immunosuppression and vaccines\nVictorian COVID-19 vaccine safety report\nAustralian Government Department of Health and Aged Care: International COVID-19 vaccines recognised by Australia\nAustralian Government Department of Health: Comirnaty (Pfizer)\u00a0\u00a0\nAustralian Government Department of Health: Spikevax (Moderna)\u00a0\u00a0\nAustralian Government Department of Health: Nuvaxovid (Novavax)\nCDC: Long COVID or post COVID conditions\u00a0\nDepartment of Health Victoria: Coronavirus \u00a0\nATAGI clinical guidance on COVID-19 vaccine administration errors\nAuthors: Francesca Machingaifa (MVEC Education Nurse Coordinator) and Rachael McGuire (MVEC Education Nurse Coordinator)\nReviewed by:\u00a0Rachael McGuire (MVEC Education Nurse Coordinator)\nDate: June 6, 2023\nMaterials in this section are updated as new information and vaccines become available. The Melbourne Vaccine Education Centre (MVEC) staff regularly reviews materials for accuracy.", "source": "mvec.mcri.edu.au/references/pfizer-biontech-covid-19-vaccine/index.html"}
{"id": "0be329be93f5-8", "text": "You should not consider the information in this site to be specific, professional medical advice for your personal health or for your family\u2019s personal health. For medical concerns, including decisions about vaccinations, medications and other treatments, you should always consult a healthcare professional.\nA B C D E F G H I J K L M N O P Q R S T U V W X Y Z", "source": "mvec.mcri.edu.au/references/pfizer-biontech-covid-19-vaccine/index.html"}
{"id": "ac7492ee3070-0", "text": "What is it?\nVaccine-associated enhanced disease (VAED) is a rare phenomenon in which a (usually) more severe clinical presentation of an infection that would normally be seen in an unvaccinated person occurs in someone who has been vaccinated. Antibodies that have been generated from vaccination bind to a pathogen and aide in a virus getting more easily into cells than it would on its own. Vaccines that have been found to cause VAED are no longer in use (see below).\nMechanisms for enhanced disease\nVAED has previously been observed during clinical trials involving individuals receiving inactivated whole-virus vaccines against respiratory syncytial virus (RSV). Clinical trials showed that children who had received the vaccine and then were later diagnosed with RSV infection developed more serious RSV symptoms. As a result, this vaccine was never approved for general use.\nThe other vaccine which has been linked to VAED is one of the earlier versions of the measles vaccines in the 1960s. It was found that following vaccination, children were at higher risk of developing an atypical form of measles disease. This vaccine has since been withdrawn, and the current measles-containing vaccines are not associated with the same adverse effects.\nIn these cases of VAED, the underlying causes remain to be further understood, but possibly relates to an abnormal T-cell (Th2) response.\nAssessment and evaluation", "source": "mvec.mcri.edu.au/references/vaccine-associated-enhanced-disease-vaed/index.html"}
{"id": "ac7492ee3070-1", "text": "Assessment and evaluation\nIt can be difficult to distinguish between vaccine-failure (also known as breakthrough disease) and VAED. Identification of a case of VAED requires the recognition that a clinical presentation is different, atypical, modified or more severe in comparison to the natural disease presentation. Many factors need to be considered when making the assessment, including background rates, age, sex, time post vaccination, duration of disease, clinical course and progression and co-morbidities. Various laboratory and clinical diagnostic parameters can be used to help assess the possibility of VAED, including detailed review of all cases of possible vaccine failure.\nCurrent National Immunisation Program (NIP) vaccines\nThe vaccines currently available through the NIP are not linked to VAED.\nCOVID-19 vaccines\nThere is no evidence to suggest\u00a0VAED is associated with the current COVID-19 vaccines. On the contrary, more COVID-19 related morbidity and mortality has been observed in unvaccinated populations globally. Ongoing surveillance and long-term vaccine follow-up will continue.\nResources\nBrighton Collaboration: Vaccine-associated Enhanced Disease: Case Definition and Guidelines for Data Collection, Analysis, and Presentation of Immunization Safety Data\nCHOP: Antibody-dependent Enhancement (ADE) and Vaccines\nAuthors: Nigel Crawford (Director SAEFVIC, Murdoch Children\u2019s Research Institute), Adele Harris (SAEFVIC Research Nurse, Murdoch Children\u2019s Research Institute) and Georgina Lewis (SAEFVIC Clinical Manager, Murdoch Children\u2019s Research Institute)\nReviewed by: Julia Smith (RCH Immunisation Fellow), Francesca Machingaifa (MVEC Education Nurse Coordinator) and Rachael McGuire (MVEC Education Nurse Coordinator)\nDate: November 29, 2022\nMaterials in this section are updated as new information and vaccines become available. The Melbourne Vaccine Education Centre (MVEC) staff regularly reviews materials for accuracy.", "source": "mvec.mcri.edu.au/references/vaccine-associated-enhanced-disease-vaed/index.html"}
{"id": "ac7492ee3070-2", "text": "You should not consider the information in this site to be specific, professional medical advice for your personal health or for your family\u2019s personal health. For medical concerns, including decisions about vaccinations, medications and other treatments, you should always consult a healthcare professional.\nA B C D E F G H I J K L M N O P Q R S T U V W X Y Z", "source": "mvec.mcri.edu.au/references/vaccine-associated-enhanced-disease-vaed/index.html"}
{"id": "424b9a92cbcf-0", "text": "Injected live-attenuated vaccines such as measles-mumps-rubella (MMR), measles-mumps-rubella-varicella (MMRV) and varicella (chickenpox) monovalent vaccination may be affected by circulating antibodies in immunoglobulin therapy or other blood products. This includes normal human immunoglobulin therapy for conditions like Kawasaki\u2019s disease or a red blood cell, platelet or plasma transfusion for treatment of a medical condition.\nThere are recommended intervals between immunoglobulins or other blood products and administration of injected live attenuated vaccines [see resources].\nThese intervals are based on the expected amount of immunoglobulin (antibody) in the different blood products. Concerns are regarding reduced efficacy of injected live-attenuated vaccines in this setting; there are no additional safety concerns.\nFor some patients requiring regular red-blood cell transfusions for a chronic haematologic condition, it may be considered appropriate to proceed with immunisation with a live-attenuated vaccine. For further details see MVEC: Live-attenuated vaccines in patients receiving regular red blood cell transfusions.\nNote that inactivated (non-live) vaccines can be safely administered at any time following blood products.\nResources\nAustralian Immunisation Handbook: Intervals between immunoglobulins or blood products and MMR, MMRV or varicella vaccination\nAustralian Immunisation Handbook: Vaccination for people who have recently received normal human immunoglobulin and other blood products\nMVEC: Live-attenuated vaccines in patients receiving regular red blood cell transfusions\nAuthors: Nigel Crawford (Director, SAEFVIC, Murdoch Children\u2019s Research Institute) and\u00a0Rachael McGuire (SAEFVIC Research Nurse, Murdoch Children\u2019s Research Institute)\nReviewed by: Luisa Clucas (MVEC Immunisation Fellow)\nDate: July 2020", "source": "mvec.mcri.edu.au/references/live-attenuated-vaccines-and-immunoglobulins-or-blood-products/index.html"}
{"id": "424b9a92cbcf-1", "text": "Date: July 2020\nMaterials in this section are updated as new information and vaccines become available. The Melbourne Vaccine Education Centre (MVEC) staff regularly reviews materials for accuracy.\nYou should not consider the information in this site to be specific, professional medical advice for your personal health or for your family\u2019s personal health. For medical concerns, including decisions about vaccinations, medications and other treatments, you should always consult a healthcare professional.\nA B C D E F G H I J K L M N O P Q R S T U V W X Y Z", "source": "mvec.mcri.edu.au/references/live-attenuated-vaccines-and-immunoglobulins-or-blood-products/index.html"}
{"id": "db7ca8a7345a-0", "text": "Travel medicine focuses on disease prevention and injury risk minimisation with advice based upon the travelling person\u2019s individual circumstances such as the location and purpose of travel, duration and time of year, as well as any underlying medical conditions or other risk factors.\nWhere to get travel advice\nGeneral Practitioners and travel medicine clinics can provide recommendations for preventative care and offer vaccination. There are also paediatricians who specialise in infectious diseases or immunisation who can provide advice for children (and their families). There are also a number of excellent websites that can be accessed to obtain country specific updates and information on emerging infections [see Resources below].\nWhen to seek advice\nFor specific pre-travel advice, consultation with a health care professional is best done a minimum of 4-6 weeks prior to departure, which allows time to develop immunity following any recommended vaccines prior to arrival at the travel destination. Depending on which vaccines are recommended, a course of vaccines over time may be indicated before a person is considered fully protected.\nAs most travel specialists require a GP referral and may have wait times for an appointment, it is important to factor this into travel planning timelines.\nVaccines\nSome routine vaccines can be given earlier than scheduled or as additional doses for the purposes of travel. Examples of this include:\nMMR (measles, mumps and rubella) vaccine: an extra, funded dose can be administered between the age of 6-11 months if travelling to an area where measles are endemic\nMeningococcal vaccines:\nMenACWY (Nimenrix) vaccines can be administered from 6 weeks of age in order to provide earlier protection (scheduled on the NIP at 12 months of age and in year 10 of secondary school)", "source": "mvec.mcri.edu.au/references/travel-medicine/index.html"}
{"id": "db7ca8a7345a-1", "text": "Meningococcal B (Bexsero) vaccines can also be given from 6 weeks of age (not funded on the National Immunisation Program (NIP) for all, but can be purchased privately for those who do not qualify for a funded dose)\nInfluenza vaccine: depending on the time of year and destination of travel, it may be advisable to receive an influenza vaccine\nCOVID-19 vaccines: due to ongoing emerging strains of COVID-19 disease, it is important to ensure a primary course of COVID-19 vaccination is complete along with any recommended boosters based on current recommendations.\nOther travel-related vaccines, depending on your location and duration of travel might include:\nBCG\nCholera\nHepatitis A\nJapanese encephalitis\nTyphoid\nRabies\nYellow fever\nOther precautions\nOther preparations for travel may include:\nconsidering the need for malaria prophylaxis (medication to prevent malaria)\nmeasures to prevent mosquito-borne disease such as wearing long-sleeved clothing, mosquito nets, and insect repellent than contains DEET\nfood and water safety.\nImmunocompromised and pregnant travellers\nIndividuals who are immunocompromised as a result of a medical condition or specific therapies are encouraged to seek travel advice early to maximise protection against vaccine preventable diseases prior to travel.\nSimilarly, women who are planning pregnancy or who are pregnant, should seek travel advice as early as possible to ensure optimum protection for both the mother and unborn baby. Women planning pregnancy with a high likelihood of travel, should consider vaccination prior to pregnancy noting that live-attenuated vaccines are contraindicated during pregnancy.\nVisiting friends and relatives (VFR)", "source": "mvec.mcri.edu.au/references/travel-medicine/index.html"}
{"id": "db7ca8a7345a-2", "text": "Visiting friends and relatives (VFR)\nVFR travel is one of the most common reasons for international travel. A VFR traveller is an immigrant who travels from the high-income country they are living in to their lower-income country of birth to visit friends or relatives. A travel consult prior to VFR travel should consider whether an individual has had routine NIP vaccines or a history of vaccine preventable disease/s as well as vaccines indicated for the country they are travelling to. Rates of some travel-related infections are higher in this population and taking appropriate precautions such as vaccination and considering food and water safety is important in ensuring optimum protection.\nResources\nMVEC travel related resources\nBCG vaccine\nInfluenza\nMeasles\nRabies\nYellow fever\nTyphoid\u00a0\nMeningococcal\nOther resources\nDepartment of Health Victoria: Yellow fever vaccination centres\nThe RCH kids info- travel health advice\nCentres for Disease Control and Prevention (CDC): Travelers\u2019 health\nBug off\nTravel health pro- travel health website\nAuthors: Nigel Crawford (Director SAEFVIC, Murdoch Children\u2019s Research Institute) and\u00a0Rachael McGuire (SAEFVIC Research Nurse, Murdoch Children\u2019s Research Institute)\nReviewed by: Rachael Purcell (RCH Immunisation Fellow), Francesca Machingaifa (MVEC Education Nurse Coordinator) and Rachael McGuire (MVEC Education Nurse Coordinator)\nDate: June 8, 2023\nMaterials in this section are updated as new information and vaccines become available. The Melbourne Vaccine Education Centre (MVEC) staff regularly reviews materials for accuracy.\nYou should not consider the information in this site to be specific, professional medical advice for your personal health or for your family\u2019s personal health. For medical concerns, including decisions about vaccinations, medications and other treatments, you should always consult a healthcare professional.", "source": "mvec.mcri.edu.au/references/travel-medicine/index.html"}
{"id": "db7ca8a7345a-3", "text": "A B C D E F G H I J K L M N O P Q R S T U V W X Y Z", "source": "mvec.mcri.edu.au/references/travel-medicine/index.html"}
{"id": "8dc4a5a4c29d-0", "text": "What is it?\nCOVID-19 disease is caused by the highly contagious SARS-CoV-2 virus, a type of coronavirus discovered in 2019 that spread rapidly resulting in a global pandemic. Multiple strains of SARS-CoV-2 have since emerged and public health authorities continue to monitor these. The Omicron strain is currently the most dominant variant circulating and has been shown to be more transmissible than previous variants. \nCOVID-19 disease has had vast impacts on society. In addition to the public health implications, the economic, social and mental health effects have been and continue to be enormous.\u00a0\nWhat to look for?\nInfections can be asymptomatic or can result in a spectrum of symptoms, from mild respiratory symptoms to more serious disease affecting multiple organs and systems. Severe disease can lead to hospitalisation and mechanical ventilation, or even death.\u00a0\u00a0\nCommon symptoms of acute COVID-19 infection can include fever, cough, myalgia (body aches), dyspnoea (difficulty breathing), gastrointestinal symptoms (e.g., diarrhoea, nausea or vomiting), headache, sore throat, loss of smell or taste, and rhinorrhoea (runny nose).", "source": "mvec.mcri.edu.au/references/covid-19/index.html"}
{"id": "8dc4a5a4c29d-1", "text": "Some individuals can experience ongoing symptoms for weeks or months after their initial diagnosis, this is known as long COVID or post-COVID conditions. Symptoms can include extreme fatigue, post-exertional malaise, dyspnoea, chest pain, palpitations, fever, arthralgia (joint pain), paresthesia (pins and needles), rash, hoarse voice, problems with memory and concentration (brain fog), sleep problems, changes with taste or smell, gastrointestinal symptoms, changes in menstrual cycles, weight loss and poor appetite, mood changes (depression, anxiety), and difficulty completing activities of daily living. In addition, long COVID can have a huge impact on an individual\u2019s quality of life, mental health, and ability to participate in work or schooling. Long COVID is more common in people who have experienced severe COVID-19 disease, those who had underlying medical conditions prior to infection (e.g., hypertension, chronic lung disease, diabetes, obesity), and those who are unvaccinated.\nPaediatric Multisystem Inflammatory Syndrome Temporally associated with SARS-CoV-2 (PIMS-TS), or Multisystem Inflammatory Syndrome in Children associated with COVID-19 (MIS-C), is a newly described condition that has been reported in children in the first 2-6 weeks after COVID-19 infection. It is an inflammatory condition, similar to Kawasaki disease, and is characterised by rash, fever, shock and abdominal pain. Children experiencing PIMS-TS almost always require hospitalisation for treatment.\nHow is it transmitted?", "source": "mvec.mcri.edu.au/references/covid-19/index.html"}
{"id": "8dc4a5a4c29d-2", "text": "How is it transmitted?\nTransmission of COVID-19 is through the inhalation of virus particles which have been made airborne after an infected person coughs, sneezes, breathes, speaks or sings. Droplets or particles can contaminate surfaces and can be spread when a person touches these surfaces and then touches their nose, mouth or eyes. Poorly ventilated settings can also contribute to the spread of COVID-19 as it means aerosol particles can remain suspended in the air for minutes to hours.\nThe incubation period for the disease is 1-14 days, with most individuals displaying symptoms 5-6 days after being exposed. Individuals are thought to be infectious up to 48 hours before symptoms appear and are most infectious in this prodromal period and the early stages of their illness. People with asymptomatic disease can still infect others. \u00a0\nEpidemiology\nSince 2019, over 765 million infections have been reported worldwide contributing to almost 7 million deaths, with true figures likely to be much higher.\u00a0\nIndividuals with immune compromise (due to taking specific medications/therapies or due to a medical condition), advancing age (particularly > 70 years), obesity, respiratory conditions, pregnancy, heart disease, diabetes, renal disease, liver disease, neurological conditions and disability are more likely to experience severe symptoms if infected with SARS-CoV-2.\nCertain occupations, such as working in health care, carry a greater chance of exposure to SARS-CoV-2 and therefore infection.\nPrevention\nStrategies to reduce risk of transmission of COVID-19 disease include standard precautions such as hand hygiene, wearing a mask indoors when remaining socially distant is not possible, and ensuring good ventilation.\u00a0Vaccines can reduce the severity of COVID-19 symptoms and need for hospitalisation.\nPrimary course", "source": "mvec.mcri.edu.au/references/covid-19/index.html"}
{"id": "8dc4a5a4c29d-3", "text": "Primary course\nA primary course of vaccination is recommended for all individuals from 5 years of age. Immune competent (those with a functioning immune system) individuals should receive 2 doses given 8 weeks apart, whereas those with immunocompromise should receive 3 doses, with 8 weeks between each dose.\nChildren aged 6 months to \u2264 4 years with severe immunocompromise, disability, and those who have complex and/or multiple health conditions which increase the risk of severe COVID-19 should also receive a primary course of COVID-19 vaccination. In this age group a primary course consists of 3 doses of Comirnaty (Pfizer) [maroon cap] with 8 weeks between each dose, regardless of immune function.\nBooster doses\nIn 2023 ATAGI recommends a single COVID-19 booster dose for all adults aged 65 years and over, as well as adults aged 18-64 years with medical comorbidities that increase their risk of severe COVID-19 disease.\nAdults aged 18-64 years (without risk factors for severe COVID-19 disease), and children and adolescents aged 5-17 years (with medical comorbidities that increase their risk of severe disease or with disability or complex health needs) can consider a booster dose. Booster doses are not recommended in anyone less than 5 years of age.\nVaccines brands available for use by age group", "source": "mvec.mcri.edu.au/references/covid-19/index.html"}
{"id": "8dc4a5a4c29d-4", "text": "Vaccines brands available for use by age group\nAge group Vaccine brand Comirnaty (Pfizer- original) [maroon cap] Comirnaty (Pfizer- original) [orange cap] Comirnaty (Pfizer- original) [purple cap] Comirnaty (Pfizer bivalent- original/BA.1) [grey cap] Comirnaty (Pfizer bivalent- original/BA.4/5) [grey cap] Spikevax (Moderna bivalent- original/BA.1) [blue cap/green label] Spikevax (Moderna bivalent- original/BA.4/5) [pre-filled syringe] Nuvaxovid (Novavax) 6 months- \u2264 4 years \u2713 5 - \u2264 11 years \u2713 12 - \u2264 17 years \u2713 \u2713 \u2713 \u2713 \u2265 18 years \u2713 \u2713 \u2713 \u2713 \u2713 \u2713 \n shaded boxes indicate preferred vaccine type used in each age group.\n shaded boxes indicate that vaccine is not available for use in this age group.\nSide effects following vaccination\nCommon side effects\u00a0\nMost side effects following COVID-19 vaccination are mild and can include pain at the injection site, fatigue, headache, lymphadenopathy and fever.\u00a0\nRare side effects", "source": "mvec.mcri.edu.au/references/covid-19/index.html"}
{"id": "8dc4a5a4c29d-5", "text": "Rare side effects\u00a0\u00a0\nMyocarditis (inflammation of the heart muscle) and pericarditis (inflammation of the lining around the heart) are rare conditions that have been reported following administration of COVID-19 vaccines. They are most commonly associated with viral infections (including COVID-19 disease) but can also be triggered by other factors such as medications and autoimmune conditions. In the setting of vaccination, the peak risk group for myocarditis is young adult males aged between 16-24 years old following a second dose of vaccination. Pericarditis occurring after vaccination is more common in the 20-45 year old age group for both males and females.\u00a0\nThrombosis with thrombocytopenia (TTS) was a rare condition that was reported to occur in people who had previously received the COVID-19 vaccine Vaxzevria (AstraZeneca). From March 20, 2023 Vaxzevria is no longer available for use in Australia.\nCommonly asked questions\nCan pregnant or breastfeeding women receive COVID-19 vaccines?Yes it is safe to administer COVID-19 vaccines at any stage of pregnancy. Due to an increased risk of severe outcomes for pregnant women and their unborn babies it is recommended that pregnant women have received a primary course of COVID-19 vaccination. Administration of booster doses can also be considered if they are due.\nBreastfeeding women can receive COVID-19 vaccines. They do not need to stop breastfeeding before or after being vaccinated.\nReal world surveillance of international data on mRNA COVID-19 vaccine administration in pregnant women has shown no significant safety concerns for either the mother or the baby. Further to this, antibodies have been detected in the cord blood and breastmilk of vaccinated women, suggesting a transfer of protection to the baby.", "source": "mvec.mcri.edu.au/references/covid-19/index.html"}
{"id": "8dc4a5a4c29d-6", "text": "Where can I access COVID-19 vaccines?COVID-19 vaccines can be accessed through GP clinics, some pharmacies (for vaccine recipients aged \u2265 5 years) and hospital immunisation services at Monash Children\u2019s Hospital,\u00a0the Royal Children\u2019s Hospital\u00a0and\u00a0Joan Kirner Women\u2019s and Children\u2019s Hospital (Sunshine). To find your closest provider and make an appointment visit the\u00a0Health direct website or phone the coronavirus hotline on 1800 675 398.\nWhat is the recommended interval between COVID-19 infection and vaccination?An interval of 6 months between COVID-19 infection and COVID-19 vaccination (primary dose or booster dose) is recommended.\nCan COVID-19 vaccines be administered on the same day as other vaccines?In most instances COVID-19 vaccines can be co-administered (given on the same day) with other vaccines, and this includes influenza vaccines. The only exception to this is for children aged 6 months to < 5 years, where separating COVID-19 vaccines and other vaccines by 7-14 days is preferred. This recommendation aims to minimise adverse events such as fever, which can occur in the 3 days following inactivated vaccines and 7-10 days post vaccination with the live-attenuated MMR vaccine.", "source": "mvec.mcri.edu.au/references/covid-19/index.html"}
{"id": "8dc4a5a4c29d-7", "text": "How do we complete a primary course of vaccination for children aged 6 months - \u2264 4 years who commenced their course with Spikevax (Moderna) `{`original/ancestral`}` now that it is no longer available?Immune competent children who commenced their primary course with 1 dose of Spikevax (Moderna), can complete their primary course with 1 dose of age-appropriate Comirnaty (Pfizer) only. Severely immunocompromised children who received 1 dose of Spikevax (Moderna), should receive a further 2 doses of Comirnaty (Pfizer) 8 weeks apart to complete the primary course. Severely immunocompromised children who received 2 doses of Spikevax (Moderna) should receive 1 further dose of Comirnaty (Pfizer) 8 weeks later to complete the primary course.\nResources\nMVEC: Vaccine platforms\u00a0\nMVEC: Immunosuppression and vaccines\nVictorian COVID-19 vaccine safety report\nAustralian Government Department of Health and Aged Care: International COVID-19 vaccines recognised by Australia\nAustralian Government Department of Health: Comirnaty (Pfizer)\u00a0\u00a0\nAustralian Government Department of Health: Spikevax (Moderna)\u00a0\u00a0\nAustralian Government Department of Health: Nuvaxovid (Novavax)\nCDC: Long COVID or post COVID conditions\u00a0\nDepartment of Health Victoria: Coronavirus \u00a0\nATAGI clinical guidance on COVID-19 vaccine administration errors\nAuthors: Francesca Machingaifa (MVEC Education Nurse Coordinator) and Rachael McGuire (MVEC Education Nurse Coordinator)\nReviewed by:\u00a0Rachael McGuire (MVEC Education Nurse Coordinator)\nDate: June 6, 2023\nMaterials in this section are updated as new information and vaccines become available. The Melbourne Vaccine Education Centre (MVEC) staff regularly reviews materials for accuracy.", "source": "mvec.mcri.edu.au/references/covid-19/index.html"}
{"id": "8dc4a5a4c29d-8", "text": "You should not consider the information in this site to be specific, professional medical advice for your personal health or for your family\u2019s personal health. For medical concerns, including decisions about vaccinations, medications and other treatments, you should always consult a healthcare professional.\nA B C D E F G H I J K L M N O P Q R S T U V W X Y Z", "source": "mvec.mcri.edu.au/references/covid-19/index.html"}
{"id": "6f035cb73659-0", "text": "Background\nChildhood cardiac disease can be congenital or acquired. Congenital cardiac disease describes a number of conditions including malformations of the heart, major blood vessels or heart valves. Approximately 1 in 100 babies born in Australia each year will have some form of congenital heart disease. Acquired cardiac disease can include rheumatic heart disease or cardiac disease secondary to Kawasaki disease.\nChildren with underlying cardiac disease are at increased risk of complications of vaccine preventable diseases when compared to children who do not have cardiac disease. This can be exacerbated by an increased risk of exposure due to the need for frequent health care appointments and hospital stays. Those at highest risk include children with cyanotic heart disease or cardiac failure.\nVaccine recommendations\nChildren with cardiac disease can safely receive vaccines according to the National Immunisation Program (NIP) vaccine schedule. Additional vaccines such as pneumococcal, influenza and COVID-19 vaccines are also recommended (see Table 1).\nFamily members and household contacts are recommended to be up to date with all vaccines including pertussis, annual influenza and COVID-19 vaccines. Close contacts of children with cardiac disease can receive live-attenuated vaccines without the need for additional precautions.\nTable 1: Vaccine recommendations for children with cardiac disease\nVaccine\nRecommendation\nInfluenza\nAnnual influenza vaccines are recommended from 6 months of age. Two doses of age-appropriate vaccines are required in the first year of vaccination for children < 9 years.\nPneumococcal", "source": "mvec.mcri.edu.au/references/children-with-cardiac-disease/index.html"}
{"id": "6f035cb73659-1", "text": "Pneumococcal\nAn additional pneumococcal conjugate vaccine (Prevenar 13\u00ae) is recommended at 6 months of age (or at diagnosis, whichever is later). A pneumococcal polysaccharide vaccine (Pneumovax 23\u00ae) should be given at 4 years of age (minimum 8 weeks post Prevenar13, whichever is later), followed by another dose at least 5 years later (max. 2 doses in a lifetime).\nCOVID-19\nChildren with cardiac disease are at a greater risk of severe COVID disease. A primary course of COVID-19 vaccines are recommended for children aged 6 months and above with further booster doses recommended for those aged \u2265 12 years.\nTravel vaccines\nSpecialist travel advice should be sought when travelling overseas, particularly to high risk areas for vaccine preventable diseases.\nChildren with cardiac disease who are to undergo a transplant should also receive further vaccines as part of their workup prior to transplant.\nImmunisation queries should be directed to the treating doctor and/or the Royal Children\u2019s Hospital Immunisation Service.\nVaccine precautions\nPrecautions are recommended when vaccinating children with cardiac disease in the following circumstances:\nin children who are immunocompromised, live-attenuated vaccines may be contraindicated\nchildren who have received blood products/and or immunoglobulin may need to delay vaccination\nif children are also asplenic or have hyposplenism, further additional vaccines are recommended\nchildren for whom cardiac surgery is indicated:\nbefore surgery \u2013 inactivated vaccines can be administered up until 1 week prior to surgery, live-attenuated vaccines can be administered up until 3 weeks prior to surgery (e.g. MMR, varicella)\nvaccines indicated following surgery should be delayed for at least one week due to the potential for confusing expected vaccine side effects with post-operative complications.", "source": "mvec.mcri.edu.au/references/children-with-cardiac-disease/index.html"}
{"id": "6f035cb73659-2", "text": "Resources\nMVEC: Influenza vaccine recommendations\nMVEC: COVID-19 vaccination in children and adolescents\nMVEC: Pneumococcal\nMVEC: Needle phobia\nDepartment of Health: Immunisation for people with medical risk conditions\nHeart Kids: Congenital heart disease and COVID-19\nAuthor: Kirsten Mitchell (SAEFVIC Research Nurse, Murdoch Children\u2019s Research Institute)\nReviewed by: Francesca Machingaifa (MVEC Education Nurse Coordinator) and Rachael McGuire (MVEC Education Nurse Coordinator)\nDate: August 5, 2022\nMaterials in this section are updated as new information and vaccines become available. The Melbourne Vaccine Education Centre (MVEC) staff regularly reviews materials for accuracy. You should not consider the information in this site to be specific, professional medical advice for your personal health or for your family\u2019s personal health. For medical concerns, including decisions about vaccinations, medications and other treatments, you should always consult a healthcare professional.\nA B C D E F G H I J K L M N O P Q R S T U V W X Y Z", "source": "mvec.mcri.edu.au/references/children-with-cardiac-disease/index.html"}
{"id": "3715f46c4b54-0", "text": "Adolescence is an important time to consider the risk of vaccine preventable diseases and the benefits of immunisation. By adolescence, immunity previously obtained from childhood vaccines can begin to decline and certain behaviours or risk factors can mean that individuals in this age group are vulnerable to other vaccine preventable diseases. As a result \u2018booster\u2019 doses of previous vaccines, as well as additional vaccines, are recommended. Many of these vaccines are offered for free on the National Immunisation Program (NIP) as part of the secondary school immunisation program (SSIP). Other recommended vaccines can be provided at cost.\nWhere to access vaccines\nNIP vaccines are provided to secondary school students at school during school hours. They are also available at council-run immunisation sessions, through GP clinics, as well as some accredited pharmacies.\nConsent\nGenerally speaking, a parent, legal guardian or other medical treatment decision maker of a child (under the age of 18 years) can provide consent for vaccination on their behalf.\nIn some circumstances a child or adolescent may be determined as mature enough to understand the proposed procedure explained to them by a medical practitioner or experienced immuniser (Gillick competence). In these circumstances they may provide their own consent.\nIf a child or adolescent refuses a vaccination after valid consent has been provided, it is important to respect their wishes and withhold vaccination.\nNational Immunisation Program vaccines\nHuman papillomavirus (HPV)", "source": "mvec.mcri.edu.au/references/adolescent-immunisation/index.html"}
{"id": "3715f46c4b54-1", "text": "National Immunisation Program vaccines\nHuman papillomavirus (HPV)\nUp to 90% of the population will be infected with a human papillomavirus (HPV) strain within their lifetime. Most HPV infections have no clinical symptoms. This means that people infected with HPV often do not know they have it and can continue transmitting the virus to others. Strains of HPV are most commonly sexually transmitted. \u00a0Vaccination against HPV can prevent genital warts and cancers caused by the disease. HPV vaccination (Gardasil\u00ae9) is provided as a single dose (for immunocompetent individuals) administered in year 7 (12-14 years of age). Adolescents with immunocompromise are recommended to receive a 3-dose course for optimal protection.\nDiptheria-tetanus-pertussis\nA primary course of diphtheria\u2013tetanus\u2013pertussis (DTPa) is administered in early childhood with a booster dose of dTpa recommended for adolescents in order to provide ongoing protection into adulthood. A single dose of dTpa (Boostrix\u00ae) is administered in year 7 (12-14 years of age).\nMeningococcal ACWY\nMeningococcal disease is caused by the bacteria\u00a0Neisseria meningitidis.\u00a0There are 13 known sub-types (serogroups) and of these, 5 are currently vaccine preventable (B and A, C, W, Y).", "source": "mvec.mcri.edu.au/references/adolescent-immunisation/index.html"}
{"id": "3715f46c4b54-2", "text": "Meningococcal disease is most prevalent in children aged \u2264 2 years, however there is another peak in disease among adolescents and young adults aged 15-24 years. A single dose of meningococcal ACWY (Nimenrix\u00ae) is funded for adolescents in year 10, with a catch up program available for those who missed this dose (15-19 years). Those with special risk factors (eg. immune suppression or asplenia) are also recommended to receive additional doses of meningococcal ACWY.\nAdditional recommended vaccines\nMeningococcal B\nSerogroups B, C, W and Y account for the highest number of cases of invasive meningococcal disease (IMD) in Australia. Whilst a meningococcal ACWY vaccine is funded as part of the school program, meningococcal B vaccines (Bexsero\u00ae or Trumenba\u00ae) are not currently funded in the adolescent population, but are, however, strongly recommended.\nCOVID-19\nA primary course of COVID-19 vaccination is recommended for all adolescents. Booster doses are recommended for adolescents with medical comorbidities that increase their risk of severe COVID-19 disease, or those who have a disability with significant or complex medical needs.\nWhilst adolescents have been shown to experience less severe COVID-19 disease, infection rates in this age group have been shown to be similar to adults. Impacts on adolescents such as mental health harms and disruptions to socialisation and education should also be considered. Vaccinating adolescents against COVID-19 is recommended to prevent infection, severe disease and death, as well as long COVID and paediatric multi-system inflammatory syndrome (PIMS-TS).\nInfluenza", "source": "mvec.mcri.edu.au/references/adolescent-immunisation/index.html"}
{"id": "3715f46c4b54-3", "text": "Influenza\nAnnual influenza vaccination is safe and strongly recommended for all adolescents. It is funded on the NIP for some at risk groups such as Aboriginal and Torres Strait Islander adolescents, and those with cardiac disease, severe asthma or diabetes. Those who are not funded to receive influenza vaccines and still wish to be vaccinated can purchase vaccines for a small fee.\nResources\nVictorian program information\nVictorian Department of Health: Secondary school vaccination program for adolescents\nOther resources\nMVEC: Needle phobia\nRaising Children Net: COVID-19 vaccination- children and teenagers\nAuthors: Nigel Crawford (Director, SAEFVIC, Murdoch Children\u2019s Research Institute), Mel Addison (SAEFVIC Research Nurse, Murdoch Children\u2019s Research Institute), and Rachael McGuire (MVEC Education Nurse Coordinator)\nReviewed by: Rachael McGuire (MVEC Education Nurse Coordinator)\nDate: April 11, 2023\nMaterials in this section are updated as new information and vaccines become available. The Melbourne Vaccine Education Centre (MVEC) staff regularly reviews materials for accuracy.\nYou should not consider the information in this site to be specific, professional medical advice for your personal health or for your family\u2019s personal health. For medical concerns, including decisions about vaccinations, medications and other treatments, you should always consult a healthcare professional.\nA B C D E F G H I J K L M N O P Q R S T U V W X Y Z", "source": "mvec.mcri.edu.au/references/adolescent-immunisation/index.html"}
{"id": "dc5f7bded0e4-0", "text": "Background\nA vaccine mandate means that proof of vaccination, or an authorised medical exemption, is required in certain settings. Mandating is generally considered a late step in optimising vaccine uptake, as it is important to ensure vaccine access is available in an equitable way, before progressing to a mandate. Vaccine mandates may vary depending on the jurisdiction and there may be some variations around Australia. The following information is specific to Victoria, and refers to COVID-19 and influenza vaccine directions, as well as the \u2018no jab, no play\u2019 and \u2018no jab, no pay\u2019 policies.\nVaccine specific directions\nCOVID-19Vaccination against COVID-19 protects against developing severe disease that may lead to hospital admission, intensive care or even death. Due to the occupational risk for disease exposure and transmission as well as having increased contact with vulnerable groups, workers in the following settings must be fully vaccinated against COVID-19 (regardless of whether they have patient contact or not):\npublic, private and denominational hospitals\npublic health services\nprivate day procedure centres\nambulance services\npatient transport services engaged by a health service or Ambulance Victoria\nresidential aged care services that are operated by public health services.\nTo be considered fully vaccinated, individuals \u2265 18 years must have completed a primary schedule of COVID-19 vaccination plus a booster dose and those aged < 18 years must have completed a primary schedule.\nFor further information refer to DH: Vaccination for healthcare workers.\nInfluenzaInfluenza vaccination is recommended for all individuals aged 6 months and over. Due to an increased risk of exposure to, and transmission of influenza disease it is mandatory that workers in the following settings are vaccinated against influenza annually (regardless of whether they have patient contact or not):\npublic, private and denominational hospitals\npublic health services\nprivate day procedure centres\nambulance services\npatient transport services engaged by a health service or Ambulance Victoria", "source": "mvec.mcri.edu.au/references/mandatory-vaccine-directions-in-victoria/index.html"}
{"id": "dc5f7bded0e4-1", "text": "ambulance services\npatient transport services engaged by a health service or Ambulance Victoria\nresidential aged care services that are operated by public health services\nForensicare.\nFor further information, refer to\u00a0DH: Vaccination for healthcare workers.\nPolicy specific vaccine directions\nNo jab, no play\u201cNo jab, no play\u201d legislation was introduced by the Victorian State Government on January 1st, 2016, in an effort to improve vaccination rates and reduce the spread of vaccine preventable diseases, This legislation requires confirmation of up to date vaccination status according to the National Immunisation Program (NIP) when enrolling in all early childhood education and care services including childcare and kindergarten. This legislation does not apply to enrolment into school.\nA current Immunisation History Statement (IHS) provided by the Australian Immunisation Register (AIR) is the only accepted proof of immunisation when enrolling in early childhood education and care services.\nNo jab, no pay\u201cNo jab, no pay\u201d legislation was introduced by the Federal Government on July 1, 2018, altering Family Tax Benefit (FTB) Part A payments and childcare subsidies if a child is not up to date for age with their scheduled immunisations as per the NIP. Recipients of FTB part A or child-care fee assistance will need to meet these immunisation requirements to ensure that payments are not reduced.\nResponsibilities of the employer/service provider and the employee/vaccinee\nEmployers and service providers are responsible for ensuring that employees/enrolees in early childhood education and care services comply with relevant orders. The employer or service provider is required to sight and store evidence of mandated vaccination status or medical exemption, if applicable.\nIt is the responsibility of the employee to be vaccinated against mandated vaccines for their profession or have a valid medical exemption.\nIt is the responsibility of individual receiving Family Tax Benefits and childcare subsidies to ensure that children are up to date with the NIP.\nMedical exemptions", "source": "mvec.mcri.edu.au/references/mandatory-vaccine-directions-in-victoria/index.html"}
{"id": "dc5f7bded0e4-2", "text": "Medical exemptions\nExemption to vaccination can be granted to individuals following assessment by an authorised practitioner who deems deferral of vaccination to be warranted. Exemptions may be permanent or temporary.\nAll medical exemptions to vaccination will be recorded on the individuals Immunisation History Statement on the\u00a0Australian Immunisation Register which can be accessed via myGOV.\nIndividuals who have previously experienced or who are at higher risk of experiencing a serious adverse event following vaccination should be referred to a specialist immunisation service. Individuals who have experienced a previous adverse event following vaccination should also be reported to\u00a0SAEFVIC.\nPermanent medical exemptionsAnaphylaxis to a previous dose of the same vaccine\u00a0or\u00a0anaphylaxis to a component of the same vaccine are the only two absolute contraindications to vaccination and warrant permanent medical exemption. Permanent exemptions to some routine vaccines can also be provided when an individual has documented evidence of natural immunity against that vaccine preventable disease (eg. varicella, measles-mumps-rubella or hepatitis B).\nIn addition, there are a small group of specific medical conditions precluding some individuals from receiving certain COVID-19 vaccine brands. For more information refer to MVEC: VicSIS.\nTemporary medical exemptionsTemporary exemptions to vaccination can also be granted in circumstances such as acute major medical illness, significant immunocompromise of short duration (for live-attenuated vaccines only), the individual is pregnant (live-attenuated vaccines only). Individuals with a confirmed history of COVID-19 infection can have their COVID-19 vaccination deferred for up to 4 months).\nChildren on an approved catch-up schedule will be automatically granted a grace period of 6 months to complete their outstanding vaccines and be up to date with the NIP.\nAuthorising providersGeneral practitioners defined by the\u00a0Health Insurance Act 1973\u00a0as:\nfellows of the Royal Australian College of General Practitioners", "source": "mvec.mcri.edu.au/references/mandatory-vaccine-directions-in-victoria/index.html"}
{"id": "dc5f7bded0e4-3", "text": "fellows of the Royal Australian College of General Practitioners\nfellows of the Australian College of Rural and Remote Medicine\non Medicare\u2019s Vocation Register of General Practitioners\nor:\na practice registrar on an approved 3GA training placement\na paediatrician\na public health physician\nan infectious diseases physician\na clinical immunologist.\nResources\nGeneral\nDH: Vaccination for healthcare workers\nMVEC: Victorian Specialist Immunisation Services (VicSIS)\nServices Australia: Record a medical contraindication\u00a0\nServices Australia: Australian Immunisation Register (AIR) \u2013 immunisation medical exemption form (IM011)\nCOVID-19 and influenza\nDH: Vaccination for healthcare workers\nATAGI Clinical guidance for COVID-19 vaccine providers\nATAGI Expanded Guidance on temporary medical exemptions for COVID-19 vaccines\nDiscussion guide for medical exemptions\nHealth Services Amendment (Mandatory Vaccination of Healthcare Workers) Act 2020\nNo jab no play/No jab no pay\nDH: No Jab No Play \u2013 Resources for providers\nDH: No Jab No Play \nBetter Health Channel \u2013 No Jab No Play\nDH: Immunisation schedule Victoria and vaccine eligibility criteria\u00a0\nAuthors: Rachael McGuire (MVEC Education Nurse Coordinator) and Francesca Machingaifa (MVEC Education Nurse Coordinator)\nReviewed by: Rachael McGuire (MVEC Education Nurse Coordinator) and Francesca Machingaifa (MVEC Education Nurse Coordinator)\nDate: April 4, 2023\nMaterials in this section are updated as new information and vaccines become available. The Melbourne Vaccine Education Centre (MVEC) staff regularly reviews materials for accuracy.\nYou should not consider the information in this site to be specific, professional medical advice for your personal health or for your family\u2019s personal health. For medical concerns, including decisions about vaccinations, medications and other treatments, you should always consult a healthcare professional.", "source": "mvec.mcri.edu.au/references/mandatory-vaccine-directions-in-victoria/index.html"}
{"id": "dc5f7bded0e4-4", "text": "A B C D E F G H I J K L M N O P Q R S T U V W X Y Z", "source": "mvec.mcri.edu.au/references/mandatory-vaccine-directions-in-victoria/index.html"}
{"id": "dfeccbfb8538-0", "text": "It is recommended that injected live-attenuated vaccines such as measles-mumps-rubella (MMR), measles-mumps-rubella-varicella (MMRV) and varicella (V)/(chickenpox) be deferred for a period of time after transfusion of immunoglobulin containing blood products, including red blood cells [see MVEC: Live-attenuated vaccines and immunoglobulins or blood products]. These recommendations are based on the potential for passive transfer of immunoglobulin (IgG) in the transfused product to affect the immune response to the vaccine.\nPatients requiring regular red-blood cell transfusions for a chronic haematologic condition (e.g. transfusion dependent thalassaemia, sickle cell disease, inherited chronic haemolytic anaemias, or inherited bone marrow failure syndromes), however, are unlikely to achieve a transfusion free period long enough to allow immunisation according to these recommendations.\nThere is limited direct data on which to base decisions in this group. The above expert recommendations are extrapolated from data on vaccine response post administration of immunoglobulin. Recommended time intervals between red blood cell transfusion and immunisation have been calculated based on the anticipated level of IgG in the red cell units, and the half-life of IgG.\nThis guideline is supported by the rationale that the red blood cell units transfused in Australia (red cells re-suspended in an additive solution) contain little residual plasma. The amount of immunoglobulin in transfused red cell units is therefore expected to be low. Despite this, a retrospective study of chronically transfused patients in Canada who received two doses of MMR containing vaccine before the recommended time interval, reported lower rates of immunity than expected in the general population. Seroconversion rates were however still significant, with 68% having serology consistent with immunity to measles and rubella [see resources].\nSummary and recommendation", "source": "mvec.mcri.edu.au/references/live-attenuated-vaccines-in-patients-receiving-regular-red-blood-cell-transfusions/index.html"}
{"id": "dfeccbfb8538-1", "text": "Summary and recommendation\nRecommendations for delay in live-attenuated vaccines post blood products are based on ensuring vaccine effectiveness. However, for patients receiving regular red cell transfusions, following these recommendations will mean indefinite deferral of live-attenuated vaccines and ongoing vulnerability to these vaccine preventable diseases.\nThese patients should be considered a unique group in this setting. For patients requiring chronic red cell transfusions, who will not achieve a transfusion free period of more than 3-6 months in the foreseeable future, we recommend live-attenuated vaccines be administered as per the National Immunisation Program (NIP), despite being within the usually recommended deferral period post transfusion. Please refer to your haematologist or an immunisation specialist for specific advice.\nThis recommendation is based on:\nthe expectation that the vaccines will still provide protection in a number of patients (albeit potentially lower than that in the general population)\nthe lack of any additional safety concerns associated with administration of the vaccine in this setting\nthe alternative being indefinite deferral of immunisation\nPatients should be informed of the potential for reduced effectiveness of the vaccine.\nA protocol for optimal timing of immunisation in relation to blood transfusion, serological testing post immunisation, and re-immunisation when there is no evidence of immunity, may help to improve response rates. Our local guideline can be accessed here.\nNote that inactivated (non-live) vaccines can be safely administered following blood products including red blood cell transfusions.\nResources\nAustralian Immunisation Handbook: Vaccination for people who have recently received normal human immunoglobulin and other blood products\nMVEC: Live-attenuated vaccines and immunoglobulins or blood products\nAustralian Red Cross Life Blood: Red cells", "source": "mvec.mcri.edu.au/references/live-attenuated-vaccines-in-patients-receiving-regular-red-blood-cell-transfusions/index.html"}
{"id": "dfeccbfb8538-2", "text": "Australian Red Cross Life Blood: Red cells\nZabeida A, Lebel MH, Renaud C, Cloutier M, Robitaille N. Reevaluating immunization delays after red blood cell transfusion. Transfusion 2019;59:2806-2811\nBest Practices Guidance of the Advisory Committee on Immunization Practices (ACIP): General Best Practice Guidelines for Immunization\nCenters for Disease Control and Prevention. General Recommendations on Immunization. In: Epidemiology and Prevention of Vaccine-Preventable Diseases\nCenters for Disease Control and Prevention. Appendix A: Schedule and Recommendations, Recommended intervals between administration of immune globulin preparations and measles-or varicella-containing vaccine. In: Epidemiology and Prevention of Vaccine-Preventable Diseases\nSiber GR, Werner BC, Halsey NA, et al. Interference of immune globulin with measles and rubella immunization. J Pediatr 1993;122:204\u201411\nAuthors:\u00a0Luisa Clucas (MVEC Immunisation Fellow), Nigel Crawford (Director SAEFVIC, Murdoch Children\u2019s Research Institute), Margie Danchin (Paediatrician, Murdoch Children\u2019s Research Institute and Royal Children\u2019s Hospital) and Anthea Greenway (Paediatric Haematologist, The Royal Children\u2019s Hospital)\nDate: July 2020\nMaterials in this section are updated as new information and vaccines become available. The Melbourne Vaccine Education Centre (MVEC) staff regularly reviews materials for accuracy.\nYou should not consider the information in this site to be specific, professional medical advice for your personal health or for your family\u2019s personal health. For medical concerns, including decisions about vaccinations, medications and other treatments, you should always consult a healthcare professional.\nA B C D E F G H I J K L M N O P Q R S T U V W X Y Z", "source": "mvec.mcri.edu.au/references/live-attenuated-vaccines-in-patients-receiving-regular-red-blood-cell-transfusions/index.html"}
{"id": "a710a8397b6a-0", "text": "Background\nHypersensitivity/allergic reactions following immunisation can be classified as:\nUrticarial \u2013 a red, itchy skin rash often referred to as hives, which characteristically has a central raised white wheal surrounded by an area of redness\nNon-urticarial rash \u2013 skin changes that don\u2019t involve hives\nAngioedema \u2013 swelling in the deeper layers of the skin\nGeneralised allergic reaction \u2013 involving symptoms like vomiting and diarrhoea\nAnaphylaxis \u2013 a sudden onset and rapid progression of symptoms involving the skin, as well as systemic symptoms respiratory and/or cardiovascular systems\nSuspected hypersensitivity reactions, particularly non-urticarial skin rashes following immunisation, are common, however true vaccine allergy, where a person is contraindicated from being immunised with the same vaccine in the future, is rare (in most studies reported as less than 1 case per million doses). For further information on diagnosing hypersensitivity reactions and anaphylaxis please refer to Guidance for differentiating anaphylaxis and acute stress response for vaccine providers.\nPost-licensure surveillance of COVID-19 vaccines show anaphylaxis following administration of Vaxzevria (AstraZeneca) occurring at similar rates to routine vaccines [refer to TGA: AstraZeneca ChAdOx1-S COVID-19 vaccine].\u00a0 Anaphylaxis following Comirnaty (Pfizer), whilst still extremely rare, occurs at a slightly higher rate of approximately 4.7 cases per million doses. Data from the US has shown that Spikevax (Moderna) has a rate of anaphylaxis with approximately 2.5 cases per million. Most of these cases (89%) occurred within 30 minutes of vaccination and 26% had a history of prior anaphylaxis.", "source": "mvec.mcri.edu.au/references/covid-19-vaccines-and-allergy/index.html"}
{"id": "a710a8397b6a-1", "text": "A confirmed vaccine allergy usually requires a specialist consultation with a vaccine allergy specialist, often with specific testing or a vaccine challenge under supervision.\nAll COVID-19 immunisation hypersensitivity/allergic reactions should be reported to your state\u2019s vaccine safety reporting service. In Victoria this is SAEFVIC. SAEFVIC staff may direct the report to an immunisation specialist or alternatively to a vaccine allergy specialist within the VicSIS network (a network of specialist immunisation clinics in Victoria), as appropriate.\n\ufeff\ufeff\nAllergy to components of COVID-19 vaccines\nPolyethylene Glycol (PEG)\nPEG is an ingredient contained in mRNA COVID-19 vaccines (Comirnaty (Pfizer) and Spikevax (Moderna)). It is also a commonly used ingredient of other medications, hand sanitisers, cosmetics, bathroom products and colonoscopy preparation products, routinely used within Australia. Whilst it is uncertain whether PEG contained in mRNA vaccines may trigger anaphylaxis, additional precautions are required prior to administration.\nIt is recommended people with a history of confirmed or suspected allergy to PEG seek specialist advice from an immunology/allergy/vaccination specialist regarding the safety of vaccination.\nNB: Vaccination with the Comirnaty (Pfizer) and Spikevax (Moderna) is contraindicated in people with documented anaphylaxis to PEG.\nPolysorbate 80\nPolysorbate 80 is chemically related to Polyethylene Glycol and is an ingredient in both Vaxzevria (AstraZeneca) and Nuvaxovid (Novavax).\nIf there is a history of confirmed or suspected allergy to Polysorbate 80 it is recommended that specialist advice be sought from an immunology/allergy/vaccination specialist regarding the safety of administering either vaccine.", "source": "mvec.mcri.edu.au/references/covid-19-vaccines-and-allergy/index.html"}
