Immunisation schedule and catch-up immunisations

Why is the change necessary?

The Australian Technical Advisory Group on Immunisation (ATAGI) considers there to be clear evidence that two primary doses at 2 and 4 months of age and a booster dose at 12 months of age rather than at 6 months of age will improve protection beyond 12 months of age.

Should children who have received a third dose of 13vPCV at 6 months of age according to the previous schedule receive a booster dose at 12 months of age?

All children aged 12 months at 1 July 2018 or later are recommended to receive a funded booster dose of 13vPCV at 12 months of age. Parents should be reassured that it is safe for their child to receive the additional dose. For this small cohort, the 12 month vaccine is funded, but is not required, to be considered fully immunised for the purposes of child care subsidies and family assistance payments.

Do all children now only need 3 doses of pneumococcal vaccine at 2, 4 and 12 months?

No, only children who do not have increased risk of pneumococcal disease will receive 3 doses.

Aboriginal children and children at increased risk of invasive pneumococcal disease will continue to get a 3rd pneumococcal vaccine dose at 6 months and will get an additional 4th dose at 12 months. This will ensure consistency across Australia.

Why is this change necessary?

The meningococcal ACWY vaccine (Nimenrix ®) provides wider protection against disease caused by serogroups A, W and Y compared to the previously offered meningococcal C vaccine (Menitorix) which provided protection against only one serogroup. Serogroups W and Y caused almost half of all recently reported cases of meningococcal disease nationally.

Is there a catch-up program?

There is no catch up program available through the NIP for children who have already received their meningococcal C vaccine. However in WA, all children aged from 5 years to 14 years who have not previously received meningococcal C vaccination will be caught up with meningococcal ACWY vaccine (MenACWY).

Please be reminded that WA Health currently funds MenACWY vaccines for individuals aged 13 months to 4 years and 15–19 years, even if they have received a Men C vaccine previously.

What if a child is late for their 12 month vaccination; do they get Hib- meningococcal C or meningococcal ACWY vaccine?

If a child has not received their 12 month meningococcal C-Hib vaccination they will be offered a meningococcal ACWY vaccine and monovalent Hib vaccine (or Menitorix® until stocks are exhausted) at the appropriate time.

Should a child who commenced a vaccination course for meningococcal ACWY prior to 12 months of age be vaccinated at 12 months of age? Is it funded?

A single dose of meningococcal ACWY vaccine, Nimenrix®, is recommended and funded to be given at 12 months of age for all children. This is regardless of whether the child has previously received any number of doses of meningococcal ACWY vaccine of the same or different brand prior to 12 months of age. However, there should be a minimum interval of 8 weeks from the latest meningococcal ACWY vaccine dose before Nimenrix® is given.

Why is this change necessary?

As 3 vaccines (MMR, Men ACWY and PCV 13) are now given at 12 months, the Hib booster dose is moved to 18 months to reduce the number of injections given at the 12 month schedule point. This change is not anticipated to result in a rise in Hib cases. Additionally, a booster dose in the second year of life is anticipated to prevent Hib disease later in childhood and ensure longer term protection.

What if a child already received a Hib vaccine at 12 months of age?

All children aged 12 months at 1 July 2018 or later are recommended to receive a funded booster dose of Hib vaccine at 18 months of age. This means they may receive 5 doses of Hib, which is safe.

For this small cohort, the 18 month vaccine is funded, but is not required to be considered fully immunised for the purposes of child care subsidies and family assistance payments.

The national immunisation schedule refers to Act-HIB vaccine at 18 months, but the WA schedule lists Menitorix. Why is there a difference?

The ATAGI states it is safe and effective to use available supplies of Menitorix® until they are exhausted, after which Act-HIB will be used.