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Immunisation Weekly Update:

20190319 Immunisation Needle Icons 31

Welcome to our weekly Immunisation update! In this week’s update read about:

  1. ADT vs dTpa – which one should you recommend?
  2. Ensure your eligible patients are vaccinated against Mpox
  3. Authorised Registered Nurse/Midwife Vaccination Standards and Authority updated to include rabies vaccine for pre-exposure prophylaxis
  4. Addressing misinformation about excessive DNA in the mRNA vaccines
  5. Education

In Australia, prior to the introduction of maternal vaccination, an average of 1 death and more than 200 hospitalisations related to pertussis occurred in infants aged 6 months and under each year. These infants are too young to be fully immunised. Older children and adults who have not received pertussis vaccination are at risk of infection and are often the source of infection in infants.

Pertussis–containing vaccine (DTPa and dTpa) is recommended for:

  • infants, children and adolescents as routine/NIP scheduled vaccinations
  • routine booster vaccination in adults, including those in special risk groups (or in close contact with a special risk group), such as:
    • women who are pregnant or breastfeeding
    • healthcare workers
    • early childhood educators and carers
    • people in close contact with infants, including family/ carers who have not had pertussis containing vaccines in the last 10 years.
  • vaccination of people who have missed scheduled doses of pertussis-containing vaccine
  • travellers whose last dose was more than 10 years ago (or more than 5 years ago in high- risk travel).

Pertussis-containing vaccines are only available in Australia as combination vaccines that include other antigens such as diphtheria and tetanus.

Government funded:

Recommended but not Government funded:

  • Adults aged 50 years and 65 years
  • Every 10 years for healthcare workers, early childhood educators and carers, and people in close contact with infants.
  • Travellers

Case study

In the instance of a person presenting to a general practice or pharmacy, who requires tetanus containing vaccine, for a tetanus prone wound, it is recommended to consider the persons’ vaccination history, occupational and lifestyle risk factors that may indicate a reason for them to require pertussis containing vaccine.

For example, a health care worker presents with a tetanus prone wound, and they require tetanus vaccination. After a review of their vaccination history and consideration of their occupational requirements, it may be worth offering the dTpa vaccination, especially if it is due within the next 12 months. This would be a privately purchased vaccine. It is worth discussing the advantages and disadvantages of ADT vs dTpa vaccines.

Similarly, an adolescent in Year 7 who presents with a tetanus prone wound, may soon be due for their adolescent vaccinations received at school. The dTpa should be recommended, and this would be government funded. At this same time HPV vaccination can also be offered to ensure they have received all recommended vaccinations for their age.

Further information

A vaccination recommendation from a health provider is vital for immunisation uptake. Immunisation providers are reminded to encourage Mpox vaccination in all eligible patients (men who have sex with men, sex workers and their sexual partners) amid concerns of rising cases and hospitalisations in NSW. Two doses of mpox vaccine are required 28 days apart to combat serious illness. A list of mpox vaccination clinics is available here. Visit CESPHN website for more information.

The Authorised Registered Nurse/Midwife Vaccination Standards and Authority have been updated to enable Authorised Nurse/Midwife Immunisers (ANIs) to administer rabies vaccine via intramuscular injection for pre-exposure prophylaxis, to immunocompetent people aged 5 years and over.

The addition of rabies vaccine to the Authority and the Standards is consistent with recent changes to the NSW Pharmacist Vaccination Standards and Authority.

The mandatory conditions which ANIs must comply with to ensure effective and efficient immunisation service delivery are outlined in the Standards. The updated Authorised Registered Nurse/Midwife Vaccination Standards and Authority has been published on the NSW Health webpage, available here NSW Health Authority for RNs and Midwives.

The Therapeutic Goods Administration (TGA) is aware of misinformation in recent media and online reports that claim the COVID-19 mRNA vaccines are contaminated with excessive levels of DNA. This is not the case. Find out more information here.

REGISTER

26 October 2024

9:00am – 4:30pm AEST

Pullman Hotel, Mascot
Practice Nurse Forum Day
CESPHN is inviting practice nurses to join us for an exciting and comprehensive day of face-to-face presentations, practical workshops, networking opportunities, and the launch of our Practice Nurse Workforce Strategy.
Establish connections with other nurses and healthcare professionals whilst elevating your nursing practice with workshops on Diabetes management, Wound care and Immunisation catch-up schedules.
REGISTER

6 November 2024

7:00pm – 8:30pm AEST
RSV and Mothers-to-Be

This session will delve into the significant burden of RSV on infants and explore preventive strategies, including practical guidance on integrating RSV vaccination into routine antenatal care.
REGISTER

7 November 2024

6:00pm – 7:00pm AEST
NSW RSV prevention program 2025

This NSW Health webinar will outline the disease impact of RSV on infants, vaccine efficacy of the maternal vaccination product Abrysvo, the RSV prevention program in NSW and ACT, and practical tips on vaccination for midwives.

The webinar is for all clinicians involved in providing care to pregnant women in the antenatal and postnatal periods and caring for newborn infants and children with medical risk conditions for severe RSV disease.
REGISTER

21 November 2024

7:00pm – 8:00pm AEST
National Mpox Webinar: Vaccination and Testing

There has been an increase of local mpox transmission rates in Australia, namely in NSW and VIC, but also in most jurisdictions. Although vaccination rates are rising, in NSW and VIC, only 15-20% have completed the full required course of two doses of the mpox vaccine (GBQ+ periodic survey). 

This webinar is for doctors & nurses in all healthcare settings and will discuss vaccination strategies, when to consider mpox as a differential diagnosis, and provide insights on clade 1b.