IMMUNOLOGY

National Immunisation Program Schedule (vaccinations)

Additional Notes for Risk Groups:

  • Pregnant Women: Recommended pertussis vaccination in each pregnancy, ideally between 20-32 weeks, and influenza vaccination at any stage of pregnancy.
  • People with Specified Medical Risk Conditions: Higher risk of complications from infections, requiring additional doses for pneumococcal, meningococcal, influenza, and other vaccines.
  • Refugees and Humanitarian Entrants: Eligible for catch-up vaccines, including hepatitis B, polio, measles-mumps-rubella, HPV, and others depending on age.
  • Immunocompromised Individuals: Additional vaccines or different schedules for pneumococcal, shingles, and meningococcal.

ATSI Specific

Vaccine2 Months (from 6 weeks)4 Months6 Months12 Months18 Months4 Years≥5 Years (Annually)50 Years and Over
Meningococcal B: Bexsero®
ATSI children w specified medical risk conditions
Pneumococcal: Prevenar 13®(WA, NT, SA, Qld)(WA, NT, SA, Qld)✔ Prevenar 13® & Pneumovax 23® (3 doses)
Influenza (age-appropriate)✔ Two doses 1 month apart, then annual✔ One dose annually✔ One dose annually
Hepatitis A: Vaqta® Paediatric(WA, NT, SA, Qld)(WA, NT, SA, Qld)
Shingles (herpes zoster): Shingrix®✔ Administer 2 doses

The following vaccines are provided free to adults:

https://www.health.gov.au/topics/immunisation/when-to-get-vaccinated/immunisation-for-adults

AgeDisease
Pregnant womenInfluenza and pertussis (whooping cough) – SeeImmunisation for pregnancy
All Aboriginal and Torres Strait Islander adultsInfluenza
Aboriginal and Torres Strait Islander adults 50 years and over           Pneumococcal and shingles
People 65 years and overInfluenza and shingles
People 70 years and overPneumococcal

Vaccines for people with medical risk conditions

based on: https://www.health.gov.au/topics/immunisation/when-to-get-vaccinated/immunisation-for-people-with-medical-risk-conditions?language=und

VaccineEligibility/ConditionsAdditional Information
Pneumococcal– Children under 12 months with specific medical conditions (6 doses over time)
– All people 12 months and over with specific conditions (3 doses)
Free for those at higher risk due to:
– Functional/anatomical asplenia
– Immunocompromising conditions
– Chronic diseases (lung, kidney, heart)
– Premature birth
– Down syndrome
– Specific surgeries (cochlear implants, intracranial shunts)
– CSF leaks
– History of invasive pneumococcal disease
Meningococcal– Children under 12 months with specific medical risk conditions (dose schedule depends on age)
– All people 12 months and over with specific conditions (2 doses of both ACWY and B vaccines)
Free for those at higher risk due to:
– Functional/anatomical asplenia/hyposplenia
– Complement deficiency
– Treatment with eculizumab
Influenza– People aged 6 months and over with medical conditions increasing risk of complications (annual vaccination)Free for those at risk due to:
– Heart disease
– Chronic lung disease
– Chronic neurological conditions
– Impaired immunity
– Haemoglobinopathies
– Diabetes
– Kidney disease
Haemophilus influenzae type b (Hib)– people who are immunocompromised , including people with asplenia and people who have received a haematopoietic stem cell transplant.Free for those eligible under the National Immunisation Program
Shingles (Shingrix)– Immunocompromised people aged 18 years and over with:
– Haematopoietic stem cell transplant
– Solid organ transplant
– Haematological malignancy
– Advanced or untreated HIV
– Free for those previously vaccinated with Zostavax if eligible
– Must wait 12 months between Zostavax and Shingrix
Condition/EligibilityPneumococcalMeningococcalInfluenzaHaemophilus influenzae type b (Hib)Shingles (Shingrix)
Functional or anatomical asplenia/hypospleniaYesYesNoYesNo
Immunocompromising conditionsYes (incl. organ and stem cell transplants, HIV)YesYesYesYes
– stem cell transplant
– solid organ transplant
– HIV
Chronic diseases (lung, kidney, heart)YesNoYesNoNo
Premature birthYesNoNoNoNo
Down syndromeYesNoNoNoNo
Previous invasive pneumococcal diseaseYesNoNoNoNo
Complement deficiencyNoYesNoNoNo
Treatment with eculizumabNoYesNoNoNo
Heart diseaseNoNoYesNoNo
Chronic lung disease (severe asthma)NoNoYesNoNo
Chronic neurological conditionsYes
cochlear implants and intracranial shunts
NoYesNoNo
DiabetesNoNoYesNoNo
Kidney diseaseNoNoYesNoNo
Haematological malignancyNoNoNoNoYes
CSF leaksYesNoNoNoNo