{"id": "a710a8397b6a-2", "text": "NB: Vaccination with Vaxzevria (AstraZeneca) or Nuvaxovid (Novavax) is contraindicated in people with documented anaphylaxis to Polysorbate 80.\nLatex\nAll of the COVID-19 vaccines available for use within Australia (Vaxzevria (AstraZeneca), Comirnaty (Pfizer), Spikevax (Moderna) and Nuvaxovid (Novavax)) can both be administered to people with latex allergies following standard precautions, with a 15-minute post-vaccination observation period.\nCOVID-19 vaccines and allergies\nReaction following a previous dose of a COVID-19 vaccine\nThe only\u00a0two\u00a0absolute contraindications to vaccination are\u00a0anaphylaxis to a previous dose of the same vaccine\u00a0or\u00a0anaphylaxis to a component of the vaccine.\nAdditional precautions are recommended for individuals with possible allergic reactions to a previous dose of a COVID-19 vaccine. In this instance, a specialist review by an immunology/allergy/vaccination specialist to undertake a risk/benefit assessment to assess suitability for further vaccination should be undertaken.\nIf an individual experiences anaphylaxis after being vaccinated with one type of COVID-19 vaccine, this does not preclude them from having another type following the additional precautions above. If there is a high risk of an allergic reaction to one of the COVID-19 vaccines due to an existing allergy to PEG or Polysorbate 80 it may be possible to a have a COVID-19 vaccine that does not contain the ingredient, depending on availability and with appropriate medical advice.\nCOVID-19 vaccination in people with allergic conditions \nFor patients with a history of anaphylaxis to food, drugs, venom or latex, it is recommended a routine observation period of 15 minutes following COVID-19 vaccination is observed.", "source": "mvec.mcri.edu.au/references/covid-19-vaccines-and-allergy/index.html"}
{"id": "a710a8397b6a-3", "text": "If a patient has a history of a known systemic mast cell activation disorder with raised mast cell tryptase that has required treatment, a referral to VicSIS prior to vaccination is recommended.\nPlease refer to\u00a0COVID-19 vaccination \u2013 ATAGI clinical guidance on COVID-19 Vaccine in Australia in 2021\u00a0or the\u00a0ASCIA\u00a0Allergy, Immunodeficiency, Autoimmunity and COVID-19 Vaccination Position Statement\u00a0for more information.\nDelayed urticaria following a COVID-19 vaccine\nAcute urticaria can occur 1-2 weeks following vaccination. The symptoms can last on average 3-4 weeks but may resolve more rapidly. The urticaria can be generalised and intensely itchy. Symptoms can be managed with age-appropriate doses of non-sedating over-the-counter antihistamines (tablets or liquid) up to 4 times per day (such as cetirizine, loratadine, fexofenadine or desloratadine), best given in spaced intervals. This type of urticaria with onset that is delayed after the vaccination is generally not an indication of reproducible allergy to the vaccine and therefore investigations are not indicated. Future vaccinations can be given in a routine environment, with a 15-minute post vaccination observation period. If symptoms develop within 24 hours of vaccination, persist beyond two weeks, or there are additional concerns, then review by an immunisation specialist or allergist could be considered.\nManagement following anaphylaxis to a COVID-19 vaccine \nShould symptoms of anaphylaxis occur immediate treatment should be provided [refer to Australian Immunisation Handbook: Adverse events following immunisation]\nInvestigations", "source": "mvec.mcri.edu.au/references/covid-19-vaccines-and-allergy/index.html"}
{"id": "a710a8397b6a-4", "text": "Investigations\nTryptase levels are recommended following potential allergic reactions as they assist with allergy assessment. Normal tryptase levels are reassuring. Tryptase levels are recommended 1 hour, 4 hours and 24 hours post reaction, however, if this is not possible, it recommended once an individual presents to an emergency department and is stable and then just prior to discharge in the case of a short admission.\nIt is recommended that EpiPens only be prescribed by an allergy/immunology specialist following a review. This is based on the following:\nvaccines can be easily avoided and EpiPens are on the Pharmaceutical Benefits Scheme for indications that cannot be avoided\na prescription of an EpiPen has been shown to increase anxiety in people once it is prescribed even if it is not clinically indicated, which is thought to be due to the perceived uncertainty of future reactions.\nResources:\nGuidance for differentiating anaphylaxis and acute stress response for vaccine providers\nJournal of Allergy and Clinical Immunology: Vocal cord dysfunction/inducible laryngeal obstruction(s) mimicking anaphylaxis during SARS-CoV-2 (COVID-19) vaccination\nASCIA Allergy, Immunodeficiency, Autoimmunity and COVID-19 Vaccination Positions Statement\nASCIA Allergy, Immunodeficiency, Autoimmunity and COVID-19 Frequently Asked Questions (FAQ)\nATAGI clinical guidance on COVID-19 vaccine in Australia in 2021\nMVEC: Allergy and immunisation\nMVEC: COVID-19 FAQs: allergies, pre-existing conditions and children", "source": "mvec.mcri.edu.au/references/covid-19-vaccines-and-allergy/index.html"}
{"id": "a710a8397b6a-5", "text": "MVEC: COVID-19 FAQs: allergies, pre-existing conditions and children\nAuthors: Rachael McGuire (MVEC Education Nurse Coordinator), Nigel Crawford (Director, SAEFVIC, Murdoch Children\u2019s Research Institute),\u00a0Daryl Cheng (Paediatrician, The Royal Children\u2019s Hospital), Francesca Machingaifa (MVEC Education Nurse Coordinator), Sara Barnes (Head of Allergy, Monash Health) and Adele Harris (Research Nurse, SAEFVIC, Murdoch Children\u2019s Research Institute)\nReviewed by: Rachael McGuire (MVEC Education Nurse Coordinator)\nDate: November 30, 2022\nMaterials in this section are updated as new information and vaccines become available. The Melbourne Vaccine Education Centre (MVEC) staff regularly review materials for accuracy.\nYou should not consider the information in this site to be specific, professional medical advice for your personal health or for your family\u2019s personal health. For medical concerns, including decisions about vaccinations, medications and other treatments, you should always consult a healthcare professional.\nA B C D E F G H I J K L M N O P Q R S T U V W X Y Z", "source": "mvec.mcri.edu.au/references/covid-19-vaccines-and-allergy/index.html"}
{"id": "d33ef49c9ba2-0", "text": "What is it?\nRabies is a disease caused by exposure to saliva or nerve tissue of an animal infected with the rabies virus or other lyssavirus.\nThe majority of exposures occur in travellers visiting places where disease is endemic (e.g\u00a0Asia, Africa)\nWhat to look for\nInitial symptoms are usually non-specific and can include cough, fever, headache, myalgia, tiredness and vomiting. Disorientation, anxiety, bizarre behaviour, agitation, hypersalivation (increase in saliva) and hyperactivity can then occur before sudden death.\nHow is it transmitted?\nDisease can occur after a scratch or bite that has broken the skin, or via direct contact with a person\u2019s mucosa (nose, eye or mouth)\nPrevention\nRabies is a vaccine preventable disease. Pre-exposure prophylaxis is often recommended for those travelling to Rabies prone areas, as well as for those who work in an at-risk occupation such as bat-handlers and veterinarians.\nPost-exposure treatment should be commenced as soon as possible. In cases of rabies exposure when prior immunisations have not been administered, treatment with Human Rabies Immunoglobulin (HRIG) and immunisation is recommended.\nResources\nAustralian Immunisation Handbook: Rabies and other lyssaviruses\nBetter Health Channel: Lyssavirus\nThe RCH Clinical Practice Guideline: Rabies\nMVEC: Travel medicine\nAuthor: Rachael McGuire (SAEFVIC Research Nurse, Murdoch Children\u2019s Research Institute)\nDate:\u00a0September 2018\nMaterials in this section are updated as new information and vaccines become available. The Melbourne Vaccine Education Centre (MVEC) staff regularly reviews materials for accuracy.", "source": "mvec.mcri.edu.au/references/rabies/index.html"}
{"id": "d33ef49c9ba2-1", "text": "You should not consider the information in this site to be specific, professional medical advice for your personal health or for your family\u2019s personal health. For medical concerns, including decisions about vaccinations, medications and other treatments, you should always consult a healthcare professional.\nA B C D E F G H I J K L M N O P Q R S T U V W X Y Z", "source": "mvec.mcri.edu.au/references/rabies/index.html"}
{"id": "9708f40a2564-0", "text": "Background\nEpilepsy is a disorder of the brain that leads to a person having seizures (disruptions to the electrical activity in the brain). Epilepsy can result from genetic conditions, brain injury or infection, hypoxic insult at birth, brain tumours or neurodegenerative diseases. However, the cause of epilepsy in most people is unknown. It can develop at any stage of life but is most commonly diagnosed in childhood, adolescence and in adults over 60 years of age. Approximately 250,000 Australians (or 1% of) are currently living with epilepsy.\nSeizures of epilepsy can be controlled with anti-epileptic medication/s and by recognising and managing triggers. Common triggers include lack of sleep, stress, illness, hormonal fluctuations, drug and alcohol use, and photosensitivity.\u00a0\nIn general, vaccination is recommended for individuals with epilepsy.\u00a0\nWhile, in rare instances, vaccines can trigger seizures, it is important to note that infections, including vaccine-preventable diseases (e.g., measles, influenza or COVID-19), can trigger seizures in individuals with epilepsy. Therefore, a risk/benefit assessment is important when planning vaccination.\u00a0\nAny seizure that occurs within 14 days of receiving a vaccine are defined as vaccine-proximate seizures (VPS). Most types of epilepsy do not have a high risk of VPS. However, there are some genetic epilepsies with a strong association with VPS. These include Dravet syndrome and genetic epilepsy with febrile seizures plus (GEFS+).\u00a0\nDravet syndrome", "source": "mvec.mcri.edu.au/references/dravet-syndrome/index.html"}
{"id": "9708f40a2564-1", "text": "Dravet syndrome\nDravet syndrome is a rare and severe form of infantile onset epilepsy with a prevalence of 1 in 15,500 \u2013 40,000 children. It is caused by a genetic mutation, usually a new/non inherited (de novo) change in the sodium channel gene (SCN1A). Children with Dravet syndrome classically present with prolonged febrile seizures in the first year of life. Seizures can be hemiclonic (one-sided) or generalised tonic-clonic. They can be sustained (lasting an extended period of time) such as in status epilepticus (SE). Following the first seizure, children with Dravet syndrome can develop refractory (uncontrolled) afebrile seizures, particularly myoclonic seizures, and a plateau or regression in their development. In approximately 30% of children with Dravet syndrome, the first seizure is vaccine-proximate (often occurring following the 4 or 6 month vaccines). \u00a0VPS occurring in infants, particularly if they are prolonged or classed as SE, should raise suspicion of Dravet syndrome. \u00a0\nImmunisation can cause an earlier age of seizure onset in children with Dravet syndrome. However, there is no difference in developmental or seizure outcomes in children who had a first seizure proximate to immunisation compared to children whose first seizure was unrelated to immunisation.\u00a0\nGenetic epilepsy with febrile seizures plus (GEFS+)\nGenetic epilepsy with febrile seizures plus (GEFS+) describes a spectrum of seizure disorders of varying severity. A diagnosis of GEFS+ is usually made in individuals who are experiencing febrile seizures beyond the usual age range of up to 6 years and who have family members across different generations with a history of different types of epilepsy involving febrile seizures and/or recurrent afebrile seizures.", "source": "mvec.mcri.edu.au/references/dravet-syndrome/index.html"}
{"id": "9708f40a2564-2", "text": "Individuals with GEFS+ may experience VPS.\u00a0\nImmunisation\nWhilst vaccination is generally recommended in individuals with Dravet syndrome and other genetic epilepsies, there is a well-reported association with febrile seizures/SE following vaccination.\u00a0Seizures most commonly occur within the first 48 hours following inactivated vaccines (e.g., influenza vaccines, COVID-19 vaccines, Infanrix hexa) and 5-10 days following live-attenuated vaccines (such as the measles-mumps-rubella, MMR, vaccine given at 12 months of age).\u00a0\nRecommendations and management\nChildren with Dravet syndrome or GEFS+ and other children at risk of vaccine-proximate seizures should be referred to a specialist immunisation clinic for assessment prior to vaccination.\u00a0\nVaccination requires a comprehensive discussion between the patient\u2019s family and the treating medical teams. Usually, expert advice from both immunisation specialists and neurologists is required and a clear plan is devised to ensure that vaccines can be administered under careful medical supervision (refer to protocol in resources). Vaccine administration for these groups includes admission for immunisation under observation and sometimes the prophylactic administration of paracetamol and benzodiazepines. Whilst there is no published data evaluating prophylactic measures to prevent seizures in children with Dravet syndrome undergoing immunisations, there is anecdotal evidence that this can reduce the rate of immunisation-related seizures and SE.\u00a0\nIndividuals with stable epilepsy, who have not had a previous VPS and whose type of epilepsy is not strongly associated with VPS, can generally be vaccinated safely in the community. However, where there are questions or concerns about the safety of vaccination in an individual, a referral to a specialist immunisation clinic could be considered.\u00a0\nResources\nRCH Kids health information: Epilepsy\nRCH Kids health information: Febrile seizures", "source": "mvec.mcri.edu.au/references/dravet-syndrome/index.html"}
{"id": "9708f40a2564-3", "text": "RCH Kids health information: Febrile seizures\nEpilepsy Action Australia: Seizure Types and Classification\nSymonds, J. et al Incidence and phenotypes of childhood-onset genetic epilepsies: a prospective population-based national cohort Brain: A journal of neurology 2019 August 142(8)2303-2318\nProtocol for immunisation in children with Dravet Syndrome and other children with vaccine-proximate seizures (RCH intranet access only)\nProtocol for immunisation of children with Dravet syndrome or other vaccine-proximate seizures\nEpilepsy Foundation: what causes epilepsy?\nAuthors: Georgina Lewis (Clinical Manager, SAEFVIC, Murdoch Children\u2019s Research Institute), Nigel Crawford (Director, SAEFVIC, Murdoch Children\u2019s Research Institute), Margie Danchin (Paediatrician, Murdoch Children\u2019s Research Institute and Royal Children\u2019s Hospital) and Gabriel Dabscheck and Katherine Howell (Neurologists, Royal Children\u2019s Hospital)\nReviewed by: Georgina Lewis (Clinical Manager, SAEFVIC, Murdoch Children\u2019s Research Institute) and Gabriel Dabscheck (Neurologist, Royal Children\u2019s Hospital)\nDate: June 22, 2023\nMaterials in this section are updated as new information and vaccines become available. The Melbourne Vaccine Education Centre (MVEC) staff regularly reviews materials for accuracy.\nYou should not consider the information in this site to be specific, professional medical advice for your personal health or for your family\u2019s personal health. For medical concerns, including decisions about vaccinations, medications and other treatments, you should always consult a healthcare professional.\nA B C D E F G H I J K L M N O P Q R S T U V W X Y Z", "source": "mvec.mcri.edu.au/references/dravet-syndrome/index.html"}
{"id": "21b9d16ff5f7-0", "text": "What is it?\nMeningococcal disease constitutes any illness caused by the bacteria\u00a0Neisseria meningitidis.\u00a0There are 13 known sub-types (serogroups) and of these, 5 are currently vaccine preventable (B and A, C, W, Y).\nInvasive meningococcal disease (IMD) can cause meningitis (inflammation of the membrane covering the brain and spinal cord) and septicaemia (infection in the blood), as well as other infections like pneumonia (lung infection), arthritis (inflammation of the joints) and conjunctivitis (eye infection). Mortality (death) can be as high as 5-10% with permanent lifelong complications occurring in 10-20% of those who survive.\nWhat to look for\nThe incubation period of meningococcal is 1-7 days, more commonly 3-4 days. People with meningococcal disease can become extremely unwell very quickly. Symptoms can include fever, headache, neck stiffness, nausea, vomiting and photophobia (sensitivity to light). Cool, mottled extremities and leg pain can also occur. Babies can appear irritable or unsettled, have a high-pitched moaning cry, refuse or not wake for feeds and be lethargic (sleepy) or floppy. A petechial or purpuric rash can appear late in the disease progression (within 13-22 hours) or not at all.\nHow is it transmitted?\nDisease can be transmitted from person to person via respiratory droplets (eg. sneezing and coughing). Meningococcal bacteria can also live harmlessly at the back of the nose or throat, resulting in individuals being asymptomatic carriers.\nEpidemiology", "source": "mvec.mcri.edu.au/references/meningococcal-disease-and-vaccines/index.html"}
{"id": "21b9d16ff5f7-1", "text": "Epidemiology\nChildren < 2 years of age have the highest incidence of meningococcal disease in Australia, with another peak of disease among adolescents and young adults (15-24 years). Aboriginal and Torres Strait Islander people have a\u00a0much greater burden of disease than non-Indigenous people.\nThere are also certain medical conditions and medications that can increase an individual\u2019s risk of IMD. These include (but are not limited to) those with functional asplenia and hyposplenia, complement deficiency and those receiving treatment with eculizamab [see below for specific information for those with increased risk of IMD].\nPrevention\nMVEC strongly recommends everyone wishing to be protected against ACWY and B strains of meningococcal disease be immunised. Some individuals are eligible for funded vaccines via the National Immunisation Program (NIP). Those aged \u2265 6 weeks of age who do not meet the funding criteria can purchase vaccines privately through some councils, GPs and pharmacies.\nThe number of vaccine doses recommended depends on a person\u2019s age and risk factors for IMD.\nMeningococcal ACWY vaccines\nMVEC recommends 2 conjugate meningococcal ACWY vaccines:\nNimenrix\u00ae\nMenveo\u00ae\nA single dose of Nimenrix\u00ae is currently provided for free at 12 months of age and for all adolescents in Year 10 (or age equivalent) with catch up available for those aged 15-19 years. It is also funded for certain individuals of any age with immunocompromising conditions.\nMeningococcal ACWY primary course and booster doses for healthy individualsPrimary course", "source": "mvec.mcri.edu.au/references/meningococcal-disease-and-vaccines/index.html"}
{"id": "21b9d16ff5f7-2", "text": "Meningococcal ACWY primary course and booster doses for healthy individualsPrimary course\nVaccine brand Course commenced at 6 weeks to \u2264 5 months of age Course commenced at 6 months to \u2264 11 months of age Course commenced at 12 months to \u2264 23 months of age Course commenced at \u2265 2 years of age Nimenrix\u00ae\u20203 doses (minimum 8 weeks between 1st and 2nd doses; 3rd dose given at \u2265 12 months of age/8 weeks after 2nd dose, whichever is later)\u00a52 doses (2nd dose at \u2265 12 months of age/8 weeks after 1st dose, whichever is later)\u00a51 dose\u00a51 dose Menveo\u00ae\u20203 doses (minimum 8 weeks between 1st and 2nd doses; 3rd dose given at \u2265 12 months of age/8 weeks after 2nd dose, whichever is later)\u00a52 doses (2nd dose at \u2265 12 months of age/8 weeks after 1st dose, whichever is later)\u00a52 doses (minimum 8 weeks apart)\u00a51 dose \n\u2020 there is no registered upper age limit for the use of Menveo\u00ae or Nimenrix\u00ae.\n\u00a5 completing the course with the same vaccine brand is preferred but may not always be practical. The NIP funded 12 month dose of Nimenrix\u00ae may be used as the dose given at \u2265 12 months of age.\nBooster doses\nFurther booster doses are not routinely recommended for healthy individuals. In circumstances where someone has previously received a primary course of meningococcal ACWY and is offered a further dose in year 10 in line with the NIP, it is acceptable to to receive this dose.", "source": "mvec.mcri.edu.au/references/meningococcal-disease-and-vaccines/index.html"}
{"id": "21b9d16ff5f7-3", "text": "Meningococcal ACWY primary course and booster doses for those at increased risk of IMDIndividuals with specified medical conditions that increase the risk of IMD are recommended and funded to receive additional meningococcal vaccines and booster doses. These groups include:\nthose with defects in, or deficiency of complement components (including factor H, factor D or properdin deficiency),\nthose currently receiving or planning treatment with eculizumab (or biosimilar),\nthose with functional or anatomical asplenia (including sickle cell disease or haemoglobinopathies and congenital or acquired asplenia),\nanyone with HIV (regardless of disease stage or CD4+ cell count),\nanyone who previously received a haemopoietic stem cell transplant (HSCT).\nPrimary course\nVaccine brand Course commenced at 6 weeks to \u2264 5 months of age Course commenced at 6 months to \u2264 11 months of age Course commenced at \u2265 12 months of age Nimenrix\u00ae\u20204 doses (minimum 8 weeks apart, with the 4th dose given at \u2265 12 months of age/more than 8 weeks after the 3rd dose, whichever is later)\u00a53 doses (minimum 8 weeks apart, with the 3rd dose given at \u2265 12 months of age/8 weeks after 2nd dose, whichever is later)\u00a52 doses (minimum 8 weeks apart)\u00a5Menveo\u00ae\u20204 doses (minimum 8 weeks apart, with the 4th dose given at \u2265 12 months of age/more than 8 weeks after the 3rd dose, whichever is later)\u00a53 doses (minimum 8 weeks apart, with the 3rd dose given at \u2265 12 months of age/8 weeks after 2nd dose, whichever is later)\u00a52 doses (minimum 8 weeks apart)\u00a5", "source": "mvec.mcri.edu.au/references/meningococcal-disease-and-vaccines/index.html"}
{"id": "21b9d16ff5f7-4", "text": "\u2020 there is no registered upper age limit for the use of Menveo\u00ae or Nimenrix\u00ae.\n\u00a5 completing the course with the same vaccine brand is preferred but may not always be practical. The NIP funded 12 month dose of Nimenrix\u00ae may be used as the booster dose for those who have commenced the course at < 12 months of age.\nBooster doses\nVaccine brand Where the primary course was completed at \u2264 6 years of age Where the primary course was completed at \u2265 7 years of age Nimenrix\u00ae\u2020\u00a7 OR Menveo\u00ae\u2020\u00a7Give a booster dose 3 years following the completion of the primary course, then further booster doses every 5 years Give a booster dose every 5 years following the completion of the primary course \n\u2020 there is no registered upper age limit for the use of Menveo\u00ae or Nimenrix\u00ae.\n\u00a7 using either Menveo\u00ae or Nimenrix\u00ae as a booster dose, regardless of the brand used for the primary course, is approriate.\nMeningococcal B vaccines\nThere are currently 2 vaccines available for protection against meningococcal B disease.\nBexsero\u00ae\nTrumenba\u00ae\nMeningococcal B vaccines brands are\u00a0not\u00a0interchangeable.\nA primary course of Bexsero\u00ae is available on the NIP for Aboriginal and Torres Strait Islander children < 2 years of age, as well as some individuals of any age with immunocompromising conditions.\nParacetamol advice", "source": "mvec.mcri.edu.au/references/meningococcal-disease-and-vaccines/index.html"}
{"id": "21b9d16ff5f7-5", "text": "Paracetamol advice\nIt is widely recognised that children receiving\u00a0Bexsero\u00ae\u00a0are more likely to experience fever following vaccination. It is for this reason that children < 4 years of age are recommended to receive prophylactic paracetamol (15mg/kg per dose) 30 minutes prior to vaccination (or as soon as possible after), as well as 2 subsequent doses (4-6 hours apart) to reduce the likelihood and severity of fever. This should be administered regardless of whether the child is experiencing a fever or not.\nMeningococcal B primary course and booster doses for healthy individualsPrimary course\nVaccine brand Course commenced at 6 weeks to \u2264 11 months of age Course commenced at 12 months to \u2264 9 years of age Course commenced at \u2265 10 years Bexsero\u00ae\u20203 doses (minimum 8 weeks between 1st and 2nd doses; 3rd dose at \u2265 12 months of age/more than 8 weeks after the 2nd dose, whichever is later)\u00a5#\u00a32 doses (minimum 8 weeks apart)\u00a5#\u00a32 doses (minimum 8 weeks apart)\u00a5Trumenba\u00ae\u2020N/A N/A 2 doses (minimum 6 months apart)\u00a5\n\u2020 Bexsero\u00ae is registered for use in those 6 weeks of age and older. Trumenba\u00ae is only registered for use in those 10 years of age or older.\n\u00a5 meningococcal B vaccine brands are not interchangeable for primary courses or booster doses.\n# prophylactic paracetamol is recommended to those < 4 years of age (refer to advice above).\n\u00a3 funded on the NIP for Aboriginal and Torres Strait Islander children < 2 years of age and those identified as medically at risk (see recommendations below for further information).\nN/A- not recommended in this age group.\nBooster doses", "source": "mvec.mcri.edu.au/references/meningococcal-disease-and-vaccines/index.html"}
{"id": "21b9d16ff5f7-6", "text": "N/A- not recommended in this age group.\nBooster doses\nFurther booster doses of meningococcal B vaccines are not routinely recommended for healthy individuals.\nMeningococcal B primary course and booster doses for those with increased risk of IMDIndividuals with specified medical conditions that increase the risk of IMD are recommended and funded to receive additional meningococcal B vaccines. From December 2022, following an NCIRS-led GRADE review of the evidence, ATAGI endorsed an update to the Australian Immunisation Handbook recommendations which now include booster doses of meningococcal B vaccines.\nEligible individuals include:\nthose with defects in, or deficiency of complement components (including factor H, factor D or properdin deficiency),\nthose currently receiving or planning treatment with eculizumab (or biosimilar),\nthose with functional or anatomical asplenia (including sickle cell disease or haemoglobinopathies and congenital or acquired asplenia),\nanyone with HIV (regardless of disease stage or CD4+ cell count),\nanyone who previously received a haemopoietic stem cell transplant (HSCT).\nMVEC strongly encourages the active follow up of individuals who meet these criteria to ensure that appropriate vaccine schedules and their recommended booster doses are administered in line with the updated guidance to optimally protect vulnerable patients.\nPrimary course", "source": "mvec.mcri.edu.au/references/meningococcal-disease-and-vaccines/index.html"}
{"id": "21b9d16ff5f7-7", "text": "Primary course\nVaccine brand Course commenced at 6 weeks to \u2264 5 months of age Course commenced at 6 months to \u2264 11 months of age Course commenced at 12 months to \u2264 9 years of age Course commenced at \u2265 10 years of age Bexsero\u00ae\u20204 doses (minimum 8 weeks apart, with the 4th dose given at \u2265 12 months of age/more than 8 weeks after the 3rd dose, whichever is later)\u00a5#3 doses (minimum 8 weeks apart, with the 3rd dose given at \u2265 12 months of age/8 weeks after 2nd dose, whichever is later)\u00a5#2 doses (minimum 8 weeks apart)\u00a5#2 doses (minimum 8 weeks apart)\u00a5Trumenba\u00ae\u2020N/A N/A N/A 3 doses (1 months between 1st and 2nd doses; 6 months between 1st and 3rd doses)\u00a5\n\u2020 Bexsero\u00ae is registered for use in those 6 weeks of age and older. Trumenba\u00ae is only registered for use in those 10 years of age or older.\n\u00a5 meningococcal B vaccine brands are not equivalent or interchangeable for primary courses or booster doses.\n# prophylactic paracetamol is recommended to those < 4 years of age (refer to advice above).\nN/A- not recommended in this age group.\nBooster doses\u00a7", "source": "mvec.mcri.edu.au/references/meningococcal-disease-and-vaccines/index.html"}
{"id": "21b9d16ff5f7-8", "text": "N/A- not recommended in this age group.\nBooster doses\u00a7 \nVaccine brand Where the primary course was completed at \u2264 6 years of age Where the primary course was completed at \u2265 7 years to \u2264 9 years of age Where the primary course was completed at \u2265 7 years of age Bexsero\u00ae\u2020Give a single booster dose 3 years after completing the primary course\u00a5Give a single booster dose 5 years after completing the primary course\u00a5Give a single booster dose 5 years after completing the primary course\u00a5Trumenba\u00ae\u2020N/A N/A Give a single booster dose 5 years after completing the primary course\u00a5\n\u00a7 refer to GRADE assessment for more information.\n\u2020 Bexsero\u00ae is registered for use in those 6 weeks of age and older. Trumenba\u00ae is only registered for use in those 10 years of age or older.\n\u00a5 meningococcal B vaccine brands are not equivalent or interchangeable for primary courses or booster doses.\nN/A- not recommended in this age group.\nResources\nBetter Health Channel: Meningococcal disease- immunisation\nAustralian Immunisation Handbook: Meningococcal\nRCH Kids Health information: Meningococcal infection\nATAGI clinical advice on changes to recommendations for meningococcal vaccines from 1 July 2020\nMVEC: Febrile seizures (febrile convulsions) and vaccines\nMVEC: Asplenia and hyposplenia\nNCIRS: Meningococcal vaccines GRADE assessments\nAuthors: Rachael McGuire (MVEC Education Nurse Coordinator), Georgina Lewis (Clinical Nurse Manager, SAEFVIC, Murdoch Children\u2019s Research Institute) and Nigel Crawford (Director SAEFVIC, Murdoch Children\u2019s Research Institute)", "source": "mvec.mcri.edu.au/references/meningococcal-disease-and-vaccines/index.html"}
{"id": "21b9d16ff5f7-9", "text": "Reviewed by: Rachael McGuire (MVEC Education Nurse Coordinator) and Nigel Crawford (Director SAEFVIC, Murdoch Children\u2019s Research Institute)\nDate: July 4, 2023\nMaterials in this section are updated as new information and vaccines become available. The Melbourne Vaccine Education Centre (MVEC) staff regularly reviews materials for accuracy.\nYou should not consider the information in this site to be specific, professional medical advice for your personal health or for your family\u2019s personal health. For medical concerns, including decisions about vaccinations, medications and other treatments, you should always consult a healthcare professional.\nA B C D E F G H I J K L M N O P Q R S T U V W X Y Z", "source": "mvec.mcri.edu.au/references/meningococcal-disease-and-vaccines/index.html"}
{"id": "034fda5b3a67-0", "text": "Background\nIt is widely recognised that Aboriginal and Torres Strait Islander peoples have higher rates of some vaccine preventable diseases (VPD) than non-Indigenous persons. This is not necessarily due to being of Aboriginal and/or Torres Strait Islander background, but rather due to the higher rates of underlying chronic health conditions and social circumstances that can lead to an increase in disease burden. For this reason, additional vaccines are recommended, some of which are available through the National Immunisation Program (NIP).\nThe recommendations and funding for additional vaccines for Aboriginal and Torres Strait Islander peoples vary from state to state, based on local disease burden. In addition, individual immunisation providers may have varying approaches to non-NIP vaccines, and this should be clarified with the local health service.\nAccessing immunisations\nRoutine and additional immunisations can be administered via GP services, councils, hospitals, local Aboriginal Health Services and some pharmacies.\nAdditional funded vaccines for Aboriginal and Torres Strait Islander people living in Victoria\nHepatitis B\nRates of hepatitis B infection in Aboriginal and Torres Strait Islander peoples population are up to 3 times higher than the non-Indigenous with notification rates increasing with age.\nHepatitis B vaccination is funded on the NIP with routine doses given at birth, 6-weeks, 4-months and 6-months of age. A booster dose is also given at 12-months of age for those who were born at < 32-weeks gestation and/or < 2000g birth weight.\nIn addition to this, hepatitis B vaccination is also funded in Victoria for all non-immune Aboriginal and Torres Strait Islander peoples of any age.\nPneumococcal\nThe risk of invasive pneumococcal disease (IPD) is greatest in young children and older adults. Rates of IPD are 6\u20137 times higher in Aboriginal and Torres Strait Islander people.", "source": "mvec.mcri.edu.au/references/aboriginal-and-torres-strait-islander-immunisation-recommendations/index.html"}
{"id": "034fda5b3a67-1", "text": "Aboriginal and Torres Strait Islander children living in Australian Capital Territory (ACT), New South Wales (NSW), Tasmania (Tas) or Victoria (Vic) are funded for 1 dose of Prevenar 13\u00ae (13vPCV) at ages 6 weeks, 4-months and 12-months (3 doses in total). For those with a risk condition/< 28-weeks gestation an extra dose of 13vPCV is given at 6-months of age (4 doses in total) as well as a dose of Pneumovax 23\u00ae (23vPPV) at 4-years of age.\nAboriginal and Torres Strait Islander children in Northern Territory (NT), Queensland (Qld), South Australia (SA) and Western Australia (WA) are funded to receive an extra dose of pneumococcal vaccine at age 6 months followed by two further doses of 23vPPV at age 4-years and at least 5 years later.\nAll Aboriginal and Torres Strait Islander individuals aged > 12 months with risk conditions are recommended to receive 1 additional dose of 13vPCV unless they have previously received a total of 4 doses of 13vPCV (according to the routine schedule for Aboriginal and Torres Strait Islander infants in NT, Qld, SA and WA) followed by two doses of 23vPPV. These doses are funded for some but not all risk conditions.\nAll Aboriginal and Torres Strait Islander adults \u2265 50 years of age are eligible for 1 dose of 13vPCV and two doses of 23vPPV.\nThe maximum number of doses of 23vPPV received in a lifetime is two.\nFor more information please refer to MVEC: Pneumococcal.\nInfluenza", "source": "mvec.mcri.edu.au/references/aboriginal-and-torres-strait-islander-immunisation-recommendations/index.html"}
{"id": "034fda5b3a67-2", "text": "Influenza\nAboriginal and Torres Strait Islander people are three times more likely than non-Indigenous people to be admitted to hospital for influenza and pneumonia.\nAnnual influenza vaccination is funded on the NIP for all Aboriginal and Torres Strait Islander peoples from 6 months of age.\nMeningococcal B and ACWY\nIn 2019, Aboriginal and Torres Strait Islander people had a 10-fold increased incidence of meningococcal disease than non-Indigenous people across some age groups. The most common strains causing infection were types B and W. The recommendation for all Aboriginal and Torres Strait Islander peoples is immunisation against meningococcal disease from 6 weeks of age.\nNimenrix\u00ae (meningococcal ACWY) is currently funded on the NIP as a single dose at 12-months of age and an adolescent dose at 14-15 years of age (Year 10 equivalent).\nMeningococcal B vaccine (Bexsero\u00ae) is free and recommended under the NIP for Aboriginal and Torres Strait Islander infants at 2, 4, and 12 months of age.\u00a0 An additional dose at 6 months of age is required for Aboriginal and Torres Strait Islander infants with certain medical risk conditions.\nMeningococcal B and meningococcal ACWY vaccines are also funded under the NIP for people of all ages with specified\u00a0medical risk conditions that increase their risk of IMD.\nFor more information refer to MVEC: Meningococcal.\nCOVID-19 vaccines", "source": "mvec.mcri.edu.au/references/aboriginal-and-torres-strait-islander-immunisation-recommendations/index.html"}
{"id": "034fda5b3a67-3", "text": "For more information refer to MVEC: Meningococcal.\nCOVID-19 vaccines\nA primary course of COVID-19 vaccines are recommended for all Aboriginal and Torres Strait Islander person > 5 years of age. Additional booster doses are also recommended for certain age groups. Aboriginal and Torres Strait Islander people are prioritised for immunisation as there is an increased risk of severe COVID-19 disease and death due to a number of factors. This includes a higher prevalence of underlying medical conditions, as well as a greater likelihood of living in communities where other preventative measures (social distancing, mask wearing and hand hygiene) cannot be maintained.\nPlease refer to COVID-19 vaccination \u2013 ATAGI clinical guidance on COVID-19 Vaccine in Australia in 2021 and COVID-19 vaccination information for Aboriginal and Torres Strait Islander people.\nAdditional funded vaccines for Aboriginal and Torres Strait Islander people living in other states\nVaccine\nAge group\nState\nBCG (tuberculosis)\nChildren < 5 years\nQLD\nPrevenar 13\u00ae (13-valent pneumococcal conjugate vaccine)\n6 months\nNT, QLD, SA, WA\nVaqta\u00ae Paediatric (hepatitis A \u2013 2 dose course)\n18 months and 4 years\nNT, QLD, SA, WA\nSA Health- Aboriginal and Torres Strait Islander people immunisation recommendations QLD Health- Aboriginal and Torres Strait Islander people immunisation recommendations WA Department of Health \u2013 Immunisation schedule ATAGI clinical advice on hepatitis A vaccine\nResources\nAboriginal health services\nVictorian Aboriginal Health Services\nOther resources\nAustralian Immunisation Handbook: Vaccination for Aboriginal and Torres Strait Islander people\nNational Aboriginal Community Controlled Health Organisation: COVID-19 Vaccine Updates and Information\nATAGI clinical advice on vaccination recommendations for Aboriginal and Torres Strait Islander people from 1 July 2020", "source": "mvec.mcri.edu.au/references/aboriginal-and-torres-strait-islander-immunisation-recommendations/index.html"}
{"id": "034fda5b3a67-4", "text": "ATAGI clinical guidance for COVID-19 vaccine providers\nNational Immunisation Program schedule for all Aboriginal and Torres Strait Islander people\nNCIRS: Aboriginal and Torres Strait Islander Immunisation\nAuthors: Rachael McGuire (MVEC Education Nurse Coordinator), Nigel Crawford (Director SAEFVIC, Murdoch Children\u2019s Research Institute) and Rebecca Feore (Immunisation Nurse, The Royal Children\u2019s Hospital)\nReviewed by:\u00a0Rachael McGuire (MVEC Education Nurse Coordinator)\nDate: November 29, 2022\nMaterials in this section are updated as new information and vaccines become available. The Melbourne Vaccine Education Centre (MVEC) staff regularly reviews materials for accuracy.\nYou should not consider the information in this site to be specific, professional medical advice for your personal health or for your family\u2019s personal health. For medical concerns, including decisions about vaccinations, medications and other treatments, you should always consult a healthcare professional.\nA B C D E F G H I J K L M N O P Q R S T U V W X Y Z", "source": "mvec.mcri.edu.au/references/aboriginal-and-torres-strait-islander-immunisation-recommendations/index.html"}
{"id": "a8534bb956d1-0", "text": "What is it?\nPertussis (whooping cough) is a serious, highly contagious, respiratory infection caused by the bacterium Bordetella pertussis.\nWhat to look for\nPertussis can be very serious in young children, especially those under 6 months of age. It usually begins just like a cold, with a runny nose and sometimes a mild fever.\u00a0 Coughing then develops, which may occur in bouts, sometimes followed by a deep gasp (or \u201cwhoop\u201d). Hospital admission may be required.\nComplications can include pneumonia, encephalitis/encephalopathy and brain damage. There are reported cases of\u00a0death from Pertussis infection.\nHow is it transmitted?\nThe Bordetella pertussis bacterium is highly infectious and is spread by coughing and\u00a0sneezing.\nPrevention\nPrevious infection with Pertussis does not provide lifelong immunity.\nImmunisation is the most effective form of prevention. Booster doses of the vaccine are required throughout life to ensure protection is maintained.\nPertussis immunisation is available for free for the following individuals:\nInfants \u2013 doses at 6 weeks, 4 months and\u00a06 months\nChildren \u2013 booster doses at 18 months and 4 years\nAdolescents \u2013 12 \u2013 13 years of age\nPregnant women \u2013 20 \u2013 32 weeks gestation\nPartners of pregnant women who are at least 28 weeks pregnant (if they have not received a dose in the last 10 years)\nParents/guardians of a baby under 6 months of age (if they have not received a dose in the last 10 years)\nResources\nBetter Health Channel Whooping cough\nAustralian Immunisation Handbook:\u00a0Pertussis\u00a0chapter\nMVEC: Maternal Vaccination During Pregnancy\nThe RCH kids health\u00a0info fact sheet", "source": "mvec.mcri.edu.au/references/pertussis-whooping-cough/index.html"}
{"id": "a8534bb956d1-1", "text": "MVEC: Maternal Vaccination During Pregnancy\nThe RCH kids health\u00a0info fact sheet\nAuthors: Mel Addison (SAEFVIC Research Nurse, Murdoch Children\u2019s Research Institute),\u00a0Rachael McGuire (SAEFVIC Research Nurse, Murdoch Children\u2019s Research Institute)\nReviewed by: Georgina Lewis (SAEFVIC Clinical Manager, Murdoch Children\u2019s Research Institute)) and\u00a0Rachael McGuire (SAEFVIC Research Nurse, Murdoch Children\u2019s Research Institute)\nDate:\u00a0July 2019\nMaterials in this section are updated as new information and vaccines become available. The Melbourne Vaccine Education Centre (MVEC) staff regularly reviews materials for accuracy.\nYou should not consider the information in this site to be specific, professional medical advice for your personal health or for your family\u2019s personal health. For medical concerns, including decisions about vaccinations, medications and other treatments, you should always consult a healthcare professional.\nA B C D E F G H I J K L M N O P Q R S T U V W X Y Z", "source": "mvec.mcri.edu.au/references/pertussis-whooping-cough/index.html"}
{"id": "510b58528b83-0", "text": "Prematurity, particularly extreme prematurity (< 28-weeks gestation) and low birth weight infants often have associated chronic (special risk) medical conditions. This can be associated with prolonged hospitalisation and frequent clinic visits. These are some of the reasons premature infants are at a greater risk of vaccine preventable diseases (VPDs) and their complications. Preterm infants may also not respond as well to some vaccines (e.g. Hepatitis B).\nImmunisation recommendations\nInfants should be immunised according to the recommended immunisation schedule based on their chronological age as opposed to their corrected age. This is because it is important to minimise the window preterm infants are not protected from VPDs. Specific special risk medical conditions, as well as birth weight need to be taken into account as extra vaccines may be required .\nIt should be noted that the Rotavirus immunisation must be given within a strict time frame, with the first dose required before turning 15-weeks (chronological age) and the second dose before 25-weeks of age.\nAdditional vaccines recommended:\n< 28-weeks gestation\nPneumococcal vaccines\nInfants born at < 28-weeks gestation are recommended to receive 4 doses of 13vPCV and 2 doses of 23vPPV\n13vPCV in a 4-dose schedule at 2, 4, 6 and 12-months of age (the first dose may be given as early as 6-weeks of age)\n2 doses of 23vPPV; 1 dose at 4-years of age and another dose at least 5 years later\n< 32-weeks gestation and/or < 2000g birth weight\nHepatitis B\nHepatitis B vaccine should be given at 12-months of age\nAdditional risk condition vaccine recommendations", "source": "mvec.mcri.edu.au/references/preterm-infant-immunisation/index.html"}
{"id": "510b58528b83-1", "text": "Additional risk condition vaccine recommendations\nInfluenza vaccine should be given annually from 6 months of age\nMeningococcal vaccines (MenB and MenACWY) are now funded under the NIP for people of all ages with medical conditions associated with the highest risk of invasive meningococcal disease\nResources:\nATAGI Clinical advice on changes to recommendations for pneumococcal vaccines from 1 July 2020\nATAGI Clinical advice on vaccination recommendations for people with risk conditions from 1 July 2020\nHousehold contacts\nIt is recommended that family members of premature infants be fully up to date with their immunisations including influenza and pertussis boosters. This concept of \u2018cocooning\u2019 will help protect vulnerable preterm infants from VPDs.\nThe whooping cough (pertussis) vaccine is free and recommended for pregnant women and can be given anytime between 20-32 weeks of each pregnancy. It should be given as early as possible (from 20 weeks) to women who have been identified as being at high risk of early delivery to protect baby in the first months of life when they are too young to be vaccinated.\nInfluenza vaccination in pregnancy is safe and strongly recommended in avoiding complications of influenza disease. It can be administered at any stage of pregnancy and not only aims to protect the expectant mother from disease, but also to provide protection to the infant once born. Babies less than 6-months of age are at greatest risk of disease and death from influenza and maternal vaccination will provide protection to babies for the first few months of life until they can be immunised against influenza from 6-months of age.\nResources\nMVEC: Influenza vaccine recommendations\nMVEC: Rotavirus\nMVEC: Maternal vaccination during pregnancy\nOrdering Preterm infant stickers for child healthcare books\u00a0\nMVEC: Special risk chapter\u00a0of the Australian Immunisation Handbook", "source": "mvec.mcri.edu.au/references/preterm-infant-immunisation/index.html"}
{"id": "510b58528b83-2", "text": "MVEC: Special risk chapter\u00a0of the Australian Immunisation Handbook\nAuthors: Nigel Crawford (Director SAEFVIC, Murdoch Children\u2019s Research Institute) and Rachael McGuire (SAEFVIC Research Nurse, Murdoch Children\u2019s Research Institute)\nReviewed by: Francesca Machingaifa (SAEFVIC Research Nurse, Murdoch Children\u2019s Research Institute) and Georgina Lewis (Clinical Manager SAEFVIC, Murdoch Children\u2019s Research Institute)\nDate: July 2020\nMaterials in this section are updated as new information and vaccines become available. The Melbourne Vaccine Education Centre (MVEC) staff regularly reviews materials for accuracy.\nYou should not consider the information in this site to be specific, professional medical advice for your personal health or for your family\u2019s personal health. For medical concerns, including decisions about vaccinations, medications and other treatments, you should always consult a healthcare professional.\nA B C D E F G H I J K L M N O P Q R S T U V W X Y Z", "source": "mvec.mcri.edu.au/references/preterm-infant-immunisation/index.html"}
{"id": "ba16b0340018-0", "text": "Background\nThe assessment of skin for clinical signs and symptoms is important when identifying adverse events following immunisation (AEFI). Most dermatological assessment guidelines commonly refer to the presentation of symptoms in patients with light skin tones.\nThe skin is one of the most complex organs in the body. It consists of 3 layers, with each layer performing different roles. The colour of a person\u2019s skin is influenced by the amount of melanin (natural pigment) which is produced by the melanocytes located in the epidermis (outer layer of the skin), with darker toned skin having more melanin present than lighter toned skin. The amount of melanin will affect the appearance of AEFI on a patient\u2019s skin and therefore AEFI, such as pallor, cyanosis, erythema and urticaria, may appear differently in varied skin tones. This can pose a challenge for immunisation providers to identify symptoms of AEFI in a timely manner.\nPallor\nPallor refers to the pale appearance of the skin, nail beds and mucous membranes. Pallor is not always a symptom of disease.\nPallor may be difficult to detect in dark toned skin and may present as ashen or grey. In brown toned skin the skin will present more yellowish in colour. An alternative method for identifying pallor in darker skin tones can be assessing the palmer surface which can appear paler.\nFollowing immunisation, pallor can be noted in events such as vasovagal syncope (fainting) and hypotonic hypo-responsive episodes (HHE).\nCyanosis\nCyanosis is a symptom of decreased oxygen in the bloodstream. There are 2 types of cyanosis:\nPeripheral cyanosis, which is observed in the extremities including hands, fingertips and feet.\nCentral cyanosis, which is detected in central parts of the body including head, torso and mucous membranes and is often more serious.", "source": "mvec.mcri.edu.au/references/identifying-aefi-in-diverse-skin-colour/index.html"}
{"id": "ba16b0340018-1", "text": "In those with light skin tones, cyanosis will present as a bluish/purple hue. In patients with naturally yellow toned skin, cyanosis may cause a grayish-greenish appearance. In those with darker skin tones, cyanosis may be trickier to assess and may be observed as grey or white.\nFollowing immunisation, cyanosis may occur in the setting of a HHE, apnoea, breath holding episode or high fever.\nErythema\nErythema describes a red appearance of skin caused by the dilation of superficial blood vessels and increased blood flow. It often occurs with skin trauma, inflammation, infection or rash.\nErythema is clearly visible on light toned skin. It may appear red or cause a purplish discoloration on some darker toned skins however it is difficult to see on very dark skin. Assessing the affected site or area for other signs including warmth, swelling or induration can assist in clinical assessment and diagnosis of erythema.\nFollowing immunisation, erythema can be widespread or localised at the injection site.\nUrticaria\nUrticaria, or hives, occur when the mast cells that lie within the skin release histamine that irritates nerve endings and causes local blood vessels to dilate and leak fluid. They can appear anywhere on the body and can be transient in nature. The cause is often not known however, they may be associated with infections or allergy.\nOn light toned skin, hives appear as itchy, raised red welts. They often have a white center or wheal which looks like a mosquito bite and are surrounded by an erythematous ring. In darker toned skin, hives appear as raised lumps however the colour changes to the skin may not be as obvious.\nFollowing immunisation, hives can occur anywhere on the body and may occur in the setting of an allergic reaction.\nResources\nImages", "source": "mvec.mcri.edu.au/references/identifying-aefi-in-diverse-skin-colour/index.html"}
{"id": "ba16b0340018-2", "text": "Resources\nImages\nInstagram: Brown skin matters\nBlack and Brown skin: Mind the gap\nOther resources\nDermNetNZ: Ethnic dermatology\nAustralasian Society of Clinical Immunology and Allergy: Urticaria\nOrtonne, J. Normal and abnormal skin colour, Annales de Dermatologie et de Venereologie December 2021 (139):S125-S129\nSommers, M. Color Awareness: A must for patient assessment, American Nurse, January 2011\nThe Dermatologist: Identifying erythema in skin of colour\nAuthors: Georgina Lewis (Clinical Manager SAEFVIC, Murdoch Children\u2019s Research Institute), Mel Addison (SAEFVIC Research Nurse, Murdoch Children\u2019s Research Institute), Francesca Machingaifa (SAEFVIC Research Nurse, Murdoch Children\u2019s Research Institute) and Rachael McGuire (SAEFVIC Research Nurse, Murdoch Children\u2019s Research Institute)\nReviewed by: Rachael McGuire (MVEC Education Nurse Coordinator)\nDate: May 31, 2022\nMaterials in this section are updated as new information and vaccines become available. The Melbourne Vaccine Education Centre (MVEC) staff regularly reviews materials for accuracy.\nYou should not consider the information in this site to be specific, professional medical advice for your personal health or for your family\u2019s personal health. For medical concerns, including decisions about vaccinations, medications and other treatments, you should always consult a healthcare professional.\nA B C D E F G H I J K L M N O P Q R S T U V W X Y Z", "source": "mvec.mcri.edu.au/references/identifying-aefi-in-diverse-skin-colour/index.html"}
{"id": "5ad0aa2de67d-0", "text": "There are a variety of factors that need to be considered in relation to the vaccination of the older population. A gradual decline of the immune system occurs as people age (known as immunosenescence), impacting how the immune system responds to new infections, as well as the effectiveness of long-term immune memory. It is for this reason that some vaccines are specifically designed for the older population and aim to enhance the immune response by using higher immunogenicity formulations or by containing adjuvants. Providing optimal protection can also be complicated due to the increasing prevalence of multiple co-morbidities in the ageing population. Specific medical conditions or targeted therapies (eg. chronic renal conditions, chemotherapy for cancers etc) can also cause older adults to be more vulnerable to infections and their complications. Further to this, relying on patient recall, as well as a lack of awareness for the recommended vaccines for the older population, can result in either missed vaccines or additional unnecessary doses being administered.\nThere are multiple vaccines recommended for the older population as outlined below.\nHerpes zoster (Shingles) vaccines\nShingles is caused by a reactivation of the varicella virus and will occur in approximately 20-30% of people in their lifetime. Older people (> 70 years of age) are more likely to suffer post-herpetic neuralgia (PHN) following a shingles infection than younger people. PHN is a chronic neuropathic pain which can affect 1 in 4 cases of shingles diagnosed in those > 80 years. It can persist for months to years with pain control being difficult to manage, impacting quality of life.\nThere are currently 2 vaccines available in Australia for the prevention of shingles:\nZostavax\u00ae- a live-attenuated vaccine\nShingrix\u00ae- an adjuvanted recombinant varicella zoster virus glycoprotein E (gE) subunit (non-live) vaccine", "source": "mvec.mcri.edu.au/references/elderly-population-immunisation-recommendations/index.html"}
{"id": "5ad0aa2de67d-1", "text": "Zostavax\u00ae\nZostavax\u00ae has been shown to reduce the incidence of developing shingles by up to 50%, as well as the incidence of PHN in those \u2265 60 years of age by 66%. It is currently funded under the National Immunisation Program (NIP) for persons aged 70 years, with a catch-up program for those aged 71\u201379 years also funded (until October 2023). As it is a live-attenuated vaccine, it is contraindicated for use in those who are immunosuppressed, or on immunosuppressive medications (eg; Rituximab, Azathioprine, Prednisolone, chemotherapy etc). Prior to administering Zostavax\u00ae it is important to take a thorough patient history to determine suitability for immunisation.\nShingrix\u00ae\nShingrix\u00ae is preferred over Zostavax\u00ae for the prevention of shingles due to a higher efficacy, particularly in the older population. In those aged \u2265 50 years, Shingrix\u00ae provided 97% protection against shingles in immunocompetent individuals and 91% protection in those aged > 70 years. Clinical trials have demonstrated high efficacy up to 4 years following vaccination with immunogenicity data indicating this is likely to persist beyond 10 years.\nShingrix\u00ae is registered for use in adults aged \u2265 50 years. It is only available through private prescription and supplies are currently limited. It\u00a0is a non-live vaccine and as such can safely be administered to immunocompromised individuals. ATAGI recommends a 7 day interval between the administration of COVID-19 vaccines and Shingrix\u00ae, and prefers that FluadQuad and Shingrix\u00ae are not co-administered on the same day.", "source": "mvec.mcri.edu.au/references/elderly-population-immunisation-recommendations/index.html"}
