Immunisation Weekly Update:

Infanrix® Hexa and Vaxelis® ordering

The NSW Vaccine Centre have directed all providers to order the Vaxelis® hexavalent vaccine for children at 6 weeks, 4 month and 6 months of age to manage supply of Infanrix® Hexa and Vaxelis®. A small quantity of Infanrix® Hexa is still available for providers to order ONLY for children that have already commenced the vaccine schedule on Infanrix® Hexa.

Vaxelis® vaccine was added to the NIP in July 2023 as an alternative NIP-funded hexavalent vaccine to Infanrix® Hexa. There is no preferential recommendation between the use of these two vaccines:

• Vaxelis^® is supplied as a single-dose, 0.5 mL pre-filled syringe in a ready-to-use formulation containing all components and does not need to be reconstituted.
• Infanrix® hexa consists of a single-dose, 0.5 mL pre-filled syringe and a vial containing a lyophilised (i.e. freeze-dried) pellet. The pellet is the Hib component that needs to be reconstituted with the DTPa-hepB-IPV components (a liquid).

A primary series of DTPa-hepB-IPV-Hib vaccination should be given using the same vaccine (e.g. three doses of Vaxelis® or three doses of Infanrix® Hexa). If the same brand is not available, vaccination should not be delayed, and providers may use the alternative hexavalent vaccine brand to complete the series.

Travel vaccination FAQs

NCIRS has launched a new Travel vaccination – frequently asked questions (FAQs) resource. These FAQs provide guidance for immunisation providers and people who are travelling overseas. Questions covered include:

• How early can infants who will be travelling overseas receive the measles-mumps-rubella vaccine?
• How should people protect themselves from influenza if they are travelling internationally or returning to Australia from overseas?
• How can travel vaccines that are recommended but not registered for use or available in Australia be accessed?

A recording of last week’s NCIRS webinar on rabies and travel vaccines will soon be available on the NCIRS website.

Provider updates on COVID-19 vaccines

Updated poster: COVID-19 vaccines in Australia – A3 poster

The COVID-19 poster was updated 12 August 2024 to include the new Pfizer (XBB.1.5) 6 months to 4 years (Maroon) vaccine. This poster provides key differences between each COVID-19 vaccine approved for use in the National COVID-19 Vaccine Program.

Updated forms: VAE and CCB reporting form

The Vaccine Administration Error (VAE) reporting form and Cold Chain Breach (CCB) reporting form were updated 13 August 2024 to include the new Pfizer (XBB.1.5) 6 months to 4 years (Maroon) vaccine. These forms are for vaccine providers to report potential CCBs or VAEs under the COVID-19 vaccination program.

Expiring soon: Pfizer Bivalent (BA.4-5) 12 years + (Grey) (ancestral formulation) 

Sites who have ordered this vaccine with a Requested Delivery Date of 23 August 2024, are reminded that these doses expire on Saturday 31 August 2024 at the latest. After this time, please do not administer the vaccine. Sites who also have stock on hand of this vaccine are reminded to check the batch expiry date and discard any remaining stock, ensuring that it is reported as wastage in CVAS.

Alternative Vaccine: Pfizer (XBB.1.5) 12 years+ (Grey)

The maximum ordering allocations for the Pfizer (XBB.1.5) 12 years+ (Grey) vaccine changed from 600 doses to 120 doses per fortnight on 3 August 2024. The minimum ordering requirement remains unchanged at 60 doses.

Mpox transmission is increasing

Monkeypox transmission is increasing, with 63 cases of mpox notified in NSW since mid-June 2024. Transmission has occurred in Sydney and regional NSW.

An Mpox alert was distributed to general practitioners on 2 August 2024, please review the alert and be mindful of Mpox presentations.

Mpox can mimic other infections (e.g. genital herpes or syphilis) and symptoms can be subtle, particularly in people who are fully or partially vaccinated. More information here.

Measles vaccine reminder

Immunisation providers are encouraged to remind patients who are travelling overseas that there are measles outbreaks occurring around the world.

The Australian Immunisation Handbook recommends the combined measles (MMR) vaccine for children 12 months or older and for people travelling overseas. Infants travelling to countries where measles is endemic or where measles outbreaks are occurring may receive the MMR vaccine from as young as 6 months, after an individual risk assessment.

MMR vaccines are available free to:

• Children at ages 12 months and 18 months, funded under the National Immunisation Program 
• Adolescents and adults born during or since 1966 who are unvaccinated, incompletely vaccinated, or do not have evidence of immunity to measles, funded under the NSW-funded additional free vaccines.

Whooping cough cases increasing

The number of whooping cough cases recorded in NSW  so far in 2024 (8,788 cases) has significantly exceeded the 2023 yearly total of 915 cases.

Immunisation providers are encouraged to remind patients that vaccination provides the best protection against serious illness and complications caused by whooping cough, and that whooping cough is especially serious for babies but can affect people at any age.

The whooping cough combination vaccine is free under the National Immunisation Program for:

• children aged 2 months, 4 months, 6 months, 18 months and 4 years
• adolescents aged 12-13 years through school-based vaccination programs
• pregnant women (ideally between 20-32) weeks.

Education

Healthed Podcast: Flu, RSV and COVID update for kids

30 min CPD, in this episode:

• What’s changing with RSV protection for young people
• RSV therapeutics for toddlers are not a vaccination, however, will still appear on Australian immunisation register and be monitored from a safety profile
• Do not delay flu shot vaccinations
• Recommendation in Australia is to not vaccinate younger kids for COVID due to baseline level of immunity