Booster dosing

Vaccinations That Require Booster Doses:

  • Diphtheria
  • Tetanus
  • Whooping Cough (Pertussis)

Diphtheria and Tetanus Vaccinations:

Administered as either:

  • dT (Diphtheria-Tetanus)
  • DTPa (Diphtheria, Tetanus, Pertussis – Whooping Cough)

Tetanus:

  • A serious disease causing severe muscle spasms, particularly in the neck and jaw (lockjaw).
  • Can lead to death in severe cases.

Recommended Booster Dose of Tetanus-Containing Vaccine for Adults:

  • If you are 50 years or older.
  • If you haven’t had a tetanus shot in the last 10 years.
  • If you have a wound more than a minor cut, and your last tetanus vaccine was over 5 years ago.
  • If you’ve previously completed the primary course of 3 doses.

Whooping Cough (Pertussis):

  • A serious disease that can lead to complications such as pneumonia, brain injury, and, in severe cases, death.
  • Especially dangerous for babies, but can affect people of any age.

Who Should Receive a Booster Dose of the Whooping Cough Vaccine:

  • Adults who haven’t had the vaccine in the past 10 years, particularly if:
    • You are 65 years or older.
    • You are in close contact with infants.

Accessing Booster Vaccines:

  • The National Immunisation Program does not cover booster vaccines for adults and seniors.
  • Additional vaccines can be purchased privately.
  • Consult a healthcare professional to determine if you or someone in your care needs additional vaccines.

QLD specific:

  • COVID-19 Updates: Continual updates on COVID-19 vaccination are provided, with the latest information accessible through Queensland Health.
  • Annual Influenza Program: Annual vaccinations recommended for everyone aged 6 months and older to prevent influenza and its complications.
  • Pertussis, Influenza, and COVID-19 Vaccination for Pregnant Women: Pertussis vaccine recommended between 20 and 32 weeks of pregnancy, Influenza vaccine can be administered concurrently but should not be delayed for simultaneous administration.
  • Shingles Vaccination: From November 1, 2023, the Shingrix® vaccine is free under the NIP for adults aged 65 years and older.
  • Hepatitis B Vaccination: Funded for specific high-risk groups under the NIP.
  • Queensland School Immunisation Program:

Meningococcal B (MenB) Vaccination Program:

  • A new QLD-funded program targeting the meningococcal B strain, rolling out in early 2024 across schools and primary care providers.
  • Infant and Childhood Program
    • Infants aged 6 weeks to 12 months of age (eligible for vaccination through the Queensland MenB Vaccination Program):
      • 3 doses of Bexsero® menB vaccine (2 dose primary course and one booster dose).
      • These will be administered with other National Immunisation Program (NIP) vaccines at 6 weeks, 4 months and 12 months of age.
    • Children aged between 12 months and less than 2 years of age (eligible for vaccination through the Queensland MenB Vaccination Program)
Age GroupVaccine DoseVaccination TimeAdditional Information
Infants (<12 months)1st Dose6 weeksAdministered with other NIP vaccines
2nd Dose4 monthsAdministered with other NIP vaccines
Booster Dose12 monthsAdministered with other NIP vaccines
Aboriginal and Torres Strait Islander Infants with Medical RisksAdditional Dose6 months
Children (12 months to <2 years)1st DoseStart any time between 12-23 months
2nd DoseMinimum 8 weeks after the 1st dose
  • Adolescent Program
    • Adolescents aged 15 to 19 years inclusive (15-<20 years) (eligible for vaccination through the Queensland MenB Vaccination Program):
      • 2 doses Bexsero® vaccine with a minimal interval of 8 weeks between doses.
    • Students in year 10 will be offered vaccination through the Queensland School Immunisation Program
    • People with specific medical conditions (eligible for vaccination through the National Immunisation Program):
      • People with the following conditions are considered to have an increased risk of invasive meningococcal disease:
      • defects in, or deficiency of, complement components, including factor H, factor D or properdin deficiency
      • people with acquired complement deficiency due to receipt of complement inhibitor therapy (including but not limited to eculizumab or ravulizumab)
      • functional or anatomical asplenia, including sickle cell disease or other haemoglobinopathies, and congenital or acquired asplenia
      • HIV, regardless of disease stage or CD4+ cell count
      • haematopoietic stem cell transplant