{"id": "5ad0aa2de67d-2", "text": "Further guidance can be provided by reviewing the Australian Immunisation Handbook: Table. Live shingles vaccine (Zostavax) screening for contraindications or by contacting SAEFVIC prior to immunisation.\nPneumococcal vaccines\nInvasive pneumococcal disease (IPD) can manifest as meningitis, pneumonia and bacteremia, with severe disease requiring hospitalisation, causing significant morbidity and even death. The elderly (along with infants) are at the highest risk of developing IPD. Recommendations for pneumococcal vaccines in adults vary according to age and medical condition [refer to ATAGI clinical advice on vaccination recommendations for people with risk conditions from 1 July 2020]. Pneumococcal vaccines are currently provided for free on the NIP for the following people:\nAboriginal and Torres Strait Islander adults with NO risk condition \u2013 1 dose of Prevenar 13\u00ae at 50 years of age, followed 8 weeks later by 2 doses of Pneumovax\u00ae\u00a023, given 5 years apart\nNon-indigenous adults with NO risk condition \u2013 1 dose of Prevenar 13\u00ae at >70 years\nNon-indigenous adolescents/adults diagnosed with a risk condition \u2013 1 dose of Prevenar 13\u00ae at diagnosis, followed by 2 doses of Pneumovax\u00ae\u00a023, given 5 years apart\nIn adults, injection site reactions may occur > 3 days following the Prevenar 13\u00ae dose given at > 70 years, particularly in those who have previously received Pneumovax\u00ae23. A history of large local injection site reactions following previous pneumococcal vaccines is not a contraindication to further doses.\nRefer to MVEC: Pneumococcal for more information.\nInfluenza vaccines", "source": "mvec.mcri.edu.au/references/elderly-population-immunisation-recommendations/index.html"}
{"id": "5ad0aa2de67d-3", "text": "Influenza vaccines\nFor older adults, and those with certain medical conditions (eg. chronic lung disease, cardiac disease, immunosuppression), influenza disease can cause serious morbidity and mortality. Annual influenza vaccination is strongly encouraged and it is available for free on the NIP for those \u2265 65 years of age and/or adults with certain medical conditions. Due to a reduced immune response to routine influenza vaccines, those aged \u2265 65 years should receive higher-immunogenicity influenza vaccines.\nRefer to MVEC: Influenza for specific information on brands and dosing.\nCOVID-19 vaccines\nOlder people and those with comorbidities (eg. hypertension, diabetes, chronic lung disease etc) are much more likely to suffer from severe COVID-19 disease if infected. Of those who are > 80 years of age and have COVID-19 disease, approximately 1 in 3 will die from it.\nCOVID-19 vaccination requires a 2-dose primary course for immunocompetent individuals, or a 3 -dose primary course for those with immunocompromise. A primary course shoulod be followed by a booster dose \u2265 3 months later, and a further \u201cwinter booster\u201d dose \u2265 3 months after that for select individuals.\nFor more information on COVID-19 vaccination for older people please refer to COVID-19 vaccination \u2013 COVID-19 vaccination decision guide for frail older people, including those in residential aged care facilities.\nConsiderations for residents of residential aged care facilities (RACF)", "source": "mvec.mcri.edu.au/references/elderly-population-immunisation-recommendations/index.html"}
{"id": "5ad0aa2de67d-4", "text": "Considerations for residents of residential aged care facilities (RACF)\nWhilst every effort should be made to immunise residents of RACF at risk of vaccine preventable diseases like COVID-19 and influenza, it is important to monitor for adverse events following immunisation (AEFIs). Due to a high incidence of cognitive impairment, elderly residents may not have capacity to self-report any side effects. Any AEFIs experienced within 5 days of vaccination should be reported to SAEFVIC. It is important to monitor for non-specific symptoms seen in the elderly population when unwell such as falls, delirium, functional decline, decrease/loss of appetite or changes in mood/behaviour.\nFor further information on additional cares that may be required and management of symptoms following vaccination in residents of RACF refer to Guidance for vaccination care of residents of Victorian Residential Aged Care Facilities.\nReporting to the Australian Immunisation Register (AIR)\nThe AIR provides a record of all vaccine doses given, the date of administration as well as the specific brands used.\u00a0Since 2016 vaccines administered to Australians of any age have been recorded onto the AIR. Patient recall, particularly in the older population, is not reliable and as such it important that immunisation records are accurately maintained and reviewed regularly.\nFrom March 2021, new legislation came into effect making reporting vaccines to AIR mandatory. This includes all COVID-19 vaccines, influenza vaccines and all National Immunisation Program vaccines.\nResources\nAustralian Government Department of Health: Immunisation for Seniors\nMVEC: Influenza\nMVEC: Zoster\nMVEC: Pneumococcal disease and vaccines\nMVEC: COVID-19 vaccines: Frequently asked questions\nMVEC: Australian Immunisation Register\nCOVID-19 vaccination \u2013 COVID-19 vaccination decision guide for frail older people, including those in residential aged care facilities", "source": "mvec.mcri.edu.au/references/elderly-population-immunisation-recommendations/index.html"}
{"id": "5ad0aa2de67d-5", "text": "Guidance for vaccination care of residents of Victorian Residential Aged Care Facilities\nAw D. Silva B. and Palmer D. Immunosenescence: emerging challenges for an ageing population Immunology 2007 Apr; 120(4): 435\u2013446\nGustafson C. Kim C. Weyand C. Goronzy J Influence of immune aging on vaccine responses Journal of Allergy and Clinical Immunology 2020 May; 145(5): 1309\u20131321\nAuthors: Daryl Cheng (Paediatrician, The Royal Children\u2019s Hospital), Francesca Machingaifa (MVEC Education Nurse Coordinator) and Rachael McGuire (MVEC Education Nurse Coordinator)\nReviewed by: Francesca Machingaifa (MVEC Education Nurse Coordinator)\nDate: August 5, 2022\nMaterials in this section are updated as new information and vaccines become available. The Melbourne Vaccine Education Centre (MVEC) staff regularly reviews materials for accuracy.\nYou should not consider the information in this site to be specific, professional medical advice for your personal health or for your family\u2019s personal health. For medical concerns, including decisions about vaccinations, medications and other treatments, you should always consult a healthcare professional.\nA B C D E F G H I J K L M N O P Q R S T U V W X Y Z", "source": "mvec.mcri.edu.au/references/elderly-population-immunisation-recommendations/index.html"}
{"id": "f60c0bd9ea3a-0", "text": "The Australian Technical Advisory Group on Immunisation (ATAGI) provides independent advice to the Minister for Health on the Immunise Australia Program and other related issues.\nIn addition to technical experts, ATAGI\u2019s membership includes a consumer representative and general practitioners.\nThe Terms of Reference of the Australian Technical Advisory Group on Immunisation are to:\nprovide technical advice to the Minister for Health on the medical administration of vaccines available in Australia, including those on the National Immunisation Program (NIP)\nthrough the department, provide advice to research funding bodies regarding the status of current immunisation research and areas where additional research is required\nadvise the Pharmaceutical Benefits Advisory Committee (PBAC) on matters relating to the ongoing strength of evidence pertaining to existing, new and emerging vaccines in relation to their effectiveness and use in Australian populations\nconsult with relevant organisations to produce the Australian Immunisation Handbook\u00a0\nconsult with the National Immunisation Committee (NIC) on the content and format of the Australian Immunisation Handbook and associated implementation strategies\nconsult with the Communicable Diseases Network Australia (CDNA) and the Advisory Committee on Vaccines (ACV) on matters relating to the implementation of immunisation policies, procedures and vaccine safety\nprovide advice on COVID-19 immunisation programs and policies, to improve confidence in COVID-19 vaccines and to ensure equitable access to COVID-19 vaccines as they become available in Australia.\nATAGI meet regularly and provide bulletins detailing the important outcomes from meetings. These bulletins, COVID-19 vaccination statements and weekly updates are available via the ATAGI website.\nThe vaccine PBAC outcomes are also publicly available.\nResources\nATAGI\u00a0\nPBAC outcomes\nAdvisory Committee on Vaccines\nAdvisory Committee on Immunization Practices (ACIP) at the Centers for Disease Control and Prevention (CDC) in USA \u2013 meetings and deliberations documents", "source": "mvec.mcri.edu.au/references/atagi-australian-technical-advisory-group-on-immunisation/index.html"}
{"id": "f60c0bd9ea3a-1", "text": "Australian Government Department of Health: Australian Technical Advisory Group on Immunisation (ATAGI) COVID-19 Working Group\nAuthor:\u00a0Nigel Crawford (Director, SAEFVIC, Murdoch Children\u2019s Research Institute)\nReviewed by:\u00a0Francesca Machingaifa (MVEC Education Nurse Coordinator, Murdoch Children\u2019s Research Institute)\nDate:\u00a0August 2021\nMaterials in this section are updated as new information and vaccines become available. The Melbourne Vaccine Education Centre (MVEC) staff regularly reviews materials for accuracy.\nYou should not consider the information in this site to be specific, professional medical advice for your personal health or for your family\u2019s personal health. For medical concerns, including decisions about vaccinations, medications and other treatments, you should always consult a healthcare professional.\nA B C D E F G H I J K L M N O P Q R S T U V W X Y Z", "source": "mvec.mcri.edu.au/references/atagi-australian-technical-advisory-group-on-immunisation/index.html"}
{"id": "39a1bd6b5bac-0", "text": "Background\nMany people may find the experience of having a needle an unpleasant one. However, for some people, the experience is much more difficult, presenting as a real phobia characterised by both severe and persistent anxiety and fear. As a result, this patient group often avoid needle-related experiences. This needle avoidance extends to the area of immunisation, resulting in the individual being left susceptible to vaccine preventable diseases. This can result in further procedures involving needles should they become unwell.\nGenerally speaking, it is recommended that children and adults with anxiety, intellectual disabilities and needle phobia\u2019s avoid attending large scale vaccination sites for immunisation. These sites are loud and busy and can increase distress. Smaller settings such as a GP clinic or pharmacy may be preferred. It is important to have a discussion with your immunisation provider prior to the appointment in order to make an individualised plan for how to approach the immunisation experience.\nStrategies to manage needle phobia and immunisation- information for individuals and care givers\nneedle phobia is real and it\u2019s ok to be scared\ndo not criticise the child or individual, this can make it worse\nwith young children, it may be best not to tell them until you arrive at clinic, as this will stop them overthinking the needle\nuse words such as \u201carm medicine\u201d or \u201cvaccine\u201d and avoid using words like \u201cneedle\u201d or \u201cinjection\u201d when descibing what is about to happen\nthe use of rewards for children may help encourage bravery\nthe application of local anaesthetic cream patches to the site a minimum of 45 minutes prior to appointment (available for purchase from chemists), may help to settle the fear of pain\nneedle phobia can be a lifelong problem if not treated appropriately.\nSpecialist phobia treatments", "source": "mvec.mcri.edu.au/references/needle-phobia/index.html"}
{"id": "39a1bd6b5bac-1", "text": "needle phobia can be a lifelong problem if not treated appropriately.\nSpecialist phobia treatments\nSpecialist trained psychologists and more recently hypnotherapists have had significant success in giving an individual mechanisms and strategies to help overcome or manage their needle phobia. Considering either pathway is recommended as a long term strategy to overcome needle phobia.\nStrategies to manage needle phobia and immunisation- information for health care providers\nEffective preparation, distraction techniques, pain management strategies and addressing the core reason for the phobia are all important steps in ensuring successful immunisation.\nChildren and adolescents\nencourage parents not to over discuss the vaccine/needle with the children prior to arrival as this can build up their fear\nhave a plan in place with the parents prior to their arrival at the clinic (in known phobic children)\ncarry out pre-immunisation checks and side effect explanation with parents when the child is out of the room or prior to arrival\nminimise discussions in front of the child as this can increase distress\nan individualised approach is more likely to lead to success\ndo not rush or attempt to force children to be vaccinated, this is likely to result in failure to vaccinate\ntake you time with clearly distressed patients, calmly talk them through the procedure and tips to manage their anxiety (deep breathing, looking away or counting).\nPeople with autism spectrum disorder (ASD)\nThe following strategies may assist in managing needle phobia in individuals with ASD:\ndiscuss the individual\u2019s communication style and capabilities with their parent/carer\nexplain everything you are going to do using clear, simple language\ninvolve the individual as much as possible by considering their likes/dislikes\nprovide support and positive reassurance\nremove distracting/disturbing stimuli\ntry not to stop stimming behaviours (eg. rocking, flapping) that may help the individual deal with distress\ndo not attempt to restrain the individual", "source": "mvec.mcri.edu.au/references/needle-phobia/index.html"}
{"id": "39a1bd6b5bac-2", "text": "do not attempt to restrain the individual\nolder individuals with ASD can be very difficult to immunise due to significant needle phobias. Restraining these children can result in injury to the carer, child or health care provider\nhave a low threshold to refer to a specialist immunisation provider for sedation.\nDistraction techniques\nYoung children or the intellectually disabled:\nbubbles upon entering the room and before and after needle\nmusical toys\nif able have one person blowing bubbles or creating noise with toy intermittently to maintain attention of child\nTV on with kids shows\nchild watching their favourite show on parents\u2019 phone.\nOlder children, adolescents or adults:\nphone/iPad with headphones watching their favourite show or music (give them time to settle into watching it)\nmake conversation eg. sport, upcoming holidays\ncountdown so they know when to be ready\nstrongly encourage them to look away.\nAdministration techniques\nprepare the vaccine out of view of the individual or before they come into room\navoid showing the individual the prepared vaccine and needle prior to administration\nplace the tray containing vaccines out of sight\nhold the vaccine to your side or behind you back until about to inject\nencourage the individual to close their eyes, look away or focus on the distraction method\ndon\u2019t over discuss the needle and administration of the vaccine\ndo necessary pre-vaccination checks and side effects only\nmake the process as quick as possible to give the patient minimal time to over-think the needle\nencourage adult individuals to bring a support person if they wish\na phobia in adolescents or adults can lead to a vasovagal or faint response. It is important that the individual is supported to lay down if needed.\nSedation\nIf immunisation attempts are unsuccessful, a referral for vaccines to be administered under sedation may be considered.\nPaediatric services", "source": "mvec.mcri.edu.au/references/needle-phobia/index.html"}
{"id": "39a1bd6b5bac-3", "text": "Paediatric services\nThe Royal Children\u2019s Hospital \u2013 Referrals for this service can be sent to Nurse Practitioner Immunisation via [email\u00a0protected]\nMonash Health \u2013 Referrals can be submitted as a HealthLink referral\nFamily Immunisation and Travel Specialists (FITS) \u2013 To make an appointment please call (03) 9508 6000.\nAdult services\nMonash Health \u2013 Referrals can be submitted as a HealthLink referral.\nResources\nRCH resources\nThe Royal Children\u2019s Hospital Clinical Practice Guidelines for Procedural Pain Management\nThe Royal Children\u2019s Hospital Be Positive: Nitrous Oxide\nThe Royal Children\u2019s Hospital comfort kids- for kids\nThe Royal Children\u2019s Hospital comfort kids- for parents\nThe Royal Children\u2019s Hospital Be Positive: Immunisations\nRCH Kids Health Info Podcast: Fear of needles. What helps?\nOther resources\nDr Daryl Cheng\u2019s Needle Phobia interview with The House of Wellness at Channel 7\nRACV: Scared of needles? Try these simple tips\nThe Conversation: Is your child frightened of needles? Here\u2019s how to prepare them for their COVID vaccine\nAuthors: Georgie Lewis (Clinical Manager, SAEFVIC, Murdoch Children\u2019s Research Institute)\u00a0and Rachael McGuire (SAEFVIC Research Nurse, Murdoch Children\u2019s Research Institute)\nReviewed by: Rachael McGuire (MVEC Education Nurse Coordinator) and Francesca Machingaifa (MVEC Education Nurse Coordinator)\nDate: February 2, 2023\nMaterials in this section are updated as new information and vaccines become available. The Melbourne Vaccine Education Centre (MVEC) staff regularly reviews materials for accuracy.\nYou should not consider the information in this site to be specific, professional medical advice for your personal health or for your family\u2019s personal health. For medical concerns, including decisions about vaccinations, medications and other treatments, you should always consult a healthcare professional.", "source": "mvec.mcri.edu.au/references/needle-phobia/index.html"}
{"id": "39a1bd6b5bac-4", "text": "A B C D E F G H I J K L M N O P Q R S T U V W X Y Z", "source": "mvec.mcri.edu.au/references/needle-phobia/index.html"}
{"id": "009225b6f5a5-0", "text": "What is it?\nMeningococcal disease constitutes any illness caused by the bacteria\u00a0Neisseria meningitidis.\u00a0There are 13 known sub-types (serogroups) and of these, 5 are currently vaccine preventable (B and A, C, W, Y).\nInvasive meningococcal disease (IMD) can cause meningitis (inflammation of the membrane covering the brain and spinal cord) and septicaemia (infection in the blood), as well as other infections like pneumonia (lung infection), arthritis (inflammation of the joints) and conjunctivitis (eye infection). Mortality (death) can be as high as 5-10% with permanent lifelong complications occurring in 10-20% of those who survive.\nWhat to look for\nThe incubation period of meningococcal is 1-7 days, more commonly 3-4 days. People with meningococcal disease can become extremely unwell very quickly. Symptoms can include fever, headache, neck stiffness, nausea, vomiting and photophobia (sensitivity to light). Cool, mottled extremities and leg pain can also occur. Babies can appear irritable or unsettled, have a high-pitched moaning cry, refuse or not wake for feeds and be lethargic (sleepy) or floppy. A petechial or purpuric rash can appear late in the disease progression (within 13-22 hours) or not at all.\nHow is it transmitted?\nDisease can be transmitted from person to person via respiratory droplets (eg. sneezing and coughing). Meningococcal bacteria can also live harmlessly at the back of the nose or throat, resulting in individuals being asymptomatic carriers.\nEpidemiology", "source": "mvec.mcri.edu.au/references/meningococcal/index.html"}
{"id": "009225b6f5a5-1", "text": "Epidemiology\nChildren < 2 years of age have the highest incidence of meningococcal disease in Australia, with another peak of disease among adolescents and young adults (15-24 years). Aboriginal and Torres Strait Islander people have a\u00a0much greater burden of disease than non-Indigenous people.\nThere are also certain medical conditions and medications that can increase an individual\u2019s risk of IMD. These include (but are not limited to) those with functional asplenia and hyposplenia, complement deficiency and those receiving treatment with eculizamab [see below for specific information for those with increased risk of IMD].\nPrevention\nMVEC strongly recommends everyone wishing to be protected against ACWY and B strains of meningococcal disease be immunised. Some individuals are eligible for funded vaccines via the National Immunisation Program (NIP). Those aged \u2265 6 weeks of age who do not meet the funding criteria can purchase vaccines privately through some councils, GPs and pharmacies.\nThe number of vaccine doses recommended depends on a person\u2019s age and risk factors for IMD.\nMeningococcal ACWY vaccines\nMVEC recommends 2 conjugate meningococcal ACWY vaccines:\nNimenrix\u00ae\nMenveo\u00ae\nA single dose of Nimenrix\u00ae is currently provided for free at 12 months of age and for all adolescents in Year 10 (or age equivalent) with catch up available for those aged 15-19 years. It is also funded for certain individuals of any age with immunocompromising conditions.\nMeningococcal ACWY primary course and booster doses for healthy individualsPrimary course", "source": "mvec.mcri.edu.au/references/meningococcal/index.html"}
{"id": "009225b6f5a5-2", "text": "Meningococcal ACWY primary course and booster doses for healthy individualsPrimary course\nVaccine brand Course commenced at 6 weeks to \u2264 5 months of age Course commenced at 6 months to \u2264 11 months of age Course commenced at 12 months to \u2264 23 months of age Course commenced at \u2265 2 years of age Nimenrix\u00ae\u20203 doses (minimum 8 weeks between 1st and 2nd doses; 3rd dose given at \u2265 12 months of age/8 weeks after 2nd dose, whichever is later)\u00a52 doses (2nd dose at \u2265 12 months of age/8 weeks after 1st dose, whichever is later)\u00a51 dose\u00a51 dose Menveo\u00ae\u20203 doses (minimum 8 weeks between 1st and 2nd doses; 3rd dose given at \u2265 12 months of age/8 weeks after 2nd dose, whichever is later)\u00a52 doses (2nd dose at \u2265 12 months of age/8 weeks after 1st dose, whichever is later)\u00a52 doses (minimum 8 weeks apart)\u00a51 dose \n\u2020 there is no registered upper age limit for the use of Menveo\u00ae or Nimenrix\u00ae.\n\u00a5 completing the course with the same vaccine brand is preferred but may not always be practical. The NIP funded 12 month dose of Nimenrix\u00ae may be used as the dose given at \u2265 12 months of age.\nBooster doses\nFurther booster doses are not routinely recommended for healthy individuals. In circumstances where someone has previously received a primary course of meningococcal ACWY and is offered a further dose in year 10 in line with the NIP, it is acceptable to to receive this dose.", "source": "mvec.mcri.edu.au/references/meningococcal/index.html"}
{"id": "009225b6f5a5-3", "text": "Meningococcal ACWY primary course and booster doses for those at increased risk of IMDIndividuals with specified medical conditions that increase the risk of IMD are recommended and funded to receive additional meningococcal vaccines and booster doses. These groups include:\nthose with defects in, or deficiency of complement components (including factor H, factor D or properdin deficiency),\nthose currently receiving or planning treatment with eculizumab (or biosimilar),\nthose with functional or anatomical asplenia (including sickle cell disease or haemoglobinopathies and congenital or acquired asplenia),\nanyone with HIV (regardless of disease stage or CD4+ cell count),\nanyone who previously received a haemopoietic stem cell transplant (HSCT).\nPrimary course\nVaccine brand Course commenced at 6 weeks to \u2264 5 months of age Course commenced at 6 months to \u2264 11 months of age Course commenced at \u2265 12 months of age Nimenrix\u00ae\u20204 doses (minimum 8 weeks apart, with the 4th dose given at \u2265 12 months of age/more than 8 weeks after the 3rd dose, whichever is later)\u00a53 doses (minimum 8 weeks apart, with the 3rd dose given at \u2265 12 months of age/8 weeks after 2nd dose, whichever is later)\u00a52 doses (minimum 8 weeks apart)\u00a5Menveo\u00ae\u20204 doses (minimum 8 weeks apart, with the 4th dose given at \u2265 12 months of age/more than 8 weeks after the 3rd dose, whichever is later)\u00a53 doses (minimum 8 weeks apart, with the 3rd dose given at \u2265 12 months of age/8 weeks after 2nd dose, whichever is later)\u00a52 doses (minimum 8 weeks apart)\u00a5", "source": "mvec.mcri.edu.au/references/meningococcal/index.html"}
{"id": "009225b6f5a5-4", "text": "\u2020 there is no registered upper age limit for the use of Menveo\u00ae or Nimenrix\u00ae.\n\u00a5 completing the course with the same vaccine brand is preferred but may not always be practical. The NIP funded 12 month dose of Nimenrix\u00ae may be used as the booster dose for those who have commenced the course at < 12 months of age.\nBooster doses\nVaccine brand Where the primary course was completed at \u2264 6 years of age Where the primary course was completed at \u2265 7 years of age Nimenrix\u00ae\u2020\u00a7 OR Menveo\u00ae\u2020\u00a7Give a booster dose 3 years following the completion of the primary course, then further booster doses every 5 years Give a booster dose every 5 years following the completion of the primary course \n\u2020 there is no registered upper age limit for the use of Menveo\u00ae or Nimenrix\u00ae.\n\u00a7 using either Menveo\u00ae or Nimenrix\u00ae as a booster dose, regardless of the brand used for the primary course, is approriate.\nMeningococcal B vaccines\nThere are currently 2 vaccines available for protection against meningococcal B disease.\nBexsero\u00ae\nTrumenba\u00ae\nMeningococcal B vaccines brands are\u00a0not\u00a0interchangeable.\nA primary course of Bexsero\u00ae is available on the NIP for Aboriginal and Torres Strait Islander children < 2 years of age, as well as some individuals of any age with immunocompromising conditions.\nParacetamol advice", "source": "mvec.mcri.edu.au/references/meningococcal/index.html"}
{"id": "009225b6f5a5-5", "text": "Paracetamol advice\nIt is widely recognised that children receiving\u00a0Bexsero\u00ae\u00a0are more likely to experience fever following vaccination. It is for this reason that children < 4 years of age are recommended to receive prophylactic paracetamol (15mg/kg per dose) 30 minutes prior to vaccination (or as soon as possible after), as well as 2 subsequent doses (4-6 hours apart) to reduce the likelihood and severity of fever. This should be administered regardless of whether the child is experiencing a fever or not.\nMeningococcal B primary course and booster doses for healthy individualsPrimary course\nVaccine brand Course commenced at 6 weeks to \u2264 11 months of age Course commenced at 12 months to \u2264 9 years of age Course commenced at \u2265 10 years Bexsero\u00ae\u20203 doses (minimum 8 weeks between 1st and 2nd doses; 3rd dose at \u2265 12 months of age/more than 8 weeks after the 2nd dose, whichever is later)\u00a5#\u00a32 doses (minimum 8 weeks apart)\u00a5#\u00a32 doses (minimum 8 weeks apart)\u00a5Trumenba\u00ae\u2020N/A N/A 2 doses (minimum 6 months apart)\u00a5\n\u2020 Bexsero\u00ae is registered for use in those 6 weeks of age and older. Trumenba\u00ae is only registered for use in those 10 years of age or older.\n\u00a5 meningococcal B vaccine brands are not interchangeable for primary courses or booster doses.\n# prophylactic paracetamol is recommended to those < 4 years of age (refer to advice above).\n\u00a3 funded on the NIP for Aboriginal and Torres Strait Islander children < 2 years of age and those identified as medically at risk (see recommendations below for further information).\nN/A- not recommended in this age group.\nBooster doses", "source": "mvec.mcri.edu.au/references/meningococcal/index.html"}
{"id": "009225b6f5a5-6", "text": "N/A- not recommended in this age group.\nBooster doses\nFurther booster doses of meningococcal B vaccines are not routinely recommended for healthy individuals.\nMeningococcal B primary course and booster doses for those with increased risk of IMDIndividuals with specified medical conditions that increase the risk of IMD are recommended and funded to receive additional meningococcal B vaccines. From December 2022, following an NCIRS-led GRADE review of the evidence, ATAGI endorsed an update to the Australian Immunisation Handbook recommendations which now include booster doses of meningococcal B vaccines.\nEligible individuals include:\nthose with defects in, or deficiency of complement components (including factor H, factor D or properdin deficiency),\nthose currently receiving or planning treatment with eculizumab (or biosimilar),\nthose with functional or anatomical asplenia (including sickle cell disease or haemoglobinopathies and congenital or acquired asplenia),\nanyone with HIV (regardless of disease stage or CD4+ cell count),\nanyone who previously received a haemopoietic stem cell transplant (HSCT).\nMVEC strongly encourages the active follow up of individuals who meet these criteria to ensure that appropriate vaccine schedules and their recommended booster doses are administered in line with the updated guidance to optimally protect vulnerable patients.\nPrimary course", "source": "mvec.mcri.edu.au/references/meningococcal/index.html"}
{"id": "009225b6f5a5-7", "text": "Primary course\nVaccine brand Course commenced at 6 weeks to \u2264 5 months of age Course commenced at 6 months to \u2264 11 months of age Course commenced at 12 months to \u2264 9 years of age Course commenced at \u2265 10 years of age Bexsero\u00ae\u20204 doses (minimum 8 weeks apart, with the 4th dose given at \u2265 12 months of age/more than 8 weeks after the 3rd dose, whichever is later)\u00a5#3 doses (minimum 8 weeks apart, with the 3rd dose given at \u2265 12 months of age/8 weeks after 2nd dose, whichever is later)\u00a5#2 doses (minimum 8 weeks apart)\u00a5#2 doses (minimum 8 weeks apart)\u00a5Trumenba\u00ae\u2020N/A N/A N/A 3 doses (1 months between 1st and 2nd doses; 6 months between 1st and 3rd doses)\u00a5\n\u2020 Bexsero\u00ae is registered for use in those 6 weeks of age and older. Trumenba\u00ae is only registered for use in those 10 years of age or older.\n\u00a5 meningococcal B vaccine brands are not equivalent or interchangeable for primary courses or booster doses.\n# prophylactic paracetamol is recommended to those < 4 years of age (refer to advice above).\nN/A- not recommended in this age group.\nBooster doses\u00a7", "source": "mvec.mcri.edu.au/references/meningococcal/index.html"}
{"id": "009225b6f5a5-8", "text": "N/A- not recommended in this age group.\nBooster doses\u00a7 \nVaccine brand Where the primary course was completed at \u2264 6 years of age Where the primary course was completed at \u2265 7 years to \u2264 9 years of age Where the primary course was completed at \u2265 7 years of age Bexsero\u00ae\u2020Give a single booster dose 3 years after completing the primary course\u00a5Give a single booster dose 5 years after completing the primary course\u00a5Give a single booster dose 5 years after completing the primary course\u00a5Trumenba\u00ae\u2020N/A N/A Give a single booster dose 5 years after completing the primary course\u00a5\n\u00a7 refer to GRADE assessment for more information.\n\u2020 Bexsero\u00ae is registered for use in those 6 weeks of age and older. Trumenba\u00ae is only registered for use in those 10 years of age or older.\n\u00a5 meningococcal B vaccine brands are not equivalent or interchangeable for primary courses or booster doses.\nN/A- not recommended in this age group.\nResources\nBetter Health Channel: Meningococcal disease- immunisation\nAustralian Immunisation Handbook: Meningococcal\nRCH Kids Health information: Meningococcal infection\nATAGI clinical advice on changes to recommendations for meningococcal vaccines from 1 July 2020\nMVEC: Febrile seizures (febrile convulsions) and vaccines\nMVEC: Asplenia and hyposplenia\nNCIRS: Meningococcal vaccines GRADE assessments\nAuthors: Rachael McGuire (MVEC Education Nurse Coordinator), Georgina Lewis (Clinical Nurse Manager, SAEFVIC, Murdoch Children\u2019s Research Institute) and Nigel Crawford (Director SAEFVIC, Murdoch Children\u2019s Research Institute)", "source": "mvec.mcri.edu.au/references/meningococcal/index.html"}
{"id": "009225b6f5a5-9", "text": "Reviewed by: Rachael McGuire (MVEC Education Nurse Coordinator) and Nigel Crawford (Director SAEFVIC, Murdoch Children\u2019s Research Institute)\nDate: July 4, 2023\nMaterials in this section are updated as new information and vaccines become available. The Melbourne Vaccine Education Centre (MVEC) staff regularly reviews materials for accuracy.\nYou should not consider the information in this site to be specific, professional medical advice for your personal health or for your family\u2019s personal health. For medical concerns, including decisions about vaccinations, medications and other treatments, you should always consult a healthcare professional.\nA B C D E F G H I J K L M N O P Q R S T U V W X Y Z", "source": "mvec.mcri.edu.au/references/meningococcal/index.html"}
{"id": "18bc567d1f5b-0", "text": "What is it?\nCOVID-19 disease is caused by the highly contagious SARS-CoV-2 virus, a type of coronavirus discovered in 2019 that spread rapidly resulting in a global pandemic. Multiple strains of SARS-CoV-2 have since emerged and public health authorities continue to monitor these. The Omicron strain is currently the most dominant variant circulating and has been shown to be more transmissible than previous variants. \nCOVID-19 disease has had vast impacts on society. In addition to the public health implications, the economic, social and mental health effects have been and continue to be enormous.\u00a0\nWhat to look for?\nInfections can be asymptomatic or can result in a spectrum of symptoms, from mild respiratory symptoms to more serious disease affecting multiple organs and systems. Severe disease can lead to hospitalisation and mechanical ventilation, or even death.\u00a0\u00a0\nCommon symptoms of acute COVID-19 infection can include fever, cough, myalgia (body aches), dyspnoea (difficulty breathing), gastrointestinal symptoms (e.g., diarrhoea, nausea or vomiting), headache, sore throat, loss of smell or taste, and rhinorrhoea (runny nose).", "source": "mvec.mcri.edu.au/references/comirnaty/index.html"}
{"id": "18bc567d1f5b-1", "text": "Some individuals can experience ongoing symptoms for weeks or months after their initial diagnosis, this is known as long COVID or post-COVID conditions. Symptoms can include extreme fatigue, post-exertional malaise, dyspnoea, chest pain, palpitations, fever, arthralgia (joint pain), paresthesia (pins and needles), rash, hoarse voice, problems with memory and concentration (brain fog), sleep problems, changes with taste or smell, gastrointestinal symptoms, changes in menstrual cycles, weight loss and poor appetite, mood changes (depression, anxiety), and difficulty completing activities of daily living. In addition, long COVID can have a huge impact on an individual\u2019s quality of life, mental health, and ability to participate in work or schooling. Long COVID is more common in people who have experienced severe COVID-19 disease, those who had underlying medical conditions prior to infection (e.g., hypertension, chronic lung disease, diabetes, obesity), and those who are unvaccinated.\nPaediatric Multisystem Inflammatory Syndrome Temporally associated with SARS-CoV-2 (PIMS-TS), or Multisystem Inflammatory Syndrome in Children associated with COVID-19 (MIS-C), is a newly described condition that has been reported in children in the first 2-6 weeks after COVID-19 infection. It is an inflammatory condition, similar to Kawasaki disease, and is characterised by rash, fever, shock and abdominal pain. Children experiencing PIMS-TS almost always require hospitalisation for treatment.\nHow is it transmitted?", "source": "mvec.mcri.edu.au/references/comirnaty/index.html"}
{"id": "18bc567d1f5b-2", "text": "How is it transmitted?\nTransmission of COVID-19 is through the inhalation of virus particles which have been made airborne after an infected person coughs, sneezes, breathes, speaks or sings. Droplets or particles can contaminate surfaces and can be spread when a person touches these surfaces and then touches their nose, mouth or eyes. Poorly ventilated settings can also contribute to the spread of COVID-19 as it means aerosol particles can remain suspended in the air for minutes to hours.\nThe incubation period for the disease is 1-14 days, with most individuals displaying symptoms 5-6 days after being exposed. Individuals are thought to be infectious up to 48 hours before symptoms appear and are most infectious in this prodromal period and the early stages of their illness. People with asymptomatic disease can still infect others. \u00a0\nEpidemiology\nSince 2019, over 765 million infections have been reported worldwide contributing to almost 7 million deaths, with true figures likely to be much higher.\u00a0\nIndividuals with immune compromise (due to taking specific medications/therapies or due to a medical condition), advancing age (particularly > 70 years), obesity, respiratory conditions, pregnancy, heart disease, diabetes, renal disease, liver disease, neurological conditions and disability are more likely to experience severe symptoms if infected with SARS-CoV-2.\nCertain occupations, such as working in health care, carry a greater chance of exposure to SARS-CoV-2 and therefore infection.\nPrevention\nStrategies to reduce risk of transmission of COVID-19 disease include standard precautions such as hand hygiene, wearing a mask indoors when remaining socially distant is not possible, and ensuring good ventilation.\u00a0Vaccines can reduce the severity of COVID-19 symptoms and need for hospitalisation.\nPrimary course", "source": "mvec.mcri.edu.au/references/comirnaty/index.html"}
{"id": "18bc567d1f5b-3", "text": "Primary course\nA primary course of vaccination is recommended for all individuals from 5 years of age. Immune competent (those with a functioning immune system) individuals should receive 2 doses given 8 weeks apart, whereas those with immunocompromise should receive 3 doses, with 8 weeks between each dose.\nChildren aged 6 months to \u2264 4 years with severe immunocompromise, disability, and those who have complex and/or multiple health conditions which increase the risk of severe COVID-19 should also receive a primary course of COVID-19 vaccination. In this age group a primary course consists of 3 doses of Comirnaty (Pfizer) [maroon cap] with 8 weeks between each dose, regardless of immune function.\nBooster doses\nIn 2023 ATAGI recommends a single COVID-19 booster dose for all adults aged 65 years and over, as well as adults aged 18-64 years with medical comorbidities that increase their risk of severe COVID-19 disease.\nAdults aged 18-64 years (without risk factors for severe COVID-19 disease), and children and adolescents aged 5-17 years (with medical comorbidities that increase their risk of severe disease or with disability or complex health needs) can consider a booster dose. Booster doses are not recommended in anyone less than 5 years of age.\nVaccines brands available for use by age group", "source": "mvec.mcri.edu.au/references/comirnaty/index.html"}
{"id": "18bc567d1f5b-4", "text": "Vaccines brands available for use by age group\nAge group Vaccine brand Comirnaty (Pfizer- original) [maroon cap] Comirnaty (Pfizer- original) [orange cap] Comirnaty (Pfizer- original) [purple cap] Comirnaty (Pfizer bivalent- original/BA.1) [grey cap] Comirnaty (Pfizer bivalent- original/BA.4/5) [grey cap] Spikevax (Moderna bivalent- original/BA.1) [blue cap/green label] Spikevax (Moderna bivalent- original/BA.4/5) [pre-filled syringe] Nuvaxovid (Novavax) 6 months- \u2264 4 years \u2713 5 - \u2264 11 years \u2713 12 - \u2264 17 years \u2713 \u2713 \u2713 \u2713 \u2265 18 years \u2713 \u2713 \u2713 \u2713 \u2713 \u2713 \n shaded boxes indicate preferred vaccine type used in each age group.\n shaded boxes indicate that vaccine is not available for use in this age group.\nSide effects following vaccination\nCommon side effects\u00a0\nMost side effects following COVID-19 vaccination are mild and can include pain at the injection site, fatigue, headache, lymphadenopathy and fever.\u00a0\nRare side effects", "source": "mvec.mcri.edu.au/references/comirnaty/index.html"}
{"id": "18bc567d1f5b-5", "text": "Rare side effects\u00a0\u00a0\nMyocarditis (inflammation of the heart muscle) and pericarditis (inflammation of the lining around the heart) are rare conditions that have been reported following administration of COVID-19 vaccines. They are most commonly associated with viral infections (including COVID-19 disease) but can also be triggered by other factors such as medications and autoimmune conditions. In the setting of vaccination, the peak risk group for myocarditis is young adult males aged between 16-24 years old following a second dose of vaccination. Pericarditis occurring after vaccination is more common in the 20-45 year old age group for both males and females.\u00a0\nThrombosis with thrombocytopenia (TTS) was a rare condition that was reported to occur in people who had previously received the COVID-19 vaccine Vaxzevria (AstraZeneca). From March 20, 2023 Vaxzevria is no longer available for use in Australia.\nCommonly asked questions\nCan pregnant or breastfeeding women receive COVID-19 vaccines?Yes it is safe to administer COVID-19 vaccines at any stage of pregnancy. Due to an increased risk of severe outcomes for pregnant women and their unborn babies it is recommended that pregnant women have received a primary course of COVID-19 vaccination. Administration of booster doses can also be considered if they are due.\nBreastfeeding women can receive COVID-19 vaccines. They do not need to stop breastfeeding before or after being vaccinated.\nReal world surveillance of international data on mRNA COVID-19 vaccine administration in pregnant women has shown no significant safety concerns for either the mother or the baby. Further to this, antibodies have been detected in the cord blood and breastmilk of vaccinated women, suggesting a transfer of protection to the baby.", "source": "mvec.mcri.edu.au/references/comirnaty/index.html"}
{"id": "18bc567d1f5b-6", "text": "Where can I access COVID-19 vaccines?COVID-19 vaccines can be accessed through GP clinics, some pharmacies (for vaccine recipients aged \u2265 5 years) and hospital immunisation services at Monash Children\u2019s Hospital,\u00a0the Royal Children\u2019s Hospital\u00a0and\u00a0Joan Kirner Women\u2019s and Children\u2019s Hospital (Sunshine). To find your closest provider and make an appointment visit the\u00a0Health direct website or phone the coronavirus hotline on 1800 675 398.\nWhat is the recommended interval between COVID-19 infection and vaccination?An interval of 6 months between COVID-19 infection and COVID-19 vaccination (primary dose or booster dose) is recommended.\nCan COVID-19 vaccines be administered on the same day as other vaccines?In most instances COVID-19 vaccines can be co-administered (given on the same day) with other vaccines, and this includes influenza vaccines. The only exception to this is for children aged 6 months to < 5 years, where separating COVID-19 vaccines and other vaccines by 7-14 days is preferred. This recommendation aims to minimise adverse events such as fever, which can occur in the 3 days following inactivated vaccines and 7-10 days post vaccination with the live-attenuated MMR vaccine.", "source": "mvec.mcri.edu.au/references/comirnaty/index.html"}
{"id": "18bc567d1f5b-7", "text": "How do we complete a primary course of vaccination for children aged 6 months - \u2264 4 years who commenced their course with Spikevax (Moderna) `{`original/ancestral`}` now that it is no longer available?Immune competent children who commenced their primary course with 1 dose of Spikevax (Moderna), can complete their primary course with 1 dose of age-appropriate Comirnaty (Pfizer) only. Severely immunocompromised children who received 1 dose of Spikevax (Moderna), should receive a further 2 doses of Comirnaty (Pfizer) 8 weeks apart to complete the primary course. Severely immunocompromised children who received 2 doses of Spikevax (Moderna) should receive 1 further dose of Comirnaty (Pfizer) 8 weeks later to complete the primary course.\nResources\nMVEC: Vaccine platforms\u00a0\nMVEC: Immunosuppression and vaccines\nVictorian COVID-19 vaccine safety report\nAustralian Government Department of Health and Aged Care: International COVID-19 vaccines recognised by Australia\nAustralian Government Department of Health: Comirnaty (Pfizer)\u00a0\u00a0\nAustralian Government Department of Health: Spikevax (Moderna)\u00a0\u00a0\nAustralian Government Department of Health: Nuvaxovid (Novavax)\nCDC: Long COVID or post COVID conditions\u00a0\nDepartment of Health Victoria: Coronavirus \u00a0\nATAGI clinical guidance on COVID-19 vaccine administration errors\nAuthors: Francesca Machingaifa (MVEC Education Nurse Coordinator) and Rachael McGuire (MVEC Education Nurse Coordinator)\nReviewed by:\u00a0Rachael McGuire (MVEC Education Nurse Coordinator)\nDate: June 6, 2023\nMaterials in this section are updated as new information and vaccines become available. The Melbourne Vaccine Education Centre (MVEC) staff regularly reviews materials for accuracy.", "source": "mvec.mcri.edu.au/references/comirnaty/index.html"}
{"id": "18bc567d1f5b-8", "text": "You should not consider the information in this site to be specific, professional medical advice for your personal health or for your family\u2019s personal health. For medical concerns, including decisions about vaccinations, medications and other treatments, you should always consult a healthcare professional.\nA B C D E F G H I J K L M N O P Q R S T U V W X Y Z", "source": "mvec.mcri.edu.au/references/comirnaty/index.html"}
{"id": "53fbcd1e96ee-0", "text": "As Australia aims to roll out a COVID-19 vaccine to everyone age eligible, it means that a number of individuals may experience a serious adverse event following immunisation (AEFI). Supporting these vaccinees is important and providing compensation to individuals who have experienced a vaccine injury is a strategy that has been used widely, for a long period of time, in countries such as the United States, UK and New Zealand to promote vaccine confidence and maintain vaccination rates. It is not a concept designed to suggest causation or fault, but a scheme to promote trust in vaccination programs as well as provide vaccine manufacturers with the reassurance to produce vaccines without fear of legal action.\nAn example of a serious AEFI requiring hospitalisation is thrombosis with thrombocytopenia syndrome (TTS) following Vaxzevria (AstraZeneca), with the symptoms experienced resulting in a significant impact on a vaccine recipient.\nThe No Fault COVID-19 Indemnity Scheme is funded by the Commonwealth government and has been introduced to allow Australians who have been significantly impacted by an adverse event following a COVID-19 vaccine to apply for access to financial assistance. There is currently no compensation scheme within Australia for applications relating to non-COVID-19 vaccines.\nWhat is involved?\nThe No Fault COVID-19 Indemnity Scheme will run for 2 years and cover the cost of injuries ($1,000 and above) in situations where a serious adverse reaction has been caused by a COVID-19 vaccination. A full list of qualifying conditions as well as harm not covered under the scheme can be found at COVID-19 vaccine claims scheme- Overview.\nAny vaccine encounter which has occurred since February 2021 is covered under this scheme. Individuals vaccinated within Australia, as well as those overseas as part of the Australian Government Overseas Network (AGON) COVID-19 vaccine rollout managed by DFAT are eligible.\nWhich vaccines are covered under this scheme?", "source": "mvec.mcri.edu.au/references/covid-19-vaccine-compensation-scheme/index.html"}
{"id": "53fbcd1e96ee-1", "text": "Which vaccines are covered under this scheme?\nAll TGA approved COVID-19 vaccines are covered under this scheme. Comirnaty (Pfizer), Spikevax (Moderna), Vaxzevria (AstraZeneca) and Nuvaxovid (Novavax) are currently in use within Australia;. COVID-19 Vaccine Janssen is also approved by the TGA however is not in use in Australia.\nHow to make a claim\nAffected individuals (or an individual acting on their behalf) can submit their interest in making a claim via Register your interest in the COVID-19 Vaccine Claims Scheme.\nEach claim is assessed by independent experts for accuracy and legitimacy. Evidence required in a claim includes:\ndetails of the injury (including any medical documentation relating to its likely relationship to a COVID-19 vaccination)\nhospitalisation\nmedical costs\nlost wages.\nResources\nAustralian Government Department of Health: COVID-19 vaccine claims scheme\nAustralian Government Department of Health: Register your interest in the COVID-19 vaccine claims scheme\nCOVID-19 Vaccine Claims Scheme- Frequently asked questions\nCOVID-19 vaccination: After your Spikevax (Moderna) vaccine\nCOVID-19 vaccination: After your Comirnaty (Pfizer) vaccine\nCOVID-19 vaccination: After your Vaxzevria (AstraZeneca) vaccine\nCOVID-19 vaccination: After your Nuvaxovid (Novavax) vaccine\nAuthors: Rachael McGuire (MVEC Education Nurse Coordinator), Nigel Crawford (Director SAEFVIC, Murdoch Children\u2019s Research Institute) and Francesca Machingaifa (MVEC Education Nurse Coordinator)\nReviewed by: Rachael McGuire (MVEC Education Nurse Coordinator)\nDate: February 1, 2022\nMaterials in this section are updated as new information and vaccines become available. The Melbourne Vaccine Education Centre (MVEC) staff regularly reviews materials for accuracy.", "source": "mvec.mcri.edu.au/references/covid-19-vaccine-compensation-scheme/index.html"}
{"id": "53fbcd1e96ee-2", "text": "You should not consider the information in this site to be specific, professional medical advice for your personal health or for your family\u2019s personal health. For medical concerns, including decisions about vaccinations, medications and other treatments, you should always consult a healthcare professional.\n\u00a0\nA B C D E F G H I J K L M N O P Q R S T U V W X Y Z", "source": "mvec.mcri.edu.au/references/covid-19-vaccine-compensation-scheme/index.html"}
{"id": "76c7c2365293-0", "text": "Rituximab is becoming a frequently used treatment option for many patients with complex medical needs, including in oncology and rheumatology. It is an immune suppressive medication which greatly impacts the production and functionality of immune cells, including the near complete depletion of B-cells. Once treatment with rituximab has been completed, recovery of immune cell function can take 3-12 months, and even longer in some cases. It may be used as a once-only dose or as a long term therapy.\nDue to the effects on lymphocytes, patients on rituximab therapy are considered immune suppressed and are at a greater risk of vaccine preventable diseases. However, recommendations for immunisation of these patients is complicated by the inability to produce an immune response to vaccines without functioning B- and T-cells.\nMany patients on rituximab are also receiving concomitant immunoglobulin therapy. As this is a blood product, it further complicates the immunisation recommendations involving live-attenuated vaccines.\nPrior to commencing treatment\nWhere possible please ensure patients are up to date for their age with the current immunisation schedule. Ideally inactivated vaccines should be completed at least 1 week prior, and any live-attenuated vaccines should be completed a minimum of 4 weeks prior to commencing treatment. The same principle also applies to COVID-19 vaccines.\nDuring treatment\nDue to lack of immune cell function, all future immunisations should be withheld whilst on rituximab. An immunisation medical exemption form should be completed where appropriate to ensure that the patient is not considered overdue [see resources].", "source": "mvec.mcri.edu.au/references/rituximab-and-immunisation-recommendations/index.html"}
{"id": "76c7c2365293-1", "text": "The exception to this, may be for influenza and COVID-19 vaccines. Some studies have indicated that a partial immune response to the influenza vaccine in patients receiving rituximab therapy may occur. For this reason MVEC recommends that patients continue to be immunised against influenza whilst on therapy and receive 2 doses of the age-appropriate vaccine annually, minimum of 4 weeks apart (regardless of age or vaccine history).\nDue to the potential risk for severe COVID-19 disease and its complications in this population, which may outweigh the lack of vaccine response, COVID-19 vaccination whilst on rituximab could be considered.\nCOVID-19 vaccination and rituximab\nStudies are still ongoing to determine optimum timing and vaccine efficacy in patients on rituximab. However, based on evidence from other vaccines, the assumption is that there is a diminished response to COVID-19 vaccination.\nTherefore, important principles to consider for this group of patients include:\nit is not recommended to delay initiation or disrupt optimum timing of rituximab if being used for cancer treatment\ndue to its immunosuppressive effects, patients on rituximab are at higher risk of severe COVID-19 disease and poor COVID-19 disease outcomes.\nAs such, COVID-19 vaccination could be performed as close to the end of a rituximab cycle as possible, or prior to the initiation of therapy. There is no current data to inform optimum timing of two-dose COVID-19 vaccination regimes and intervals.\nRefer to MVEC: immunosuppression and vaccines\nImmunisation of household contacts\nAll close contacts should ensure that they are up to date with the routine immunisation schedule, including MMR, varicella and pertussis vaccines. Annual Influenza vaccination is strongly recommended. COVID-19 vaccination is encouraged.\nSerology", "source": "mvec.mcri.edu.au/references/rituximab-and-immunisation-recommendations/index.html"}
{"id": "76c7c2365293-2", "text": "Serology\nThere is no need to check serology pre- or post-rituximab therapy. There is currently no established immune correlate of protection for COVID-19.\nPatients should be aware of their immune suppression and avoid potential exposures to vaccine preventable diseases. The need to continue preventative measures such as social distancing,\u00a0mask wearing\u00a0and hand\u00a0hygiene should be discussed. Medical advice should be sought if exposure does occur [see resources for post-exposure immunoglobulin recommendations].\nPost treatment\nPost the completion of rituximab therapy, immunoglobulin and B-cell levels should be checked every 3 months. Once both levels have returned to normal AND \u2265 6 months post treatment has lapsed (whichever is later), immunisation with both inactivated and live-attenuated vaccines can recommence. For patients who have received immunoglobulin alongside their rituximab, specific intervals are recommended between the administration of live-attenuated vaccines and blood products/immunoglobulin [refer to MVEC: Live-attenuated vaccines and immunoglobulins or blood products]. Any previous vaccine history (routine vaccines) should be disregarded due to the loss of immune memory. There is currently no recommendation for additional booster doses of COVID-19 vaccines.\nPlease refer to MVEC: Post rituximab therapy immunisation guideline\u00a0for re-immunisation recommendations.\nResources\nMVEC: Post Rituximab therapy immunisation guideline\nMVEC: Influenza vaccine recommendations\nDHHS: Medical exemption forms\nAustralian Immunisation Handbook: Post-exposure prophylaxis for people non-immune to hepatitis B\nAustralian Immunisation Handbook: Post exposure prophylaxis for people non-immune to measles\nAustralian Immunisation Handbook: Post exposure prophylaxis for people non-immune to varicella\nAustralian Immunisation Handbook: Post exposure prophylaxis for people non-immune to tetanus", "source": "mvec.mcri.edu.au/references/rituximab-and-immunisation-recommendations/index.html"}
