Immunisation weekly update – 3 August 2022

COVID-19 vaccines for children aged 6 months to <5 years

On 3 August 2022, ATAGI released recommendations on COVID-19 vaccine use in children aged 6 months to <5 years.

Recommended for at-risk children: ATAGI recommends COVID-19 vaccination for children aged 6 months to <5 years with severe immunocompromise, disability, and those who have complex and/or multiple health conditions which increase the risk of severe COVID-19. This includes conditions listed in the ATAGI recommendations and similar conditions.

Not recommended for all children: ATAGI does not currently recommend vaccination for children aged 6 months to <5 years who are not in the risk categories for severe COVID-19.

Dosing and schedule: Paediatric formulation (25mcg) Moderna COVID-19 vaccine, 2 primary doses 8 weeks apart. Children with severe immunocompromise should receive a 3rd primary dose, 8 weeks after the 2nd dose.

Monkeypox (MPX) 

Availability of vaccines 

Two vaccines are/will be available in Australia for prevention of monkeypox: 

• ACAM2000™ (2nd generation) is only available from the National Medical Stockpile on a request basis for State and Territory governments
• JYNNEOS® (3rd generation) have been secured in limited supplies by the Commonwealth and some States and Territories
• NSW Health is working as quickly as possible to facilitate access to JYNNEOS® vaccines

Access to vaccines 

Vaccines for the prevention of monkeypox virus is being managed by NSW Health. More information about MPX vaccination hubs and/or access to vaccines will become available soon. Check our CESPHN Alerts webpage for a consolidation of monkeypox information from key organisations (NSW Heath, Dept of Health, ACON, SHIL, and more)

Monkeypox resources

• ATAGI has released guidance on the use of smallpox vaccine for protection against Monkeypox (MPX) virus infection.
• The Department of Health and Aged Care has produced a collection of Monkeypox (MPX) resources for health professionals. The monkeypox situation in Australia is updated regularly on their website.
• NSW Health have created a Monkeypox factsheet for patients and Monkeypox clinical alerts for general practice. The monkeypox situation in NSW is updated regularly on their website.

Monkeypox support – Key contacts for GPs

• Infectious Disease Specialist (ID specialist) 8890 5555 – for any suspected monkeypox cases, GPs must immediately contact the ID specialist before taking any samples. The ID specialist will advise on the appropriate test and clinical management of the case.
• Public Health Unit (PHU) 1300 066 055 – GPs must notify any suspected cases of monkeypox to the PHU to initiate a public health investigation, contact tracing and control measures. MPX has been added to the list of notifiable diseases under the Public Health Act 2010.
• NSW Sexual Health Infolink (SHIL) 1800 451 624 – SHIL provides specialist clinical support and information to health professionals who are treating clients with sexual health issues, including monkeypox infections.

Monkeypox support – Key contacts for patients 

• NSW Sexual Health Infolink (SHIL) 1800 451 624 – SHIL provides sexual health information and referral services to community members, including monkeypox information and advice. 
• ACON 9206 2000 – provides monkeypox information for LGBTQ+ communities in NSW. ACON is working with health authorities to facilitate vaccine access as quickly as possible, particularly for higher risk groups in LGBTQ+ communities.

New AIR code for smallpox vaccine 

There have been 3 smallpox vaccines added to the list of AIR vaccine code formats that are able to be recorded on the Australian Immunisation Register. Smallpox vaccines given overseas can be recorded either using the specific vaccine code or the generic smallpox code. 

• ACAM2000
• JYNNEOS
• Generic smallpox

GP knowledge gaps with Zostavax use in the immunocompromised  

New research has found notable knowledge gaps continue to exist among Australian general practitioners (GPs) regarding live attenuated zoster vaccination of immunocompromised people.

While the vaccine is safe, its use is contraindicated in severely immunocompromised people because the virus from the vaccine can cause serious disseminated infection. There have been three Zostavax-related deaths in immunocompromised people between 2017 and 2020 in Australia.

The research, led by NCIRS, used an online survey to assess the knowledge of GPs regarding Zostavax. GPs were asked to respond to five clinical scenarios testing their knowledge of Zostavax contraindications, and the proportion of correct answers ranged from 25% to 82% across all scenarios.

Important resources for immunisation providers

• Zostavax screening form – all patients must be screened for contraindications to Zostavax
• Australian Immunisation Handbook – information about herpes zoster, vaccine recommendations, and precautions to the use of Zostavax

If uncertain, DO NOT vaccinate

• If providers are uncertain about whether vaccination is safe, do not vaccinate
• Seek expert advice from an immunisation specialist: email NSWISS at SCHN-NSWISS@health.nsw.gov.au

Immunisation news 

Catch up on previous Immunisation Weekly Updates and Public Health Alerts (Monkeypox)

Please note: There will be no COVID-19 update for primary care this Thursday, 4 August. Catch-up on previous webinars.