Meningococcal B (Bexsero®) vaccination schedule according to the manufacturer’s guidelines:

Prophylactic Paracetamol Recommendations

Due to the increased risk of fever1, prophylactic paracetamol is recommended with every dose of Bexsero in children <2 years of age2

Bexsero recommendations.png

Note: The Australian Immunisation Handbook recommends the prophylactic use of paracetamol with every dose of Bexsero administered to children <2 years of age, regardless of presence of fever. 2 †Or as soon as practicable afterward.2 *ATAGI recommends doses of paracetamol to be given 6 hours apart.2

Bexsero can be given concomitantly with the following vaccine antigens (monovalent or as combination vaccines)

  • Diphtheria, tetanus, acellular pertussis, hepatitis B, inactivated poliomyelitis, Haemophilus influenzae type B
  • Meningococcal group A, C, W, Y conjugate
  • Heptavalent pneumococcal conjugate
  • Measles, mumps, rubella, varicella

Catch-up Vaccinations:

  • Vaccines for children and adolescents aged 10 to 19 years are free under the National Immunisation Program.
  • This is to help those who didn’t get them in childhood to get up to date through a catch up schedule
    • Human papillomavirus (HPV) up to and including 25 years
    • dTpa, meningococcal ACWY up to and including 19 years
    • meningococcal B : children aged over 12 months to less than 2 years.

Pneumococcal Vaccination

Risk conditions at increased risk of pneumococcal disease:

  • Previous episode of invasive pneumococcal disease
  • Functional or anatomical asplenia, including
    • sickle cell disease or other haemoglobinopathies
    • congenital or acquired asplenia (for example, splenectomy) or hyposplenia
  • Immunocompromising conditions, including
    • congenital or acquired immune deficiency, including symptomatic IgG subclass or isolated IgA deficiency
    • haematological malignancies
    • solid organ transplant
    • haematopoietic stem cell transplant
    • HIV infection
    • immunosuppressive therapy, where sufficient immune reconstitution for vaccine response is expected; this includes those with underlying conditions requiring but not yet receiving immunosuppressive therapya
    • non-haematological malignancies receiving chemotherapy or radiotherapy (currently or anticipated)a
  • Proven or presumptive cerebrospinal fluid (CSF) leak, including
    • cochlear implants
    • intracranial shunts
  • Chronic respiratory disease, includingb
    • suppurative lung disease, bronchiectasis and cystic fibrosis
    • chronic lung disease in preterm infants
    • chronic obstructive pulmonary disease (COPD) and chronic emphysemaa
    • severe asthma (defined as requiring frequent hospital visits or the use of multiple medications)a
    • interstitial and fibrotic lung diseasea
  • Chronic renal disease
    • relapsing or persistent nephrotic syndrome
    • chronic renal impairment – eGFR <30 mL/min (stage 4 disease)c
  • Cardiac disease, including b
    • congenital heart diseased
    • coronary artery diseased
    • heart failured
  • Children born less than 28 weeks gestationd
  • Trisomy 21d
  • Chronic liver disease, includingb
    • chronic hepatitisa
    • cirrhosisa
    • biliary atresiaa
  • Diabetesa – Not funded under the NIP
  • Smoking (current or in the immediate past)a
  • Harmful use of alcohol (consuming on average ≥60 g of alcohol (6 Australian standard drinks) per day for males and ≥40 g of alcohol (4 Australian standard drinks) per day for females)a

a. Not funded under the NIP
b. Individual conditions listed beneath or those that are similar based on clinical judgment
c. Funded under the NIP for eGFR <15 mL/min only (including patients on dialysis)
d. Funded under the NIP for children <5 years of age only

Leave a Reply

Your email address will not be published. Required fields are marked *

This site uses Akismet to reduce spam. Learn how your comment data is processed.