{"id": "76c7c2365293-3", "text": "Australian Immunisation Handbook: Post exposure prophylaxis for people non-immune to tetanus\nCheng D, Barton R, Greenway A, Crawford N Rituximab and protection from vaccine preventable diseases; applying the evidence to pediatric patients. Expert Review of Vaccines 2016 Volume 15(12): 1567-1574\nAuthors:\u00a0Rachael McGuire (SAEFVIC Research Nurse, Murdoch Children\u2019s Research Institute), Daryl Cheng (Senior Research Fellow, Murdoch Children\u2019s Research Institute) and Theresa Cole (Consultant, Allergy and Immunology, The Royal Children\u2019s Hospital)\nReviewed by: Theresa Cole (Consultant, Allergy and Immunology, The Royal Children\u2019s Hospital)\nDate: April 6, 2023\nMaterials in this section are updated as new information and vaccines become available. The Melbourne Vaccine Education Centre (MVEC) staff regularly reviews materials for accuracy. You should not consider the information in this site to be specific, professional medical advice for your personal health or for your family\u2019s personal health. For medical concerns, including decisions about vaccinations, medications and other treatments, you should always consult a healthcare professional.\nA B C D E F G H I J K L M N O P Q R S T U V W X Y Z", "source": "mvec.mcri.edu.au/references/rituximab-and-immunisation-recommendations/index.html"}
{"id": "7c99d9cba3a1-0", "text": "Most vaccines available for use in Australia are administered via intramuscular or subcutaneous route, with several being administered intradermally or orally. Administering vaccines via the recommended route and using correct technique is of paramount importance to ensure optimal immune response, minimise side effects and reduce the risk of injury to the patient.\nRoutes of administration\nIntramuscularIntramuscular vaccines are administered into the muscle layer of tissue at a 90\u00b0 angle. Muscle contains a vast amount of blood vessels resulting in increased blood supply which enables the vaccine to disperse easily. In addition, muscles contain dendritic (antigen-presenting) immune cells that initiate a long-lasting immune response. Intramuscular vaccines tend to have fewer side-effects other than redness and pain at the injection site, which are usually mild and short lived.\nSubcutaneousSubcutaneous vaccines are administered into the subcutaneous, or fatty layer beneath the skin at a 45\u00b0 angle. Vaccines designed for subcutaneous administration are absorbed at a slower and more constant rate as there is less blood supply in subcutaneous tissue than muscle.\nIntradermalIntradermal vaccines are administered into the outer layers of skin, between the epidermis and the dermis at a 5-15\u00b0 angle. The epidermal and dermal layers contain many different cells including the antigen-presenting cells (APC\u2019s) that are thought to play a significant role in mediating an efficient and protective immune response to specific vaccines. The 3 main APC\u2019s are macrophages, dendritic cells and B cells. APC\u2019s present specific antigens to particular cells in the immune system that are responsible in eliciting an immune mediated response that in turn creates memory cells and antibodies.\nIntradermal vaccination is a unique method of vaccine delivery which requires specific training to ensure vaccine safety and efficacy.", "source": "mvec.mcri.edu.au/references/administration-of-injected-vaccines-correct-technique/index.html"}
{"id": "7c99d9cba3a1-1", "text": "OralOral vaccines activate immune cells in the mucousal membranes lining the gastrointestinal tract which is beneficial in protecting against diseases that affect the gut.\nDepending on the vaccine, oral vaccines can come in either tablet or liquid formulation. Liquid vaccines recommended for oral administration should never be injected. Oral vaccines available in tablet form should not be chewed or broken.\nPlease note, if an infant receiving an oral vaccine spits out a small amount of the dose of vaccine it is still considered a valid dose and doesn\u2019t need repeating. If they spit out most of the dose of vaccine within minutes of receiving it, a repeat dose should be administered at the same visit.\nInjectable vaccines\nIntramuscular and subcutaneous injection\nRecommended site for injection in infants < 12 months of ageThe recommended injection site is the middle third of the vastus lateralis (anterolateral thigh).\nTo locate the correct anatomical site for injection:\nensure the infant\u2019s leg is completely exposed\nlocate the upper and lower anatomical landmarks- greater trochanter of femur and patella\ndraw an imaginary line between the 2 landmarks down the front of the thigh\nthen imagine the thigh is divided into thirds\nthe correct injection site is located in the middle third and on the outer aspect of the imaginary line (see images below).\nWhere only two vaccines are scheduled it is recommended to give one vaccine into each thigh. If more than two vaccines are recommended at the one visit, two vaccines may be given into each thigh ensuring they are separated by 2.5 cm (refer to images below). When administering more than one vaccine into the same thigh, it is important to consider the reactogenicity of each vaccine. Those that are considered more reactogenic should be in different thighs where possible. For example, meningococcal B (Bexsero\u00ae) is frequently associated with increased local site reactions.", "source": "mvec.mcri.edu.au/references/administration-of-injected-vaccines-correct-technique/index.html"}
{"id": "7c99d9cba3a1-2", "text": "In some circumstances where the thigh cannot be used (e.g. congenital limb malformations, active eczema or hip brace placement) the deltoid may be used (refer to the recommended site for injection in children \u2265 12 months for guidance).\nRecommended site for injection in children \u2265 12 months of age, adolescents and adultsThe recommended injection site is the deltoid (upper arm).\nTo locate the correct anatomical site for injection:\nexpose the arm completely from the top of the shoulder to the elbow; remove shirt or clothing if needed\nlocate the upper and lower anatomical landmarks- acromion (shoulder tip) and the muscle insertion of the deltoid (deltoid tuberosity)\ndraw an imaginary inverted triangle below the shoulder tip, using the identified landmarks (see images below)\nthe site for injection is halfway between the acromion and the deltoid tuberosity, in the middle of the deltoid muscle (triangle).\nTwo or more vaccines may be given into the same deltoid ensuring they are separated by 2.5 cm (refer to images below). When administering more than one vaccine into the same deltoid, it is important to consider the reactogenicity of each vaccine. Those that are considered more reactogenic should be in different deltoids where possible. For example, meningococcal B (Bexsero\u00ae) and pneumococcal polysaccharide (Pneumovax\u00ae 23) are frequently associated with increased local site reactions.\nUtilising the anterolateral thigh may also be required in this age group (e.g. congenital limb malformations, history of auxillary clearance, active eczema or insufficient spacing available). In these circumstances, there is a preference for administering the least reactogenic vaccines via this site (refer to the recommended site for injection in children \u2264 12 months for guidance).\nIntradermal injection", "source": "mvec.mcri.edu.au/references/administration-of-injected-vaccines-correct-technique/index.html"}
{"id": "7c99d9cba3a1-3", "text": "Intradermal injection\nRecommended sites for intradermal injection in any ageThe recommended sites for intradermal administration are the volar (inner) surface of the mid-forearm or over the deltoid region over where the deltoid muscle inserts into the humerus.\nThe deltoid region on the left arm is specifically recommended for BCG administration in any age groups as administration at this site minimises the risk of keloid scarring.\nWhich vaccines can be given intradermally?Examples of vaccines given by the ID route include BCG and hepatitis B\u00a0(for non-responders). Mantoux and\u00a0Q Fever\u00a0tests are also performed intradermally.\nHepatitis B vaccine is usually given by the IM route however there is a small percentage of the population who do not mount a protective immune response to the IM course of hepatitis B vaccines. If they have been deemed by their provider as a non-responder the intradermal route is considered as an alternative [refer to\u00a0MVEC: Hepatitis B\u00a0for more information].\nVaccine Dose Recommended site BCG (tuberculosis) < 12 months 0.05ml \u2265 12 months 0.1ml Left upper arm over the region where the deltoid muscle inserts into the humerus\u00a7 Engerix\u00ae-B Adult (hepatitis B)\u00a5 0.25ml (20mcg/1.0ml) per dose Left upper arm over the deltoid region Jynneos\u00ae (MPX) 0.1ml Left upper arm over the deltoid region or the volar surface of the mid-forearm Tuberculin skin test (TST/Mantoux) 0.1ml Volar surface of mid-forearm Q-Vax skin test (Q fever test) 0.1ml of diluted Q-Vax skin test Volar surface of mid-forearm", "source": "mvec.mcri.edu.au/references/administration-of-injected-vaccines-correct-technique/index.html"}
{"id": "7c99d9cba3a1-4", "text": "\u00a7This is the recommended site to minimise the risk of keloid formation\n\u00a5Refer to MVEC: Hepatitis B for more information on the management of non-responders\nIntradermal vaccination technique\nUse a short (10mm) 26-27 gauge needle with a short bevel and a 1ml insulin syringe\nWear protective eye wear when administering BCG vaccine as eye splashes can ulcerate\nIdentify the correct injection site (see Table 1 above)\nStretch the skin between a finger and your thumb\nInsert the bevel into the dermis with the bevel facing upwards, to a distance of approx. 2mm. The bevel should be visible through the epidermis\nYou should feel resistance as you inject, if you don\u2019t, the needle may be in subcutaneous tissue. If the injection is not intradermal, withdraw the needle and repeat at a new site. When given correctly, an intradermal injection should raise a blanched bleb.\n\ufeff\ufeff\nPreparing the site for injection\nThe skin at the injection site should be visibly clean prior to administering a vaccine. The swabbing of clean skin before giving an injection is\u00a0not necessary. If the skin is visibly dirty, clean the site with alcohol wash/single use alcohol swab and allow the site to dry completely before administering the injection. If active/infected eczema is present at the recommended site, consider an alternate site to minimise the risk of\u00a0injection site abscess. If there is no alternate site suitable, consider cleaning the site with an alcohol based wash/single use alcohol swab and allowing the site to dry completely\u00a0before injecting.\nRecommended needle size, length and angle for administering vaccines", "source": "mvec.mcri.edu.au/references/administration-of-injected-vaccines-correct-technique/index.html"}
{"id": "7c99d9cba3a1-5", "text": "Recommended needle size, length and angle for administering vaccines\nAge or size of the patient Needle type Angle of needle insertion Infant, child or adult for IM injection 22 \u2013 25 gauge, 25mm in length Preterm infant or very small infant for IM injection 23 \u2013 25 gauge, 16mm in length Very large/obese patient for IM injection 22 \u2013 25 gauge, 38mm in length Subcutaneous injection in all patients 25 \u2013 27 gauge, 16mm in length Intradermal injection in all patients 26 \u2013 27 gauge, 10mm in length \n* Table adapted from the Australian Immunisation Handbook\nPositioning for vaccination\nInfants and younger childrenIt is important that children remain still during a vaccination to ensure that the vaccine can be administered into the correct anatomical site, as well as reduce the risk of any unintended injury (eg. needle stick injury). It is important to involve both the child and parent/guardian in discussions when deciding if a child can sit independently or requires support. When positioning a child for vaccination it is important to ensure that they are comfortable and the mobile joints of the limb receiving the vaccine are stable. The immunisation provider must be able to adequately visualise the anatomical landmarks and correct site for injection (deltoid or anterolateral thigh).\nInfants can be held in the cuddle position or on their parents lap facing the provider, with the parent/guardian holding their arms securely and their thighs completely exposed. Younger children can be held in the cuddle or straddle positions with their upper arm completely exposed as demonstrated in the clip below.\nFor infants receiving oral vaccines, it is recommended they are positioned in such a way that the vaccine can be administered via gentle squeezing of the vaccine tube into their inner cheek, such as a feeding position.\n\ufeff\ufeff", "source": "mvec.mcri.edu.au/references/administration-of-injected-vaccines-correct-technique/index.html"}
{"id": "7c99d9cba3a1-6", "text": "\ufeff\ufeff\nOlder children, adolescents and adultsIt is recommended that older children, adolescents and adults sit in a straight-backed chair with their feet on the floor for vaccine administration. Providers should encourage the vaccine recipient to relax their forearms and rest their hands on their upper thighs, keeping their arms flexed at the elbow to assist in relaxing the deltoid muscle.\nVaccine recipients who are prone to vasovagal responses (fainting) should be vaccinated lying down to prevent unintended injury due to a fall.\nResources\nMVEC: Injection site reactions\nMVEC: Injection site nodules\nMVEC: Shoulder injury related to vaccine administration (SIRVA)\nDHHS: \u201cWhere should I inject vaccines?\u201d poster\nAuthors:\u00a0Mel Addison (SAEFVIC Research Nurse, Murdoch Children\u2019s Research Institute) and\u00a0Rachael McGuire (SAEFVIC Research Nurse, Murdoch Children\u2019s Research Institute)\nReviewed by: Francesca Machingaifa (MVEC Education Nurse Coordinator) and Rachael McGuire (MVEC Education Nurse Coordinator)\nDate: July 6, 2023\nMaterials in this section are updated as new information and vaccines become available. The Melbourne Vaccine Education Centre (MVEC) staff regularly reviews materials for accuracy.\nYou should not consider the information in this site to be specific, professional medical advice for your personal health or for your family\u2019s personal health. For medical concerns, including decisions about vaccinations, medications and other treatments, you should always consult a healthcare professional.\nA B C D E F G H I J K L M N O P Q R S T U V W X Y Z", "source": "mvec.mcri.edu.au/references/administration-of-injected-vaccines-correct-technique/index.html"}
{"id": "5aca82c19f5d-0", "text": "Some families have concerns around the measles-mumps-rubella (MMR) vaccine and the diagnosis of autism. At MVEC we encourage parents to find the best available evidence to help them make a decision around vaccinating their child. The MMR live-attenuated vaccine is recommended on the\u00a0National Immunisation Program at 12-months of age and combined with the varicella vaccine (MMRV) at 18-months of age.\nA great resource for addressing MMR concerns is a decision aid developed by the National Centre for Immunisation Research and Surveillance (NCIRS) in Sydney. It is targeted at:\nParents or caregivers of a child approaching their due date for MMR vaccination.\nAnyone who would like more information about MMR vaccination\nNote: this guide provides general information only, and is not intended as a substitute for consultations with qualified health professionals. For specific queries talk with your local doctor or immunisation provider, or contact us at [email\u00a0protected] or Telephone: 1300 882 924\nResource\nNCIRS: MMRV decision aid\nSKAI: What about autism?\nVaccines and Autism: Children\u2019s Hospital of Philadelphia\nAuthors: Nigel Crawford (Director, SAEFVIC, Murdoch Children\u2019s Research Institute)\u00a0and Rachael McGuire (SAEFVIC Research Nurse, Murdoch Children\u2019s Research Institute)\nReviewed by: Rachael McGuire (SAEFVIC Research Nurse, Murdoch Children\u2019s Research Institute)\nDate: July 2020\nMaterials in this section are updated as new information and vaccines become available. The Melbourne Vaccine Education Centre (MVEC) staff regularly reviews materials for accuracy.\nYou should not consider the information in this site to be specific, professional medical advice for your personal health or for your family\u2019s personal health. For medical concerns, including decisions about vaccinations, medications and other treatments, you should always consult a healthcare professional.", "source": "mvec.mcri.edu.au/references/mmr-vaccine-and-autism/index.html"}
{"id": "5aca82c19f5d-1", "text": "A B C D E F G H I J K L M N O P Q R S T U V W X Y Z", "source": "mvec.mcri.edu.au/references/mmr-vaccine-and-autism/index.html"}
{"id": "f4197ff03f7f-0", "text": "Background\nLike any medication in development, vaccine candidates must undergo rigorous testing procedures and scientific evaluation to prove not only their effect on the targeted disease, but also to determine their safety, before being licensed and registered for use in vaccination programs. In Australia, the Therapeutic Goods Administration (TGA) is responsible for assessing vaccines and other medicines for use in Australia.\nOnce vaccines have been introduced into the community, the safety and effectiveness of vaccines then continues to be monitored in the post-licensure phase through active surveillance programs and further post-licensure trials. This is to ensure that there is ongoing monitoring for how the vaccines are working in the \u2018real-world\u2019, noting they will be administered to a much larger and more diverse population than during the development phase.\nDevelopment phase\nDuring vaccine development, initial safety testing of a vaccine candidate occurs in two stages. Stage one involves pre-clinical assessment in the laboratory. Stage two involves the evaluation of the vaccine candidate in three phases of human clinical trials. If a vaccine candidate is not deemed safe in any stage, it cannot progress into the further stages of clinical trials, with this data being reviewed by an independent data safety monitoring board (DSMB).\nPhase I clinical trials: the vaccine candidate is given to small numbers (25\u201350) of healthy adults with the primary goal of assessing safety.\nPhase II clinical trials: if the vaccine candidate is found to be safe in Phase I, it is then given to hundreds of people to determine how effectively it stimulates immune responses, the optimal dose regimen, and whether there are any side effects.\nPhase III clinical trials: if the vaccine candidate is found to be effective and safe in Phase I and II, it is then given to many thousands of people to test whether it protects large populations from the target disease and to determine if there are any uncommon or serious side effects.", "source": "mvec.mcri.edu.au/references/vaccine-development-and-safety/index.html"}
{"id": "f4197ff03f7f-1", "text": "A vaccine must pass all of these phases before it is registered for use by the TGA. Previously, approval of vaccines could take up to 10 years. However, the process has been streamlined throughout the COVID-19 pandemic and can now be completed in under 12 months, noting all of the appropriate clinical phase trials and data requirements from the regulators have not changed.\nPost-licensure phase\nDespite the extensive safety testing undertaken in clinical trials before a vaccine is licensed, some side effects are so rare, they cannot be detected in a trial population (e.g., such as with thrombosis with thrombocytopenia syndrome [TTS] following COVID-19 adenoviral vector vaccines). In addition, the efficacy of a vaccine may be different when given to a larger and more diverse population compared with those who participated in the clinical trial (e.g., due to the presence of underlying medical conditions, different age groups etc). For these reasons, assessment of safety and efficacy continues to be monitored in post-licensure assessments through:\nfurther clinical trials\nsurveillance of the impact of the vaccine on the disease it aims to prevent using networks such as\u00a0PAEDS\nsurveillance of adverse events following immunisation using systems such as\u00a0AusVaxSafety and reporting services like\u00a0SAFEVAC\u00a0and\u00a0SAEFVIC.\nWhat happens if a problem is suspected?\nAny suspected vaccine safety signals undergo a thorough investigation by the TGA, with the support of the jurisdictional vaccine safety services.\nIf a suspected problem could be serious, authorities will consider a range of actions including modifying the product information (PI) and if extremely serious it may include suspending use of the vaccine during the investigation.\nProvisional approval", "source": "mvec.mcri.edu.au/references/vaccine-development-and-safety/index.html"}
{"id": "f4197ff03f7f-2", "text": "Provisional approval\nProvisional approval has been the formal pathway used in Australia for speeding up access to COVID-19 vaccine candidates using preliminary clinical data. The provisional pathway allows for the temporary registration of promising medicines or vaccines based on early data, where the benefits of early access (such as in a pandemic), outweigh any risks.\nIt is very important to note that this evaluation process remains a full review and a vaccine is still required to pass all the same phases of clinical trials and meet the same requirements for safety and efficacy as any other vaccine in development.\nAs further clinical data to confirm the safety of a vaccine becomes available, full registration can then be granted (On April 21, 2023 Spikevax (Moderna) was transitioned from the provisional pathway to full registration).\n\ufeff\ufeff\nHealth Technology Assessment (HTA) of vaccines\nWhilst vaccines are undergoing development and regulatory approval, in parallel they also need to undergo health economics assessment if they are going to go onto the National Immunisation Program (NIP). In Australia this assessment of vaccines is undertaken by the Pharmaceutical Benefits Advisory Committee (PBAC).\nThis pathway was not utilised during the COVID-19 pandemic, due to the speed and complexity of the public health emergency, but PBAC approval will be required for all new vaccines that are coming down the pipeline. As part of this assessment, ATAGI provides advice to the PBAC regarding how these vaccines may be best utilised in the Australian context, taking into account vaccine effectiveness, safety and equity.\nResources\nMVEC: Vaccine platforms\nMVEC COVID19 Road to a Vaccine Podcast, Episode 7: The importance of regulatory bodies in the development of vaccines, with Professor Norman Baylor\nMVEC COVID19 Road to a Vaccine Podcast, Episode 16: COVID19 vaccine candidates regulatory process update, with Professor Norman Baylor\nAustralian Academy of Science: How are vaccines shown to be safe?", "source": "mvec.mcri.edu.au/references/vaccine-development-and-safety/index.html"}
{"id": "f4197ff03f7f-3", "text": "Australian Academy of Science: How are vaccines shown to be safe?\nThe International Coalition of Medicines Regulatory Authorities: ICMRA statement about confidence in vaccine safety and effectiveness (for healthcare professionals)\nThe International Coalition of Medicines Regulatory Authorities: ICMRA statement about confidence in vaccine safety and effectiveness (for the general public)\nAuthors: Georgina Lewis (Clinical Manager SAEFVIC, Murdoch Children\u2019s Research Institute) and Rachael McGuire (SAEFVIC Research Nurse, Murdoch Children\u2019s Research Institute)\nReviewed by: Georgina Lewis (Clinical Manager SAEFVIC, Murdoch Children\u2019s Research Institute), Rachael McGuire (SAEFVIC Research Nurse, Murdoch Children\u2019s Research Institute) and Nigel Crawford (Director SAEFVIC, Murdoch Children\u2019s Research Institute)\nDate: May 10, 2023\nMaterials in this section are updated as new information and vaccines become available. The Melbourne Vaccine Education Centre (MVEC) staff regularly reviews materials for accuracy.\nYou should not consider the information in this site to be specific, professional medical advice for your personal health or for your family\u2019s personal health. For medical concerns, including decisions about vaccinations, medications and other treatments, you should always consult a healthcare professional.\nA B C D E F G H I J K L M N O P Q R S T U V W X Y Z", "source": "mvec.mcri.edu.au/references/vaccine-development-and-safety/index.html"}
{"id": "8ac3db22921e-0", "text": "Drive-through immunisation clinics are an alternative venue for supporting vaccine delivery. A drive-through clinic can assist members of the community to continue to receive recommended immunisations whilst maintaining physical distancing.\nA drive-through clinic may not be a setting that is recommended for all patients. It is important that patients be screened for their suitability to use a drive-through service prior to immunisation. Pre-screening of patients can identify previous immunisation reactions, history of vasovagal reactions or needle phobia.\nRunning sessions by appointment may allow for planning the type and amount of vaccines required and also allows the flow of patients to be staggered in order to prevent traffic congestion.\nPreparation for drive-through clinics\nThere are many different factors that need to be considered when setting up for this type of immunisation venue.\nThe location\nConsider a location within close proximity of the GP service or health care facility (if applicable). An ideal location would allow for a 1-directional flow of traffic in order to avoid congestion and ensure the safety of roaming staff members. Each individual parking bay should allow enough room for all 4 car doors to completely open without any obstructions (to ensure full access to each patient should AEFI occur).\nEquipment\nCarefully consider the equipment required to set up and maintain a drive-through clinic. Equipment should include clear signage, bed/chair to manage adverse events if required, an anaphylaxis response kit, essential paperwork, (such as pre-immunisation checklists and vaccine side effects forms), equipment to maintain the cold chain, as well as any equipment necessary to prepare and administer vaccines. Remote access to patient records and the Australian Immunisation Register (AIR) is recommended to allow for review of immunisation records. as well as appropriate documentation of any vaccines administered.\nStaff\nStaff may include nurse immunisers, as well as medical and administrative personnel.\nThe cold chain", "source": "mvec.mcri.edu.au/references/drive-through-immunisation-clinics/index.html"}
{"id": "8ac3db22921e-1", "text": "Staff may include nurse immunisers, as well as medical and administrative personnel.\nThe cold chain\nStorage of vaccines in a drive-through clinic setting must comply with the cold chain recommendations set out by the vaccine manufacturer. \u00a0The time between vaccines being removed from purpose-built vaccine fridges to being administered should be as short as possible.\nDuring a drive-through immunisation session\nImmunisation history, pre-immunisation checklist, possible vaccine side effects and suitability for immunisation must be reviewed and discussed prior to vaccination.\nEmergency equipment (anaphylaxis response kit) and a telephone must be readily available should they be required.\nCorrect injection technique is essential, ensuring that the entire limb is exposed and correct anatomical landmarks identified to locate the correct injection site. If a patient cannot be safely immunised in the car (eg: child seated in the middle car seat) or is not a suitable candidate for in-vehicle immunisation then they could be immunised out of the car in a chair, then returned to the car to wait for the recommended 15 minute waiting period. Patients should be advised not to get in and out of their cars whilst parked.\nPost-immunisation in a drive-though session\nFollowing immunisation, patients must remain at the vaccination venue for at least 15 minutes and should be advised to avoid driving for at least 15 minutes following vaccination. Patients waiting in their vehicles should be instructed to use the car horn to gain attention in their 15 minute observation period if required. All vaccines should be recorded on the AIR and appropriate documentation should be completed and provided to the patient.\nResources\nMVEC: Cold chain\nMVEC: Shoulder Injury Related to Vaccine Administration\nMVEC: Shoulder Injury Related to Vaccine Administration (SIRVA) eLearning package\nNational Vaccine Storage Guidelines \u2018Strive for 5\u2019\nMVEC: Administration of injected vaccines- correct technique\nATAGI Clinical Statement on Vaccination Observation Time", "source": "mvec.mcri.edu.au/references/drive-through-immunisation-clinics/index.html"}
{"id": "8ac3db22921e-2", "text": "ATAGI Clinical Statement on Vaccination Observation Time\nATAGI statement on considerations for establishing drive-through COVID-19 vaccination clinic sites\nAuthors: Francesca Machingaifa (SAEFVIC Research Nurse, Murdoch Children\u2019s Research Institute) and Rachael McGuire (SAEFVIC Research Nurse, Murdoch Children\u2019s Research Institute)\nReviewed by: Rachael McGuire (MVEC Education Nurse Coordinator)\nDate: August 2021\nMaterials in this section are updated as new information and vaccines become available. The Melbourne Vaccine Education Centre (MVEC) staff regularly reviews materials for accuracy.\nYou should not consider the information in this site to be specific, professional medical advice for your personal health or for your family\u2019s personal health. For medical concerns, including decisions about vaccinations, medications and other treatments, you should always consult a healthcare professional.\nA B C D E F G H I J K L M N O P Q R S T U V W X Y Z", "source": "mvec.mcri.edu.au/references/drive-through-immunisation-clinics/index.html"}
{"id": "9739abf80c3a-0", "text": "Background\nIn order to prevent the rejection of transplanted organs, people who have undergone a solid organ transplant require varying doses of immune suppressive medication. Once a patient is immune suppressed, seroprotection gained from immunisation may be suboptimal and therefore additional doses of vaccines may be recommended. Some vaccines (live-attenuated vaccines) may be contraindicated.\nTo overcome this and maximise immune responses it is recommended where possible that all vaccines are administered well before transplant with live-attenuated vaccines administered a minimum of 4 weeks prior to transplant.\nPlease refer to MVEC: Pre-solid organ transplant recipient immunisation guideline (0-18 years) for more information.\nFor immunisation recommendations following a solid organ transplant please refer to your immunisation specialist for specific advice.\nMVEC special risk guidelines\nThese guidelines have been prepared by immunisation staff from the Royal Children\u2019s Hospital and Monash Health and endorsed at a monthly immunisation meeting. Attendees at this meeting include paediatricians, infectious disease physicians, nurse immunisation specialists, infection control team members and a representative from the Immunisation Section of the Victorian Department of Health.\nThese guidelines are based on the latest available evidence and aim to align with recommendations in the\u00a0Australian Immunisation Handbook.\nVaccine funding\nSome of the recommendations in these guidelines are outside the scope of the National Immunisation Program (NIP). Different jurisdictions and individual hospitals have varying approaches to non-NIP vaccines, which should be clarified with the local health service.\nWe welcome any feedback on the guidelines, please email:\u00a0[email\u00a0protected]\nResources\n MVEC: Pre-solid organ transplant recipient immunisation guideline (0-18 years)\nMVEC: Special risk chapter of the Australian Immunisation Handbook\nMVEC: Meningococcal vaccines in special risk and immunosuppressed patients\nMVEC: Meningococcal disease and vaccines", "source": "mvec.mcri.edu.au/references/solid-organ-transplant-recipient/index.html"}
{"id": "9739abf80c3a-1", "text": "MVEC: Meningococcal disease and vaccines\nAuthors: Nigel Crawford (Director, SAEFVIC, Murdoch Children\u2019s Research Institute) and Rachael McGuire (SAEFVIC Research Nurse, Murdoch Children\u2019s Research Institute)\nReviewed by: Rachael McGuire (MVEC Education Nurse Coordinator) and Annie Cobbledick (Immunisation Pharmacist, the Royal Children\u2019s Hospital)\nDate:\u00a0March 2021\nMaterials in this section are updated as new information and vaccines become available. The Melbourne Vaccine Education Centre (MVEC) staff regularly reviews materials for accuracy.\nYou should not consider the information in this site to be specific, professional medical advice for your personal health or for your family\u2019s personal health. For medical concerns, including decisions about vaccinations, medications and other treatments, you should always consult a healthcare professional.\nA B C D E F G H I J K L M N O P Q R S T U V W X Y Z", "source": "mvec.mcri.edu.au/references/solid-organ-transplant-recipient/index.html"}
{"id": "973567293903-0", "text": "Background\nChildren with neutropenia are at increased risk of bacterial and fungal infections. Preventing infections is this group is therefore a priority and we should be aiming to protect these children against vaccine preventable diseases (VPDs) according to the National Immunisation Program (NIP).\nThere is a lack of direct data to base vaccine recommendations in this group. This group of patients is not addressed in the Australian Immunisation Handbook. A number of international expert groups have however published recommendations in this area (see resources).\nInactivated vaccines are considered safe, and international guidelines recommend they be administered to patients with neutropenia as per routine immunisation schedules. Given patients with neutropenia are at increased risk of bacterial infections, some also recommend additional pneumococcal vaccines, as for patients at increased risk of invasive pneumococcal disease (IPD).\nLive-attenuated viral vaccines are contraindicated in patients who are severely immunocompromised, due to the risk of unchecked viral replication and vaccine associated disease. Neutropenia itself, however, is not a contraindication to live-attenuated viral vaccines as patients with an isolated neutropenia would be expected to handle viral infections, and live-attenuated viral vaccines in most circumstances. International guidelines recommend these vaccines be given to patients with congenital or cyclical neutropenia, or neutropenia in general. However, some recommend against these vaccines in patients with undefined phagocytic cell defects or phagocytic cell defects undefined at a molecular level, and others recommend prior immunology review. This is because some conditions which affect neutrophil number or function may also affect lymphocyte number or function. Live-attenuated viral vaccines are contraindicated in patients with leucocyte adhesion disorder, Chediak Higashi syndrome or other defects in cytolytic granule release.", "source": "mvec.mcri.edu.au/references/neutropenia-vaccine-recommendations-for-children-with-chronic-neutropenia/index.html"}
{"id": "973567293903-1", "text": "Live bacterial vaccines (including the BCG vaccine) are contraindicated in patients who are immunocompromised including those with some phagocytic cell defects. This is due to an increased risk of vaccine associated adverse events in this group.\nOur recommendations are based on these international guidelines and local consensus.\nRecommendations\nInactivated vaccines\nInactivated vaccines are recommended as per the NIP. We also recommend additional pneumococcal vaccines, as for patients at high risk of invasive pneumococcal disease (see resources).\nLive-attenuated viral vaccines\nNeutropenia itself is not a contraindication to live-attenuated viral vaccines. In cases of an undefined neutropenia some caution should be exercised, given neutropenia can occur in the setting of conditions which also affect lymphocyte number and function\nFor patients with congenital neutropenia or cyclical neutropenia caused by a known molecular defect (which is not associated with any other immune dysfunction), live-attenuated viral vaccines are recommended as per the NIP.\nA number of patients with chronic moderate-severe neutropenia (neutrophil count <1 x10^9/L) will not have a defined molecular defect, the cause may be unclear, or they may have suspected immune neutropenia for which there is no diagnostic test. In these patients, an evaluation for an underlying immune defect is recommended prior to administration of live-attenuated viral vaccines (see MVEC Flowchart: Live attenuated viral vaccines in patients with chronic neutropenia). If there are no concerning features on history, examination or screening investigations, live-attenuated viral vaccines are recommended, as per the NIP. If any abnormalities or concerns are raised, a formal immunology consult should be sought prior.", "source": "mvec.mcri.edu.au/references/neutropenia-vaccine-recommendations-for-children-with-chronic-neutropenia/index.html"}
{"id": "973567293903-2", "text": "In patients for whom the neutropenia is expected to be transient, or further investigation is planned in the near future (e.g. bone marrow examination or molecular studies), consideration should be given to delaying live-attenuated viral vaccines until this information is available.\nLive-attenuated viral vaccines are contraindicated in patients with leucocyte adhesion disorder, Chediak Higashi syndrome or other defects in cytolytic granule release.\nLive bacterial vaccines\nLive bacterial vaccines (e.g. the BCG vaccine, oral typhoid vaccine) are generally contraindicated in patients with neutropenia. Typhoid protection can be provided by using an inactivated vaccine. If there is a high risk of Tuberculosis in an individual with neutropenia, BCG vaccine should be discussed with both an immunisation specialist and haematologist.\nResources\nMVEC Flowchart: Live attenuated viral vaccines in patients with chronic neutropenia\nAustralian Immunisation Handbook: Risk conditions for Pneumococcal Disease\nAustralian Immunisation Handbook: Vaccination for people who are immunocompromised\n2013 IDSA Clinical practice guideline for vaccination of the immunocompromised host\nMedical advisory committee of the immune deficiency foundation: Recommendations for live viral and bacterial vaccines in immunodeficient patients and their close contacts 2014\nCanadian Immunisation Guide: Immunization of immunocompromised persons\nMartire B, Azzari C, Badolato R, Canessa C, Cirillo E, Gallo V, et al. Vaccination in immunocompromised host: Recommendations of Italian Primary Immunodeficiency Network Centers (IPINET). Vaccine. 2018;36(24):3541-54", "source": "mvec.mcri.edu.au/references/neutropenia-vaccine-recommendations-for-children-with-chronic-neutropenia/index.html"}
{"id": "973567293903-3", "text": "Authors: Luisa Clucas (Clinical Haematology Registrar, Royal Children\u2019s Hospital), Anthea Greenway (Head of Clinical Haematology, Royal Children\u2019s Hospital), Theresa Cole (Consultant, Allergy and Immunology, Royal Children\u2019s Hospital), and Nigel Crawford (Director SAEFVIC, Murdoch Children\u2019s Research Institute)\nDate: August 2021\nMaterials in this section are updated as new information and vaccines become available. The Melbourne Vaccine Education Centre (MVEC) staff regularly reviews materials for accuracy.\nYou should not consider the information in this site to be specific, professional medical advice for your personal health or for your family\u2019s personal health. For medical concerns, including decisions about vaccinations, medications and other treatments, you should always consult a healthcare professional.\nA B C D E F G H I J K L M N O P Q R S T U V W X Y Z", "source": "mvec.mcri.edu.au/references/neutropenia-vaccine-recommendations-for-children-with-chronic-neutropenia/index.html"}
{"id": "e37a4822d62b-0", "text": "What is it?\nKawasaki disease (KD) is the second most common form of vasculitis (inflammation of blood vessels) in childhood, affecting 200-300 Australian children every year. It mostly occurs in children aged under 5, with some rare cases affecting older children or adults. KD is a collection of symptoms including persistent fever, conjunctival infection, rash, painful oedema of the hands and feet, lymphadenopathy and oral symptoms such as strawberry tongue, erythema and cracking and bleeding of the lips. Children with KD are at risk of developing coronary artery aneurysms, and in some cases damage to the heart valves or muscle, if prompt treatment is not initiated. Up to 10% of children with KD will go on to develop problems with the coronary arteries, and it is the most common form of acquired heart disease in children in developed nations.\nTreatment\nMorbidity and mortality is reduced by the prompt initiation of treatment with the administration of intravenous immunoglobulin (IVIg). IVIg prevents damage to large arteries of the heart in 80% of cases. Low dose aspirin is prescribed for a few weeks following diagnosis to prevent cardiac complications.\u00a0\nKawasaki disease and immunisation\nThere is no evidence that vaccination can lead to KD. Whilst a diagnosis of KD may be made following immunisation, this association is temporal and research has not identified a causal association.\nDue to the inflammation that occurs with KD, BCG administration sites can become during the illness if BCG was administered in the 6 months prior.\u00a0\nVaccine precautions\nInactivated routine vaccines can be administered as per the National Immunisation Program (NIP) once a child has recovered from the acute illness.", "source": "mvec.mcri.edu.au/references/kawasaki-disease-and-immunisation/index.html"}
{"id": "e37a4822d62b-1", "text": "Live-attenuated vaccines such as measles-mumps-rubella-varicella and measles-mumps-rubella must be delayed 11 months following the administration of intravenous immunoglobulin (IVIg) as the transfusion of IVIg can affect the immune response to the vaccine.\nResources\nMVEC: Live-attenuated vaccines and immunoglobulins or blood products\nMVEC: Children with cardiac disease\nRCH Kids Health Information: Kawasaki disease\u00a0\nRCH Clinical practice guidelines: Kawasaki disease\nKawasaki Disease Foundation\nAuthor: Adele Harris (SAEFVIC Research Nurse, Murdoch Children\u2019s Research Institute).\nReviewed by: Francesca Machingaifa (MVEC Education Nurse Coordinator) and Rachael McGuire (MVEC Education Nurse Coordinator)\nDate: June 2022\nMaterials in this section are updated as new information and vaccines become available. The Melbourne Vaccine Education Centre (MVEC) staff regularly reviews materials for accuracy.\nYou should not consider the information in this site to be specific, professional medical advice for your personal health or for your family\u2019s personal health. For medical concerns, including decisions about vaccinations, medications and other treatments, you should always consult a healthcare professional.\n\u00a0\n\u00a0\nA B C D E F G H I J K L M N O P Q R S T U V W X Y Z", "source": "mvec.mcri.edu.au/references/kawasaki-disease-and-immunisation/index.html"}
{"id": "779ef0289a98-0", "text": "Immunisation assessment is an extremely important aspect of healthcare during pregnancy. When planning a pregnancy, talk to your health care provider about any vaccines you might need beforehand. Live-attenuated vaccines should be given at least a month before conception.\nRecommended vaccines\nInfluenza, pertussis and COVID-19 vaccines are the only vaccines routinely recommended for pregnant women. They are provided for free via the National Immunisation Program (NIP).\nSome other vaccines can be administered in special circumstances but are not routinely recommended. Refer to the Australian Immunisation Handbook for further information.\nInfluenza\nInfluenza vaccination is safe and strongly recommended for pregnant women to avoid complications from influenza disease. It can be administered at any stage of pregnancy and not only aims to protect the expectant mother from disease, but also to provide passive protection to the infant.\nPregnant women are at greater risk of morbidity and mortality from influenza disease than non-pregnant women. They are more than twice as likely to be hospitalised with influenza disease as other people with influenza.\nBabies less than 6-months of age are at greatest risk of disease and death from influenza and maternal vaccination will provide protection to babies for the first few months of life until they can be immunised against influenza from 6-months of age.\nPertussis\nPertussis (whooping cough) immunisation during pregnancy is a safe and effective way to protect the mother and prevent disease of the newborn.\u00a0It is recommended that a single dose of the vaccine be administered between 20 and 32 weeks of pregnancy, in every pregnancy, including pregnancies that are closely spaced.", "source": "mvec.mcri.edu.au/references/maternal-vaccination-during-pregnancy/index.html"}
{"id": "779ef0289a98-1", "text": "Maternal antibodies against pertussis provide protection for babies until they have at least received 2 doses of their own pertussis containing vaccine (given at 6-weeks and 4-months of age). Babies less than 6-months of age are at greatest risk of severe disease and death from pertussis.\nCOVID-19 vaccines\nDue to an increased risk of severe outcomes for pregnant women and their unborn babies it is recommended that pregnant women are routinely offered COVID-19 vaccines. Vaccines can be given at any stage of pregnancy.\nSurveillance of international data on administration of mRNA COVID-19 vaccines (Comirnaty (Pfizer)\u00a0or\u00a0Spikevax (Moderna)) to pregnant women has shown no significant safety concerns for either the mother or the baby. Evidence demonstrates antibodies can pass into breastmilk and cord blood which may provide protection to infants via passive immunity.\nNuvaxovid (Novavax) may be administered to pregnant and breastfeeding women however there is no immunogenicity or safety data on it\u2019s use in this patient group.\nPregnant women have been shown to have an increased risk of needing admission to the intensive care unit and requiring mechanical ventilation if they contract COVID-19 compared with non-pregnant women of the same age.\nWomen who are planning pregnancy or who are breastfeeding can safely receive a COVID-19 vaccine. You do not need to stop breastfeeding before or after vaccination.\nFor more information refer to the following:\nJoint statement between RANZCOG and ATAGI about COVID-19 vaccination for pregnant women\nCOVID-19 vaccination- ATAGI clinical guidance on COVID-19 vaccine in Australia in 2021\nCOVID-19 vaccination- COVID-19 vaccination decision guide for women who are pregnant, breastfeeding or planning pregnancy\nAJOG: COVID-19 vaccine response in pregnant and lactating women: a cohort study\nContraindicated vaccines", "source": "mvec.mcri.edu.au/references/maternal-vaccination-during-pregnancy/index.html"}
{"id": "779ef0289a98-2", "text": "Contraindicated vaccines\nAll live-attenuated vaccines are contraindicated during pregnancy due to the potential risk to the unborn baby [see Table 1 below]. In most circumstances the risk is hypothetical however, there is insufficient evidence to support vaccination in this patient group. The limited safety data from inadvertent administration of live-attenuated viral vaccines such as the MMR and Varicella vaccines is reassuring.\nTable 1: Live-attenuated vaccines contraindicated in pregnancy\nDisease\nBrand name\nRotavirus\nRotarix\u00ae, Rotateq\u00ae\nMMR (measles-mumps-rubella)\nPriorix\u00ae, MMR II\u00ae\nMMRV (measles-mumps-rubella-varicella)\nPriorix-tetra\u00ae, ProQuad\u00ae\nVaricella (chickenpox)\nVarilrix\u00ae, Varivax\u00ae\nZoster (shingles)\nZostavax\u00ae\nTuberculosis\nBCG (varying brands)\nYellow fever\nStamaril\u00ae\nTyphoid^\nVivotif\u00ae\nJapanese encephalitis\nImojev\u00ae\n^Oral vaccine\nResources\nCOVID-19 vaccination- ATAGI clinical guidance on COVID-19 vaccine in Australia in 2021.\nCOVID-19 vaccination- COVID-19 vaccination decision guide for women who are pregnant,breastfeeding or planning pregnancy\nRaising Children Network: COVID-19 vaccination: preganancy and breastfeeding\nGray, K.J et al COVID-19 vaccine response in pregnant and lactating women: a cohort study American Journal of Obstetrics and Gynecology\nABC News report: \u2018Antivaxxer\u2019 tells of \u2018nightmare\u2019 after passing whooping cough onto baby daughter", "source": "mvec.mcri.edu.au/references/maternal-vaccination-during-pregnancy/index.html"}
{"id": "779ef0289a98-3", "text": "Amirthalingam, G. et al Effectiveness of maternal pertussis vaccination in England: an observational study The Lancet October 2014 384(9953) 1521-1528\nSteedman, M. et al Strategies to boost maternal immunization to achieve further gains in improved maternal and newborn health Health Affairs 2016 (35)309-316\nAustralian Immunisation Handbook: Vaccination for women who are planning pregnancy, pregnant or breastfeeding\nAustralian Government Department of Health: Influenza and pertussis vaccination in pregnancy\nYear Round Influenza Vaccination FAQ\nMonash Health immunisation resources\n2019 Patient Information sheet Influenza vaccine during pregnancy\n2019 Patient information sheet Boostrix during pregnancy\nPatient information sheet Rubella Vaccine\nMVEC resources\nMVEC: Vaccines in Pregnancy eLearning package\u00a0\nMVEC: Pertussis\nMVEC: Influenza vaccine recommendations\nMVEC: Breastfeeding and immunisations\nMVEC: COVID-19 vaccine FAQs: women\u2019s health\nAuthors: Michelle Giles (Infectious Diseases Consultant, Monash Health) and Rachael McGuire (MVEC Education Nurse Coordinator)\nReviewed by: Rachael McGuire (MVEC Education Nurse Coordinator) and Francesca Machingaifa (MVEC Education Nurse Coordinator)\nDate: November 30, 2022\nMaterials in this section are updated as new information and vaccines become available. The Melbourne Vaccine Education Centre (MVEC) staff regularly reviews materials for accuracy.\nYou should not consider the information in this site to be specific, professional medical advice for your personal health or for your family\u2019s personal health. For medical concerns, including decisions about vaccinations, medications and other treatments, you should always consult a healthcare professional.\nA B C D E F G H I J K L M N O P Q R S T U V W X Y Z", "source": "mvec.mcri.edu.au/references/maternal-vaccination-during-pregnancy/index.html"}
{"id": "99cbdc91a09b-0", "text": "Background\nCystic Fibrosis (CF) is a genetic disorder, primarily affecting the lungs as well as the pancreas, liver, kidneys and intestines.\u00a0 In patients with CF, the cells that are responsible for producing mucous, sweat and other fluids are impaired. As a result of this, secretions become thick and sticky, impacting the function of certain organs in the body. 1 in 2500 babies in Australia are born with CF each year.\nSymptoms of CF include frequent chest infections, poor weight gain and growth, intestinal obstructions, infertility (commonly in males) and diabetes. Treatment includes intensive daily physiotherapy, enzyme replacement medication, salt and vitamin supplements, exercise and a high calorie diet. Insulin and blood glucose monitoring is required for patients that develop diabetes. Many patients progress to requiring a lung transplant resulting in immunocompromise. CF patients are at high risk of infections, including some that are vaccine preventable.\nImmunisation recommendations\nPatients with CF are recommended to complete the routine immunisation schedule as per the National Immunisation Program (NIP) as well as some additional funded immunisations.\nSecondary school vaccines are available on the NIP and should be administered to all children with CF including Year 7 (12-13 years of age): Boostrix\u00ae (diphtheria\u2013tetanus\u2013pertussis) and Gardasil\u00ae 9 (human papillomavirus) and in Year 10 (14-19 years) Nimenrix\u00ae (meningococcal ACWY).\nInfluenza\nPatients with CF are funded to receive influenza vaccines annually from 6 months of age. 2 doses of the age-appropriate vaccine are required in the first year of receiving the vaccine [refer to MVEC: Influenza vaccine recommendations].\nPneumococcal", "source": "mvec.mcri.edu.au/references/cystic-fibrosis-immunisation-recommendations/index.html"}
{"id": "99cbdc91a09b-1", "text": "Pneumococcal\nPrevenar 13\u00ae (pneumococcal conjugate) should be given 6 weeks, 4 months, 6 months (additional dose) and 12 months.\nA dose of Pneumovax\u00ae 23 (pneumococcal polysaccharide) should be should be given at 4 years of age. A second dose should then be given at least 5 years later.\nFurther booster vaccines are required if being worked up for a lung transplant [refer to MVEC: Solid organ transplant recipient]\nCOVID-19\nPatients with CF are at an increased risk of severe symptoms of COVID-19 disease if they become infected. A primary course of vaccination is recommended for all individuals aged 6 months and over, with booster doses recommended for some individuals, depending on age and additional risk factors.\nOther vaccines to consider\nVaricella\nCurrently a single dose of varicella vaccine is funded on the NIP. The combination MMRV (ProQuad/Priorix-tetra) is scheduled for 18-months of age, however giving 2 doses of the varicella vaccine can enhance protection. A second varicella vaccine dose can be obtained with a private script. As the varicella vaccine is a live-attenuated vaccine, doses should be separated by a minimum of 4 weeks.\nHepatitis A\nCF patients are at risk of associated liver disease. The Royal Children\u2019s Hospital funds a 2-dose course of Hepatitis A vaccines for their patient cohort. Administration can be commenced from 12 months of age.\nResources\nCystic Fibrosis Australia\nMVEC: Solid organ transplant recipient\nAustralian Immunisation Handbook: List of conditions associated with an increased risk of invasive pneumococcal disease\nDHHS: Immunisation schedule Victoria and vaccine eligibility criteria", "source": "mvec.mcri.edu.au/references/cystic-fibrosis-immunisation-recommendations/index.html"}
{"id": "99cbdc91a09b-2", "text": "DHHS: Immunisation schedule Victoria and vaccine eligibility criteria\nAuthors:\u00a0Rachael McGuire (SAEFVIC Research Nurse, Murdoch Children\u2019s Research Institute) Nigel Crawford (Director SAEFVIC, Murdoch Children\u2019s Research Institute) and Nadine Henare (Nurse Coordinator- Immunisation, The Royal Children\u2019s Hospital)\nReviewed by: Francesca Machingaifa (MVEC Education Nurse Coordinator)\nDate: August 5, 2022\nMaterials in this section are updated as new information and vaccines become available. The Melbourne Vaccine Education Centre (MVEC) staff regularly reviews materials for accuracy.\nYou should not consider the information in this site to be specific, professional medical advice for your personal health or for your family\u2019s personal health. For medical concerns, including decisions about vaccinations, medications and other treatments, you should always consult a healthcare professional.\nA B C D E F G H I J K L M N O P Q R S T U V W X Y Z", "source": "mvec.mcri.edu.au/references/cystic-fibrosis-immunisation-recommendations/index.html"}
{"id": "461bce7eb815-0", "text": "What is it?\nDiphtheria is a rare but potentially life-threatening acute illness caused by the bacteria Corynebacterium diphtheriae. This bacteria can produce a potent toxin which causes serious disease. It mostly commonly causes an acute respiratory illness characterised by a \u201cpseudo membrane\u201d which forms over the pharyngeal area (throat).\nOther less common forms of illness caused by C. diphtheriae include laryngeal/tracheobronchial diphtheria, nasal diphtheria and cutaneous diphtheria.\nWhat to look for\nThe incubation period is 2-5 days. Early symptoms include low-grade fever, lethargy and malaise. Affected people may develop a sore throat, which may cause pain on swallowing or a hoarse voice.\nOne to two days after symptom onset, a \u201cpseudo membrane\u201d develops in 95% of cases, which appears as a thick, grey and leathery membrane at the back of the throat. This is formed from cell debris and inflammatory exudate. Breathing difficulty may occur, especially if part of the membrane dislodges and obstructs the airway.\nToxin-related complications include myocarditis (heart muscle inflammation), neuropathy (nerve damage) and in rare cases, acute tubular nephropathy (kidney damage).\nHow is it transmitted?\nDiphtheria is very contagious and is spread by inhalation of respiratory droplets from an infected person. Diphtheria can also be spread via skin lesions, in cases of cutaneous diphtheria, and the bacteria can also survive on environmental surfaces for weeks.\u00a0 Asymptomatic carriers may transmit the bacteria.\nHumans are the only known reservoir for diphtheria.\nEpidemiology", "source": "mvec.mcri.edu.au/references/diphtheria/index.html"}
{"id": "461bce7eb815-1", "text": "Humans are the only known reservoir for diphtheria.\nEpidemiology\nIn the pre-vaccine era, young children (< 10 years old) were at highest risk for contracting diphtheria. \u00a0Diphtheria previously represented one of the leading causes of death in childhood, with an associated mortality rate of 5-10%.\nDiphtheria is now rare in high income countries with high vaccination coverage, but remains endemic in many lower income countries. Outbreaks across the globe continue to be an issue, with 16,000 cases worldwide reported in 2018.\nCases in Australia are more commonly associated with the return of international travellers.\nPrevention\nDiphtheria is vaccine-preventable, with protection available through administration of combination vaccines routinely administered via the National Immunisation Program (NIP) at:\n6 weeks, 4 months and 6 months \u2013 Infanrix\u00ae hexa/Vaxelis\u00ae\n18 months \u2013 Infanrix\u00ae/Tripacel\u00ae\n4years \u2013 Infanrix\u00ae IPV/Quadracel\u00ae\n12-13 years (Year 7) \u2013 Boostrix\u00ae\nAdditional doses of Boostrix\u00ae are recommended and funded for pregnant women during every pregnancy (regardless of how closely spaced). Further doses are recommended (not funded) for adults at \u2265 50\u00a0years of age, if their last dose was more than 10 years ago. Regular boosters are recommended every 10 years for travellers to high risk countries, and for some high-risk laboratory workers.\nInjection site pain is commonly reported following diphtheria vaccination. This is usually mild and resolves within a few days. Uncommon side effects reported include headache, lethargy, malaise and fever.\nResources\nAustralian Immunisation Handbook: Diphtheria\nCDC: Diphtheria\nAIHW: Diphtheria in Australia", "source": "mvec.mcri.edu.au/references/diphtheria/index.html"}
{"id": "461bce7eb815-2", "text": "CDC: Diphtheria\nAIHW: Diphtheria in Australia\nAustralian Government Department of Health and Aged Care: Changes to the National Immunisation Program schedule from July 1 2023\nAuthors: Julia Smith (RCH Immunisation Fellow) and Rachael McGuire (MVEC Education Nurse Coordinator)\nReviewed by:\u00a0Rachael McGuire (MVEC Education Nurse Coordinator)\nDate: July 4, 2023\nMaterials in this section are updated as new information and vaccines become available. The Melbourne Vaccine Education Centre (MVEC) staff regularly reviews materials for accuracy.\nYou should not consider the information in this site to be specific, professional medical advice for your personal health or for your family\u2019s personal health. For medical concerns, including decisions about vaccinations, medications and other treatments, you should always consult a healthcare professional.\nA B C D E F G H I J K L M N O P Q R S T U V W X Y Z", "source": "mvec.mcri.edu.au/references/diphtheria/index.html"}
{"id": "08fba296cbef-0", "text": "What is it?\nHuman papillomavirus (HPV)\u00a0is a double stranded DNA virus that can infect both men and women. It can affect a person\u2019s anogenital or respiratory tract. There are more than 100 known sub-types of HPV, with 40 of them affecting the anogenital region.\nWhat to look for\nMost people infected with HPV show no acute clinical symptoms at all however infection can progress to have significant health impacts or diseases such as cancer.\nHPV subtypes 6, 11, 40, 42, 43, 44, 54, 61, 70, 72, 81 and 89 are associated with the development of lesions such as genital warts, cutaneous warts and respiratory papillomatosis (wart-like lesions in the respiratory tract). Respiratory papillomatosis is characterised by warty growths within the respiratory tract which can lead to airway occlusion and can be fatal in severe cases.\nTypes 16, 18, 31, 33, 35, 45, 52 and 58 are oncogenic (cancer causing) strains of HPV and are associated with cancers of the cervix, vulva, vagina, penis, anus, oral cavity and oropharynx. Australian data from 2005-2015 has shown that 77% of all cervical cancers were associated with infections with either HPV-16 or HPV-18.\nHow is it transmitted?\nHPV is a highly contagious virus that is transmitted through different forms of intimate contact. With infections often asymptomatic, people often do not know they are carriers and can unknowingly transmit the virus to others.", "source": "mvec.mcri.edu.au/references/human-papillomavirus-hpv/index.html"}
{"id": "08fba296cbef-1", "text": "Genital HPVs are transmitted through sexual contact. Risks of exposure to HPV can be related to the number of sexual partners a person has had. Condoms can reduce the risk of transmission of genital HPVs, however, do not eliminate risk entirely.\nInfected mothers can transmit the virus to their newborn during delivery resulting in oral HPV infections in the newborn. In some cases, this can lead to the development of respiratory papillomatosis.\nEpidemiology\nSurveillance of HPV infections is complicated due to the majority of infections being asymptomatic. It is estimated that up to 90% of the population will be infected with at least one type of HPV at some point in their lives. Cervical cancer is the fourth most common cancer affecting women globally.\nImmunocompromised individuals, in particular those with HIV, and men who have sex with men (MSM) are at higher risk of HPV infection and developing HPV-related cancers.\nPrevention\nVaccination can provide protection against HPV infection and the development of HPV-related lesions and cancers. It is ideally administered prior to a person becoming sexually active.\nThere are 2 vaccines available in Australia:\nCervarix\u00ae- 2vHPV recombinant vaccine protecting against types 16 and 18\nGardasil\u00ae9- 9vHPV recombinant vaccine protecting against types 6, 11, 16, 18, 31, 33, 45, 52 and 58.\nGardasil\u00ae9 is funded on the National Immunisation Program (NIP) as a single dose for immune competent males and females in Year 7 (or age equivalent) primarily through the school-based program. A funded catch-up program is also available for individuals \u2264 26 years of age.", "source": "mvec.mcri.edu.au/references/human-papillomavirus-hpv/index.html"}
{"id": "08fba296cbef-2", "text": "ATAGI further recommends that males \u2265 26 years of age who are at high risk of disease, as well as immunocompromised individuals of any age, are also vaccinated. Gardasil\u00ae9 is registered for use in both males and females up to the age of 45 years. Cervarix\u00ae is registered for use in females only up to 45 years of age.\nImmunocompromised individuals of any age and immune competent individuals 26 years of age and over require a 3 dose schedule in order to be optimally protected. Doses should be administered at 0, 2 and 6 months.\nSide effects\nHPV vaccination is generally well tolerated with mild side effects such as fever, nausea, headache, dizziness and fatigue commonly occurring in the first 24-48 hours.\nSyncope (fainting) is also commonly reported in the adolescent population however is likely associated with the process of vaccination rather than the vaccine itself. Anyone prone to syncopal episodes should lay down for 15 minutes before during and after the vaccination process to minimise the risk of injury due to falls.\nCommonly asked questions\nI thought the HPV schedule was 2 doses?A review of extensive evidence regarding vaccine efficacy, effectiveness and safety from around the world, has shown that a single dose of Gardasil\u00ae9 provides comparable protection to two doses of the vaccine in immune-competent individuals \u2264 25 years of age. As a result, from February 6, 2023, the National Immunisation Program (NIP) moved to offering a single dose only in Year 7.\nThis advice also reflects the recommendations of the World Health Organization and advice from immunisation experts in the UK.", "source": "mvec.mcri.edu.au/references/human-papillomavirus-hpv/index.html"}
{"id": "08fba296cbef-3", "text": "I received 1 dose in 2022 and am due for dose 2, do I still need this?With 1 dose of Gardasil\u00ae 9 considered a complete schedule from February 6 2023, anyone immune competent aged 25 years or less who has previously only received 1 dose is now considered up to date and there is no need for further doses. This up to date status should be reflected on the Australian Immunisation Register (AIR) from February 11, 2023.\nWhat is the schedule for those with immune compromise?Immunocompromised individuals (except those with asplenia/hyposplenia) are still recommended to receive a 3 dose course of vaccination (at 0, 2 and 6 months) to ensure optimal protection.\nIs the vaccine worth it for those who are already sexually active?Vaccination may still be beneficial for people who are already sexually active as it can provide protection against new vaccine-preventable HPV infections, infections caused by other vaccine-preventable strains of HPV, reinfection with vaccine-preventable HPV strains they have already been exposed to as well as protection against existing persistent HPV infections at other sites.\nVaccination is a preventative measure, and will not treat a current infection or prevent disease that may be caused by a HPV-related infection.\nShould people aged \u2265 26 years be vaccinated?Ideally vaccination should occur prior to exposure to infection (i.e., prior to sexual activity), however there may be some benefit in people aged 26 years and over being vaccinated. A case by case discussion with a healthcare provider to discuss if vaccination is recommended is encouraged.\nIndividuals \u2265 26 years who are recommended to receive vaccination should receive a 3 dose course (0, 2 and 6 months) at cost to the patient.\nResources\nThe Australian Immunisation handbook: Human papillomavirus", "source": "mvec.mcri.edu.au/references/human-papillomavirus-hpv/index.html"}
{"id": "08fba296cbef-4", "text": "Resources\nThe Australian Immunisation handbook: Human papillomavirus\nImmunisation against infectious diseases (UK): Human papillomavirus chapter\nAustralian Government Department of Health and Aged Care: HPV (human papillomavirus) vaccine\nNews: Changes to HPV vaccine dose schedules for young Australians_ 6 February 2023\nAuthors: Nigel Crawford (Director, SAEFVIC, Murdoch Children\u2019s Research Institute), Georgie Lewis (SAEFVIC Clinical Manager, Murdoch Children\u2019s Research Institute) and Rachael McGuire (SAEFVIC Research Nurse, Murdoch Children\u2019s Research Institute)\nReviewed by:\u00a0Rachael McGuire (MVEC Education Nurse Coordinator)\nDate: May 10, 2023\nMaterials in this section are updated as new information and vaccines become available. The Melbourne Vaccine Education Centre (MVEC) staff regularly reviews materials for accuracy.\nYou should not consider the information in this site to be specific, professional medical advice for your personal health or for your family\u2019s personal health. For medical concerns, including decisions about vaccinations, medications and other treatments, you should always consult a healthcare professional.\nA B C D E F G H I J K L M N O P Q R S T U V W X Y Z", "source": "mvec.mcri.edu.au/references/human-papillomavirus-hpv/index.html"}
{"id": "69d36301be21-0", "text": "What is it?\nPertussis (whooping cough) is a serious, highly contagious, respiratory infection caused by the bacterium Bordetella pertussis.\nWhat to look for\nPertussis can be very serious in young children, especially those under 6 months of age. It usually begins just like a cold, with a runny nose and sometimes a mild fever.\u00a0 Coughing then develops, which may occur in bouts, sometimes followed by a deep gasp (or \u201cwhoop\u201d). Hospital admission may be required.\nComplications can include pneumonia, encephalitis/encephalopathy and brain damage. There are reported cases of\u00a0death from Pertussis infection.\nHow is it transmitted?\nThe Bordetella pertussis bacterium is highly infectious and is spread by coughing and\u00a0sneezing.\nPrevention\nPrevious infection with Pertussis does not provide lifelong immunity.\nImmunisation is the most effective form of prevention. Booster doses of the vaccine are required throughout life to ensure protection is maintained.\nPertussis immunisation is available for free for the following individuals:\nInfants \u2013 doses at 6 weeks, 4 months and\u00a06 months\nChildren \u2013 booster doses at 18 months and 4 years\nAdolescents \u2013 12 \u2013 13 years of age\nPregnant women \u2013 20 \u2013 32 weeks gestation\nPartners of pregnant women who are at least 28 weeks pregnant (if they have not received a dose in the last 10 years)\nParents/guardians of a baby under 6 months of age (if they have not received a dose in the last 10 years)\nResources\nBetter Health Channel Whooping cough\nAustralian Immunisation Handbook:\u00a0Pertussis\u00a0chapter\nMVEC: Maternal Vaccination During Pregnancy\nThe RCH kids health\u00a0info fact sheet", "source": "mvec.mcri.edu.au/references/whooping-cough/index.html"}
{"id": "69d36301be21-1", "text": "MVEC: Maternal Vaccination During Pregnancy\nThe RCH kids health\u00a0info fact sheet\nAuthors: Mel Addison (SAEFVIC Research Nurse, Murdoch Children\u2019s Research Institute),\u00a0Rachael McGuire (SAEFVIC Research Nurse, Murdoch Children\u2019s Research Institute)\nReviewed by: Georgina Lewis (SAEFVIC Clinical Manager, Murdoch Children\u2019s Research Institute)) and\u00a0Rachael McGuire (SAEFVIC Research Nurse, Murdoch Children\u2019s Research Institute)\nDate:\u00a0July 2019\nMaterials in this section are updated as new information and vaccines become available. The Melbourne Vaccine Education Centre (MVEC) staff regularly reviews materials for accuracy.\nYou should not consider the information in this site to be specific, professional medical advice for your personal health or for your family\u2019s personal health. For medical concerns, including decisions about vaccinations, medications and other treatments, you should always consult a healthcare professional.\nA B C D E F G H I J K L M N O P Q R S T U V W X Y Z", "source": "mvec.mcri.edu.au/references/whooping-cough/index.html"}
{"id": "b200ac34b796-0", "text": "What is it?\nCOVID-19 disease is caused by the highly contagious SARS-CoV-2 virus, a type of coronavirus discovered in 2019 that spread rapidly resulting in a global pandemic. Multiple strains of SARS-CoV-2 have since emerged and public health authorities continue to monitor these. The Omicron strain is currently the most dominant variant circulating and has been shown to be more transmissible than previous variants. \nCOVID-19 disease has had vast impacts on society. In addition to the public health implications, the economic, social and mental health effects have been and continue to be enormous.\u00a0\nWhat to look for?\nInfections can be asymptomatic or can result in a spectrum of symptoms, from mild respiratory symptoms to more serious disease affecting multiple organs and systems. Severe disease can lead to hospitalisation and mechanical ventilation, or even death.\u00a0\u00a0\nCommon symptoms of acute COVID-19 infection can include fever, cough, myalgia (body aches), dyspnoea (difficulty breathing), gastrointestinal symptoms (e.g., diarrhoea, nausea or vomiting), headache, sore throat, loss of smell or taste, and rhinorrhoea (runny nose).", "source": "mvec.mcri.edu.au/references/moderna-covid-19-vaccine/index.html"}
{"id": "b200ac34b796-1", "text": "Some individuals can experience ongoing symptoms for weeks or months after their initial diagnosis, this is known as long COVID or post-COVID conditions. Symptoms can include extreme fatigue, post-exertional malaise, dyspnoea, chest pain, palpitations, fever, arthralgia (joint pain), paresthesia (pins and needles), rash, hoarse voice, problems with memory and concentration (brain fog), sleep problems, changes with taste or smell, gastrointestinal symptoms, changes in menstrual cycles, weight loss and poor appetite, mood changes (depression, anxiety), and difficulty completing activities of daily living. In addition, long COVID can have a huge impact on an individual\u2019s quality of life, mental health, and ability to participate in work or schooling. Long COVID is more common in people who have experienced severe COVID-19 disease, those who had underlying medical conditions prior to infection (e.g., hypertension, chronic lung disease, diabetes, obesity), and those who are unvaccinated.\nPaediatric Multisystem Inflammatory Syndrome Temporally associated with SARS-CoV-2 (PIMS-TS), or Multisystem Inflammatory Syndrome in Children associated with COVID-19 (MIS-C), is a newly described condition that has been reported in children in the first 2-6 weeks after COVID-19 infection. It is an inflammatory condition, similar to Kawasaki disease, and is characterised by rash, fever, shock and abdominal pain. Children experiencing PIMS-TS almost always require hospitalisation for treatment.\nHow is it transmitted?", "source": "mvec.mcri.edu.au/references/moderna-covid-19-vaccine/index.html"}
{"id": "b200ac34b796-2", "text": "How is it transmitted?\nTransmission of COVID-19 is through the inhalation of virus particles which have been made airborne after an infected person coughs, sneezes, breathes, speaks or sings. Droplets or particles can contaminate surfaces and can be spread when a person touches these surfaces and then touches their nose, mouth or eyes. Poorly ventilated settings can also contribute to the spread of COVID-19 as it means aerosol particles can remain suspended in the air for minutes to hours.\nThe incubation period for the disease is 1-14 days, with most individuals displaying symptoms 5-6 days after being exposed. Individuals are thought to be infectious up to 48 hours before symptoms appear and are most infectious in this prodromal period and the early stages of their illness. People with asymptomatic disease can still infect others. \u00a0\nEpidemiology\nSince 2019, over 765 million infections have been reported worldwide contributing to almost 7 million deaths, with true figures likely to be much higher.\u00a0\nIndividuals with immune compromise (due to taking specific medications/therapies or due to a medical condition), advancing age (particularly > 70 years), obesity, respiratory conditions, pregnancy, heart disease, diabetes, renal disease, liver disease, neurological conditions and disability are more likely to experience severe symptoms if infected with SARS-CoV-2.\nCertain occupations, such as working in health care, carry a greater chance of exposure to SARS-CoV-2 and therefore infection.\nPrevention\nStrategies to reduce risk of transmission of COVID-19 disease include standard precautions such as hand hygiene, wearing a mask indoors when remaining socially distant is not possible, and ensuring good ventilation.\u00a0Vaccines can reduce the severity of COVID-19 symptoms and need for hospitalisation.\nPrimary course", "source": "mvec.mcri.edu.au/references/moderna-covid-19-vaccine/index.html"}
{"id": "b200ac34b796-3", "text": "Primary course\nA primary course of vaccination is recommended for all individuals from 5 years of age. Immune competent (those with a functioning immune system) individuals should receive 2 doses given 8 weeks apart, whereas those with immunocompromise should receive 3 doses, with 8 weeks between each dose.\nChildren aged 6 months to \u2264 4 years with severe immunocompromise, disability, and those who have complex and/or multiple health conditions which increase the risk of severe COVID-19 should also receive a primary course of COVID-19 vaccination. In this age group a primary course consists of 3 doses of Comirnaty (Pfizer) [maroon cap] with 8 weeks between each dose, regardless of immune function.\nBooster doses\nIn 2023 ATAGI recommends a single COVID-19 booster dose for all adults aged 65 years and over, as well as adults aged 18-64 years with medical comorbidities that increase their risk of severe COVID-19 disease.\nAdults aged 18-64 years (without risk factors for severe COVID-19 disease), and children and adolescents aged 5-17 years (with medical comorbidities that increase their risk of severe disease or with disability or complex health needs) can consider a booster dose. Booster doses are not recommended in anyone less than 5 years of age.\nVaccines brands available for use by age group", "source": "mvec.mcri.edu.au/references/moderna-covid-19-vaccine/index.html"}
{"id": "b200ac34b796-4", "text": "Vaccines brands available for use by age group\nAge group Vaccine brand Comirnaty (Pfizer- original) [maroon cap] Comirnaty (Pfizer- original) [orange cap] Comirnaty (Pfizer- original) [purple cap] Comirnaty (Pfizer bivalent- original/BA.1) [grey cap] Comirnaty (Pfizer bivalent- original/BA.4/5) [grey cap] Spikevax (Moderna bivalent- original/BA.1) [blue cap/green label] Spikevax (Moderna bivalent- original/BA.4/5) [pre-filled syringe] Nuvaxovid (Novavax) 6 months- \u2264 4 years \u2713 5 - \u2264 11 years \u2713 12 - \u2264 17 years \u2713 \u2713 \u2713 \u2713 \u2265 18 years \u2713 \u2713 \u2713 \u2713 \u2713 \u2713 \n shaded boxes indicate preferred vaccine type used in each age group.\n shaded boxes indicate that vaccine is not available for use in this age group.\nSide effects following vaccination\nCommon side effects\u00a0\nMost side effects following COVID-19 vaccination are mild and can include pain at the injection site, fatigue, headache, lymphadenopathy and fever.\u00a0\nRare side effects", "source": "mvec.mcri.edu.au/references/moderna-covid-19-vaccine/index.html"}
{"id": "b200ac34b796-5", "text": "Rare side effects\u00a0\u00a0\nMyocarditis (inflammation of the heart muscle) and pericarditis (inflammation of the lining around the heart) are rare conditions that have been reported following administration of COVID-19 vaccines. They are most commonly associated with viral infections (including COVID-19 disease) but can also be triggered by other factors such as medications and autoimmune conditions. In the setting of vaccination, the peak risk group for myocarditis is young adult males aged between 16-24 years old following a second dose of vaccination. Pericarditis occurring after vaccination is more common in the 20-45 year old age group for both males and females.\u00a0\nThrombosis with thrombocytopenia (TTS) was a rare condition that was reported to occur in people who had previously received the COVID-19 vaccine Vaxzevria (AstraZeneca). From March 20, 2023 Vaxzevria is no longer available for use in Australia.\nCommonly asked questions\nCan pregnant or breastfeeding women receive COVID-19 vaccines?Yes it is safe to administer COVID-19 vaccines at any stage of pregnancy. Due to an increased risk of severe outcomes for pregnant women and their unborn babies it is recommended that pregnant women have received a primary course of COVID-19 vaccination. Administration of booster doses can also be considered if they are due.\nBreastfeeding women can receive COVID-19 vaccines. They do not need to stop breastfeeding before or after being vaccinated.\nReal world surveillance of international data on mRNA COVID-19 vaccine administration in pregnant women has shown no significant safety concerns for either the mother or the baby. Further to this, antibodies have been detected in the cord blood and breastmilk of vaccinated women, suggesting a transfer of protection to the baby.", "source": "mvec.mcri.edu.au/references/moderna-covid-19-vaccine/index.html"}
{"id": "b200ac34b796-6", "text": "Where can I access COVID-19 vaccines?COVID-19 vaccines can be accessed through GP clinics, some pharmacies (for vaccine recipients aged \u2265 5 years) and hospital immunisation services at Monash Children\u2019s Hospital,\u00a0the Royal Children\u2019s Hospital\u00a0and\u00a0Joan Kirner Women\u2019s and Children\u2019s Hospital (Sunshine). To find your closest provider and make an appointment visit the\u00a0Health direct website or phone the coronavirus hotline on 1800 675 398.\nWhat is the recommended interval between COVID-19 infection and vaccination?An interval of 6 months between COVID-19 infection and COVID-19 vaccination (primary dose or booster dose) is recommended.\nCan COVID-19 vaccines be administered on the same day as other vaccines?In most instances COVID-19 vaccines can be co-administered (given on the same day) with other vaccines, and this includes influenza vaccines. The only exception to this is for children aged 6 months to < 5 years, where separating COVID-19 vaccines and other vaccines by 7-14 days is preferred. This recommendation aims to minimise adverse events such as fever, which can occur in the 3 days following inactivated vaccines and 7-10 days post vaccination with the live-attenuated MMR vaccine.", "source": "mvec.mcri.edu.au/references/moderna-covid-19-vaccine/index.html"}
{"id": "b200ac34b796-7", "text": "How do we complete a primary course of vaccination for children aged 6 months - \u2264 4 years who commenced their course with Spikevax (Moderna) `{`original/ancestral`}` now that it is no longer available?Immune competent children who commenced their primary course with 1 dose of Spikevax (Moderna), can complete their primary course with 1 dose of age-appropriate Comirnaty (Pfizer) only. Severely immunocompromised children who received 1 dose of Spikevax (Moderna), should receive a further 2 doses of Comirnaty (Pfizer) 8 weeks apart to complete the primary course. Severely immunocompromised children who received 2 doses of Spikevax (Moderna) should receive 1 further dose of Comirnaty (Pfizer) 8 weeks later to complete the primary course.\nResources\nMVEC: Vaccine platforms\u00a0\nMVEC: Immunosuppression and vaccines\nVictorian COVID-19 vaccine safety report\nAustralian Government Department of Health and Aged Care: International COVID-19 vaccines recognised by Australia\nAustralian Government Department of Health: Comirnaty (Pfizer)\u00a0\u00a0\nAustralian Government Department of Health: Spikevax (Moderna)\u00a0\u00a0\nAustralian Government Department of Health: Nuvaxovid (Novavax)\nCDC: Long COVID or post COVID conditions\u00a0\nDepartment of Health Victoria: Coronavirus \u00a0\nATAGI clinical guidance on COVID-19 vaccine administration errors\nAuthors: Francesca Machingaifa (MVEC Education Nurse Coordinator) and Rachael McGuire (MVEC Education Nurse Coordinator)\nReviewed by:\u00a0Rachael McGuire (MVEC Education Nurse Coordinator)\nDate: June 6, 2023\nMaterials in this section are updated as new information and vaccines become available. The Melbourne Vaccine Education Centre (MVEC) staff regularly reviews materials for accuracy.", "source": "mvec.mcri.edu.au/references/moderna-covid-19-vaccine/index.html"}
{"id": "b200ac34b796-8", "text": "You should not consider the information in this site to be specific, professional medical advice for your personal health or for your family\u2019s personal health. For medical concerns, including decisions about vaccinations, medications and other treatments, you should always consult a healthcare professional.\nA B C D E F G H I J K L M N O P Q R S T U V W X Y Z", "source": "mvec.mcri.edu.au/references/moderna-covid-19-vaccine/index.html"}
{"id": "b4cbb5cde4da-0", "text": "Background\nThe Australian Academy of Science is a not-for profit organisation whose aim is to provide independent and factual information, promote public trust and understanding of science, and support global scientific collaboration. Members of the Academy have been elected for their exceptional contributions to science and research.\nThe science of immunisation\n\u2018The Science of Immunisation- questions and answers\u2019 was first produced by the Academy in 2012 and aims to\u00a0assist in the understanding of the scientific processes behind vaccination and to encourage trust in vaccines for COVID-19 and other diseases.\nTopics include:\nwhat is immunisation?\nwhat is in a vaccine?\nwho benefits from vaccines?\nare vaccines safe?\nwhat does the future hold for vaccination?\nResources\nThe science of immunisation- questions and answers (2021 Edition)\nAuthor: Rachael McGuire (MVEC Education Nurse Coordinator)\nReviewed by:\u00a0Rachael McGuire (MVEC Education Nurse Coordinator)\nDate: May 2021\nMaterials in this section are updated as new information and vaccines become available. The Melbourne Vaccine Education Centre (MVEC) staff regularly reviews materials for accuracy.\nYou should not consider the information in this site to be specific, professional medical advice for your personal health or for your family\u2019s personal health. For medical concerns, including decisions about vaccinations, medications and other treatments, you should always consult a healthcare professional.\nA B C D E F G H I J K L M N O P Q R S T U V W X Y Z", "source": "mvec.mcri.edu.au/references/australian-academy-of-science/index.html"}
{"id": "53fd6db4ff6b-0", "text": "What is it?\nPolio (poliomyelitis) is caused by a gastrointestinal (gut) infection with one of 3 types of polioviruses (serotypes 1, 2 or 3). Polioviruses are RNA enteroviruses from the Picornaviridae family.\nOnce an individual is infected, the poliovirus replicates in the gut and enters the bloodstream via lymphoid tissue where it can then cause symptoms in the central nervous system.\nWhat to look for\nApproximately 70% of polio infections are asymptomatic or present as a non-specific febrile illness. In symptomatic cases an individual may experience fever, headache, gastrointestinal disturbance (nausea and vomiting) or malaise. In severe infections muscle pain and stiffness of the neck and back can occur.\nParalysis typically presents asymmetrically and can be life threatening when the respiratory and swallowing muscles are affected. The extent of paralysis is usually seen within 3-4 days of symptom onset and any existing paralysis present after 60 days is likely to be permanent. It is estimated that flaccid paralysis occurs in less than 1 percent of all polio cases.\nA recurrence of muscle weakness in the years after an initial polio infection is known as post-polio syndrome. It is attributed to a progressive loss or dysfunction of motor neurons as opposed to a persistent or reactivated infection.\nHow is it transmitted?\nWild polio is transmitted through contact with the faeces or saliva of an infected person and is most often associated with conditions of poor sanitation.\nThe incubation period of polio is 3-35 days, with a person infectious during the 7-10 days prior to the onset of symptoms. Following acute infection, a person can continue to excrete the polio virus for up to 6 weeks in their faeces, or 2 weeks in saliva.\nEpidemiology", "source": "mvec.mcri.edu.au/references/polio/index.html"}
{"id": "53fd6db4ff6b-1", "text": "Epidemiology\nPolio infection predominantly occurs in children with the greatest burden of disease affecting those less than 5 years of age (80-90% of cases).\nGlobal vaccination programs and high rates of immunisation have shown great success with the near eradication of wild polio worldwide. A total of 350,000 infections were reported in 1988 across 125 countries and in 2021 this was reduced down to 6 reported cases across countries including Pakistan and Afghanistan. The COVID-19 pandemic has greatly impacted these vaccination programs and since 2022 a resurgence of case across many countries (including the United States and the UK) have been reported, largely in pockets of unimmunised communities.\nPrevention\nVaccination remains the most effective measure in disease prevention with protection available in Australia through the administration of a course of inactivated vaccines. Polio vaccination is funded on the National Immunisation Program (NIP) as a combination vaccine for children at:\n6 weeks, 4 months and 6 months \u2013 Infanrix\u00ae hexa/Vaxelis\u00ae\n4 years \u2013 Infanrix\u00ae IPV/Quadracel\u00ae\nIndividuals who missed a dose or who have an incomplete vaccine history should be offered immunisation to ensure that they are protected. Catch up vaccines are funded for some individuals.\nCompleting a primary course of vaccination generally provides life-long protection and booster doses are not routinely indicated for the broader population. However, they may be indicated for travellers visiting countries with known cases of polio.\nPrecautions", "source": "mvec.mcri.edu.au/references/polio/index.html"}
{"id": "53fd6db4ff6b-2", "text": "Precautions\nThe oral live-attenuated polio vaccine is no longer available in Australia due to the potential low risk (1 case per 2.4 million doses) of Vaccine Associated Paralytic Poliomyelitis (VAPP), also known as Vaccine Derived Poliovirus (VDPV). Following receipt of the oral polio vaccine some of the vaccine virus may be shed in a person\u2019s faeces for up to 6 weeks. In areas of low vaccine coverage this has the potential to cause disease in an unvaccinated individual.\nResources\nAustralian Immunisation Handbook: Poliomyelitis\nCDC: Vaccines and Preventable Diseases \u2013 Vaccine Derived Poliovirus\nThe Blue Book: Guidelines for the control of infectious diseases\nAustralian Government Department of Health and Aged Care: Changes to the National Immunisation Program schedule from July 1 2023\nAuthors: Rachael McGuire (MVEC Education Nurse Coordinator)\nReviewed by: Rachael McGuire (MVEC Education Nurse Coordinator)\nDate: July 4, 2023\nMaterials in this section are updated as new information and vaccines become available. The Melbourne Vaccine Education Centre (MVEC) staff regularly reviews materials for accuracy.\nYou should not consider the information in this site to be specific, professional medical advice for your personal health or for your family\u2019s personal health. For medical concerns, including decisions about vaccinations, medications and other treatments, you should always consult a healthcare professional.\nA B C D E F G H I J K L M N O P Q R S T U V W X Y Z", "source": "mvec.mcri.edu.au/references/polio/index.html"}
{"id": "f30468629881-0", "text": "MVEC supports all scientific efforts to rapidly develop safe and effective SARS CoV-2 vaccine(s). This includes technology developed over 50 years ago and has been a proven way to support the production of viral vaccines that have saved so many lives around the world.\nBackground\nIn the early 1960\u2019s foetal embryo fibroblast cells were first obtained from 2 elective terminations of pregnancy in order to grow vaccine viruses. These same cell lines have continued to grow in laboratory conditions since this time and have been used in the development of various vaccines including rubella, measles, hepatitis A and rabies vaccines.\nHow is foetal tissue used in vaccine development?\nVaccine viruses are grown within foetal cell lines because they are human and will mimic how viruses will act when infecting a human host. They can be sustained over time and have been shared by multiple vaccine researchers and developers and are clearly outlined to regulatory authorities, such as the Therapeutic Goods Administration (TGA) in Australia and the Food and Drug Administration (FDA) in America.\nThere are three current SARS CoV-2 vaccine candidates that have used this technology as part of their development.\u00a0 They are the Oxford AstraZeneca (UK); Johnson and Johnson (Jansen research US) and CanSino biologics (China). All of these vaccines are in the class called \u2018Virus vectors\u2019 and use an adenovirus (common human virus) to help carry the DNA of the SARS CoV-2 spike protein, the part of the virus researchers are targeting to produce a protective immune response.\nWhy don\u2019t we try to use vaccines without these foetal embryonic cell lines?", "source": "mvec.mcri.edu.au/references/foetal-embryonic-cells-utilised-in-vaccine-development-platforms/index.html"}
{"id": "f30468629881-1", "text": "Why don\u2019t we try to use vaccines without these foetal embryonic cell lines?\nThe SARS CoV-2 pipeline is progressing at pandemic speed and it was important to utilise proven technologies to support vaccine development. Replication of viruses in the laboratory can be difficult, so these established platforms, as detailed above, is scientifically justifiable There is also a hypothetical concern for transmission of animal diseases if animal embryonic cell lines were to be used for this purpose.\nIt is also uncertain how many of the SARS CoV-2 vaccines will be shown to be safe and effective, so given the impact of the pandemic and lives that may be saved by vaccine(s), we should be open to discussing these products and addressing ethics issues that are being raised as part of COVID-19 vaccine readiness planning.\nReligious and ethical implications\nEven though foetal cells lines are used to grow vaccine viruses, the resultant vaccine does not contain these cells, fragments of these cells, or any DNA recognisable as human. During the manufacturing process, the foetal cells often burst when the vaccine virus grows, and the resulting vaccine virus is purified before being used in the final vaccine product.\nIn 2005, Pope Benedict XVI as head of the Catholic Church, released a statement in support of using vaccines derived from foetal cell lines, outlining that they \u201cmay be considered in order to avoid a serious risk not only for one\u2019s own children but also, and perhaps more specifically, for the health conditions of the population as a whole \u2013 especially for pregnant women\u201d. They may be \u201cmorally justified as an extrema ratio due to the necessity to provide for the good of one\u2019s children and of the people who come in contact with the children\u201d [refer to Moral reflections on vaccines prepared from cells derived from aborted human foetuses].\nResources\nChildren\u2019s Hospital of Philadelphia, Vaccine Education Centre: Vaccine Ingredients- fetal tissues", "source": "mvec.mcri.edu.au/references/foetal-embryonic-cells-utilised-in-vaccine-development-platforms/index.html"}
{"id": "f30468629881-2", "text": "Resources\nChildren\u2019s Hospital of Philadelphia, Vaccine Education Centre: Vaccine Ingredients- fetal tissues\nChildren\u2019s Hospital of Philadelphia, Vaccine Education Centre: News & Views- Why were fetal cells used to make certain vaccines?\nJohns Hopkins Bloomberg School of Public Health, Institute for Vaccine Safety: Religion and Vaccines\nPontifical Academy for Life: Note on Italian vaccine issue, 2017\nNCIRS: Vaccine components fact sheet\nAustralian Government Department of Health and Ageing: Myths and Realities, responding to arguments against vaccination (5th edition 2013)\nAuthors:\u00a0Nigel Crawford (Director, SAEFVIC, Murdoch Children\u2019s Research Institute), Rachael McGuire (SAEFVIC Research Nurse, Murdoch Children\u2019s Research Institute), and Georgina Lewis (SAEFVIC Clinical Manager, Murdoch Children\u2019s Research Institute)\nDate:\u00a0August 2020\nMaterials in this section are updated as new information and vaccines become available. The Melbourne Vaccine Education Centre (MVEC) staff regularly reviews materials for accuracy.\nYou should not consider the information in this site to be specific, professional medical advice for your personal health or for your family\u2019s personal health. For medical concerns, including decisions about vaccinations, medications and other treatments, you should always consult a healthcare professional.\nA B C D E F G H I J K L M N O P Q R S T U V W X Y Z", "source": "mvec.mcri.edu.au/references/foetal-embryonic-cells-utilised-in-vaccine-development-platforms/index.html"}
{"id": "646d818143f9-0", "text": "What is it?\nCOVID-19 disease is caused by the highly contagious SARS-CoV-2 virus, a type of coronavirus discovered in 2019 that spread rapidly resulting in a global pandemic. Multiple strains of SARS-CoV-2 have since emerged and public health authorities continue to monitor these. The Omicron strain is currently the most dominant variant circulating and has been shown to be more transmissible than previous variants. \nCOVID-19 disease has had vast impacts on society. In addition to the public health implications, the economic, social and mental health effects have been and continue to be enormous.\u00a0\nWhat to look for?\nInfections can be asymptomatic or can result in a spectrum of symptoms, from mild respiratory symptoms to more serious disease affecting multiple organs and systems. Severe disease can lead to hospitalisation and mechanical ventilation, or even death.\u00a0\u00a0\nCommon symptoms of acute COVID-19 infection can include fever, cough, myalgia (body aches), dyspnoea (difficulty breathing), gastrointestinal symptoms (e.g., diarrhoea, nausea or vomiting), headache, sore throat, loss of smell or taste, and rhinorrhoea (runny nose).", "source": "mvec.mcri.edu.au/references/covid-19-vaccine-candidate-novavax/index.html"}
{"id": "646d818143f9-1", "text": "Some individuals can experience ongoing symptoms for weeks or months after their initial diagnosis, this is known as long COVID or post-COVID conditions. Symptoms can include extreme fatigue, post-exertional malaise, dyspnoea, chest pain, palpitations, fever, arthralgia (joint pain), paresthesia (pins and needles), rash, hoarse voice, problems with memory and concentration (brain fog), sleep problems, changes with taste or smell, gastrointestinal symptoms, changes in menstrual cycles, weight loss and poor appetite, mood changes (depression, anxiety), and difficulty completing activities of daily living. In addition, long COVID can have a huge impact on an individual\u2019s quality of life, mental health, and ability to participate in work or schooling. Long COVID is more common in people who have experienced severe COVID-19 disease, those who had underlying medical conditions prior to infection (e.g., hypertension, chronic lung disease, diabetes, obesity), and those who are unvaccinated.\nPaediatric Multisystem Inflammatory Syndrome Temporally associated with SARS-CoV-2 (PIMS-TS), or Multisystem Inflammatory Syndrome in Children associated with COVID-19 (MIS-C), is a newly described condition that has been reported in children in the first 2-6 weeks after COVID-19 infection. It is an inflammatory condition, similar to Kawasaki disease, and is characterised by rash, fever, shock and abdominal pain. Children experiencing PIMS-TS almost always require hospitalisation for treatment.\nHow is it transmitted?", "source": "mvec.mcri.edu.au/references/covid-19-vaccine-candidate-novavax/index.html"}
{"id": "646d818143f9-2", "text": "How is it transmitted?\nTransmission of COVID-19 is through the inhalation of virus particles which have been made airborne after an infected person coughs, sneezes, breathes, speaks or sings. Droplets or particles can contaminate surfaces and can be spread when a person touches these surfaces and then touches their nose, mouth or eyes. Poorly ventilated settings can also contribute to the spread of COVID-19 as it means aerosol particles can remain suspended in the air for minutes to hours.\nThe incubation period for the disease is 1-14 days, with most individuals displaying symptoms 5-6 days after being exposed. Individuals are thought to be infectious up to 48 hours before symptoms appear and are most infectious in this prodromal period and the early stages of their illness. People with asymptomatic disease can still infect others. \u00a0\nEpidemiology\nSince 2019, over 765 million infections have been reported worldwide contributing to almost 7 million deaths, with true figures likely to be much higher.\u00a0\nIndividuals with immune compromise (due to taking specific medications/therapies or due to a medical condition), advancing age (particularly > 70 years), obesity, respiratory conditions, pregnancy, heart disease, diabetes, renal disease, liver disease, neurological conditions and disability are more likely to experience severe symptoms if infected with SARS-CoV-2.\nCertain occupations, such as working in health care, carry a greater chance of exposure to SARS-CoV-2 and therefore infection.\nPrevention\nStrategies to reduce risk of transmission of COVID-19 disease include standard precautions such as hand hygiene, wearing a mask indoors when remaining socially distant is not possible, and ensuring good ventilation.\u00a0Vaccines can reduce the severity of COVID-19 symptoms and need for hospitalisation.\nPrimary course", "source": "mvec.mcri.edu.au/references/covid-19-vaccine-candidate-novavax/index.html"}
{"id": "646d818143f9-3", "text": "Primary course\nA primary course of vaccination is recommended for all individuals from 5 years of age. Immune competent (those with a functioning immune system) individuals should receive 2 doses given 8 weeks apart, whereas those with immunocompromise should receive 3 doses, with 8 weeks between each dose.\nChildren aged 6 months to \u2264 4 years with severe immunocompromise, disability, and those who have complex and/or multiple health conditions which increase the risk of severe COVID-19 should also receive a primary course of COVID-19 vaccination. In this age group a primary course consists of 3 doses of Comirnaty (Pfizer) [maroon cap] with 8 weeks between each dose, regardless of immune function.\nBooster doses\nIn 2023 ATAGI recommends a single COVID-19 booster dose for all adults aged 65 years and over, as well as adults aged 18-64 years with medical comorbidities that increase their risk of severe COVID-19 disease.\nAdults aged 18-64 years (without risk factors for severe COVID-19 disease), and children and adolescents aged 5-17 years (with medical comorbidities that increase their risk of severe disease or with disability or complex health needs) can consider a booster dose. Booster doses are not recommended in anyone less than 5 years of age.\nVaccines brands available for use by age group", "source": "mvec.mcri.edu.au/references/covid-19-vaccine-candidate-novavax/index.html"}
{"id": "646d818143f9-4", "text": "Vaccines brands available for use by age group\nAge group Vaccine brand Comirnaty (Pfizer- original) [maroon cap] Comirnaty (Pfizer- original) [orange cap] Comirnaty (Pfizer- original) [purple cap] Comirnaty (Pfizer bivalent- original/BA.1) [grey cap] Comirnaty (Pfizer bivalent- original/BA.4/5) [grey cap] Spikevax (Moderna bivalent- original/BA.1) [blue cap/green label] Spikevax (Moderna bivalent- original/BA.4/5) [pre-filled syringe] Nuvaxovid (Novavax) 6 months- \u2264 4 years \u2713 5 - \u2264 11 years \u2713 12 - \u2264 17 years \u2713 \u2713 \u2713 \u2713 \u2265 18 years \u2713 \u2713 \u2713 \u2713 \u2713 \u2713 \n shaded boxes indicate preferred vaccine type used in each age group.\n shaded boxes indicate that vaccine is not available for use in this age group.\nSide effects following vaccination\nCommon side effects\u00a0\nMost side effects following COVID-19 vaccination are mild and can include pain at the injection site, fatigue, headache, lymphadenopathy and fever.\u00a0\nRare side effects", "source": "mvec.mcri.edu.au/references/covid-19-vaccine-candidate-novavax/index.html"}
{"id": "646d818143f9-5", "text": "Rare side effects\u00a0\u00a0\nMyocarditis (inflammation of the heart muscle) and pericarditis (inflammation of the lining around the heart) are rare conditions that have been reported following administration of COVID-19 vaccines. They are most commonly associated with viral infections (including COVID-19 disease) but can also be triggered by other factors such as medications and autoimmune conditions. In the setting of vaccination, the peak risk group for myocarditis is young adult males aged between 16-24 years old following a second dose of vaccination. Pericarditis occurring after vaccination is more common in the 20-45 year old age group for both males and females.\u00a0\nThrombosis with thrombocytopenia (TTS) was a rare condition that was reported to occur in people who had previously received the COVID-19 vaccine Vaxzevria (AstraZeneca). From March 20, 2023 Vaxzevria is no longer available for use in Australia.\nCommonly asked questions\nCan pregnant or breastfeeding women receive COVID-19 vaccines?Yes it is safe to administer COVID-19 vaccines at any stage of pregnancy. Due to an increased risk of severe outcomes for pregnant women and their unborn babies it is recommended that pregnant women have received a primary course of COVID-19 vaccination. Administration of booster doses can also be considered if they are due.\nBreastfeeding women can receive COVID-19 vaccines. They do not need to stop breastfeeding before or after being vaccinated.\nReal world surveillance of international data on mRNA COVID-19 vaccine administration in pregnant women has shown no significant safety concerns for either the mother or the baby. Further to this, antibodies have been detected in the cord blood and breastmilk of vaccinated women, suggesting a transfer of protection to the baby.", "source": "mvec.mcri.edu.au/references/covid-19-vaccine-candidate-novavax/index.html"}
{"id": "646d818143f9-6", "text": "Where can I access COVID-19 vaccines?COVID-19 vaccines can be accessed through GP clinics, some pharmacies (for vaccine recipients aged \u2265 5 years) and hospital immunisation services at Monash Children\u2019s Hospital,\u00a0the Royal Children\u2019s Hospital\u00a0and\u00a0Joan Kirner Women\u2019s and Children\u2019s Hospital (Sunshine). To find your closest provider and make an appointment visit the\u00a0Health direct website or phone the coronavirus hotline on 1800 675 398.\nWhat is the recommended interval between COVID-19 infection and vaccination?An interval of 6 months between COVID-19 infection and COVID-19 vaccination (primary dose or booster dose) is recommended.\nCan COVID-19 vaccines be administered on the same day as other vaccines?In most instances COVID-19 vaccines can be co-administered (given on the same day) with other vaccines, and this includes influenza vaccines. The only exception to this is for children aged 6 months to < 5 years, where separating COVID-19 vaccines and other vaccines by 7-14 days is preferred. This recommendation aims to minimise adverse events such as fever, which can occur in the 3 days following inactivated vaccines and 7-10 days post vaccination with the live-attenuated MMR vaccine.", "source": "mvec.mcri.edu.au/references/covid-19-vaccine-candidate-novavax/index.html"}
{"id": "646d818143f9-7", "text": "How do we complete a primary course of vaccination for children aged 6 months - \u2264 4 years who commenced their course with Spikevax (Moderna) `{`original/ancestral`}` now that it is no longer available?Immune competent children who commenced their primary course with 1 dose of Spikevax (Moderna), can complete their primary course with 1 dose of age-appropriate Comirnaty (Pfizer) only. Severely immunocompromised children who received 1 dose of Spikevax (Moderna), should receive a further 2 doses of Comirnaty (Pfizer) 8 weeks apart to complete the primary course. Severely immunocompromised children who received 2 doses of Spikevax (Moderna) should receive 1 further dose of Comirnaty (Pfizer) 8 weeks later to complete the primary course.\nResources\nMVEC: Vaccine platforms\u00a0\nMVEC: Immunosuppression and vaccines\nVictorian COVID-19 vaccine safety report\nAustralian Government Department of Health and Aged Care: International COVID-19 vaccines recognised by Australia\nAustralian Government Department of Health: Comirnaty (Pfizer)\u00a0\u00a0\nAustralian Government Department of Health: Spikevax (Moderna)\u00a0\u00a0\nAustralian Government Department of Health: Nuvaxovid (Novavax)\nCDC: Long COVID or post COVID conditions\u00a0\nDepartment of Health Victoria: Coronavirus \u00a0\nATAGI clinical guidance on COVID-19 vaccine administration errors\nAuthors: Francesca Machingaifa (MVEC Education Nurse Coordinator) and Rachael McGuire (MVEC Education Nurse Coordinator)\nReviewed by:\u00a0Rachael McGuire (MVEC Education Nurse Coordinator)\nDate: June 6, 2023\nMaterials in this section are updated as new information and vaccines become available. The Melbourne Vaccine Education Centre (MVEC) staff regularly reviews materials for accuracy.", "source": "mvec.mcri.edu.au/references/covid-19-vaccine-candidate-novavax/index.html"}
{"id": "646d818143f9-8", "text": "You should not consider the information in this site to be specific, professional medical advice for your personal health or for your family\u2019s personal health. For medical concerns, including decisions about vaccinations, medications and other treatments, you should always consult a healthcare professional.\nA B C D E F G H I J K L M N O P Q R S T U V W X Y Z", "source": "mvec.mcri.edu.au/references/covid-19-vaccine-candidate-novavax/index.html"}
{"id": "391a7ea2a3a4-0", "text": "What is it?\nTuberculosis (TB) is caused by an infection with the bacteria Mycobacterium tuberculosis. In rarer cases, TB may be attributed to infection with Mycobacterium bovis or Mycobacterium africanum.\nTB is categorised as being an active disease (the infected person is displaying symptoms and is infectious) or a latent infection (the bacteria is dormant and the infected person has no symptoms and is not infectious). Latent TB can become active if an infected person\u2019s immune system becomes weakened (due to a medical condition or taking immunosuppressive therapies), following serious illness, with drug or alcohol abuse, or with increasing age.\nWhat to look for\nApproximately 60% of TB cases in Australia present as pulmonary (lung) TB. Common symptoms include a chronic cough which may be accompanied by haemoptysis (coughing blood) as well as fevers, night sweats, weight loss and malaise (generally feeling unwell).\nIn some cases, infection can also occur in the brain, bones, kidneys or lymph nodes. TB meningitis (brain infection) and TB septicaemia (blood infection) are considered the most serious manifestations of TB disease.\nMost people infected with TB are asymptomatic. 10% of people infected with TB will go on to develop clinical disease at some point in their lifetime.\nHow is it transmitted?\nPulmonary TB can be spread to others via aerosol transmission of infected droplets through coughing or sneezing. People with TB infections without lung or laryngeal involvement generally cannot transmit disease. However, urine is considered infectious in the case of renal TB. In countries where Mycobacterium bovis is prevalent (it is not prevalent in Australia), the bacteria can also be transmitted by ingesting unpasteurised milk.", "source": "mvec.mcri.edu.au/references/bcg-vaccine/index.html"}
{"id": "391a7ea2a3a4-1", "text": "A person is considered infectious until 14 days after being on active treatment AND until they have tested negative on a sputum sample. Following an active infection the bacteria will remain dormant (non-infectious) within scar tissue where it can be reactivated later in life (even decades later). Once reactivated the bacteria is capable of being transmitted again.\nEpidemiology\nAustralia has one of the lowest rates of TB in the world, affecting less than 7 per 100,000 people. Aboriginal and Torres Strait Islander people residing in the Northern Territory and Far North Queensland have a much greater burden of disease compared with non-Indigenous people in those areas and Aboriginal and Torres Strait Islander people living in other states.\nGlobally, it is estimated that approximately one-quarter of the world\u2019s population is infected with TB, causing 1.5 million deaths annually. Bangladesh, China, India, Indonesia, Nigeria, Pakistan, Philippines and South Africa have the highest incidence of infection, accounting for almost half of the world\u2019s TB cases.\nChildren under 5 years of age, the older population, those with immunocompromise (due to medical condition or immunocompromising therapies) and those impacted by poor living conditions have the highest rates of infection.\nPrevention\nVaccination with the BCG vaccine is effective in reducing the incidence of TB meningitis and death in children less than 5 years of age in countries where TB is prevalent. Vaccination is not routinely recommended in developed countries like Australia where disease incidence is low. In Australia the following groups of people are recommended to be vaccinated:\nchildren < 5 years living in Aboriginal and Torres Strait Islander communities in Queensland\nAboriginal and Torres Strait Islander neonates living in Queensland\nchildren < 5 years of age travelling internationally to areas where tuberculosis is prevalent.", "source": "mvec.mcri.edu.au/references/bcg-vaccine/index.html"}
{"id": "391a7ea2a3a4-2", "text": "children < 5 years of age travelling internationally to areas where tuberculosis is prevalent.\nBCG vaccination for individuals travelling to areas with a high incidence of disease is ideally administered 4-6 weeks prior to travel.\nTuberculin skin testing\nTuberculin skin testing (TST) or Mantoux testing prior to BCG vaccination is recommended on a case-by case basis to determine if a person already has a level of immunity to TB. It involves the intradermal injection of a tuberculin purified protein derivative (PPD).\nIn people who have previously received a BCG or have previously had TB exposure, a hypersensitivity reaction can be recognised 48-72 hours later.\nIt is important to note that TST results may be unreliable for 4-6 weeks following a measles infection or receiving a measles-containing vaccine.\nVaccine administration\nBCG vaccine is administered via the intradermal route. Only healthcare providers trained in intradermal technique should provide BCG vaccination.\nThe recommended site for injection is on the left arm over where the deltoid muscle inserts into the humerus. Administration at this site will minimise the risk of keloid scarring.\nIn children < 12 months of age the recommended dose is 0.05ml\nIn children > 12 months of age the recommended dose is 0.1ml\nOther injected live-attenuated vaccines can either be administered on the same day as BCG or 4 weeks apart. There is no recommended interval between BCG and oral live-attenuated vaccines.\nContraindications and precautions\nBCG is a live-attenuated vaccine and is therefore contraindicated in individuals with immunosuppression or in those who are pregnant.\nIf active eczema, dermatitis or psoriasis is present at the site of injection, vaccination should be deferred until the skin can be treated and is clear of symptoms.", "source": "mvec.mcri.edu.au/references/bcg-vaccine/index.html"}
{"id": "391a7ea2a3a4-3", "text": "Side effects following vaccination\nBCG, like all vaccines, has a list of common and expected side effects and a list of rare side effects that may occur in the weeks following vaccine administration.\nCommon and expected side effects can include:\na small red papule will appear at the injection site in the weeks following the vaccine\nan ulcer (open sore) may develop 2-3 weeks later (usually less than 1 cm in diameter) and last from a few weeks to months\nthe majority of infants will develop a flat scar at the site once the ulcer heals.\nRare or more serious side effects can include:\naxillary lymphadenopathy (swelling of the lymph nodes under the left arm)\npersisting ulcer lasting longer than a few months\na large abscess (collection of pus) at the injection site\nkeloid scarring at the site.\nNB: If you suspect a rare or serious side effect, it is strongly recommended to seek medical advice either from a GP or the medical clinic where the BCG was administered. For specialist immunisation advice or to report an adverse event following immunisation (AEFI), please contact SAEFVIC.\nPost vaccination care\nFollowing vaccination the site must be kept clean and dry. Normal activities like bathing and swimming can continue ensuring that the area is patted dry afterwards.\nIf the ulcer is oozing it may be covered with a dry gauze and can be cleaned with an alcohol swab. Ointments, creams or antiseptics should not be applied directly to the site.\nFor more information refer to What to expect following the BCG vaccination \u2013 RCH parent handout.\nResources\nBCG Clinics in Victoria\nThe Royal Children\u2019s Hospital: BCG Clinic\nMonash Health Immunisation Service\nOffspring Child Health Specialists\nFamily Immunisation & Travel Specialists (FITS)\nA/Prof Mike Starr\u00a0\nCraigieburn Specialist Consulting Suites", "source": "mvec.mcri.edu.au/references/bcg-vaccine/index.html"}
{"id": "391a7ea2a3a4-4", "text": "A/Prof Mike Starr\u00a0\nCraigieburn Specialist Consulting Suites\nMedical One- QV\nKids Travel Doc\nThe Children\u2019s Private Medical Group\nWyndham Private Medical Centre\nTravel Clinics Australia- Caulfied\nTravel Clinics Australia- Williams Landing\nOther\nMVEC: Intradermal vaccination\nRCH Kids Health Information: Tuberculosis disease (TB)\nAustralian Immunisation Handbook: Tuberculosis\nRCH Kids Health Information BCG vaccine for TB\nWhat to expect following the BCG vaccination \u2013 RCH parent handout\nWhat to expect after your child receives the BCG vaccination \u2013 Monash Hospital parent handout\nDhanawade, S. Kumbhar, S. Gore, A. and Patil, V. Scar formation and tuberculin conversion following BCG vaccination in infants: A prospective cohort study, Journal of Family Medicine and Primary Care 2015 Jul-Sep 4(3) 384-387\nAuthors: Nigel Crawford (Director SAEFVIC, Murdoch Children\u2019s Research Institute) and Rachael McGuire (SAEFVIC Research Nurse, Murdoch Children\u2019s Research Institute)\nReviewed by: Rachael McGuire (MVEC Education Nurse Coordinator)\nDate: June 13, 2023\nMaterials in this section are updated as new information and vaccines become available. The Melbourne Vaccine Education Centre (MVEC) staff regularly reviews materials for accuracy.\nYou should not consider the information in this site to be specific, professional medical advice for your personal health or for your family\u2019s personal health. For medical concerns, including decisions about vaccinations, medications and other treatments, you should always consult a healthcare professional.\n\u00a0\nA B C D E F G H I J K L M N O P Q R S T U V W X Y Z", "source": "mvec.mcri.edu.au/references/bcg-vaccine/index.html"}
{"id": "489a2dc10416-0", "text": "What is it?\nHaemophilus influenzae is a type of bacteria that can live in a person\u2019s nose and throat. It is considered part of the normal flora of the nasopharynx (upper respiratory tract) and generally does not cause symptoms of disease. However, when the bacteria invade other areas of the body, severe infections and complications can occur. Encapsulated strains of haemophilus influenzae (bacteria with distinct polysaccharide capsules) are more likely to cause invasive infections than non-encapsulated subtypes (those without polysaccharide capsules). Of the 6 encapsulated subtypes (named A-F), type B (Hib) is the only vaccine\u2013preventable strain. \u00a0\nWhat to look for\nThe symptoms of an invasive Hib infection will depend on the location of the infection (e.g., brain, lungs).\u00a0\nMeningitis (brain inflammation) is the most common presentation of an invasive Hib infection and is often accompanied by bacteraemia (blood infection). Invasive infections can also manifest as otitis media (ear infections), epiglottitis (swelling of the throat), pneumonia (lung infections), arthritis (joint infection), cellulitis (skin infection), osteomyelitis (inflammation to the bone) and pericarditis (inflammation to the sac surrounding the heart). \u00a0\nEven with treatment, 3% of Hib meningitis cases occurring in developed countries will be fatal, and 10-30% of cases will have permanent neurological complications.\u00a0\u00a0\nHow can it be transmitted?\nHib can be passed from person to person through inhaling the respiratory droplets of an infected person (produced from coughing or sneezing). In some instances, it can also be transmitted by direct contact with infectious secretions (e.g., touching nasal mucous on a tissue or surface).", "source": "mvec.mcri.edu.au/references/haemophilus-influenzae-type-b-hib/index.html"}
{"id": "489a2dc10416-1", "text": "Carriers may be symptomatic or asymptomatic. A person can transmit the bacteria for as long it is present in the nasopharynx.\u00a0\nEpidemiology\nBefore vaccination was included on the National Immunisation Program (NIP) in 1992, Hib was the biggest cause of invasive bacterial infection in children in Australia. Since then, the number of Hib infections notified has reduced by 95%.\u00a0\nAboriginal and Torres Strait Islander children have a much greater burden of disease than the non-Indigenous population.\u00a0\u00a0\nAsplenia and hyposplenia are conditions associated with a lifelong risk of bacterial infections. Individuals with these conditions are therefore at a greater risk of invasive disease if they have not been appropriately immunised.\u00a0\nPrevention\nProtection is offered through the intramuscular administration of inactivated, conjugate vaccines (combination and single antigen vaccines). They are provided on the NIP at:\u00a0\n6 weeks, 4 months, and 6 months- Infanrix\u00ae hexa/Vaxelis\u00ae\u00a0\n18 months- ActHIB\u00ae\u00a0\u00a0\nNB: Children <5 years of age with asplenia and hyposplenia should be up to date with the routine schedule and if not, they should be offered catch-up. Those aged 5 years and over who did not complete their primary course of vaccination should receive a single dose of Hib-containing vaccine.\u00a0\nVaccine side effects\nInjection site reactions and fever have been reported following administration of Hib-containing vaccines. Symptoms usually appear within the first 4 hours and resolve within 24 without the need for intervention or additional monitoring.\u00a0\nResources\nMVEC: Asplenia and hyposplenia\nAustralian Immunisation Handbook: Haemophilus influenzae type b (Hib)\nAustralian Government Department of Health and Aged Care: Changes to the National Immunisation Program schedule from July 1 2023", "source": "mvec.mcri.edu.au/references/haemophilus-influenzae-type-b-hib/index.html"}
{"id": "489a2dc10416-2", "text": "Authors: Georgina Lewis (Clinical Manager SAEFVIC, Murdoch Children\u2019s Research Institute) and Rachael McGuire (MVEC Education Nurse Coordinator)\nReviewed by: Rachael McGuire (MVEC Education Nurse Coordinator)\nDate: July 4, 2023\nMaterials in this section are updated as new information and vaccines become available. The Melbourne Vaccine Education Centre (MVEC) staff regularly reviews materials for accuracy.\nYou should not consider the information in this site to be specific, professional medical advice for your personal health or for your family\u2019s personal health. For medical concerns, including decisions about vaccinations, medications and other treatments, you should always consult a healthcare professional.\nA B C D E F G H I J K L M N O P Q R S T U V W X Y Z", "source": "mvec.mcri.edu.au/references/haemophilus-influenzae-type-b-hib/index.html"}
{"id": "bdc527b53ea7-0", "text": "SAEFVIC (Surveillance of Adverse Events Following Vaccination In the Community) is the central reporting service in Victoria for any significant adverse event following immunisation (AEFI).\nAn AEFI is defined by the Australian Immunisation Handbook as \u201cany untoward medical occurrence that follows immunisation. It does not necessarily have a causal relationship with the vaccine\u201d. A vaccine error is also considered an AEFI and may be related to the way a vaccine was stored, prepared or administered.\nReporting adverse events is not mandatory in Victoria, however doing so allows the rapid investigation of any potential vaccine or system problems by Victorian and national health authorities (Therapeutic Goods Administration). This helps to ensure a safe and effective immunisation program and it maintains community confidence in vaccines.\nFollowing the report of adverse events, SAEFVIC can facilitate individualised clinical assistance for patients and families affected by an AEFI. This may be done via a face-to-face or telehealth consultation with a specialist or with an immunisation nurse over the phone.\nPlease see your GP, local emergency department or call 000 if immediate assistance is required.\nResources\nSAEFVIC\nMVEC: Victorian Specialist Immunisation Services (VicSIS)\nMVEC: Adverse events reporting Australia\nMVEC: AusVaxSafety: vaccine safety surveillance in Australia\nAuthors: Nigel Crawford (Director, SAEFVIC, Murdoch Children\u2019s Research Institute), Georgina Lewis (Clinical Manager, SAEFVIC, Murdoch Children\u2019s Research Institute) and Rachael McGuire (Research Nurse, SAEFVIC, Murdoch Children\u2019s Research Institute)\nReviewed by: Rachael McGuire (MVEC Education Nurse Coordinator)\nDate: October 20, 2022\nMaterials in this section are updated as new information and vaccines become available. The Melbourne Vaccine Education Centre (MVEC) staff regularly reviews materials for accuracy.", "source": "mvec.mcri.edu.au/references/saefvic/index.html"}
{"id": "bdc527b53ea7-1", "text": "You should not consider the information in this site to be specific, professional medical advice for your personal health or for your family\u2019s personal health. For medical concerns, including decisions about vaccinations, medications and other treatments, you should always consult a healthcare professional.\nA B C D E F G H I J K L M N O P Q R S T U V W X Y Z", "source": "mvec.mcri.edu.au/references/saefvic/index.html"}
{"id": "ed95f4d7bf27-0", "text": "Background\nIndividuals undergoing cancer treatments (eg. chemotherapy, immunosuppressive therapies or haematopoietic stem cell transplants (HSCT)) are at a higher risk of contracting infectious diseases due to their malignancy, as well as the immune suppression caused by their treatment. Immune suppression can result in an inability to fight new infections, as well as result in the loss of previous immune memory from past infections and vaccines.\nGenerally speaking, vaccines are withheld during cancer therapy due to an inability to create an effective immune response. The exception to this would be influenza vaccines and COVID-19 vaccines. Individuals with severe neutropenia should not receive vaccines due to the risk of febrile neutropenia.\nFollowing the completion of treatment, individuals are recommended to either be re-vaccinated completely or receive booster doses of vaccines to ensure effective protection against vaccine preventable diseases. The recommendations for vaccine doses/schedules may vary according to type of cancer treatment received, the age of the recipient and any other co-morbidities.\nThe recommendations for the vaccination of children \u2264 18 years following cancer treatment (within 2 years of completing treatment) are outlined below.\nTiming\nInactivated vaccines following cancer treatment can be administered from 6 months after the completion of treatment and if the underlying illness is in remission. Live-attenuated vaccines should only be given in consultation with the patient\u2019s treating oncologist.\nPost-chemotherapy immunisation guideline\nInactivated vaccines\nCOVID-19 vaccines\nLive-attenuated vaccines\nPost-HSCT immunisation guideline\nInactivated vaccines\nCOVID-19 vaccines\nLive-attenuated vaccines\nResources\nMVEC: Post-HSCT immunisation guideline March 2022 (PDF version)\nMVEC: Post chemotherapy immunisation guideline March 2022 (PDF version)\nMVEC: Influenza vaccine recommendations\nMVEC: COVID-19 vaccination in children and adolescents", "source": "mvec.mcri.edu.au/references/cancer-immunisation-guideline-chemotherapy-and-post-haematopoietic-stem-cell-transplant_2/index.html"}
{"id": "ed95f4d7bf27-1", "text": "MVEC: COVID-19 vaccination in children and adolescents\nMVEC: Needle phobia\nMVEC: Live-attenuated vaccines and immunoglobulins or blood products\nAuthors: Rachael McGuire (MVEC Education Nurse Coordinator) and Nigel Crawford (Director SAEFVIC, Murdoch Children\u2019s Research Institute)\nReviewed by: Rachael McGuire (MVEC Education Nurse Coordinator), Francesca Machingaifa (MVEC Education Nurse Coordinator) and Teresa Lazzaro (Consultant Paediatrician, Royal Children\u2019s Hospital)\nDate: March 10, 2022\nMaterials in this section are updated as new information and vaccines become available. The Melbourne Vaccine Education Centre (MVEC) staff regularly reviews materials for accuracy.\nYou should not consider the information in this site to be specific, professional medical advice for your personal health or for your family\u2019s personal health. For medical concerns, including decisions about vaccinations, medications and other treatments, you should always consult a healthcare professional.\nA B C D E F G H I J K L M N O P Q R S T U V W X Y Z", "source": "mvec.mcri.edu.au/references/cancer-immunisation-guideline-chemotherapy-and-post-haematopoietic-stem-cell-transplant_2/index.html"}
{"id": "1b058519a069-0", "text": "What is it?\nRotavirus gastroenteritis is caused by non-enveloped RNA viruses. It is a common cause of viral gastroenteritis in children. Globally, it is the most common cause of viral gastroenteritis related deaths in those less than 5 years of age.\nWhat to look for\nRotavirus gastroenteritis classically occurs following a 1-3 day incubation period. Symptoms of disease include vomiting, diarrhoea, fever, dehydration and drowsiness. Symptoms can be particularly severe in children who are malnourished or immunocompromised.\nHow is it transmitted?\nRotaviruses can be transmitted via the faecal-oral route.\nPrevention\nPrevious infection with rotavirus does not provide lifelong immunity. Hand hygiene and disinfecting contaminated surfaces are important measures for preventing transmission.\nPrior to the introduction of rotavirus vaccination onto the National Immunisation Program (NIP) in 2007, approximately 10,000 children (< 5 years of age) were hospitalised each year with rotavirus gastroenteritis, with an average of one death per year. These rates have dropped dramatically since its introduction.\nVaccines\nThere are two live-attenuated rotavirus vaccines available for children in Australia:\nRotarix- 2 dose course, available on the NIP at 6 weeks of age and 4 months of age\nRotaTeq- 3 dose course, previously given on the NIP, now available through private script.\nThere is limited data on the safety and efficacy of rotavirus vaccination when given outside of specific age groups. For this reason, it is recommended that rotavirus vaccines are administered within a set timeframe, with particular attention paid to the upper age limits. If adherence to the recommended timeframes for administration is not possible, vaccination should be withheld indefinitely. Pre-term infants are recommended to receive vaccines based on chronological age, not corrected age.", "source": "mvec.mcri.edu.au/references/rotavirus/index.html"}
{"id": "1b058519a069-1", "text": "Vaccine\nDose\nRoute\nAge range for 1st dose\nAge range for 2nd dose\nAge range for 3rd dose\nMinimum interval between doses\nRotarix\n2 doses (1.5ml/dose)\nOral*\n6-14 weeks (not for administration once infant has \u00a0turned 15 weeks of age)\n10-24 weeks (not for administration once infant has turned 25 weeks of age)\nNA\n4 weeks\nRotaTeq\n3 doses (2ml/dose)\nOral*\n6-12 weeks (not for administration once infant has turned 13 weeks of age)\n10-32 weeks (ideally administer by 28 weeks of age to allow for a 3rd dose to be administered 4 weeks later)\n14-32 weeks\n*whilst vaccines should be administered orally where possible, infants who have a feeding tube (eg nasogastric/PEG) can receive rotavirus vaccines via their tube. Rotavirus vaccines should never be injected.\nRotavirus vaccination is not required in order for a child to be considered up to date with their routine vaccines. It is not mandatory for the purposes of the no jab no pay or no jab no play legislations.\nPlease note, if an infant spits out a small amount of the dose of vaccine it is still considered a valid dose and doesn\u2019t need repeating. If they spit out most of the dose of vaccine within minutes of receiving it, a repeat dose should be administered at the same visit.\nSide effects and management\nSide effects from rotavirus vaccination more commonly occur within the first 7 days following vaccination and can include vomiting, diarrhoea and irritability.", "source": "mvec.mcri.edu.au/references/rotavirus/index.html"}
{"id": "1b058519a069-2", "text": "Supportive therapies such as paracetamol and additional fluids (breastmilk/formula) can help manage symptoms. Good hand hygiene practices are particularly important when handling soiled nappies during this period to minimise the risk of transmission as the virus can shed in stools for 7-10 post immunisation.\nVery rare side effects can include anaphylaxis. It is recommended that infants are observed for 15 minutes following vaccination to monitor for symptoms.\nThere is some suggestion from Australian and international research that there is a small increase in intussusception cases in infants who receive the oral rotavirus vaccine. Intussusception is a rare condition where the bowel slides or telescopes inside itself causing a blockage. Infants may cry, pull up their legs and later have vomiting and sometimes blood in the stools. In most cases the cause of intussusception is not known. It has been estimated that the increased risk with rotavirus vaccines means an additional six cases per 100,000 infants vaccinated.\nPrecautions\nBoth rotavirus vaccines are live-attenuated oral vaccines. There is a theoretical risk of vaccine-associated gastroenteritis if vaccines are administered to infants with immunocompromise. However, for some infants with less severe immunocompromise the benefits of vaccine-induced protection may outweigh this risk. Further clarification on the degree of immunocompromise may be sought from specialist immunisation services.\nInfants living in households with persons who have an immunodeficiency disorder or impaired immune status can still be vaccinated. Counselling on hand hygiene and disposing of soiled nappies to minimise the risk of vaccine-virus transmission is recommended.\nFor infants who are immunocompromised (other than severe combined immunodeficiency disorder) or living with HIV, the benefits of vaccination are thought to outweigh any potential risks of vaccine-associated gastroenteritis.\nContraindications", "source": "mvec.mcri.edu.au/references/rotavirus/index.html"}
{"id": "1b058519a069-3", "text": "Contraindications\nRotavirus vaccine should not be given to any infant with a previous history of intussusception or a congenital bowel abnormality which pre-disposes them to intussusception.\nInfants with severe combined immunodeficiency disorder (SCID) should not receive rotavirus vaccines due to the risks of vaccine-associated gastroenteritis, and lack of immune-system ability to generate a protective immune response.\nThe vaccine should not be administered to infants with anaphylaxis to a previous dose of rotavirus vaccine.\nInfants whose mothers have received biological disease-modifying anti-rheumatic drugs (bDMARDS) during the third trimester of pregnancy should not receive vaccination without seeking specialist advice.\nResources\nMVEC: Preterm infant immunisation\nAustralian Immunisation Handbook: Rotavirus\nRCH Kids Health Info: Gastroenteritis\nGSK Rotarix Dosing and Administration Wheel (Rotarix Wheel) ERRORS\nAuthors: Georgie Lewis (SAEFVIC Clinical Manager, Murdoch Children\u2019s Research Institute) and Rachael McGuire (SAEFVIC Research Nurse, Murdoch Children\u2019s Research Institute)\nReviewed by: Rachael Purcell (RCH Immunisation Fellow), Rachael McGuire (MVEC Education Nurse Coordinator) and Francesca Machingaifa (MVEC Education Nurse Coordinator)\nDate: March 2022\nMaterials in this section are updated as new information and vaccines become available. The Melbourne Vaccine Education Centre (MVEC) staff regularly reviews materials for accuracy.\nYou should not consider the information in this site to be specific, professional medical advice for your personal health or for your family\u2019s personal health. For medical concerns, including decisions about vaccinations, medications and other treatments, you should always consult a healthcare professional.\nA B C D E F G H I J K L M N O P Q R S T U V W X Y Z", "source": "mvec.mcri.edu.au/references/rotavirus/index.html"}
{"id": "4eefd45fcdbb-0", "text": "English (Australia)\t\t\n English (Australia)\t\t\n \u0939\u093f\u0928\u094d\u0926\u0940        \nWhat is it?\nInfluenza viruses are single stranded RNA orthomyxoviruses which can cause acute viral infections of the respiratory tract. Infections are often classified according to the type of influenza virus responsible for the infection, typically A, B, or C. Influenza types A and B are more commonly responsible for causing severe disease. Influenza A can be further subtyped based on the differences in surface antigens.\nWhat to look for\nThe incubation period of influenza disease is 1-4 days with typical symptoms including fever, headache, myalgia (muscle aches), lethargy (tiredness), coryza (runny nose), sore throat and cough. Gastrointestinal symptoms such as nausea, vomiting and diarrhoea can also occur. Children with influenza will often present with symptoms of croup.\nMost influenza infections will resolve within 2-7 days. However, complications including otitis media (ear infections), secondary bacterial pneumonia (lung infections) and encephalitis (brain inflammation) can prolong the illness and disease outcomes.\nHow is it transmitted\nInfluenza is highly contagious. Transmission is via respiratory droplets, aerosol or through direct contact with the respiratory secretions of an infected person.\nEpidemiology\nInfluenza disease can occur as sporadic cases, as an epidemic, or as a pandemic. Whilst outbreaks more commonly occur in the winter months in temperate climates, there is a greater variation seen in the timing of cases in the tropics.\nAged care facilities, health care facilities and child care centres are well recognised as high-risk areas for influenza outbreaks.", "source": "mvec.mcri.edu.au/references/influenza-vaccine-recommendations/index.html"}
{"id": "4eefd45fcdbb-1", "text": "Pregnant women, children < 5 years of age, those aged > 65 years, people with underlying medical conditions, and Aboriginal and Torres Strait Islander peoples carry the highest rates of morbidity and mortality within Australia.\nPrevention\nInfluenza vaccination is available and recommended for anyone \u2265 6 months of age who wish to be protected against influenza disease and its complications. Due to the circulating strains of influenza virus changing each year, vaccination is recommended annually to provide the most effective protection against disease.\nInfluenza vaccines are provided for free on the National Immunisation Program (NIP) for high-risk groups, including:\nchildren aged 6 months to < 5years\npeople aged \u2265 6 months of age with\u00a0certain medical risk factors\nall adults \u2265 65 years of age\npregnant women (at any stage of pregnancy)\nall\u00a0Aboriginal & Torres Strait Islander people \u2265 6 months of age.\nThose aged 5 years and over who do not qualify for funded vaccines can purchase vaccines privately through some councils, GPs and\u00a0pharmacies.\nVaccine platform\nThe influenza vaccines available in Australia are inactivated, meaning that they cannot replicate and cause influenza disease. They can be cell-based or egg-based depending on how they are manufactured.\nTraditional influenza vaccines are made by cultivating influenza viruses in chicken eggs. Cell-based influenza vaccines are made by growing influenza viruses in animal cells lines (canine kidney). By using a cell-based platform, influenza vaccines have the potential to provide protection against influenza strains that are more closely matched to the circulating influenza strains in the community.\nCell-based influenza vaccines have been used internationally since 2012 and in 2021 a cell-based influenza was registered for use within Australia for the first time. Flucelvax quad\u00ae is available for private purchase for immunisation of those aged \u2265 2 years.", "source": "mvec.mcri.edu.au/references/influenza-vaccine-recommendations/index.html"}
{"id": "4eefd45fcdbb-2", "text": "In 2023 the influenza virus strains included in the seasonal influenza vaccines are the same for both cell-based and egg-based vaccines:\nA/Sydney/5/2021 (H1N1) pdm09-like virus\nA/Darwin/9/2021 (H3N2)-like virus\nB/Austria/1359417/2019-like (B/Victoria lineage)-like virus\nB/Phuket/3073/2013-like (B/Yamagata lineage)-like virus\nAdjuvanted vaccines\nDue to a gradual decline in effectiveness of the\u00a0immune system of older people (a process known as immunosenescence) immunity following vaccination with standard influenza vaccines can be suboptimal. In addition, those aged \u2265 65 years have the highest rates of influenza disease burden and associated complications including pneumonia and death. Therefore, adjuvanted influenza vaccines are the preferred vaccine type for the older population.\nThere are two adjuvanted influenza vaccines registered for use in Australia:\nFluad\u00ae Quad- registered for use in adults \u2265 65 years and funded under the NIP\nFluzone High-Dose Quad- registered for use in individuals aged \u2265 60 years and privately available on prescription.\nTable 1: The 2023 influenza vaccine brand recommendations according to age", "source": "mvec.mcri.edu.au/references/influenza-vaccine-recommendations/index.html"}
{"id": "4eefd45fcdbb-3", "text": "Table 1: The 2023 influenza vaccine brand recommendations according to age\nAge Group Vaccine brand and dose Vaxigrip Tetra\u00ae (0.5 ml) Fluarix\u00ae Tetra (0.5 ml) Afluria\u00ae Quad (0.5 ml) FluQuadri\u00ae (0.5ml) Influvac\u00ae Tetra (0.5ml) Flucelvax\u00ae Quad (0.5ml) Fluad\u00ae Quad (0.5ml) Fluzone High-Dose Quad (0.7ml) < 6 months 6 months - < 2 years \u2713*^\u2713*^\u2713*^\u2713*^\u2265 2 - < 5 years \u2713*^\u2713*^\u2713*^\u2713*^\u2713*^\u2265 5 - < 60 years \u2713*^\u2713*^\u2713*^\u2713*^\u2713*^\u2713*^\u2265 60 - < 65 years \u2713^\u2713^\u2713^\u2713^\u2713^\u2713^\u2713#\u2265 65 years \u2713\u03b2^#\u2713\u03b2^#\u2713\u03b2^#\u2713\u03b2^#\u2713\u03b2^#\u2713\u03b2^#\u2713#\u2713#\n* 2 doses, minimum of 4-weeks apart should be given to children < 9 years of age in the first year of receiving the influenza vaccine, a single dose is recommended in subsequent years.\n#Adjuvanted quadrivalent influenza vaccines are preferentially recommended for people adults \u2265 65 years.", "source": "mvec.mcri.edu.au/references/influenza-vaccine-recommendations/index.html"}
{"id": "4eefd45fcdbb-4", "text": "\u03b2Fluarix-tetra\u00ae/FluQuadri\u00ae/Afluria Quad\u00ae/Vaxigrip tetra\u00ae/Influvac tetra\u00ae/ Flucelvax Quad\u00ae are registered for use in those aged \u2265 65 years however adjuvanted vaccines are the preferred vaccines for this age group.\n^2 doses are recommended in the first year following SOT/HSCT regardless of history of influenza vaccination due to\u00a0immunosuppression. The exception to this is in individuals receiving an adjuvanted influenza vaccine where only 1 dose is recommended.\n shaded boxes indicate vaccines funded under the NIP for eligible individuals.\n shaded boxes not registered for use in this age group.\n shaded boxes indicate adjuvanted vaccines.\nExpected side effects\nCommon side effects following vaccination include pain, redness and swelling at the injection site as well as fever, malaise and myalgia. Symptoms usually occur within the first 24-48 hours following immunisation.\nCell-based influenza vaccines have a similar side-effect profile to traditional egg-based influenza vaccines. Side effects may occur slightly more commonly following immunisation with adjuvanted quadrivalent formulations than with standard influenza vaccine formulations.\nCommonly asked questions\nWhen is the ideal time to be immunised against the flu?Annual vaccination before the onset of influenza season is recommended for all individuals \u2265 6 months of age. The peak period of circulating influenza disease in Australia is typically June to September. However, out of season cases can and do occur. Optimal protection against influenza occurs within the first 3-4 months following vaccination. It is never too late in the season to vaccinate.\nPregnant women can safely receive the influenza vaccine during any stage of pregnancy. Where a pregnancy crosses over seasons, some pregnant women may be recommended to receive 2 influenza vaccines, one from each year.", "source": "mvec.mcri.edu.au/references/influenza-vaccine-recommendations/index.html"}
{"id": "4eefd45fcdbb-5", "text": "Do healthy people need to be immunised against influenza?Influenza can be a very serious disease resulting in hospitalisation and death. Even in cases where disease and its complications are not severe, it can cause a great inconvenience for the individual, including the cost of GP visits and medications, as well as time off work for themselves or to care for their sick child.\nIn some cases, a person may not get severe disease but infection can be spread to other people. This can be significant when it is spread to those who are too young to be immunised or are at higher risk of complications of disease.\nIf an individual has had confirmed influenza disease this year, are they still recommended to receive an influenza vaccine and when should they receive it?The influenza vaccine would still be recommended for someone with a history of confirmed influenza infection as the vaccine protects against multiple strains of influenza disease. The influenza vaccine can be administered as soon as the patient has recovered from their illness.\nCan the influenza vaccine be given at the same time as other vaccines?Generally speaking, yes, influenza vaccines may be co-administered with most other vaccines on the same day. This includes live-attenuated vaccines (eg. measles and varicella) and the pertussis vaccine in pregnancy.\nCOVID-19 vaccines can safely be co-administered with influenza vaccines. However, in children aged 6 months \u2013 5 years of age, an interval of 7-14 days is preferred to minimise adverse events such as fever.\nIf a patient received a 2022 influenza vaccine at the end of the season in early 2023, do they still need a 2023 influenza vaccine?Yes. A 2023 influenza vaccine is still recommended in order to provide protection against this year\u2019s circulating strains. A minimum interval of 4 weeks is recommended.", "source": "mvec.mcri.edu.au/references/influenza-vaccine-recommendations/index.html"}
{"id": "4eefd45fcdbb-6", "text": "In children < 9 years of age who received the influenza vaccine for the first time last year but only received 1 dose, how many doses are required this year?Only 1 dose is required in this instance. 2 doses of the influenza vaccine are recommended for children < 9 years of age in the first year of receiving the vaccine. However, if the second dose was inadvertently missed, it does not require catch up and only 1 dose is required in future years.\nAre influenza vaccines safe for people with allergies?Based on prospective and retrospective studies of influenza vaccination in those with and without egg allergy (including egg anaphylaxis), the presence of egg allergy does not increase the risk of allergic reactions to the influenza vaccine. Egg-based influenza vaccines can be administered in community vaccination clinics (which may or may not have direct medical practitioner supervision), General Practitioner surgeries or immunisation clinics as a single dose followed by the recommended 15 minute observation period. It is not necessary to preferentially administer cell-based influenza vaccines in this patient group.\nAll influenza vaccines available under the NIP in 2023 are latex free meaning that people with a latex allergy can safely be vaccinated.\nFor further queries on influenza vaccination, please contact us via our immunisation support.\nResources\nATAGI advice on seasonal influenza vaccines in 2023\nTGA: AIVC recommendation for the composition of influenza vaccine for Australia in 2023\nDepartment of Health: Seasonal influenza vaccine\nAustralian Immunisation Handbook: Influenza\nAustralasian Society of Clinical Immunology and Allergy: Vaccination of the egg allergic individual\nMVEC: Maternal vaccination during pregnancy", "source": "mvec.mcri.edu.au/references/influenza-vaccine-recommendations/index.html"}
{"id": "4eefd45fcdbb-7", "text": "MVEC: Maternal vaccination during pregnancy\nAuthors: A/Prof Nigel Crawford (Director SAEFVIC, Murdoch Children\u2019s Research Institute), Rachael McGuire (Research Nurse SAEFVIC, Murdoch Children\u2019s Research Institute), Georgina Lewis (Clinical Manager SAEFVIC, Murdoch Children\u2019s Research Institute) and Mel Addison (Research Nurse SAEFVIC, Murdoch Children\u2019s Research Institute).\nReviewed by: Rachael McGuire (MVEC Education Nurse Coordinator).\nDate: August 12, 2023\nMaterials in this section are updated as new information becomes available. The Melbourne Vaccine Education Centre (MVEC) staff regularly review materials for accuracy.\nYou should not consider the information in this site to be specific, professional medical advice for your personal health or for your family\u2019s personal health. For medical concerns, including decisions about vaccinations, medications and other treatments, you should always consult a healthcare professional.\nA B C D E F G H I J K L M N O P Q R S T U V W X Y Z", "source": "mvec.mcri.edu.au/references/influenza-vaccine-recommendations/index.html"}
{"id": "d00fa60045f2-0", "text": "The Paediatric Integrated Cancer Service (PICS) is a statewide initiative supported by Cancer Australia, with guidelines endorsed by the Australian and New Zealand Childrens Haemotology/Oncology Group (ANZHOG).\nThe PICS immunisation resources detail vaccines to consider during cancer therapy [e.g. influenza (flu)], as well as highlighting the vaccines that are required after completion of chemotherapy. These resources cross-link with the MVEC Cancer immunisation guidelines (see Resources below).\nThe PICS Immunisation information sheets have been translated into a number of different languages.\nResources\nPaediatric Integrated Cancer Service (PICS): Immunisation Resources\nMVEC: Cancer immunisation guideline- chemotherapy and post haematopoietic stem cell transplant\nAuthor: Nigel Crawford (Director, SAEFVIC, Murdoch Children\u2019s Research Institute)\nDate:\u00a0February 2018\nMaterials in this section are updated as new information and vaccines become available. The Melbourne Vaccine Education Centre (MVEC) staff regularly reviews materials for accuracy.\nYou should not consider the information in this site to be specific, professional medical advice for your personal health or for your family\u2019s personal health. For medical concerns, including decisions about vaccinations, medications and other treatments, you should always consult a healthcare professional.\nA B C D E F G H I J K L M N O P Q R S T U V W X Y Z", "source": "mvec.mcri.edu.au/references/paediatric-integrated-cancer-service-pics-immunisation-resources/index.html"}
{"id": "8a810e9a8af1-0", "text": "Immunisation assessment is an extremely important aspect of healthcare during pregnancy. When planning a pregnancy, talk to your health care provider about any vaccines you might need beforehand. Live-attenuated vaccines should be given at least a month before conception.\nRecommended vaccines\nInfluenza, pertussis and COVID-19 vaccines are the only vaccines routinely recommended for pregnant women. They are provided for free via the National Immunisation Program (NIP).\nSome other vaccines can be administered in special circumstances but are not routinely recommended. Refer to the Australian Immunisation Handbook for further information.\nInfluenza\nInfluenza vaccination is safe and strongly recommended for pregnant women to avoid complications from influenza disease. It can be administered at any stage of pregnancy and not only aims to protect the expectant mother from disease, but also to provide passive protection to the infant.\nPregnant women are at greater risk of morbidity and mortality from influenza disease than non-pregnant women. They are more than twice as likely to be hospitalised with influenza disease as other people with influenza.\nBabies less than 6-months of age are at greatest risk of disease and death from influenza and maternal vaccination will provide protection to babies for the first few months of life until they can be immunised against influenza from 6-months of age.\nPertussis\nPertussis (whooping cough) immunisation during pregnancy is a safe and effective way to protect the mother and prevent disease of the newborn.\u00a0It is recommended that a single dose of the vaccine be administered between 20 and 32 weeks of pregnancy, in every pregnancy, including pregnancies that are closely spaced.", "source": "mvec.mcri.edu.au/references/pregnancy-and-vaccines/index.html"}
{"id": "8a810e9a8af1-1", "text": "Maternal antibodies against pertussis provide protection for babies until they have at least received 2 doses of their own pertussis containing vaccine (given at 6-weeks and 4-months of age). Babies less than 6-months of age are at greatest risk of severe disease and death from pertussis.\nCOVID-19 vaccines\nDue to an increased risk of severe outcomes for pregnant women and their unborn babies it is recommended that pregnant women are routinely offered COVID-19 vaccines. Vaccines can be given at any stage of pregnancy.\nSurveillance of international data on administration of mRNA COVID-19 vaccines (Comirnaty (Pfizer)\u00a0or\u00a0Spikevax (Moderna)) to pregnant women has shown no significant safety concerns for either the mother or the baby. Evidence demonstrates antibodies can pass into breastmilk and cord blood which may provide protection to infants via passive immunity.\nNuvaxovid (Novavax) may be administered to pregnant and breastfeeding women however there is no immunogenicity or safety data on it\u2019s use in this patient group.\nPregnant women have been shown to have an increased risk of needing admission to the intensive care unit and requiring mechanical ventilation if they contract COVID-19 compared with non-pregnant women of the same age.\nWomen who are planning pregnancy or who are breastfeeding can safely receive a COVID-19 vaccine. You do not need to stop breastfeeding before or after vaccination.\nFor more information refer to the following:\nJoint statement between RANZCOG and ATAGI about COVID-19 vaccination for pregnant women\nCOVID-19 vaccination- ATAGI clinical guidance on COVID-19 vaccine in Australia in 2021\nCOVID-19 vaccination- COVID-19 vaccination decision guide for women who are pregnant, breastfeeding or planning pregnancy\nAJOG: COVID-19 vaccine response in pregnant and lactating women: a cohort study\nContraindicated vaccines", "source": "mvec.mcri.edu.au/references/pregnancy-and-vaccines/index.html"}
{"id": "8a810e9a8af1-2", "text": "Contraindicated vaccines\nAll live-attenuated vaccines are contraindicated during pregnancy due to the potential risk to the unborn baby [see Table 1 below]. In most circumstances the risk is hypothetical however, there is insufficient evidence to support vaccination in this patient group. The limited safety data from inadvertent administration of live-attenuated viral vaccines such as the MMR and Varicella vaccines is reassuring.\nTable 1: Live-attenuated vaccines contraindicated in pregnancy\nDisease\nBrand name\nRotavirus\nRotarix\u00ae, Rotateq\u00ae\nMMR (measles-mumps-rubella)\nPriorix\u00ae, MMR II\u00ae\nMMRV (measles-mumps-rubella-varicella)\nPriorix-tetra\u00ae, ProQuad\u00ae\nVaricella (chickenpox)\nVarilrix\u00ae, Varivax\u00ae\nZoster (shingles)\nZostavax\u00ae\nTuberculosis\nBCG (varying brands)\nYellow fever\nStamaril\u00ae\nTyphoid^\nVivotif\u00ae\nJapanese encephalitis\nImojev\u00ae\n^Oral vaccine\nResources\nCOVID-19 vaccination- ATAGI clinical guidance on COVID-19 vaccine in Australia in 2021.\nCOVID-19 vaccination- COVID-19 vaccination decision guide for women who are pregnant,breastfeeding or planning pregnancy\nRaising Children Network: COVID-19 vaccination: preganancy and breastfeeding\nGray, K.J et al COVID-19 vaccine response in pregnant and lactating women: a cohort study American Journal of Obstetrics and Gynecology\nABC News report: \u2018Antivaxxer\u2019 tells of \u2018nightmare\u2019 after passing whooping cough onto baby daughter", "source": "mvec.mcri.edu.au/references/pregnancy-and-vaccines/index.html"}
{"id": "8a810e9a8af1-3", "text": "Amirthalingam, G. et al Effectiveness of maternal pertussis vaccination in England: an observational study The Lancet October 2014 384(9953) 1521-1528\nSteedman, M. et al Strategies to boost maternal immunization to achieve further gains in improved maternal and newborn health Health Affairs 2016 (35)309-316\nAustralian Immunisation Handbook: Vaccination for women who are planning pregnancy, pregnant or breastfeeding\nAustralian Government Department of Health: Influenza and pertussis vaccination in pregnancy\nYear Round Influenza Vaccination FAQ\nMonash Health immunisation resources\n2019 Patient Information sheet Influenza vaccine during pregnancy\n2019 Patient information sheet Boostrix during pregnancy\nPatient information sheet Rubella Vaccine\nMVEC resources\nMVEC: Vaccines in Pregnancy eLearning package\u00a0\nMVEC: Pertussis\nMVEC: Influenza vaccine recommendations\nMVEC: Breastfeeding and immunisations\nMVEC: COVID-19 vaccine FAQs: women\u2019s health\nAuthors: Michelle Giles (Infectious Diseases Consultant, Monash Health) and Rachael McGuire (MVEC Education Nurse Coordinator)\nReviewed by: Rachael McGuire (MVEC Education Nurse Coordinator) and Francesca Machingaifa (MVEC Education Nurse Coordinator)\nDate: November 30, 2022\nMaterials in this section are updated as new information and vaccines become available. The Melbourne Vaccine Education Centre (MVEC) staff regularly reviews materials for accuracy.\nYou should not consider the information in this site to be specific, professional medical advice for your personal health or for your family\u2019s personal health. For medical concerns, including decisions about vaccinations, medications and other treatments, you should always consult a healthcare professional.\nA B C D E F G H I J K L M N O P Q R S T U V W X Y Z", "source": "mvec.mcri.edu.au/references/pregnancy-and-vaccines/index.html"}
{"id": "f127aa01e5f8-0", "text": "Where a person\u2019s immunisations are not up to date with the National Immunisation Program (NIP), it is important to arrange a catch up schedule for immunisations to be completed in the shortest and most effective time frame to ensure protection against vaccine preventable diseases.\nPrior to commencing a catch up schedule, written documentation of any previous immunisations should be obtained where possible. Documentation could include the Immunisation History Statement (AIH) from AIR, personal immunisation records (ie: green book) or medical records. Overseas records may need translating.\nSerology is not routinely recommended prior to catch up immunisation.\nAll refugee and humanitarian entrants including asylum seekers are eligible for free catch up immunisations [see resources].\nPlease be aware that some individuals may be recommended to receive additional immunisations due to predisposing conditions or at risk circumstances. For further queries please contact MVEC here.\nFor individuals <10 years of age\nAustralian Immunisation Handbook: catch up calculator\nFor individuals aged 10 years to 19 years\nVictorian immunisation catch-up tool\nRefugee and asylum seekers\nThe Victorian DHHS and Health Translations has an excellent resource for catch up immunisations in refugees and asylum seekers. It has been translated into more than 10 languages (see Catch up vaccinations for refugees and asylum seekers in Victoria).\nResources\nDHHS: Victorian immunisation schedule and eligibility criteria for free vaccines\nVaccine history timeline in Australia\nAustralian Immunisation Handbook: Catch up vaccination\nVictorian Refugee Health Network\nVaccine schedule by country\nAuthors: Nigel Crawford (Paediatrician, The Royal Children\u2019s Hospital, Melbourne) and Rachael McGuire (SAEFVIC Research Nurse, Murdoch Children\u2019s Research Institute)\nReviewed by: Rachael McGuire (MVEC Education Nurse Coordinator)\nDate: January 31, 2022", "source": "mvec.mcri.edu.au/references/catch-up-immunisations/index.html"}
{"id": "f127aa01e5f8-1", "text": "Date: January 31, 2022\nMaterials in this section are updated as new information and vaccines become available. The Melbourne Vaccine Education Centre (MVEC) staff regularly reviews materials for accuracy.\nYou should not consider the information in this site to be specific, professional medical advice for your personal health or for your family\u2019s personal health. For medical concerns, including decisions about vaccinations, medications and other treatments, you should always consult a healthcare professional.\nA B C D E F G H I J K L M N O P Q R S T U V W X Y Z", "source": "mvec.mcri.edu.au/references/catch-up-immunisations/index.html"}
{"id": "28dea811385f-0", "text": "What is it?\nShoulder Injury Related to Vaccine Administration (SIRVA) is a rare but serious complication following suspected inadvertent administration of a vaccine too high in the deltoid or into the shoulder joint. This may cause a local inflammatory response and potential trauma to local structures within the shoulder joint including bursae, ligaments and tendons resulting in sudden onset shoulder pain and restricted movement. Symptoms can last for weeks to months or as long as years. Affected individuals can experience varying degrees of disability which can impact on their activities of daily living, social and emotional wellbeing.\u00a0\nSymptoms\nDistinguishing symptoms/features of SIRVA include:\u00a0\nsudden onset shoulder pain within 48 hours of vaccination- different to the injection site pain expected following vaccination\u00a0\nrestricted range of movement (RROM) of affected shoulder\u00a0\npersistent shoulder pain and RROM lasting >1 week, lasting weeks to months\u00a0\nsuspicion of incorrect vaccination site \u2013 too high in the upper arm.\u00a0\nImpacts and implications\nThe impacts of SIRVA can include:\u00a0\ninterrupted sleep due to pain\u00a0\u00a0\ndifficulty with personal care, care of others and activities of daily living\u00a0\ninability to participate in sports or hobbies\u00a0\u00a0\nmodified work duties\u00a0\ntime off work related to symptoms and/or treatments and investigations\u00a0\nloss of income due to time off work\u00a0\u00a0\nfinancial burden due to cost of treatments and investigations\u00a0\u00a0\nemotional and social wellbeing.\u00a0\nFurther implications for an individual with SIRVA can include vaccine hesitancy, reduced confidence in healthcare/immunisation providers and the potential for impaired immunogenicity.\nDiagnosis\u00a0\nA GP, specialist or allied health professional such as a physiotherapist can diagnose SIRVA based on presenting symptoms and clinical history following an immunisation.", "source": "mvec.mcri.edu.au/references/shoulder-injury-related-to-vaccine-administration/index.html"}
{"id": "28dea811385f-1", "text": "If radiological investigations such as ultrasound or MRI are undertaken to support or confirm a diagnosis, abnormalities including bursitis, adhesive capsulitis, impingement syndrome, synovitis or tendon tears may be identified.\u00a0\u00a0\nEarly diagnosis of SIRVA leads to timely treatment which is thought to lessen the duration and severity of symptoms.\u00a0\u00a0\nTreatment options\nSIRVA can be treated in a variety of ways and may include any of the following:\u00a0\nover the counter pain/anti-inflammatory medications\u00a0\nprescription pain/anti-inflammatory medication\u00a0\noral corticosteroids\u00a0\ncorticosteroid joint injections\u00a0\nphysiotherapy or other allied health professionals\u00a0\u00a0\nmassage\nsurgery(rare).\u00a0\nHow to prevent SIRVA\nSIRVA can be prevented by following the recommended vaccination procedures for correct injection technique.\u00a0\nExpose Identify Imagine Inject Expose the whole upper arm Identify upper and lower anatomical landmarks (acromion and deltoid tuberosity) Imagine an inverted triangle 2-3 fingers below the acromion Inject vaccine in the centre of the triangle into the deltoid muscle \nPlease refer to MVEC: Administration of injected vaccines- correct technique\u00a0for further information on correct injection technique.\nWhere to report a case of SIRVA\nAll confirmed or suspected cases of SIRVA should be reported to SAEFVIC (the Victorian vaccine safety service). Reports can be made by consumers, immunisation providers or treating healthcare professionals.\u00a0\nSAEFVIC can provide clinical advice or facilitate consultation with an immunisation specialist if required.\u00a0\nResources\nMVEC: Administration of injected vaccines- correct technique\nMVEC Education portal eLearning package: Shoulder Injury Related to Vaccine Administration (SIRVA)\nAustralian immunisation handbook: Avoiding shoulder injury related to vaccine administration\nSIRVA (Shoulder injury related to vaccine administration); A case series- \u201cAre you on target?\u201d", "source": "mvec.mcri.edu.au/references/shoulder-injury-related-to-vaccine-administration/index.html"}
{"id": "28dea811385f-2", "text": "Cross GB, Moghaddas J, Buttery J, Ayoub S, Korman TM. Don\u2019t aim too high: Avoiding shoulder injury related to vaccine administration. Aust Fam Physician 2016;45(5):303-306\nPetrakis N, Addison M, Penak B, Schrader S, Mallard J, Clothier H. J , Buttery J. P, Crawford N. W & Cheng D. R\u00a0\u00a0(2023)\u00a0Shoulder injury following COVID-19 vaccine administration: a case series and proposed diagnostic algorithm,\u00a0Expert Review of Vaccines,\u00a022:1,\u00a0299-306\nAuthors: Mel Addison (SAEFVIC Research Nurse, Murdoch Children\u2019s Research Institute), Rachael McGuire (SAEFVIC Research Nurse, Murdoch Children\u2019s Research Institute), Georgie Lewis (SAEFVIC Clinical Manager, Murdoch Children\u2019s Research Institute) and Nigel Crawford (Director SAEFVIC, Murdoch Children\u2019s Research Institute)\nReviewed by: Mel Addison (SAEFVIC Research Nurse, Murdoch Children\u2019s Research Institute)\nDate: March 23, 2023\nMaterials in this section are updated as new information and vaccines become available. The Melbourne Vaccine Education Centre (MVEC) staff regularly reviews materials for accuracy.\nYou should not consider the information in this site to be specific, professional medical advice for your personal health or for your family\u2019s personal health. For medical concerns, including decisions about vaccinations, medications and other treatments, you should always consult a healthcare professional.\nA B C D E F G H I J K L M N O P Q R S T U V W X Y Z", "source": "mvec.mcri.edu.au/references/shoulder-injury-related-to-vaccine-administration/index.html"}
{"id": "c5457901b065-0", "text": "A number of families and consumers and healthcare professionals have been asking MVEC staff about the MTHFR gene and possible adverse events following immunisation [AEFI]\nMTHFR stands for methylenetetrahydrofolate reductase, which is the name of an enzyme involved in folate metabolism\nMTHFR gene polymorphisms, or harmless changes in the gene, are very common. MTHFR gene mutations are different to gene polymorphisms and are very rare and present differently [see below Resources: MTHFR VCGS].\nResearch and clinical reports have shown that multiple MTHFR gene polymorphisms have been linked to thromboembolism (or blood clots), but there has been no proven, or conclusive link regarding other health conditions. This includes adverse events [AEFI] following vaccines administered on the Australian National Immunisation Program.\nWe have sought advice from our expert colleagues at the Victorian Clinical Genetic Services, who have provided an excellent, clearly written document regarding the indications for and usefulness of the MHFTR test [see below Resources: MTHFR VCGS].\nWhat to do?\nAt MVEC, we believe that there is no clinical indication for MTHFR polymorphism testing before vaccination, as there is no proven increased risk of an AEFI\nIf a family member has already had the test, we do not recommend any testing of relatives and feel it is safe to proceed with all immunisations\nResources\nVCGS MTHFR Information sheet\nAuthors: Nigel Crawford (Director SAEFVIC, Murdoch Children\u2019s Research Institute) and Margie Danchin (Senior Research Fellow, Murdoch Children\u2019s Research Institute)\nDate:\u00a0February 2018\nMaterials in this section are updated as new information and vaccines become available. The Melbourne Vaccine Education Centre (MVEC) staff regularly reviews materials for accuracy.", "source": "mvec.mcri.edu.au/references/mthfr-gene/index.html"}
{"id": "c5457901b065-1", "text": "You should not consider the information in this site to be specific, professional medical advice for your personal health or for your family\u2019s personal health. For medical concerns, including decisions about vaccinations, medications and other treatments, you should always consult a healthcare professional.\nA B C D E F G H I J K L M N O P Q R S T U V W X Y Z", "source": "mvec.mcri.edu.au/references/mthfr-gene/index.html"}
{"id": "813b3e908e0d-0", "text": "A hypotonic-hyporesponsive episode (HHE) is defined as the sudden onset of hypotonia (muscle limpness), reduced responsiveness or unresponsiveness and pallor or cyanosis occurring after vaccination in early childhood (< 2 years of age).\nMost children are initially irritable and febrile prior to the event and respiration may be shallow during the event. HHE\u2019s can be immediate or delayed. The immediate HHE\u2019s are often preceded by crying, breath holding and are like an immediate vasovagal phenomenon. Close inspection is required to ensure there are no features suggestive of an allergic reaction. The delayed reactions usually occur 1 to 48 hours after vaccination and resolve spontaneously; the median episode duration is 6-30 minutes. Diagnosis of HHE is made clinically and often no investigations are required.\nThis occurs where no other cause is evident, such as seizure or anaphylaxis. This is distinguished from a vasovagal-syncope (fainting episode), which presents with similar signs and symptoms but occurs soon after vaccination (< 5mins) and usually occurs in an older age group (\u2265 2 years of age).\nThe pathogenesis of HHE is unknown but is likely to be multifactorial. HHE is rare and results in transient signs, and hence, there are limitations to investigation.\nAssociations and incidence\nHHE has been documented to occur after immunisation with all vaccines, but historically had been most associated with whole-cell pertussis vaccines in early infancy.\u00a0There has been a decreased incidence following the change from whole-cell pertussis to acellular pertussis vaccines.\nHHE has been observed mainly after the first doses of vaccines at 6 to 8 weeks of age.\nIn Australia during 2012, 2.2 cases of HHE were reported per 100,000 doses of pertussis-containing vaccine given to children <1 year of age.\nTreatment", "source": "mvec.mcri.edu.au/references/hypotonic-hyporesponsive-episode-hhe/index.html"}
{"id": "813b3e908e0d-1", "text": "Treatment\nThese episodes self-resolve and often don\u2019t need any treatment. However, the initial management should be for shock and include assessment of airway, breathing and circulation. Careful clinical observation and documentation of the event are vital for differential diagnosis. Urgent medical review is advised for paediatric assessment and to exclude other causes.\nImplications and considerations for future vaccines\nHHE is not a contraindication to further doses of vaccines, including pertussis containing vaccines.\nThe recurrence rate for a further HHE is 3.5% [refer to Resources]. No long term sequelae have been identified in the small number of children who have had long term follow-up.\nThe next scheduled immunisations may need to be given under medical supervision, this can be arranged by contacting the vaccine safety service in your state.\nAny adverse event following immunisation (AEFI) in Victoria should be reported to SAEFVIC.\nResources\nHypotonic-Hyporesponsive Episode \u2013 A SAEFVIC Case Study July 2017\nVaccine: Hypotonic-hyporesponsive episode (HHE) as an adverse event following immunization in early childhood: Case definition and guidelines for data collection, analysis, and presentation\nPaediatrics: Hypotonic-hyporesponsive episodes reported to the Vaccine Adverse Event Reporting System (VAERS) 1996 -1998\nAustralian Immunisation Handbook: After vaccination\nVaccine: Recurrence risk of a hypotonic hyporesponsive episode in two Australian specialist immunisation clinics\nAuthors: Daniela Say (MVEC Immunisation Fellow) and Teresa Lazzaro (Paediatrician, Immunisation Service, Royal Children\u2019s Hospital Melbourne)\nReviewed by: Rachael McGuire (MVEC Education Nurse)\nDate: November 29, 2022", "source": "mvec.mcri.edu.au/references/hypotonic-hyporesponsive-episode-hhe/index.html"}
{"id": "813b3e908e0d-2", "text": "Date: November 29, 2022\nMaterials in this section are updated as new information and vaccines become available. The Melbourne Vaccine Education Centre (MVEC) staff regularly reviews materials for accuracy.\nYou should not consider the information in this site to be specific, professional medical advice for your personal health or for your family\u2019s personal health. For medical concerns, including decisions about vaccinations, medications and other treatments, you should always consult a healthcare professional.\nA B C D E F G H I J K L M N O P Q R S T U V W X Y Z", "source": "mvec.mcri.edu.au/references/hypotonic-hyporesponsive-episode-hhe/index.html"}
{"id": "5527f08b955c-0", "text": "Background\nLike any medication in development, vaccine candidates must undergo rigorous testing procedures and scientific evaluation to prove not only their effect on the targeted disease, but also to determine their safety, before being licensed and registered for use in vaccination programs. In Australia, the Therapeutic Goods Administration (TGA) is responsible for assessing vaccines and other medicines for use in Australia.\nOnce vaccines have been introduced into the community, the safety and effectiveness of vaccines then continues to be monitored in the post-licensure phase through active surveillance programs and further post-licensure trials. This is to ensure that there is ongoing monitoring for how the vaccines are working in the \u2018real-world\u2019, noting they will be administered to a much larger and more diverse population than during the development phase.\nDevelopment phase\nDuring vaccine development, initial safety testing of a vaccine candidate occurs in two stages. Stage one involves pre-clinical assessment in the laboratory. Stage two involves the evaluation of the vaccine candidate in three phases of human clinical trials. If a vaccine candidate is not deemed safe in any stage, it cannot progress into the further stages of clinical trials, with this data being reviewed by an independent data safety monitoring board (DSMB).\nPhase I clinical trials: the vaccine candidate is given to small numbers (25\u201350) of healthy adults with the primary goal of assessing safety.\nPhase II clinical trials: if the vaccine candidate is found to be safe in Phase I, it is then given to hundreds of people to determine how effectively it stimulates immune responses, the optimal dose regimen, and whether there are any side effects.\nPhase III clinical trials: if the vaccine candidate is found to be effective and safe in Phase I and II, it is then given to many thousands of people to test whether it protects large populations from the target disease and to determine if there are any uncommon or serious side effects.", "source": "mvec.mcri.edu.au/references/development-of-vaccines/index.html"}
{"id": "5527f08b955c-1", "text": "A vaccine must pass all of these phases before it is registered for use by the TGA. Previously, approval of vaccines could take up to 10 years. However, the process has been streamlined throughout the COVID-19 pandemic and can now be completed in under 12 months, noting all of the appropriate clinical phase trials and data requirements from the regulators have not changed.\nPost-licensure phase\nDespite the extensive safety testing undertaken in clinical trials before a vaccine is licensed, some side effects are so rare, they cannot be detected in a trial population (e.g., such as with thrombosis with thrombocytopenia syndrome [TTS] following COVID-19 adenoviral vector vaccines). In addition, the efficacy of a vaccine may be different when given to a larger and more diverse population compared with those who participated in the clinical trial (e.g., due to the presence of underlying medical conditions, different age groups etc). For these reasons, assessment of safety and efficacy continues to be monitored in post-licensure assessments through:\nfurther clinical trials\nsurveillance of the impact of the vaccine on the disease it aims to prevent using networks such as\u00a0PAEDS\nsurveillance of adverse events following immunisation using systems such as\u00a0AusVaxSafety and reporting services like\u00a0SAFEVAC\u00a0and\u00a0SAEFVIC.\nWhat happens if a problem is suspected?\nAny suspected vaccine safety signals undergo a thorough investigation by the TGA, with the support of the jurisdictional vaccine safety services.\nIf a suspected problem could be serious, authorities will consider a range of actions including modifying the product information (PI) and if extremely serious it may include suspending use of the vaccine during the investigation.\nProvisional approval", "source": "mvec.mcri.edu.au/references/development-of-vaccines/index.html"}
{"id": "5527f08b955c-2", "text": "Provisional approval\nProvisional approval has been the formal pathway used in Australia for speeding up access to COVID-19 vaccine candidates using preliminary clinical data. The provisional pathway allows for the temporary registration of promising medicines or vaccines based on early data, where the benefits of early access (such as in a pandemic), outweigh any risks.\nIt is very important to note that this evaluation process remains a full review and a vaccine is still required to pass all the same phases of clinical trials and meet the same requirements for safety and efficacy as any other vaccine in development.\nAs further clinical data to confirm the safety of a vaccine becomes available, full registration can then be granted (On April 21, 2023 Spikevax (Moderna) was transitioned from the provisional pathway to full registration).\n\ufeff\ufeff\nHealth Technology Assessment (HTA) of vaccines\nWhilst vaccines are undergoing development and regulatory approval, in parallel they also need to undergo health economics assessment if they are going to go onto the National Immunisation Program (NIP). In Australia this assessment of vaccines is undertaken by the Pharmaceutical Benefits Advisory Committee (PBAC).\nThis pathway was not utilised during the COVID-19 pandemic, due to the speed and complexity of the public health emergency, but PBAC approval will be required for all new vaccines that are coming down the pipeline. As part of this assessment, ATAGI provides advice to the PBAC regarding how these vaccines may be best utilised in the Australian context, taking into account vaccine effectiveness, safety and equity.\nResources\nMVEC: Vaccine platforms\nMVEC COVID19 Road to a Vaccine Podcast, Episode 7: The importance of regulatory bodies in the development of vaccines, with Professor Norman Baylor\nMVEC COVID19 Road to a Vaccine Podcast, Episode 16: COVID19 vaccine candidates regulatory process update, with Professor Norman Baylor\nAustralian Academy of Science: How are vaccines shown to be safe?", "source": "mvec.mcri.edu.au/references/development-of-vaccines/index.html"}
{"id": "5527f08b955c-3", "text": "Australian Academy of Science: How are vaccines shown to be safe?\nThe International Coalition of Medicines Regulatory Authorities: ICMRA statement about confidence in vaccine safety and effectiveness (for healthcare professionals)\nThe International Coalition of Medicines Regulatory Authorities: ICMRA statement about confidence in vaccine safety and effectiveness (for the general public)\nAuthors: Georgina Lewis (Clinical Manager SAEFVIC, Murdoch Children\u2019s Research Institute) and Rachael McGuire (SAEFVIC Research Nurse, Murdoch Children\u2019s Research Institute)\nReviewed by: Georgina Lewis (Clinical Manager SAEFVIC, Murdoch Children\u2019s Research Institute), Rachael McGuire (SAEFVIC Research Nurse, Murdoch Children\u2019s Research Institute) and Nigel Crawford (Director SAEFVIC, Murdoch Children\u2019s Research Institute)\nDate: May 10, 2023\nMaterials in this section are updated as new information and vaccines become available. The Melbourne Vaccine Education Centre (MVEC) staff regularly reviews materials for accuracy.\nYou should not consider the information in this site to be specific, professional medical advice for your personal health or for your family\u2019s personal health. For medical concerns, including decisions about vaccinations, medications and other treatments, you should always consult a healthcare professional.\nA B C D E F G H I J K L M N O P Q R S T U V W X Y Z", "source": "mvec.mcri.edu.au/references/development-of-vaccines/index.html"}
{"id": "4095718a3c34-0", "text": "What is it?\nPeople with G6PD deficiency do not have enough of an enzyme (chemical) called glucose-6-phosphate dehydrogenase (G6PD). It is a genetic disorder which predominantly occurs in males.\nWithout G6PD, red blood cells are destroyed when exposed to certain foods, infections, medicines or chemicals. Red blood cells breaking down in excess can result in haemolytic anaemia (reduced number of red blood cells), jaundice (yellow skin or eyes), shortness of breath and other symptoms.\nG6PD is an inherited condition and cannot be spread from one person to another.\u00a0Managing G6PD deficiency involves avoiding foods and medications that can trigger the episodes of the condition.\nG6PD deficiency and vaccines\nVaccination is an important way of preventing the potential triggers that viral and bacterial infections can be in people with G6PD deficiency. Vaccines have not been identified as a medication to avoid. People with G6PD deficiency can be safely immunised in community settings without the need for additional monitoring.\nG6PD deficiency and COVID-19 vaccines\nLike routine vaccines, COVID-19 vaccines can be safely administered to people with G6PD deficiency. Clinical trials and real-world evidence have not identified any specific concerns regarding COVID-19 vaccines and people with G6PD deficiency.\nThere is no evidence that a particular brand of COVID-19 vaccination is preferred for people with G6PD deficiency.\u00a0\nResources\nThe RCH kids health information: G6PD\nHealthdirect: G6PD deficiency\nAuthors: Georgina Lewis (SAEFVIC Clinical Nurse Manager, Murdoch Children\u2019s Research Institute) and Nigel Crawford (Paediatrician, The Royal Children\u2019s Hospital, Melbourne)\nReviewed by: Rachael McGuire (MVEC Education Nurse Coordinator), Francesca Machingaifa (MVEC Education Nurse Coordinator) and Davina Buntsma (MVEC Immunisation Fellow)", "source": "mvec.mcri.edu.au/references/g6pd-deficiency-and-vaccines/index.html"}
{"id": "4095718a3c34-1", "text": "Date: November 30, 2022\nMaterials in this section are updated as new information and vaccines become available. The Melbourne Vaccine Education Centre (MVEC) staff regularly reviews materials for accuracy.\nYou should not consider the information in this site to be specific, professional medical advice for your personal health or for your family\u2019s personal health. For medical concerns, including decisions about vaccinations, medications and other treatments, you should always consult a healthcare professional.\n\u00a0\nA B C D E F G H I J K L M N O P Q R S T U V W X Y Z", "source": "mvec.mcri.edu.au/references/g6pd-deficiency-and-vaccines/index.html"}
{"id": "ea7402916395-0", "text": "What is it?\nYellow fever is an acute viral haemorrhagic disease transmitted by infected mosquitos (arbovirus).\nWhat to look for?\nThe incubation period of yellow fever is 3-6 days. The initial signs and symptoms are generally non-specific and include fever, chills, myalgia, fatigue and nausea or vomiting. Symptoms usually resolve within 3-4 days.\nApproximately 15-25% of cases will enter a second, more toxic phase, within 24 hours after recovering from initial symptoms. This presents with a return of high fevers, vomiting, epigastric pain, jaundice (in reference to the name \u201cyellow fever\u201d), multi-organ failure and haemorrhage. Bleeding can occur from the mouth, nose, eyes or stomach.\n20-25% of severe cases will result in death within 7-10 days after the onset of this second toxic phase.\nHow is it transmitted?\nIt is transmitted to humans by the bites of infected mosquitoes. Monkeys are the primary reservoir for yellow fever. Although, in heavily populated urban areas with high mosquito density, infected mosquitos can transmit the virus from person to person.\nEpidemiology\nYellow fever disease occurs in the tropical and subtropical regions of Africa, the Caribbean and Central/South America. Disease risk depends on the time of year, duration of travel and degree of mosquito exposure.\nPrevention\nStamaril\u00ae is the yellow fever vaccine registered for use in Australia. A single dose provides life-long protection. Yellow fever immunisation is not routinely given on the National Immunisation Program (NIP) and is only be administered in Australia as a travel vaccine by accredited yellow fever vaccination centres.", "source": "mvec.mcri.edu.au/references/yellow-fever/index.html"}
{"id": "ea7402916395-1", "text": "Accredited yellow fever vaccination centres will provide vaccine recipients with an International Certificate of Vaccination or Prophylaxis as proof of vaccination. All travellers entering Australia who have been in a declared yellow fever infected country within 6 days of arrival to Australia must show proof of vaccination. If you are travelling to yellow fever infected countries, it is strongly recommended that you check the yellow fever entry requirements for all the countries you intend to enter, prior to travel.\nVaccine precautions and contraindications\nStamaril\u00ae is a live-attenuated vaccine and is contraindicated in those who are:\nAnaphylactic to a previous dose of Stamaril\u00ae\nAnaphylactic to a component of Stamaril\u00ae\nAllergic or anaphylactic to eggs^\nImmunocompromised individuals\nInfants < 9-months of age\nHave a history of thymus disorders\nPregnant women^\n^Consider referral to Specialist Immunisation Clinic for discussion\nPrecautions should be taken when considering immunisation of:\nAdults aged \u226560 years\nBreastfeeding women\nAdverse events following immunisation (AEFI)\nYellow fever-vaccine associated neurotropic disease (YF-AND) is a rare but serious AEFI of yellow fever vaccination. It includes diagnoses such as meningoencephalitis, Guillain-Barr\u00e9 syndrome, acute disseminated encephalomyelitis and bulbar palsy.\nYellow fever vaccine associated viscerotropic disease (YF-AVD) is rare and occurs in 3-4 cases per million doses of vaccine. It is characterised by multi-organ system failure and mimics natural yellow fever disease. Risk factors include older age and patients with a history of thymus disease.\nAny suspected AEFI should be reported to SAEFVIC online or by calling 1300 882 924 (option 1).\nResources", "source": "mvec.mcri.edu.au/references/yellow-fever/index.html"}
{"id": "ea7402916395-2", "text": "Resources\nDHHS: Yellow fever vaccination centres\nAustralian Immunisation Handbook: Yellow fever\nAustralian Government Department of Health: Yellow fever general fact sheet\nWorld Health Organization: Yellow fever\nAuthors: Rachael McGuire (SAEFVIC Research Nurse, Murdoch Children\u2019s Research Institute) and Daniela Say (MVEC Immunisation Fellow, Murdoch Children\u2019s Research Institute)\nDate: December 2020\nMaterials in this section are updated as new information and vaccines become available. The Melbourne Vaccine Education Centre (MVEC) staff regularly reviews materials for accuracy. You should not consider the information in this site to be specific, professional medical advice for your personal health or for your family\u2019s personal health. For medical concerns, including decisions about vaccinations, medications and other treatments, you should always consult a healthcare professional.\n\u00a0\nA B C D E F G H I J K L M N O P Q R S T U V W X Y Z", "source": "mvec.mcri.edu.au/references/yellow-fever/index.html"}
{"id": "cabd36dc63d0-0", "text": "What is it?\nQ fever is caused by the bacteria\u00a0Coxiella Burnetii.\nWhat to look for\nInfection is asymptomatic in at least half of cases. Those who experience symptoms may develop fever, chills, sweats, fatigue, severe headache, weakness, and muscle and joint pain. Complications can include hepatitis, pneumonia and endocarditis. Death is rare. \nHow is it transmitted?\nThe bacteria can survive in air, soil and water. It is transmitted to humans by inhaling infected soil and dust. The main sources of infection for humans include cattle, sheep and goats.\nPrevention\nImmunising high risk groups (abattoir workers, farmers, stockyard workers, shearers, animal transporters, and others exposed to cattle, camels, goats, and kangaroos or their products) is the best way to prevent Q fever. Before vaccination, serological and skin testing should be performed. If previous infection is confirmed, vaccination is not needed. Vaccination generally provides lifelong protection.\nVaccination is not recommended in those <15 years.\nEgg allergy is a contraindication to immunisation.\nResources\nThe Department of Health: Q fever\nAustralian Immunisation Handbook: Q fever chapter\nHealth Direct Australia: Q fever\nAustralian Q Fever Register\nAuthor:\u00a0Rachael McGuire (SAEFVIC Research Nurse, Murdoch Children\u2019s Research Institute)\nDate: September 2018\nMaterials in this section are updated as new information and vaccines become available. The Melbourne Vaccine Education Centre (MVEC) staff regularly reviews materials for accuracy.\nYou should not consider the information in this site to be specific, professional medical advice for your personal health or for your family\u2019s personal health. For medical concerns, including decisions about vaccinations, medications and other treatments, you should always consult a healthcare professional.", "source": "mvec.mcri.edu.au/references/q-fever/index.html"}
{"id": "cabd36dc63d0-1", "text": "A B C D E F G H I J K L M N O P Q R S T U V W X Y Z", "source": "mvec.mcri.edu.au/references/q-fever/index.html"}
{"id": "fde6f891c4f7-0", "text": "What are they?\nMulti-dose vials contain more than one dose of a medicine/vaccine in a single vial. Whilst all vaccines on the National Immunisation Program are single-use preparations, BCG vaccines and COVID-19 vaccines are available in multi-dose vials in Australia. Multi-dose vials are more economical, take less time to manufacture and require less storage space than single-use preparations, however, there is an increased risk of infection control breaches associated with their use.\nInfection control principles\nThere is an increased risk of blood-borne viruses or bacterial contamination with the use of multi-dose vials due to an increased risk of cross contamination. These risks can be mitigated by:\nMaintaining standard principles of infection control and strict aseptic technique when accessing multi-dose vials\nPreparing doses of vaccines from multi-dose vials in a clean, designated medication preparation area\nCleaning the stopper with an alcohol swab and allowing to dry every time the vial is accessed\nUsing a new, sterile syringe and needle each time the vial is accessed. Needles should never be left inside the vial\nDiscarding a multi-dose vial if the vaccine\u2019s integrity or sterility is compromised\nStorage and usage\nFollow the manufacturer\u2019s recommendations for refrigeration, storage, usage timeframes and expiry dates. Protect from sunlight and freezing where required.\nAlways label a multi-dose vial with the date and time of first access or reconstitution\nThe expiry date is the date after which an unused multi-dose vial should be discarded\nThe use by date is the date after which a multi-dose vial that has been accessed should no longer be used. A use by date supercedes the expiry date\nCheck reconstituted vaccines for signs of deterioration, such as a change in colour or clarity. If there are signs of deterioration, refer to the vaccine product information. Do not use the vaccine", "source": "mvec.mcri.edu.au/references/multi-dose-vials/index.html"}
{"id": "fde6f891c4f7-1", "text": "Multi-dose vials that require reconstitution\nOnly the recommended diluent should be used to reconstitute a multi-dose vial\nIntroduce the diluent down the side of the vial to avoid foaming or potentially denaturing the vaccine.\u00a0Mix gently with a careful swirling motion. Do not shake\nGive reconstituted vaccines as soon as practicable after reconstituting. This is because reconstituted vaccines may deteriorate rapidly\nOnce accessed, label the multi-dose vial with the date and time of reconstitution\nPre-filling syringes\nPre-preparing\u00a0syringes with vaccines\u00a0is not recommended for several reasons:\nThe uncertainty of vaccine stability\nThe risk of contamination\nIncreased risk of potential errors in administration\nPotential vaccine wastage\nIf you are in a setting where pre-preparing multiple\u00a0doses is required,\u00a0then only draw up the number of doses necessary to keep the immunisation session running efficiently. These doses must be labelled with the\u00a0date and time the vial was accessed and should be\u00a0used as soon as possible, ensuring that the cold chain is maintained.\nPrinciples of administration\nAttach a new, sterile, disposable injecting needle of appropriate size and length to administer the vaccine\nBe careful not to prime the needle with any of the vaccine as this can increase the risk of injection site reactions\nAdminister the vaccine as soon as practicable after drawing it up\nDiscard multi-dose vials at the end of an Immunisation session/6 hours after accessing (whichever is sooner) or according to manufacturer\u2019s guidelines\nRefer to the product information to determine the specified timeframe the vaccine must be used by once the vial has been accessed\nResources\nMVEC: Use of Multi-dose Vials eLearning package\nATAGI guidance on the use of multi-dose vials for COVID-19 vaccination", "source": "mvec.mcri.edu.au/references/multi-dose-vials/index.html"}
{"id": "fde6f891c4f7-2", "text": "ATAGI guidance on the use of multi-dose vials for COVID-19 vaccination\nACIPC: Aseptic Technique Clinician Cheat Sheet\nCanadian Immunization Guide: Vaccine administration practices\nCenter for Disease Control Injection Safety: Questions about multi-dose vials\nMedical Journal of Australia: Vaccination, consent and multi-dose vials\nWHO policy statement: Multi-dose Vial Policy (MDVP)\nAuthors:\u00a0Francesca Machingaifa (MVEC Education Nurse Coordinator) and Rachael McGuire (MVEC Education Nurse Coordinator)\nReviewed by: Francesca Machingaifa (MVEC Education Nurse Coordinator)\nDate: March 2022\nMaterials in this section are updated as new information and vaccines become available. The Melbourne Vaccine Education Centre (MVEC) staff regularly reviews materials for accuracy.\nYou should not consider the information in this site to be specific, professional medical advice for your personal health or for your family\u2019s personal health. For medical concerns, including decisions about vaccinations, medications and other treatments, you should always consult a healthcare professional.\nA B C D E F G H I J K L M N O P Q R S T U V W X Y Z", "source": "mvec.mcri.edu.au/references/multi-dose-vials/index.html"}
{"id": "060cdb39cc48-0", "text": "In 2016, the previously known Australian Childhood Immunisation Register (ACIR) expanded to an all of life register and became known as the Australian Immunisation Register (AIR). It is a national register recording the immunisations of all Australians of all ages.\nWhy should vaccines be recorded?\nThe AIR records any vaccine doses administered, the date of administration and the specific brands given. \u00a0It also identifies any vaccines that are due or overdue according to the National Immunisation Program (NIP). Immunisation history statements (IHS) can also be generated from AIR.\nFor families accessing Family Tax Benefit Part A payments or childcare subsidies, a child\u2019s AIR record needs to show that immunisations are up to date to ensure that payments are not reduced.\nIn order to confirm enrolment into early childhood education and care services (including childcare and kindergarten), an up to date IHS from AIR must be produced.\nA comprehensive reporting of all vaccinations administered, helps to increase vaccination coverage rates and the effectiveness of the NIP.\nWho can record immunisations?\nAny recognised immunisation provider can record vaccines onto AIR.\nWhat vaccines should be recorded?\nAll vaccines administered since January 1 1996 can be recorded onto AIR. This includes all vaccines on the NIP, influenza and travel vaccines, as well as any additional vaccines given to an individual (eg. tetanus vaccines given for tetanus prone wounds, Boostrix\u00ae in pregnancy, meningococcal B vaccines etc). Any vaccines given overseas can and should also be recorded.\nIn 2021, a legislation change came into effect mandating the reporting of all NIP, influenza and COVID-19 vaccines to AIR.\nImmunisation exemptions and catch up plans\nAll approved immunisation exemptions and recognised catch up plans are documented onto AIR to ensure that immunisation records are accurate.\nDo patients need to be eligible for medicare in order to have an AIR record?", "source": "mvec.mcri.edu.au/references/australian-immunisation-register/index.html"}
{"id": "060cdb39cc48-1", "text": "Do patients need to be eligible for medicare in order to have an AIR record?\nNo. Everyone can have an AIR record. If a person does not have medicare, immunisations can still be recorded based on name, date of birth and address.\nImmunisation history statements\nAn IHS can be used to keep track of vaccines that have been given, that are due or that are overdue. All medical exemptions are noted on an IHS. IHS is the only acceptable form of documentation when enroling into early childhood education and care services.\nHow do I access my own AIR record?\nStatements can be accessed using a Medicare online account through myGov. Alternatively, copies may be obtained from any immunisation provider or the AIR enquiries line.\nResources\nAustralian Government Department of Human Services: Australian Immunisation Register (AIR)\nAustralian Government Department of Human Services: AIR education for vaccination providers\nAustralian Government Department of Human Services: Help using AIR online\nAustralian Government Department of Human Services: Immunisation medical exemption form\nAuthor: Rachael McGuire (MVEC, Education Nurse Coordinator)\nReviewed by: Rachael McGuire (MVEC, Education Nurse Coordinator)\nDate: February 2021\nMaterials in this section are updated as new information and vaccines become available. The Melbourne Vaccine Education Centre (MVEC) staff regularly reviews materials for accuracy.\nYou should not consider the information in this site to be specific, professional medical advice for your personal health or for your family\u2019s personal health. For medical concerns, including decisions about vaccinations, medications and other treatments, you should always consult a healthcare professional.\nA B C D E F G H I J K L M N O P Q R S T U V W X Y Z", "source": "mvec.mcri.edu.au/references/australian-immunisation-register/index.html"}
{"id": "185f6e9e0d35-0", "text": "What is it?\nMpox is a viral zoonosis (an infection spread from animals to humans). It is caused by a virus that belongs to the\u00a0Orthopoxvirus\u00a0genus (which also causes the variola virus responsible for smallpox disease and the vaccinia virus, which is used in smallpox vaccines). Mpox was first discovered in 1958 and there have been small outbreaks since, predominantly in Western and Central Africa. Since the eradication of smallpox in 1980, mpox has become the most important orthopoxvirus affecting humans, however, causes less severe disease than smallpox.\nWhat to look for\nThe incubation period of mpox is usually 7-14 days, but can be as short as 5 days or as long as 21 days. The initial symptoms include fever, headache, backache and muscle aches, fatigue and lymphadenopathy. Lymphadenopathy in this early phase is a key feature of mpox.\n1-3 days following the beginning of fever, a rash may develop, often beginning on the mouth and face, and then spreading to other areas of the body. The face is involved in 95% infections, followed by the palms of the hands and soles of the feed (75%). Oral mucous membranes are involved in 70% of cases, and involvement of the genitalia is also common (30%).\nThe rash is initially characterised as being erythematous (reddened) and macular (flat), which then develops papular features (raised areas) and turns into well-demarcated pustules and vesicles. These then dry into crusts and fall off. The number of lesions is highly variable, ranging from a couple to over a thousand.", "source": "mvec.mcri.edu.au/references/monkeypox/index.html"}
{"id": "185f6e9e0d35-1", "text": "The infection is usually self-limiting with symptoms lasting from 2-4 weeks. Complications can include secondary infection such as cellulitis, sepsis, infection of the cornea (which can be threaten vision), bronchopneumonia and encephalitis. The case fatality ratio is between 3-6%. More severe illness can occur in immunocompromised people.\nHow is it transmitted?\nMpox is spread via either animal-to-human transmission (zoonotic) or human-to-human transmission.\nZoonotic transmission involves direct contact with the bodily fluids, blood, or lesions (cutaneous or mucosal) of infected animals. This is most common for people living near or within forest areas with exposure to infected animals.\nHuman-to-human transmission involves close contact with respiratory secretions, the skin lesions of an infected person, or a contaminated objects such as linen or clothing. Droplet particle transmission requires prolonged face-to-face exposure, placing household contacts at highest risk. This can be minimised by isolating away from other members of the household.\nHealthcare workers caring for individuals with mpox must undertake infection control precautions and handling of laboratory specimens should be by suitably trained staff.\nEpidemiology\nMpox is very common in West and Central Africa, often in areas with tropical rainforests. However, there are currently outbreaks in many other countries across the globe including Australia and parts of Europe and the United Kingdom.\nVaccines\nThe vaccinia virus is a poxvirus related to smallpox and mpox and is contained in smallpox vaccines. Historically, smallpox vaccines have been used in the prevention of smallpox infection, however, they are also likely to be effective against mpox.\nThere are two types of smallpox vaccines available for use in Australia for the prevention of mpox:", "source": "mvec.mcri.edu.au/references/monkeypox/index.html"}
{"id": "185f6e9e0d35-2", "text": "ACAM2000\u2122 \u2013 2nd generation, live-attenuated vaccine\nJYNNEOS\u00ae \u2013 3rd generation, non-replicating vaccine\nRecommendations\nEither vaccine can be administered subcutaneously as either primary preventative vaccination (PPV) or post-exposure preventative vaccination (PEPV) based on an individual risk-benefit assessment. ATAGI preferentially recommends JYNNEOS\u00ae vaccine due to the ease of administration and decreased likelihood of side effects.\nFor PPV, administering JYNNEOS\u00ae via the intradermal route can be considered in all eligible populations to maximise vaccine supply. In circumstances where vaccine supply is limited severely immunocompromised individuals should be prioritised over other eligible groups such as healthcare workers to receive their second dose of JYNNEOS\u00ae (ACAM2000\u2122 \u00a0is contraindicated in this population). Intradermal vaccination is currently recommended for PPV only.\nFor PEPV, vaccination within 4 days is recommended to provide optimal protection against the development of mpox infection. Vaccination between 4-14 days following exposure may lessen the severity of disease.\nVaccination is currently recommended for the following groups:\nthose who are categorised by public health authorities as a high-risk mpox contact in the previous 14 days (PEPV)\ngay, bisexual, and other men, non-binary individuals assigned male at birth, trans men who have sex with men (including cis and trans men) who are the highest risk of infection with mpox. Markers indicating increased risk of infection include:\nthose living with HIV\nrecent history of multiple sexual partners, including group sex or sex on licensed premises\nother markers including recent sexually transmitted disease or on HIV PrEP due to number of partners\nrecommendations from sexual health clinics\nsex workers, particularly those with clients who belong to high-risk groups", "source": "mvec.mcri.edu.au/references/monkeypox/index.html"}
{"id": "185f6e9e0d35-3", "text": "sex workers, particularly those with clients who belong to high-risk groups\nanyone in the above categories planning to travel to a country experiencing a mpox outbreak (immunisation is recommended 4-6 weeks prior to travelling)\nanyone at greater risk of poorer outcomes due to mpox infection, such as those with severe immunocompromise\nimmunisation providers who are administering ACAM2000\u2122.\nIndividuals who have a history of confirmed mpox infection should defer vaccination in the short-medium term after recovery due to the immunity gained from natural infection.\nPrecautions\nVaccination with JYNNEOS\u00ae can be considered in children aged < 18 years where the benefits of vaccination outweigh the risks of disease. Despite limited safety data, there are no theoretical safety concerns surrounding the administration of JYNNEOS\u00ae in pregnant or breastfeeding women.\nIndividuals receiving ACAM2000\u2122 as PPV should consider an interval of 4 weeks between vaccination and administration of COVID-19 vaccines due to the rare risk of\u00a0myocarditis/pericarditis.\nIndividuals with a history of keloid scarring are not recommended to receive JYNNEOS\u00ae via the intradermal route, with subcutaneous being preferred.\nContraindications\nAnyone with a history of anaphylaxis to a previous dose of the vaccine to be administered or anaphylaxis to a component of the vaccine to be administered should not be vaccinated. \u00a0Due to the risk of vaccine associated disease, ACAM2000\u2122 is contraindicated for those with immunocompromise or those who are pregnant.\nIndividuals with active eczema, atopic dermatitis or other exfoliative skin conditions should not receive ACAM2000\u2122 due to the risk of developing eczema vaccinatum (a reaction to smallpox vaccination experienced by people with eczema/atopic dermatitis resulting in a severe rash and systemic illness).", "source": "mvec.mcri.edu.au/references/monkeypox/index.html"}
{"id": "185f6e9e0d35-4", "text": "Vaccine Age Platform Route Volume Primary course Booster JYNNEOS\u00ae \u2265 18 years Non-replicating ankara vector Subcutaneous \u00a70.5ml 2 doses, min. 28 days apart* If previous smallpox vaccine was received > 10 years ago Intradermal \u00a7\u20ac\u00a30.1ml 2 doses, min. 28 days apart ACAM2000\u2122 \u00a5\u2265 18 years Live-attenuated Percutaneous ^#1 droplet (0.0025 mL) of reconstituted vaccine 1 dose \n*an interval longer than 28 days is acceptable. If supply is limited, severely immunocompromised individuals should be prioritised to receive their 2nd dose as close to 28 days from dose 1 as possible.\n\u00a7 Using alternate routes of vaccine delivering to complete a primary course is acceptable (eg, intradermal for dose 1 and subcutaneous for dose 2)\n\u20ac Intradermal administration is an alternate route of vaccination for pre-exposure prophylaxis. It is not preferred for the first dose of post-exposure prophylaxis and is NOT recommended in people with severe immunocompromise\n\u00a3 Vaccination providers administering intradermally should ensure that they are appropriately trained in intradermal technique. Where a dose of intradermal vaccine is inadvertently administered subcutaneously, a repeat dose of 0.5ml should be administered subcutaneously as soon as possible to ensure that the vaccinee receives an appropriate level of protection\n^ Percutaneous administration involves using a bifurcated needle and scarification technique requiring specialised training and accreditation\n# for full aftercare instructions, refer the product information", "source": "mvec.mcri.edu.au/references/monkeypox/index.html"}
{"id": "185f6e9e0d35-5", "text": "# for full aftercare instructions, refer the product information\n\u00a5 ACAM2000 is a live-attenuated vaccine and therefore as outlined above, it\u2019s use is contraindicated in some patient groups. For a full list of contraindications and precautions refer to the ATAGI clinical guidance on vaccination against Mpox.\nFollowing vaccination\nIndividuals receiving ACAM2000\u2122 should be advised that 2-5 days after vaccination a papule will form at the injection site. This will progress to a vesicle (blister) then pustule (blister with pus) before scabbing and forming a permanent pitted scar. Individuals are recommended to cover the injection site with a gauze bandage secured with adhesive tape until scabbing occurs, noting that the wound is infectious until the wound dries up.\nCommon systemic side effects following vaccination with either vaccine include muscle aches, headache, fatigue and nausea. Localised side effects can include injection site itch, pain redness and swelling (and permanent scarring following ACAM2000\u2122.\nACAM2000\u2122 is also associated with a risk of myocarditis and pericarditis as well as other serious side effects noted\u00a0here.\nResources\nVictorian program information\nVictorian Department of Health: Mpox [includes information on where to access vaccines]\nOther resources\nATAGI clinical guidance on vaccination against mpox\nAustralian Government Department of Health and Aged Care: Mpox resources\nMpox virus infection: CDNA National Guidelines for Public Health Units\nBetter Health Channel: Mpox\nAuthors: Rachael Purcell (RCH Immunisation Fellow), Francesca Machingaifa (MVEC Education Nurse Coordinator) and Rachael McGuire (MVEC Education Nurse Coordinator)\nReviewed by: Rachael McGuire (MVEC Education Nurse Coordinator)\nDate: March 23, 2023", "source": "mvec.mcri.edu.au/references/monkeypox/index.html"}
{"id": "185f6e9e0d35-6", "text": "Date: March 23, 2023\nMaterials in this section are updated as new information and vaccines become available. The Melbourne Vaccine Education Centre (MVEC) staff regularly reviews materials for accuracy.\nYou should not consider the information in this site to be specific, professional medical advice for your personal health or for your family\u2019s personal health. For medical concerns, including decisions about vaccinations, medications and other treatments, you should always consult a healthcare professional.\nA B C D E F G H I J K L M N O P Q R S T U V W X Y Z", "source": "mvec.mcri.edu.au/references/monkeypox/index.html"}
{"id": "f16bd1114cd2-0", "text": "What is it?\nThe RCH Immunisation Service drop-in centre was established in March 2001.\nThe drop-in centre provides opportunistic vaccines for patients and parents at the hospital, and, where available, non-patients (appointments are required for catch-up immunisation plans). Led by a specialist nursing team (and run by Nurse Practitioner and Manager Sonja Elia), it also provides specialist immunisation advice. The team supports outpatient clinics such as the Immunisation Clinic (Tuesday am), Immigrant Health clinic (Monday pm) and dedicated BCG clinics (for infants aged less then 12 months). The drop-in centre provides seasonal vaccines, such as influenza; and delivers Palivizumab (RSV prophylaxis) for at risk infants. Additional vaccines such as varicella, meningococcal B and meningococcal ACWY are also available for purchase.\nThe staff at the drop-in centre employ a range of distraction techniques to reduce pain and anxiety and when these techniques are unsuccessful, an \u201cimmunisation under sedation\u201d service can be offered. Please telephone the service for more information regarding this, bookings are essential.\nPlease note that the RCH has implemented additional precautions to ensure the safety of all patients, families and staff at this time. Access to medical care remains an essential service during the COVID-19 pandemic and staying up to date with scheduled immunisations is encouraged.\nReferrals\nImmunisation clinic \u2013 referrals can be sent directly to fax number (03) 9345 4163.\nBCG clinic \u2013 referrals can be sent directly to fax number (03) 9345 5034.\nInpatients and Outpatients \u2013 can be seen by one of the Immunisation Nurse Specialists at RCH, no referral is required.\nContact", "source": "mvec.mcri.edu.au/references/the-royal-childrens-hospital-immunisation-service-drop-in-centre/index.html"}
{"id": "f16bd1114cd2-1", "text": "Contact\nTelephone: Immunisation hotline 1300 882 924 (option 2) or direct (03) 9345 6599 / 9345 6399.\nPager: 4330 via hospital switchboard (03) 9345 5522.\nEmail: [email\u00a0protected]\nFacsimile: (03) 9345 4100.\nResources\nThe Royal Children\u2019s Hospital, Immunisation Service Drop-in Centre\nMVEC: BCG vaccine\nMVEC: Influenza vaccine recommendations\nMVEC: Needle phobia\nMVEC: Meningococcal vaccines\nMVEC: Catch up immunisations\nMVEC: Private vaccine prices at The Royal Children\u2019s Hospital\nAuthor: Sonja Elia (Nurse Practitioner and Manager Immunisation Service, RCH)\nReviewed by: Sonja Elia (Nurse Practitioner and Manager Immunisation Service, RCH)\nDate: July 15, 2022\nMaterials in this section are updated as new information and vaccines become available. The Melbourne Vaccine Education Centre (MVEC) staff regularly reviews materials for accuracy.\nYou should not consider the information in this site to be specific, professional medical advice for your personal health or for your family\u2019s personal health. For medical concerns, including decisions about vaccinations, medications and other treatments, you should always consult a healthcare professional.\nA B C D E F G H I J K L M N O P Q R S T U V W X Y Z", "source": "mvec.mcri.edu.au/references/the-royal-childrens-hospital-immunisation-service-drop-in-centre/index.html"}
{"id": "474e9a4ced4e-0", "text": "AusVaxSafety is an active national surveillance system of all vaccines on the National Immunisation Program (NIP), which monitors adverse events following immunisation (AEFI) to detect possible vaccine safety signals. With funding from the Australian Government Department of Health, it commenced in 2014 and is led by the National Centre for Immunisation Research and Surveillance (NCIRS). The Victorian vaccine safety surveillance is coordinated by SAEFVIC, based at the Murdoch Children\u2019s Research Institute (MCRI).\nAusVaxSafety monitors de-identified data using three software programs: SmartVax,\u00a0 Vaxtracker and NPS Medicine Insight. Information is gathered directly from patients or their carers via SMS or email. It is used across more than 350 sites including general practices, hospital- and community-based immunisation clinics, and Aboriginal medical services spread throughout all Australian states and territories.\nAll data is shared with the Therapeutic Goods Administration (TGA), the Australian Government Department of Health and the participating state health departments, all of whom have a shared responsibility for monitoring the safe use of vaccines.\nResources\nNCIRS: AusVax Safety\nMVEC: SAEFVIC\nMVEC: Adverse event reporting Australia\nAuthor:\u00a0Annette Alafaci (SAEFVIC Research Assistant, Murdoch Children\u2019s Research Institute)\nReviewed by: Annette Alafaci (SAEFVIC Research Assistant, Murdoch Children\u2019s Research Institute) and Rachael McGuire (SAEFVIC Research Nurse, Murdoch Children\u2019s Research Institute)\nDate: July 2020\nMaterials in this section are updated as new information and vaccines become available. The Melbourne Vaccine Education Centre (MVEC) staff regularly reviews materials for accuracy.\nYou should not consider the information in this site to be specific, professional medical advice for your personal health or for your family\u2019s personal health. For medical concerns, including decisions about vaccinations, medications and other treatments, you should always consult a healthcare professional.", "source": "mvec.mcri.edu.au/references/ausvaxsafety-vaccine-safety-surveillance-in-australia/index.html"}
{"id": "474e9a4ced4e-1", "text": "A B C D E F G H I J K L M N O P Q R S T U V W X Y Z", "source": "mvec.mcri.edu.au/references/ausvaxsafety-vaccine-safety-surveillance-in-australia/index.html"}
{"id": "0200ed2b4407-0", "text": "A number of families and health care providers may wonder if immunisations are permitted based on religious beliefs, given the presence of gelatin derived from pork in some vaccines.\nLeaders of the Jewish faith have declared that pork derived additives in medicines are permitted for those observant of the Jewish faith. Rabbi Abraham Adler, from the Kashrus and Medicines Information Service in the United Kingdom has advised:\n\u201cIt should be noted that according to Jewish laws, there is no problem with porcine or other animal derived ingredients in non-oral products. This includes vaccines, injections, suppositories, creams and ointments\u201d\nScholars of the Islamic Organization for Medical Sciences have also determined that the process by which the original pork product is transformed into gluten, alters it enough whereby it is permitted for observers of Muslim faith to receive vaccines. A 2001 letter from the World Health Organization Regional Office for the Eastern Mediterranean reported:\n\u201cthe gelatin formed as a result of the transformation of the bones, skin, and tendons of a judicially impure animal is pure, and it is judicially permissible to eat\u201d\nGrand Mufti of Australia has also released supportive statements noting that the use of vaccines containing gelatin derived from pork is permitted for observant Muslims.\nSeventh-Day Adventists are not forbidden to use pork derivatives in medical products.\nIf there are any queries regarding porcine products in vaccines please contact [email\u00a0protected]\nResources\nAustralian Government Department of Health: Questions about vaccination\nInstitute for Vaccine Safety: Religious leaders approval of use of vaccines containing porcine gelatin\nNCIRS: Vaccine components fact sheet\nAuthors: Rachael McGuire (SAEFVIC Research Nurse, Murdoch Children\u2019s Research Institute), Nigel Crawford (Director, SAEFVIC, Murdoch Children\u2019s Research Institute) and Georgie Lewis (SAEFVIC Clinical Manager, Murdoch Children\u2019s Research Institute)\nDate:\u00a0February 2019", "source": "mvec.mcri.edu.au/references/porcine-gelatin-and-vaccines/index.html"}
{"id": "0200ed2b4407-1", "text": "Date:\u00a0February 2019\nMaterials in this section are updated as new information and vaccines become available. The Melbourne Vaccine Education Centre (MVEC) staff regularly reviews materials for accuracy.\nYou should not consider the information in this site to be specific, professional medical advice for your personal health or for your family\u2019s personal health. For medical concerns, including decisions about vaccinations, medications and other treatments, you should always consult a healthcare professional.\n\u00a0\nA B C D E F G H I J K L M N O P Q R S T U V W X Y Z", "source": "mvec.mcri.edu.au/references/porcine-gelatin-and-vaccines/index.html"}
{"id": "17c1a3420144-0", "text": "Thrombosis with thrombocytopenia syndrome (TTS), also known as Vaccine-induced prothrombotic immune thrombocytopenia (VIPIT) or vaccine-induced immune thrombotic thrombocytopenia (VITT), was a rare syndrome reported in people who received adenoviral vector COVID-19 vaccines such as Vaxzevria (AstraZeneca) and the Johnson & Johnson/Janssen COVID-19 vaccine.\nPlease note: adenoviral vector COVID-19 vaccines are no longer available for use in Australia. The following information remains for reference purposes.\nWhat is TTS?\nThe syndrome is characterised by thrombosis formation (blood clots) combined with thrombocytopenia (low platelet count) with symptoms typically presenting in the 4-42 days after vaccination.\nAccording to the Center for Diseases Control (CDC) TTS is classified into 2 tiers based on the location of thrombosis and severity of symptoms. Cases are further classified based on if there has been recent exposure to heparin or not.\nTier 1:\nuncommon site of thrombosis (eg. brain \u2013 cerebral venous sinus thrombosis [CVST] or gut \u2013 eg. splanchnic vein, associated with bowel ischaemia and surgery, portal vein or other rare venous and arterial thromboses)\nmay also concurrently have thrombosis in more common locations (eg. deep vein thrombosis or pulmonary embolism)\nplatelet count < 150,000 per microliter\npositive (+) anti-PF4 ELISA result is supportive, but not required for diagnosis.\nTier 2:\ncommon sites of thrombosis such as leg or lungs (eg. venous thromboembolism, deep vein thrombosis, pulmonary embolism)\nplatelet count < 150,000 per microliter", "source": "mvec.mcri.edu.au/references/thrombosis-with-thrombocytopenia-syndrome/index.html"}
{"id": "17c1a3420144-1", "text": "platelet count < 150,000 per microliter\npositive anti-PF4 ELISA result is required.\nTier 1 tends to be associated with more severe presentations and carries a higher risk of morbidity and mortality than Tier 2. Evidence suggests that Tier 1 is more common in younger age groups.\n\ufeff\ufeff\nHow did adenoviral vector vaccines trigger TTS?\nThe exact mechanism of how TTS is triggered is still under investigation, however the majority of cases were associated with the finding of anti-PF4 antibodies. There are no clear diagnostic markers to indicate who is at risk of this syndrome. This is currently under investigation.\nTTS appears to be similar to an autoimmune condition known as heparin induced thrombocytopenia (HIT), which is where an immune reaction to the medication heparin impacts platelet function, leading to thrombosis (clots).\nThe risk of TTS\nIt is estimated that the risk of developing TTS after dose 1 of Vaxzevria (AstraZeneca) was approximately 2.6 per 100,000 persons, with those under 60 years experiencing more severe outcomes. The risk of developing TTS following dose 2 occurred at a much lower rate.\nThe risk of developing other clotting disorders after receiving adenviral vector vaccines\nThere is currently no evidence that adenoviral vector vaccines increase the overall risk of developing other standalone thromboses (eg. other clotting disorders leading to deep vein thromboses, pulmonary emboli, myocardial infarction, stroke) beyond the baseline rate in the general population.\nTTS was different to other commonly diagnosed thromboses as it was triggered by an immune response to a specific type of vaccine which then results in the combination of both thrombosis (clots) and thrombocytopenia (low platelet count).\nResources", "source": "mvec.mcri.edu.au/references/thrombosis-with-thrombocytopenia-syndrome/index.html"}
{"id": "17c1a3420144-2", "text": "Resources\nMJA: Australian and New Zealand approach to diagnosis and management of vaccine\u2010induced immune thrombosis and thrombocytopenia\nThrombosis and Haemostasis Society of Australia and New Zealand (THANZ) Multidisciplinary VITT Guideline for Doctors\nHealthPathways Thrombosis with Thrombocytopenia Syndrome (TTS) pathway (login required)\nATAGI statement on revised recommendations on the use of COVID-19 Vaccine AstraZeneca, 17 June 2021\nATAGI: Joint statement from ATAGI and THANZ on Thrombosis with Thrombocytopenia Syndrome (TTS) and the use of COVID-19 AstraZeneca\nTHANZ advisory statement for haemotologists, August 19, 2021: Suspected Vaccine induced immune thrombotic thrombocytopenia (VITT)\nAustralasian College of Emergency Medicine: Thrombosis with Thrombocytopenia Syndrome following COVID-19 vaccination\nCOVID-19 vaccination \u2013\u00a0Information for Immunisation Providers on Thrombosis with Thrombocytopenia Syndrome (TTS) following COVID-19 vaccination\nPatient information sheet on AstraZeneca COVID-19 vaccine and thrombosis with thrombocytopenia syndrome (TTS)\nAuthors: Daryl Cheng (Paediatricican, Royal Children\u2019s Hospital), Francesca Machingaifa (MVEC Education Nurse Coordinator), Davina Buntsma (MVEC Immunisation Fellow) and Rachael McGuire (MVEC Education Nurse Coordinator)\nReviewed by: Linny Kimly Phuong (Immunisation Consultant, SAEFVIC), Rachael McGuire (MVEC Education Nurse Coordinator) and Hannah Morgan (Epidemiologist, SAEFVIC)\nDate: May 2, 2023", "source": "mvec.mcri.edu.au/references/thrombosis-with-thrombocytopenia-syndrome/index.html"}
{"id": "17c1a3420144-3", "text": "Date: May 2, 2023\nMaterials in this section are updated as new information and vaccines become available. The Melbourne Vaccine Education Centre (MVEC) staff regularly reviews materials for accuracy.\nYou should not consider the information in this site to be specific, professional medical advice for your personal health or for your family\u2019s personal health. For medical concerns, including decisions about vaccinations, medications and other treatments, you should always consult a healthcare professional.\nA B C D E F G H I J K L M N O P Q R S T U V W X Y Z", "source": "mvec.mcri.edu.au/references/thrombosis-with-thrombocytopenia-syndrome/index.html"}
{"id": "157fa17dce6e-0", "text": "What is gelatin\nGelatin is a protein product derived from collagen. It is added to some vaccines to act as a stabiliser to ensure they remain effective after manufacture. The type of gelatin used in vaccines (usually porcine in origin) is different from the gelatin used in foods (usually bovine in origin) and is highly purified.\nGelatin allergy\nThe incidence of anaphylaxis to gelatin is extremely low. Some individuals with an allergy to gelatin will react to the ingestion of gelatin. Others react only when a vaccine containing gelatin is injected or with the use of intraoperative hemostatic agents (e.g. surgical Gelfoam\u00ae).\nGelatin and vaccines\nGelatin in vaccines can cause allergic reactions therefore people with severe allergies to gelatin should avoid gelatin-containing vaccines.\nPatients who report allergic reactions to the ingestion of gelatin should seek expert advice before receiving any vaccine containing gelatin.\nVaccines licensed in Australia which contain gelatin (porcine)\nMMRII\u00ae (measles-mumps-rubella)\nProQuad\u00ae (measles-mumps-rubella-varicella)\nVarivax\u00ae (varicella)\nZostavax\u00ae (varicella-zoster)\nRabavert\u00ae (rabies)\nMerieux\u00ae (rabies)\nVivotif\u00ae (typhoid)\nIf you have any concerns regarding a gelatin allergy and immunisation, please discuss with a healthcare professional or immunisation specialist.\nResources\nChildren\u2019s Hospital of Philadelphia: Vaccine Ingredients \u2013 Gelatin\nMVEC: Porcine gelatin and vaccines\nWorld allergy organisation: Ask the expert MMR vaccine\nAustralian Immunisation Handbook: Components of vaccines used in Australia", "source": "mvec.mcri.edu.au/references/gelatin-allergy-and-vaccines/index.html"}
{"id": "157fa17dce6e-1", "text": "Australian Immunisation Handbook: Components of vaccines used in Australia\nAuthors: Adele Harris (SAEFVIC Research Nurse, Murdoch Children\u2019s Research Institute), Nigel Crawford (Director, SAEFVIC, Murdoch Children\u2019s Research Institute), Kirsten Perrett (Clinician Scientist Fellow, Murdoch Children\u2019s Research Institute) & Nicole Wong (Immunisation Fellow, Royal Children\u2019s Hospital)\nReviewed by: Rachael McGuire (SAEFVIC Research Nurse, Murdoch Children\u2019s Research Institute)\nDate: July 2020\nMaterials in this section are updated as new information and vaccines become available. The Melbourne Vaccine Education Centre (MVEC) staff regularly reviews materials for accuracy.\nYou should not consider the information in this site to be specific, professional medical advice for your personal health or for your family\u2019s personal health. For medical concerns, including decisions about vaccinations, medications and other treatments, you should always consult a healthcare professional.\nA B C D E F G H I J K L M N O P Q R S T U V W X Y Z", "source": "mvec.mcri.edu.au/references/gelatin-allergy-and-vaccines/index.html"}
{"id": "5d6310fcc6cf-0", "text": "Background\nImmune thrombocytopenia, also previously known as idiopathic thrombocytopenia purpura (ITP), is an uncommon autoimmune condition in which the body\u2019s own immune system attacks platelets (the cells found in the blood which normally help the blood to clot). In ITP, the body produces antibodies which attack and destroy platelets, which decreases their number and can cause symptoms such as bruising, pin-point red spots (petechiae) on the skin or bleeding (e.g. nose bleeds or bleeding from the gums). Some people have no symptoms at all.\nITP is most often triggered by a viral illness, occurring in the weeks prior to symptoms developing. ITP can be acute (lasting less than 6 months) or chronic (lasting longer than 6 months), with acute ITP far more common in children and chronic ITP far more common in adults. The symptoms of acute and chronic ITP are the same. Approximately one in every 10,000 child will be affected by ITP.\nSome cases of ITP are discovered by chance. In some instances, ITP may go away without any treatment. However, when platelets are very low or there are symptoms of bleeding treatment may be needed. Corticosteroids and intravenous immunoglobulin are the most common forms of initial treatment.\nITP and measles, mumps and rubella vaccines (MMR)", "source": "mvec.mcri.edu.au/references/immune-thrombocytopenia-itp/index.html"}
{"id": "5d6310fcc6cf-1", "text": "ITP and measles, mumps and rubella vaccines (MMR)\nMMR vaccines have been associated with ITP, with the risk estimated at approximately 1 in 25,000 vaccinations.\u00a0 However, the risk of ITP following MMR vaccine is much lower than the risk seen with natural measles or rubella infections. Patients with a history of ITP are still recommended to receive the MMR vaccine in line with the National Immunisation Program (NIP) as although there is a small risk of relapse, this risk is still present with the viruses themselves, and it is important that people are protected against these viruses which can cause significant morbidity and mortality.\nITP and COVID-19 vaccines\nA link between COVID-19 vaccines and ITP is currently being investigated. This is because of the known link between MMR vaccine and ITP, and also because ITP can be triggered by COVID-19 infection. A study in Scotland reported a link between Vaxzevria (AstraZeneca) and ITP, with rates seen post vaccination higher than background rates of ITP in the community . To date, there has been no association found between mRNA COVID-19 vaccines (Comirnaty or Spikevax) and ITP. Monitoring and investigations are and underway in Australia.\nShould patients with a history of ITP receive COVID-19 vaccines?", "source": "mvec.mcri.edu.au/references/immune-thrombocytopenia-itp/index.html"}
{"id": "5d6310fcc6cf-2", "text": "Should patients with a history of ITP receive COVID-19 vaccines?\nYes. The effect of COVID-19 vaccination on pre-existing ITP (acute and chronic) has not been well characterised. Limited and early data indicates that vaccination may worsen thrombocytopenia in approximately 10% of patients with chronic ITP post vaccination. However, it is important to note that ITP is most often triggered by a virus, and that the risk of relapse or worsening of ITP is likely higher if these patients contract COVID-19 than the risk following vaccination itself. Patients with a history of ITP are therefore recommended to proceed with vaccination, however, if clinical symptoms worsen post vaccination (days to weeks) then monitoring of platelets and escalation of therapy may be required.\nCan patients who develop ITP following a dose of COVID-19 vaccine receive future doses?\nYes. Patients who develop ITP following receipt of a COVID-19 vaccine can receive future doses (including booster doses) once they are advised that it is safe to do so. Vaccination should be deferred until platelets are stable (>50 x 109/L and off any ITP treatment for >3 months). If a patient remains on immunosuppression (eg. corticosteroids) they should discuss with a heamatologist whether to proceed.", "source": "mvec.mcri.edu.au/references/immune-thrombocytopenia-itp/index.html"}
{"id": "5d6310fcc6cf-3", "text": "If a patient (> 18 years) has ITP following a dose of Vaxzevria (AstraZeneca), they should receive an mRNA vaccine (eg. Comirnaty or Spikevax) or Nuvaxovid (Novavax) for their subsequent doses. If a patient has ITP following the first dose of an mRNA vaccine or Nuvaxovid they should proceed with the second dose of the same vaccine, as no association has been found between these vaccines and ITP to date. There remains a risk of relapse regardless of vaccine brand, however this risk of relapse is higher with COVID-19 disease itself. Close monitoring should occur following vaccination with dose 2 to ensure that there is no further drop in platelets.\nITP and other vaccines\nThere are some small studies or case reports which suggest a possible increased risk of ITP and other vaccines, such as influenza, HPV, polio and pneumococcal vaccines. However, to date, no vaccines have been proven to be associated with ITP other than the MMR and Vaxzevria (AstraZeneca) vaccines described above. People with a history of ITP are safe to receive all routine NIP and travel vaccines as required.\nResources\nMiller E, Waight P, Farrington CP, Andrews N, Stowe J, Taylor B. Idiopathic thrombocytopenic purpura and MMR vaccine. Arch Dis Child. 2001;84(3):227-9\nBlack C, Kaye JA, Jick H. MMR vaccine and idiopathic thrombocytopaenic purpura. Br J Clin Pharmacol. 2003;55(1):107-11", "source": "mvec.mcri.edu.au/references/immune-thrombocytopenia-itp/index.html"}
{"id": "5d6310fcc6cf-4", "text": "Bhattacharjee S, Banerjee M. Immune Thrombocytopenia Secondary to COVID-19: a Systematic Review. SN Compr Clin Med. 2020:1-11\nSimpson CR, Shi T, Vasileiou E, Katikireddi SV, Kerr S, Moore E, et al. First-dose ChAdOx1 and BNT162b2 COVID-19 vaccines and thrombocytopenic, thromboembolic and hemorrhagic events in Scotland. Nat Med. 2021;27(7):1290-7\nRinaldi M, Perricone C, Ortega-Hernandez OD, Perricone R, Shoenfeld Y. Immune thrombocytopaenic purpura: an autoimmune cross-link between infections and vaccines. Lupus. 2014;23(6):554-67\nGarbe E, Andersohn F, Bronder E, Salama A, Klimpel A, Thomae M, et al. Drug-induced immune thrombocytopaenia: results from the Berlin Case-Control Surveillance Study. Eur J Clin Pharmacol. 2012;68(5):821-32\nAuthors: Sally Gordon (VicSIS Manager, Department of Health), Paul Monagle (Clinical Haematologist, Royal Children\u2019s Hospital), Francesca Machingaifa (MVEC Education Nurse Coordinator), Rachael McGuire (MVEC Education Nurse Coordinator) and Nigel Crawford (Director SAEFVIC, Murdoch Children\u2019s Research Institute)\nReviewed by: Paul Monagle (Clinical Haematologist, Royal Children\u2019s Hospital), Nigel Crawford (Director SAEFVIC, Murdoch Children\u2019s Research Institute) and Rachael McGuire (MVEC Education Nurse Coordinator)\nDate: July 21, 2022", "source": "mvec.mcri.edu.au/references/immune-thrombocytopenia-itp/index.html"}
{"id": "5d6310fcc6cf-5", "text": "Date: July 21, 2022\nMaterials in this section are updated as new information and vaccines become available. The Melbourne Vaccine Education Centre (MVEC) staff regularly reviews materials for accuracy.\nYou should not consider the information in this site to be specific, professional medical advice for your personal health or for your family\u2019s personal health. For medical concerns, including decisions about vaccinations, medications and other treatments, you should always consult a healthcare professional.\nA B C D E F G H I J K L M N O P Q R S T U V W X Y Z", "source": "mvec.mcri.edu.au/references/immune-thrombocytopenia-itp/index.html"}
{"id": "aba540f7ad7e-0", "text": "Background\nEczema, or atopic dermatitis, is a skin condition affecting many people of all ages but is most common in infants and young children. It affects approximately 40% of babies and children worldwide and often appears in the first year of life. Many children grow out of eczema around the age of 5 years however, there are some individuals who will have eczema throughout their life.\nEczema, along with asthma, allergy and allergic rhinitis are more formally known as atopic conditions. Of those children with moderate to severe eczema, a small number will go on to develop food allergy, asthma of childhood and/or allergic rhinitis.\nIt is not well understood why some individuals develop eczema or other atopic conditions however, there is research and clinical trials currently underway looking into possible genetic, immunological and environmental causes for eczema.\nVaccines\nIt is safe and recommended for individuals with eczema to receive vaccines according to the National Immunisation Program (NIP); and there is currently no robust evidence suggesting a causal link between immunisation and eczema. Eczema affects people differently and there are multiple triggers that may cause flares including viral or bacterial infections, environmental allergens, stress and some medications.\nRecommendations\nEczema may flare in the days following immunisation, however this is not a contraindication to future vaccines.\u00a0 It is recommended to follow an eczema treatment plan which may include regular moisturiser, topical steroids and barrier creams. If the first presentation of eczema following immunisation, it is recommended to seek GP assessment for an appropriate management plan.\nPrecautions", "source": "mvec.mcri.edu.au/references/eczema-and-immunisations/index.html"}
{"id": "aba540f7ad7e-1", "text": "Precautions\nIf there is active eczema at the intended site of injection, an alternate site could be considered to reduce the risk of infection (or abscess). If no other site is deemed suitable, cleaning the site with an alcohol-based wash/single use alcohol swab and allowing the site to dry completely before injecting could be considered.\nBCG vaccination should be deferred if there is active eczema at the injection site.\nThe smallpox vaccine ACAM2000\u2122 is contraindicated in individuals with active eczema, atopic dermatitis or other exfoliative skin conditions due to the risk of developing eczema vaccinatum (a reaction to smallpox vaccination experienced by people with eczema/atopic dermatitis resulting in a severe rash and systemic illness).\nResources\nAustralasian Society of Clinical Immunology and Allergy: Eczema (Atopic dermatitis)\nOlesen A, Juul S, Thestrup-Pedersen K, Atopic dermatitis is increased following vaccination for measles, mumps and rubella or measles infection. ActaDV 2003;83(6):445-50\nDermNet NZ: Atopic dermatitis\nAustralian Immunisation Handbook: Tuberculosis\nAustralian Immunisation Handbook:Preparing for vaccination\nMVEC: Mpox (monkeypox)\nRCH Kids Health Info: Eczema\nAuthors: Mel Addison (SAEFVIC Research Nurse, Murdoch Children\u2019s Research Institute)\nReviewed by: Mel Addison (SAEFVIC Research Nurse, Murdoch Children\u2019s Research Institute) and Francesca Machingaifa (MVEC Education Nurse Coordinator)\nDate: January 30, 2023\nMaterials in this section are updated as new information and vaccines become available. The Melbourne Vaccine Education Centre (MVEC) staff regularly reviews materials for accuracy.", "source": "mvec.mcri.edu.au/references/eczema-and-immunisations/index.html"}
{"id": "aba540f7ad7e-2", "text": "You should not consider the information in this site to be specific, professional medical advice for your personal health or for your family\u2019s personal health. For medical concerns, including decisions about vaccinations, medications and other treatments, you should always consult a healthcare professional.\nA B C D E F G H I J K L M N O P Q R S T U V W X Y Z", "source": "mvec.mcri.edu.au/references/eczema-and-immunisations/index.html"}
{"id": "16baf513b07c-0", "text": "What is it?\nThe Monash Health Immunisation Service was established in 2012.\nIt is a nurse-led, all-age immunisation drop-in service, with adult and paediatric immunisation physician support and clinics. The service provides immunisation education and management for high risk groups including oncology, renal, diabetic, respiratory and cardiac, transplant, hyposplenic and asplenic patients. It provides opportunistic immunisation for inpatients and outpatients according to the National Immunisation Program (NIP), influenza vaccines, and antenatal immunisations.\nMonash Immunisation Service provides assistance with complex immunisation issues, catch-up immunisation advice, immunisation adverse event management and supports an outpatient immunisation clinic. The service also has a dedicated BCG clinic for children aged 0-5 years (GP referral required).\nMonash Health Immunisation Service is part of the VicSIS network. The VicSIS network provides specialist vaccination services for people who have experienced an adverse event following immunisation (AEFI) with a COVID-19 vaccine, or those who are identified as at risk of an AEFI (for example, people with a history of anaphylaxis). For further information refer to MVEC: The VicSIS Network.\nContact\nTelephone: 1300 882 924 (option 4)\nPager: 4488 via switchboard 9594 6666\nEmail: [email\u00a0protected]\nFacsimile: 03\u00a09594 6325\nLocation\nSuite I, Jessie McPherson Private Consulting Suite\nLevel 2, Monash Medical Centre, Clayton\nResources\nMonash Immunisation homepage\nMVEC: Maternal vaccination during pregnancy\nMVEC: BCG vaccine\nMVEC: Influenza vaccine recommendations\nMVEC: The VicSIS Network", "source": "mvec.mcri.edu.au/references/monash-health-immunisation-service/index.html"}
{"id": "16baf513b07c-1", "text": "MVEC: Influenza vaccine recommendations\nMVEC: The VicSIS Network\nAuthors: Joanne Hickman (NUM Monash Immunisation, Monash Health), Jim Buttery (Paediatrician/ ID physician, Monash Health) and Rachael McGuire (SAEFVIC Research Nurse, Murdoch Children\u2019s Research Institute)\nReviewed by: Francesca Machingaifa (MVEC Education Nurse Coordinator)\nDate: March 2021\nMaterials in this section are updated as new information and vaccines become available. The Melbourne Vaccine Education Centre (MVEC) staff regularly reviews materials for accuracy.\nYou should not consider the information in this site to be specific, professional medical advice for your personal health or for your family\u2019s personal health. For medical concerns, including decisions about vaccinations, medications and other treatments, you should always consult a healthcare professional.\nA B C D E F G H I J K L M N O P Q R S T U V W X Y Z", "source": "mvec.mcri.edu.au/references/monash-health-immunisation-service/index.html"}
{"id": "f1aa3844ae43-0", "text": "Background \nPostural tachycardia syndrome (POTS) is a syndrome where individuals experience a cluster of symptoms including an inappropriate level of tachycardia (rapid heartbeat) upon standing. The condition is more common in females, especially adolescents and young adults. There can be a number of associated symptoms, including dizziness, weakness, vision changes, difficulty concentrating, sleep disturbances or nausea.\nAlthough the pathophysiology of POTS is yet to be fully understood, it is thought to be due to an abnormal autonomic nervous system response. When changing positions from sitting to standing, gravity sends blood to the legs and pelvis activating the sympathetic (fight or flight) nervous system, releasing noradrenaline. This tightens bloods vessels in the lower body so that blood is moved back to the heart, slightly increasing the heart rate, usually all in under a second, keeping blood pressure and bloody supply to the brain stable. In individuals with POTS, this process does not work as well as it should and the brain compensates by increasing the heart rate.\nPOTS can have an impact on quality of life, with many people experiencing both physical symptoms as well as other effects on mood, cognition and sleep. However, most cases can be successfully managed with lifestyle modifications. Medications are only required in rare circumstances.\nPOTS and vaccines\nA diagnosis of POTS is not a contraindication to receiving vaccinations. In fact, some cases of POTS are thought to occur following an acute infection, some of which are vaccine-preventable. Therefore it is important that any individual who has a diagnosis of, or is concerned about, POTS should receive all recommended vaccinations.\nHuman papillomavirus (HPV)", "source": "mvec.mcri.edu.au/references/pots-postural-tachycardia-syndrome-and-immunisation/index.html"}
{"id": "f1aa3844ae43-1", "text": "Human papillomavirus (HPV)\nThere have been concerns previously after a small number of case reports described POTS being diagnosed following human papillomavirus (HPV) vaccination. However, this has been thoroughly assessed by the Centers for Disease Control and Prevention (CDC) and after examining the data from more than 80 million doses of vaccines, no causal link has been established between HPV vaccines and POTS.\nCOVID-19\nThere has not been an\u00a0established\u00a0link between COVID-19 vaccines and an increased risk of developing\u00a0POTS. In fact, there have been reports of POTS developing after COVID-19 infection and POTS has been recognised as a post-covid condition (colloquially known as long COVID). Therefore being vaccinated against COVID-19 is recommended for individuals concerned about developing this condition.\nSummary\u00a0\nFor individuals with a previous diagnosis of POTS who are concerned for a worsening of their condition after vaccination, it is important to consider that most vaccine side effects are mild and transient. Overall the benefits of vaccination are likely to far outweigh the risks. However, any concerns should be discussed with an individual\u2019s treating healthcare practitioner.\nResources\nBaker Heart and Diabetes Institute: Orthostatic intolerance\nCDC: Questions about HPV Vaccine Safety\nCDC: Evaluating and Caring for Patients with Post-COVID Conditions: Interim Guidance\nImmunologic Research: Postural orthostatic tachycardia syndrome (POTS) and other autonomic disorders after COVID-19 infection: a case series of 20 patients\nAuthor: Julia Smith (RCH Immunisation Fellow)\nDate: September 20, 2022\nMaterials in this section are updated as new information and vaccines become available. The Melbourne Vaccine Education Centre (MVEC) staff regularly reviews materials for accuracy.", "source": "mvec.mcri.edu.au/references/pots-postural-tachycardia-syndrome-and-immunisation/index.html"}
{"id": "f1aa3844ae43-2", "text": "You should not consider the information in this site to be specific, professional medical advice for your personal health or for your family\u2019s personal health. For medical concerns, including decisions about vaccinations, medications and other treatments, you should always consult a healthcare professional.\nA B C D E F G H I J K L M N O P Q R S T U V W X Y Z", "source": "mvec.mcri.edu.au/references/pots-postural-tachycardia-syndrome-and-immunisation/index.html"}
{"id": "70b843f0638a-0", "text": "Background\nThe spleen plays an important role in preventing infection by removing bacteria (particularly encapsulated bacteria) from the blood stream. Individuals with anatomical asplenia (absent spleen) or functional asplenia/hyposplenia (no function or decreased function) are therefore at an increased risk of infection. In addition to being up to date with National Immunisation Program (NIP) and COVID-19 vaccines, individuals with asplenia or hyposplenia are recommended and funded to receive extra vaccines (outlined below).\nThe reason for asplenia or hyposplenia may be congenital or due to surgical removal (eg. in the case of trauma). Children with congenital asplenia, cancer related asplenia and those with sickle cell anaemia have a higher risk of infection than those who have had splenectomy for trauma.\nScheduling additional vaccines can be complicated by the cause of asplenia or hyposplenia. Where possible people having a planned splenectomy should ideally receive all additional vaccines at least 2 weeks prior to surgery. This is to ensure optimal protection prior to spleen removal. Those who undergo an unplanned or emergency splenectomy should defer vaccines for at least 7 days following surgery to allow time for recovery.\nIndividuals with asplenia/hyposplenia have a lifelong risk of infection. In addition to vaccination, patients are also recommended to receive prophylactic antibiotics.\nAdditional vaccine recommendations for children (< 18 years)\nPneumococcal", "source": "mvec.mcri.edu.au/references/hyposplenia/index.html"}
{"id": "70b843f0638a-1", "text": "Additional vaccine recommendations for children (< 18 years)\nPneumococcal\nVaccine brand Prevenar 13\u00ae (pneumococcal conjugate vaccine 13vPCV) Pneumovax 23\u00ae (pneumococcal polysaccharide vaccine 23vPPV) Age at diagnosis \u2265 6 weeks to \u2264 11 months 3 doses (min. 8 weeks apart) + 1 booster\u00a5\u03b2\u00a7Single dose at \u2265 4 years^\u2265 12 months Single dose\u2126^\u03b2\u00a7Single dose at \u2265 4 years^Additional booster doses N/A 5 years following completion of initial dose\u20ac\n\u00a5 doses as per NIP at 6 weeks, 4 months, 6 months (additional dose for those with a special risk condition) and routinely at 12 months of age.\n\u03b2 booster doses are given at \u2265 12 months of age/8 weeks since previous dose (whichever is later).\n\u00a7 if not up to date with NIP recommendations refer to the Australian Immunisation Handbook for catch up advice.\n^ ideally Prevenar 13\u00ae is administered first, followed by Pneumovax 23\u00ae at \u2265 4 years of age/minimum of 8 weeks later (whichever is later). If Pneumovax 23\u00ae is inadvertently administered first, a minimum of 12 months should elapse before administering Prevenar 13\u00ae.\n\u2126 to be given a minimum of 8 weeks following any previous doses.\n\u20ac maximum of 2 doses of Pneumovax 23\u00ae in a lifetime.\nN/A- not recommended.\nMeningococcal", "source": "mvec.mcri.edu.au/references/hyposplenia/index.html"}
{"id": "70b843f0638a-2", "text": "N/A- not recommended.\nMeningococcal\nVaccine brand Nimenrix\u00ae (meningococcal quadrivalent conjugate vaccine 4vMenCV ACWY) Bexsero\u00ae (meningococcal B recombinant multicomponent vaccine MenBV) Age at diagnosis \u2265 6 weeks to \u2264 5 months 3 doses (min. 8 weeks apart) + 1 booster^#\u20203 doses (minimum 8 weeks apart) + 1 booster dose^\u00a5\u00a7\u2265 6 months to \u2264 11 months 2 doses (min. 8 weeks apart) + 1 booster^#\u20202 doses (minimum 8 weeks apart) + 1 booster dose^\u00a5\u00a7\u2265 12 months 2 doses#\u20202 doses (minimum 8 weeks apart)^\u00a5\u00a7Additional booster doses Where the primary course was completed at \u2264 6 years of age Give a booster dose 3 years following the completion of the primary course, then further booster doses every 5 years\u2020Give a single booster dose only 3 years after completing the primary course\u00a7Where the primary course was completed at \u2265 7 years of age Give a booster dose every 5 years following the completion of the primary course\u2020Give a single booster dose only 5 years after completing the primary course\u00a7\n^ booster doses are given at \u2265 12 months of age/8 weeks since the previous dose (whichever is later).\n# a single dose of Nimenrix\u00ae is funded on the NIP at 12 months and for year 10 students and adolescents aged 15-19 years who missed receiving the vaccine at school.", "source": "mvec.mcri.edu.au/references/hyposplenia/index.html"}
{"id": "70b843f0638a-3", "text": "\u00a5 administration of prophylactic paracetamol is recommended for those < 4 years of age (15mg/kg per dose) 30 minutes prior to vaccination (or as soon as possible after), as well as 2 subsequent doses (4-6 hours apart) to reduce the likelihood and severity of fever.\n\u2020 Menveo\u00ae may be used interchangeably as an alternate brand to Nimenrix\u00ae. Where possible completing a course with the same brand is preferred.\n\u00a7 Bexsero\u00ae is registered for use from 6 weeks of age. Trumenba\u00ae is an alternate meningococcal B vaccine available as a 3 dose course for individuals asplenia/hyposplenia aged 10 years or older. Meningococcal B vaccines are not interchangeable.\nHaemophilus influenzae type B (HIB)\nVaccine brand Infanrix hexa\u00ae/ActHIB\u00ae Age at diagnosis \u2265 6 weeks As per NIP^\u00a7\n^ if < 5 years of age and not up to date with NIP refer to the Australian Immunisation Handbook for catch up recommendations.\n\u00a7 a single dose is recommended for those aged 5 years or over who have not previously completed a primary course.\nInfluenza\nVaccine brand Variable- refer to MVEC: Influenza for age-appropriate brands and details Age at diagnosis < 6 months N/A\u00a3\u2265 6 months Recommended annually\u00a3\u20ac\nN/A- not recommended in this age group.\n\u00a3\u00a0 immunisation of family members recommended.\n\u20ac\u00a0 2 doses, given 4 weeks apart is recommended for those < 9 years of age in the 1st year of receiving the vaccine.\nAdditional vaccine recommendations for adults (\u2265 18 years)\nPneumococcal", "source": "mvec.mcri.edu.au/references/hyposplenia/index.html"}
{"id": "70b843f0638a-4", "text": "Additional vaccine recommendations for adults (\u2265 18 years)\nPneumococcal\nVaccine brand Prevenar 13\u00ae (pneumococcal conjugate vaccine 13vPCV) Pneumovax 23\u00ae (pneumococcal polysaccharide vaccine 23vPPV) Dose Single dose at diagnosis\u03b2\u00a7\u00a5^Single dose (min. 8 weeks following completion of Prevenar 13\u00ae)\u03b2\u00a5\u2020Additional booster doses N/A 5 years following completion of the initial dose\u03b2\u00a5\u2020\n\u03b2 please note that pneumococcal vaccination for adults is recommended and funded under the NIP. In instances where doses have already been given they do not need to be repeated following a new diagnosis of asplenia/hyposplenia.\n\u00a7 dose only required if patient has never received a dose of Prevenar 13\u00ae before.\n\u00a5 ideally Prevenar 13\u00ae is administered first, followed by Pneumovax 23\u00ae a minimum of 8 weeks later. If Pneumovax 23\u00ae is inadvertently administered first, a minimum of 12 months should elapse before administering Prevenar 13\u00ae.\n^ individuals who previously received Synflorix\u00ae or Prevenar 7\u00ae are recommended to receive a single dose of Prevenar 13\u00ae at diagnosis.\n\u2020 maximum of 2 doses only of Pneumovax 23\u00ae in a lifetime.\nN/A- not recommended.\nMeningococcal", "source": "mvec.mcri.edu.au/references/hyposplenia/index.html"}
{"id": "70b843f0638a-5", "text": "N/A- not recommended.\nMeningococcal\nVaccine brand Nimenrix\u00ae (meningococcal quadrivalent conjugate vaccine 4vMenCV ACWY) Bexsero\u00ae (meningococcal B recombinant multicomponent vaccine MenBV) Dose 2 doses (min. 8 weeks apart)\u00df\u2020^\u00a72 doses (min. 8 weeks apart)\u00df\u03a9Additional booster doses Give a booster dose every 5 years following the completion of the primary course\u2020^\u00a7\u00a5Give a single booster dose only 5 years after completing the primary course\u03a9\n\u00df in instances where a primary course has previously been given there is no need to repeat the course.\n\u2020 Menveo\u00ae may be used interchangeably as an alternate brand to Nimenrix\u00ae. Where possible completing a course with the same brand is preferred.\n^ individuals who previously received meningococcal C only vaccines (eg NeisVac-C\u00ae, Menjugate\u00ae or Meningitec\u00ae) should be re-immunised with meningococcal ACWY as recommended in these guidelines. There should be a minimum interval of at least 8 weeks between meningococcal vaccine doses.\n\u00a7 individuals who previously received polysaccharide meningococcal ACWY vaccines (Menomume\u00aeor Mencevax\u00ae) should be re-immunised with conjugate meningococcal ACWY as recommended in these guidelines. There should be a minimum of 6 months elapse before administering a conjugate meningococcal ACWY vaccine.\n\u00a5 there is no maximum number or doses in a lifetime.", "source": "mvec.mcri.edu.au/references/hyposplenia/index.html"}
{"id": "70b843f0638a-6", "text": "\u00a5 there is no maximum number or doses in a lifetime.\n\u03a9 Trumenba\u00ae is an alternate meningococcal vaccine available as a 3 dose course for individuals asplenia/hyposplenia aged 10 years or older. Meningococcal B vaccines are\u00a0not interchangeable for primary courses or booster doses.\nHaemophilus influenzae type B (HIB)\nVaccine brand ActHIB\u00ae Dose Single dose at diagnosis^Additional booster dose N/A \n^ dose only required if patient did not previously complete their primary course.\nInfluenza\nVaccine brand Variable- refer to MVEC: Influenza for age-appropriate brands and details Dose Single dose given annually\u00a7^\n\u00a7 immunisation of family members is recommended.\n^ people who have received a solid organ transplant/HSCT should be given 2 doses of influenza vaccine, 4 weeks apart in the first year of being vaccinated following their transplant.\nVaccine funding\nSome of the recommendations in these guidelines are outside the scope of the National Immunisation Program (NIP). Different jurisdictions and individual hospitals have varying approaches to non-NIP vaccines, which should be clarified with the local health service.\nResources\nMVEC: Meningococcal\nMVEC: Pneumococcal and vaccines\nMVEC: Influenza\nNCIRS: Meningococcal vaccines GRADE assessments\nSpleen Australia\nAuthors: Rachael McGuire (MVEC Education Nurse Coordinator) and Nigel Crawford (Director SAEFVIC, Murdoch Children\u2019s Research Institute)\nReviewed by: Rachael McGuire (MVEC Education Nurse Coordinator) and Nigel Crawford (Director SAEFVIC, Murdoch Children\u2019s Research Institute)\nDate: March 28, 2023", "source": "mvec.mcri.edu.au/references/hyposplenia/index.html"}
{"id": "70b843f0638a-7", "text": "Date: March 28, 2023\nMaterials in this section are updated as new information and vaccines become available. The Melbourne Vaccine Education Centre (MVEC) staff regularly reviews materials for accuracy.\nYou should not consider the information in this site to be specific, professional medical advice for your personal health or for your family\u2019s personal health. For medical concerns, including decisions about vaccinations, medications and other treatments, you should always consult a healthcare professional.\nA B C D E F G H I J K L M N O P Q R S T U V W X Y Z", "source": "mvec.mcri.edu.au/references/hyposplenia/index.html"}
{"id": "1bdd81e0d4cd-0", "text": "Background\nAs a pillar of the ACT Accelerator (Access to COVID-19 Tools) partnership, COVAX is a global vaccine access initiative, co-led by Gavi (the Vaccine Alliance), the Coalition for Epidemic Preparedness Innovations (CEPI) and the World Health Organization, alongside UNICEF. The objective of COVAX is to accelerate the development and manufacture of COVID-19 vaccines with the aim of ensuring equitable access to vaccination for every country.\nAll participating countries can source COVID-19 vaccines via the COVAX facility. Over 90 upper-income countries have joined COVAX, with a further 90 lower-income countries being eligible for support.\nAustralia and COVAX\nAs part of this global effort to supporting fair and equitable access to COVID-19 vaccines, the Australian Government has joined COVAX. This participation and investment means that Australia is able to source vaccine doses as they become available from a diverse portfolio of potential COVID-19 vaccines, as well as supporting manufacturers.\nAustralia has made several financial contributions to the COVAX, initially with an upfront payment which guaranteed the purchase of over 25 million doses of COVID-19 vaccines for the Australian population. Further contributions to the Advanced Market Commitment (AMC) of the COVAX Facility whose primary focus is to ensure the lower income countries have access to COVID-19 vaccines have also been made.\nResources\nGAVI: COVAX explained\nAustralian Government Department of Health: Australia\u2019s vaccine agreements\nWHO: COVAX Announces additional deals to access promising COVID-19 vaccine candidates; plans global rollout starting Q1 2021\nAuthors:\u00a0Daniela Say (MVEC Immunisation Fellow) and Nigel Crawford (Director SAEFVIC, Murdoch Children\u2019s Research Institute)\nReviewed by: Francesca Machingaifa (MVEC Education Nurse Coordinator) and Rachael McGuire (MVEC Education Nurse Coordinator)\nDate: January 2022", "source": "mvec.mcri.edu.au/references/covax-facility/index.html"}
{"id": "1bdd81e0d4cd-1", "text": "Date: January 2022\nMaterials in this section are updated as new information and vaccines become available. The Melbourne Vaccine Education Centre (MVEC) staff regularly reviews materials for accuracy.\nYou should not consider the information in this site to be specific, professional medical advice for your personal health or for your family\u2019s personal health. For medical concerns, including decisions about vaccinations, medications and other treatments, you should always consult a healthcare professional.\nA B C D E F G H I J K L M N O P Q R S T U V W X Y Z", "source": "mvec.mcri.edu.au/references/covax-facility/index.html"}
{"id": "89e9f4fa4850-0", "text": "Hepatitis B is an infection caused by the hepatitis B virus resulting in jaundice, nausea, vomiting, pain and fever.\nDisease is transmitted via blood and body fluids of an infected person.\nInitial hepatitis B infection can often be asymptomatic, meaning a person may be unaware that they are carrying the infection.\nFollowing the acute infection, up to 10% of those infected in adulthood, and up to 90% of those infected in infancy will become chronically infected.\nChronic infection with hepatitis B virus can lead to end stage liver failure (cirrhosis) and hepatocellular carcinoma.\nPrevention of hepatitis B infection\nHepatitis B vaccine is currently provided for free on the National Immunisation Program (NIP) at birth (within 7 days), 6-weeks, 4-months and 6-months.\nA single booster dose is also funded at 12-months of age for those who are born at < 32-weeks gestation and/or < 2000 grams [See MVEC: Preterm Infant Immunisation]\n\u00a0Hepatitis B vaccination is also funded in Victoria for additional at risk groups:\nAboriginal and Torres Strait Islander people\nHousehold contacts or sexual partners of people living with hepatitis B infection\nPeople who inject drugs or are on opioid substitution therapy\nPeople living with hepatitis C\nMen who have sex with men (MSM)\nPeople living with HIV\nPrisoners and remandees\nPeople who are no longer in a custodial setting but did not complete the vaccine course while in custody\nPeople from endemic countries who arrived in Australia in the last 10 years\nCertain occupations (including those directly involved in patient care and/or the handling of human tissue, blood or body fluids) also carry an increased risk of exposure to hepatitis B virus. In these instances the vaccine is recommended but not funded on the NIP.\nSerological testing", "source": "mvec.mcri.edu.au/references/hepatitis-b/index.html"}
{"id": "89e9f4fa4850-1", "text": "Serological testing\nPerforming hepatitis B serology following hepatitis B vaccination is not routinely indicated.\nPost vaccination screening, carried out 4-weeks after the final vaccine dose, is recommended for those at significant occupational risk (eg health care workers), those at risk of severe complications of hepatitis B disease (eg immunocompromised, those with pre-existing liver disease), those in whom poor immune response may occur (eg impaired renal function) and sexual partners and household contacts of people living with hepatitis B.\nIf serology is performed more than 8-weeks post the final vaccination dose, results may be considered less reliable.\nSerology should be performed every 12-months in patients with impaired renal function +/- dialysis regardless of previous serological testing [see Table 1].\nPatients with impaired renal function\nPatients with impaired renal function +/- dialysis are at increased risk of hepatitis B infection. In addition they often have a diminished immune response to the hepatitis B vaccine. The cause of this is not completely understood. It is well documented that the earlier a patient is immunised in the disease progression, the better the response and more long term protection they will have.\nImpaired renal function is defined as chronic kidney disease (CKD) 4-5 (GFR < 30ml/min)\nSome patients with impaired renal function may progress to a renal transplant [MVEC: Solid organ transplant recipient]\nThere is evidence to suggest that by vaccinating patients with impaired renal function with a combination hepatitis A and B vaccine (Twinrix\u00ae Adult 720/20), seroconversion can be enhanced [see Table 1].\nIf immune response remains sub-optimal following the immunisation recommendations in Table 1, please refer to the below recommendations for management of non-responders to hepatitis B vaccination.\nTable 1: Recommended vaccine schedule for those with renal impairment using combined hepatitis A and B vaccine [Twinrix\u00ae Adult 720/20]", "source": "mvec.mcri.edu.au/references/hepatitis-b/index.html"}
{"id": "89e9f4fa4850-2", "text": "Age at diagnosis of disease\nAnti-HBs titre\nTwinrix\u00ae Adult\u00a0(720/20)#\nSerology\n< 12 months\n2 doses (separated by 6 months)\n[Commence vaccine course at \u2265 12-months of age]\nAt diagnosis\n1 month post 2nd dose of Twinrix\u00ae Adult (month 7)\nEvery 12 months thereafter\n\u2265\u00a012 months\nIf baseline titre at diagnosis is\u00a0\u2265 10m IU/mL:\n2 doses (separated by 6 months)\nAt diagnosis\n1 month post 2nd dose of Twinrix\u00ae Adult\u00a0(month 7)\nEvery 12 months thereafter\nIf baseline titre at diagnosis is < 10m IU/mL:\n3 doses (4 weeks between dose 1 and 2; 5 months between doses 2 and 3)\nAt diagnosis\n1 month post 2nd dose of Twinrix\u00ae Adult\u00a0(month 2)\n1 month post 3rd dose of Twinrix\u00ae Adult\u00a0(month 7)\nEvery 12 months thereafter\n# Twinrix\u00ae Adult\u00a0(720/20) is a combination Hepatitis A and B vaccine. It contains 720 ELISA units of HAV antigens and 20mcg of Hepatitis B surface antigen protein. Each dose is 1.0ml given intramuscularly\nNon-responders to hepatitis B vaccination\nA non-responder to hepatitis B vaccination is any person with a documented age-appropriate vaccine history, who has a current Anti-HBs level of <10m lU/mL 4-8 weeks following the final vaccine dose.\nMVEC recommends the following immunisation pathway for all non-responders: MVEC pathway for routine intramuscular (IM) hepatitis B vaccine non-responders \u2265 12-months of age", "source": "mvec.mcri.edu.au/references/hepatitis-b/index.html"}
{"id": "89e9f4fa4850-3", "text": "Persistant non-responders should be informed of their immune status and advised to minimise exposures.\nHepatitis B immunoglobulin may be given to non-immune persons within 72 hours of exposure to prevent infection.\nReference\nTung J, Carlisle E, Smieja M, Kim PT, Lee CH. A Randomized Clinical Trial of Immunization With Combined Hepatitis A and B Versus Hepatitis B Alone for Hepatitis B Seroprotection in Hemodialysis Patients. Am J Kidney Dis. 2010;56(4):713-9.\nPlayford EG, Hogan PG, Bansal AS, Harrison K, Drummond D, Looke DF, Whitby M. Intradermal recombinant hepatitis B vaccine for healthcare workers who fail to respond to intramuscular vaccine. Infection Control and Hospital Epidemiology 2002 Feb;23(2):87-90\nAustralian Immunisation Handbook- Hepatitis B\nMVEC pathway for routine intramuscular (IM) hepatitis B vaccine non-responders \u2265 12-months of age\nThe Australian Immunisation Handbook: hepatitis B chapter\nBetter Health Channel: hepatitis B\nDHHS: Immunisation schedule Victoria and vaccine schedule eligibility criteria\nMVEC: Solid organ transplant recipient\nMVEC: Preterm infant immunisation\nRCH clinical practice guidelines: Needle stick injury\nAuthors: Nigel Crawford (Director, SAEFVIC, Murdoch Children\u2019s Research Institute) and Rachael McGuire (SAEFVIC Research Nurse, Murdoch Children\u2019s Research Institute)\nReviewed by:\u00a0Rachael McGuire (SAEFVIC Research Nurse, Murdoch Children\u2019s Research Institute)\nDate: July 2020\nMaterials in this section are updated as new information and vaccines become available. The Melbourne Vaccine Education Centre (MVEC) staff regularly reviews materials for accuracy.", "source": "mvec.mcri.edu.au/references/hepatitis-b/index.html"}
{"id": "89e9f4fa4850-4", "text": "You should not consider the information in this site to be specific, professional medical advice for your personal health or for your family\u2019s personal health. For medical concerns, including decisions about vaccinations, medications and other treatments, you should always consult a healthcare professional.\nA B C D E F G H I J K L M N O P Q R S T U V W X Y Z", "source": "mvec.mcri.edu.au/references/hepatitis-b/index.html"}
{"id": "6d98d34477bf-0", "text": "Background\nThe spleen plays an important role in preventing infection by removing bacteria (particularly encapsulated bacteria) from the blood stream. Individuals with anatomical asplenia (absent spleen) or functional asplenia/hyposplenia (no function or decreased function) are therefore at an increased risk of infection. In addition to being up to date with National Immunisation Program (NIP) and COVID-19 vaccines, individuals with asplenia or hyposplenia are recommended and funded to receive extra vaccines (outlined below).\nThe reason for asplenia or hyposplenia may be congenital or due to surgical removal (eg. in the case of trauma). Children with congenital asplenia, cancer related asplenia and those with sickle cell anaemia have a higher risk of infection than those who have had splenectomy for trauma.\nScheduling additional vaccines can be complicated by the cause of asplenia or hyposplenia. Where possible people having a planned splenectomy should ideally receive all additional vaccines at least 2 weeks prior to surgery. This is to ensure optimal protection prior to spleen removal. Those who undergo an unplanned or emergency splenectomy should defer vaccines for at least 7 days following surgery to allow time for recovery.\nIndividuals with asplenia/hyposplenia have a lifelong risk of infection. In addition to vaccination, patients are also recommended to receive prophylactic antibiotics.\nAdditional vaccine recommendations for children (< 18 years)\nPneumococcal", "source": "mvec.mcri.edu.au/references/asplenia/index.html"}
{"id": "6d98d34477bf-1", "text": "Additional vaccine recommendations for children (< 18 years)\nPneumococcal\nVaccine brand Prevenar 13\u00ae (pneumococcal conjugate vaccine 13vPCV) Pneumovax 23\u00ae (pneumococcal polysaccharide vaccine 23vPPV) Age at diagnosis \u2265 6 weeks to \u2264 11 months 3 doses (min. 8 weeks apart) + 1 booster\u00a5\u03b2\u00a7Single dose at \u2265 4 years^\u2265 12 months Single dose\u2126^\u03b2\u00a7Single dose at \u2265 4 years^Additional booster doses N/A 5 years following completion of initial dose\u20ac\n\u00a5 doses as per NIP at 6 weeks, 4 months, 6 months (additional dose for those with a special risk condition) and routinely at 12 months of age.\n\u03b2 booster doses are given at \u2265 12 months of age/8 weeks since previous dose (whichever is later).\n\u00a7 if not up to date with NIP recommendations refer to the Australian Immunisation Handbook for catch up advice.\n^ ideally Prevenar 13\u00ae is administered first, followed by Pneumovax 23\u00ae at \u2265 4 years of age/minimum of 8 weeks later (whichever is later). If Pneumovax 23\u00ae is inadvertently administered first, a minimum of 12 months should elapse before administering Prevenar 13\u00ae.\n\u2126 to be given a minimum of 8 weeks following any previous doses.\n\u20ac maximum of 2 doses of Pneumovax 23\u00ae in a lifetime.\nN/A- not recommended.\nMeningococcal", "source": "mvec.mcri.edu.au/references/asplenia/index.html"}
{"id": "6d98d34477bf-2", "text": "N/A- not recommended.\nMeningococcal\nVaccine brand Nimenrix\u00ae (meningococcal quadrivalent conjugate vaccine 4vMenCV ACWY) Bexsero\u00ae (meningococcal B recombinant multicomponent vaccine MenBV) Age at diagnosis \u2265 6 weeks to \u2264 5 months 3 doses (min. 8 weeks apart) + 1 booster^#\u20203 doses (minimum 8 weeks apart) + 1 booster dose^\u00a5\u00a7\u2265 6 months to \u2264 11 months 2 doses (min. 8 weeks apart) + 1 booster^#\u20202 doses (minimum 8 weeks apart) + 1 booster dose^\u00a5\u00a7\u2265 12 months 2 doses#\u20202 doses (minimum 8 weeks apart)^\u00a5\u00a7Additional booster doses Where the primary course was completed at \u2264 6 years of age Give a booster dose 3 years following the completion of the primary course, then further booster doses every 5 years\u2020Give a single booster dose only 3 years after completing the primary course\u00a7Where the primary course was completed at \u2265 7 years of age Give a booster dose every 5 years following the completion of the primary course\u2020Give a single booster dose only 5 years after completing the primary course\u00a7\n^ booster doses are given at \u2265 12 months of age/8 weeks since the previous dose (whichever is later).\n# a single dose of Nimenrix\u00ae is funded on the NIP at 12 months and for year 10 students and adolescents aged 15-19 years who missed receiving the vaccine at school.", "source": "mvec.mcri.edu.au/references/asplenia/index.html"}
{"id": "6d98d34477bf-3", "text": "\u00a5 administration of prophylactic paracetamol is recommended for those < 4 years of age (15mg/kg per dose) 30 minutes prior to vaccination (or as soon as possible after), as well as 2 subsequent doses (4-6 hours apart) to reduce the likelihood and severity of fever.\n\u2020 Menveo\u00ae may be used interchangeably as an alternate brand to Nimenrix\u00ae. Where possible completing a course with the same brand is preferred.\n\u00a7 Bexsero\u00ae is registered for use from 6 weeks of age. Trumenba\u00ae is an alternate meningococcal B vaccine available as a 3 dose course for individuals asplenia/hyposplenia aged 10 years or older. Meningococcal B vaccines are not interchangeable.\nHaemophilus influenzae type B (HIB)\nVaccine brand Infanrix hexa\u00ae/ActHIB\u00ae Age at diagnosis \u2265 6 weeks As per NIP^\u00a7\n^ if < 5 years of age and not up to date with NIP refer to the Australian Immunisation Handbook for catch up recommendations.\n\u00a7 a single dose is recommended for those aged 5 years or over who have not previously completed a primary course.\nInfluenza\nVaccine brand Variable- refer to MVEC: Influenza for age-appropriate brands and details Age at diagnosis < 6 months N/A\u00a3\u2265 6 months Recommended annually\u00a3\u20ac\nN/A- not recommended in this age group.\n\u00a3\u00a0 immunisation of family members recommended.\n\u20ac\u00a0 2 doses, given 4 weeks apart is recommended for those < 9 years of age in the 1st year of receiving the vaccine.\nAdditional vaccine recommendations for adults (\u2265 18 years)\nPneumococcal", "source": "mvec.mcri.edu.au/references/asplenia/index.html"}
{"id": "6d98d34477bf-4", "text": "Additional vaccine recommendations for adults (\u2265 18 years)\nPneumococcal\nVaccine brand Prevenar 13\u00ae (pneumococcal conjugate vaccine 13vPCV) Pneumovax 23\u00ae (pneumococcal polysaccharide vaccine 23vPPV) Dose Single dose at diagnosis\u03b2\u00a7\u00a5^Single dose (min. 8 weeks following completion of Prevenar 13\u00ae)\u03b2\u00a5\u2020Additional booster doses N/A 5 years following completion of the initial dose\u03b2\u00a5\u2020\n\u03b2 please note that pneumococcal vaccination for adults is recommended and funded under the NIP. In instances where doses have already been given they do not need to be repeated following a new diagnosis of asplenia/hyposplenia.\n\u00a7 dose only required if patient has never received a dose of Prevenar 13\u00ae before.\n\u00a5 ideally Prevenar 13\u00ae is administered first, followed by Pneumovax 23\u00ae a minimum of 8 weeks later. If Pneumovax 23\u00ae is inadvertently administered first, a minimum of 12 months should elapse before administering Prevenar 13\u00ae.\n^ individuals who previously received Synflorix\u00ae or Prevenar 7\u00ae are recommended to receive a single dose of Prevenar 13\u00ae at diagnosis.\n\u2020 maximum of 2 doses only of Pneumovax 23\u00ae in a lifetime.\nN/A- not recommended.\nMeningococcal", "source": "mvec.mcri.edu.au/references/asplenia/index.html"}
{"id": "6d98d34477bf-5", "text": "N/A- not recommended.\nMeningococcal\nVaccine brand Nimenrix\u00ae (meningococcal quadrivalent conjugate vaccine 4vMenCV ACWY) Bexsero\u00ae (meningococcal B recombinant multicomponent vaccine MenBV) Dose 2 doses (min. 8 weeks apart)\u00df\u2020^\u00a72 doses (min. 8 weeks apart)\u00df\u03a9Additional booster doses Give a booster dose every 5 years following the completion of the primary course\u2020^\u00a7\u00a5Give a single booster dose only 5 years after completing the primary course\u03a9\n\u00df in instances where a primary course has previously been given there is no need to repeat the course.\n\u2020 Menveo\u00ae may be used interchangeably as an alternate brand to Nimenrix\u00ae. Where possible completing a course with the same brand is preferred.\n^ individuals who previously received meningococcal C only vaccines (eg NeisVac-C\u00ae, Menjugate\u00ae or Meningitec\u00ae) should be re-immunised with meningococcal ACWY as recommended in these guidelines. There should be a minimum interval of at least 8 weeks between meningococcal vaccine doses.\n\u00a7 individuals who previously received polysaccharide meningococcal ACWY vaccines (Menomume\u00aeor Mencevax\u00ae) should be re-immunised with conjugate meningococcal ACWY as recommended in these guidelines. There should be a minimum of 6 months elapse before administering a conjugate meningococcal ACWY vaccine.\n\u00a5 there is no maximum number or doses in a lifetime.", "source": "mvec.mcri.edu.au/references/asplenia/index.html"}
{"id": "6d98d34477bf-6", "text": "\u00a5 there is no maximum number or doses in a lifetime.\n\u03a9 Trumenba\u00ae is an alternate meningococcal vaccine available as a 3 dose course for individuals asplenia/hyposplenia aged 10 years or older. Meningococcal B vaccines are\u00a0not interchangeable for primary courses or booster doses.\nHaemophilus influenzae type B (HIB)\nVaccine brand ActHIB\u00ae Dose Single dose at diagnosis^Additional booster dose N/A \n^ dose only required if patient did not previously complete their primary course.\nInfluenza\nVaccine brand Variable- refer to MVEC: Influenza for age-appropriate brands and details Dose Single dose given annually\u00a7^\n\u00a7 immunisation of family members is recommended.\n^ people who have received a solid organ transplant/HSCT should be given 2 doses of influenza vaccine, 4 weeks apart in the first year of being vaccinated following their transplant.\nVaccine funding\nSome of the recommendations in these guidelines are outside the scope of the National Immunisation Program (NIP). Different jurisdictions and individual hospitals have varying approaches to non-NIP vaccines, which should be clarified with the local health service.\nResources\nMVEC: Meningococcal\nMVEC: Pneumococcal and vaccines\nMVEC: Influenza\nNCIRS: Meningococcal vaccines GRADE assessments\nSpleen Australia\nAuthors: Rachael McGuire (MVEC Education Nurse Coordinator) and Nigel Crawford (Director SAEFVIC, Murdoch Children\u2019s Research Institute)\nReviewed by: Rachael McGuire (MVEC Education Nurse Coordinator) and Nigel Crawford (Director SAEFVIC, Murdoch Children\u2019s Research Institute)\nDate: March 28, 2023", "source": "mvec.mcri.edu.au/references/asplenia/index.html"}
{"id": "6d98d34477bf-7", "text": "Date: March 28, 2023\nMaterials in this section are updated as new information and vaccines become available. The Melbourne Vaccine Education Centre (MVEC) staff regularly reviews materials for accuracy.\nYou should not consider the information in this site to be specific, professional medical advice for your personal health or for your family\u2019s personal health. For medical concerns, including decisions about vaccinations, medications and other treatments, you should always consult a healthcare professional.\nA B C D E F G H I J K L M N O P Q R S T U V W X Y Z", "source": "mvec.mcri.edu.au/references/asplenia/index.html"}