Advice to general practice regarding immunisation support from Population Health Units (PHUS) during the H1N1 Influenza 09 (Human Swine Influenza) outbreak

• Queensland Health Population Health Units (PHUs) may need to scale back the immunisation support they provide to general practice during the current outbreak of H1N1 Influenza 09 (Human Swine Influenza). Please click here for advice from Queensland Health to general practice. 
  
  PHUs may not be able to:
  
  • Answer queries about immunisation catch-up; please click here are refer to the catch-up pack provided.
    
  • Provide immunisation histories on children under the age of 8 years; please use the ACIR secure site at http://www.medicareaustralia.gov.au/provider/patients/acir/index.jsp to access histories for children aged 0-7 years of age or contact ACIR on 1800 653 809
    
    
  PHUs will still provide assistance with:
  
  • Cold chain breaches
  • Immunisation histories for adolescents requesting Boostrix®, Hepatitis B vaccine, Varilrix® or Gardasil® outside the school based vaccination program or for Aboriginal and Torres Strait Islander people
  Practices may choose to fax their queries through to their local PHU although there may be delays in a response depending on priorities.

Click here to download the Immunisation Saves Lives logo

• Improving Childhood Immunisation Coverage Rates - A guide for Division staff (October 08)
• Improving Childhood Immunisation Coverage Rates - A guide for Practice staff (October 08)
• Improving Childhood Immunisation Coverage Rates - Using the ACIR 32A Report: A guide for Division Staff (October 08)
• ACIR Update 32A Database

The Australian Immunisation Handbook, 9th edition 2008 (p.232) recommends a booster dose of dTpa vaccine for the following groups:

• Adults planning a pregnancy
• Parents immediately post-delivery (preferably before hospital discharge)
• Carers of young children, e.g. grandparents
• Adults working with young children, especially child care workers
• Any adult expressing an interest in receiving a booster dose

The only contraindications to acellular pertussis vaccines are:

• Anaphylaxis following a previous dose of an acellular pertussis vaccine
• Anaphylaxis following any vaccine component

It is very important that parents and close family members are vaccinated against pertussis as in 50% of cases in infants, family members have been identified as the source of infection.  Data on duration of immunity is limited, although immunity to pertussis is likely to wane after 10 years and therefore booster doses may be beneficial after this time.

Pertussis notifications to Qld Health - April 2009

Queensland Health poster - Protect your baby from whooping cough

As per the National Immunisation Program in Queensland, dTpa (Boostrix) is only funded for children in Year 10.  Anyone else requesting dTpa vaccination will need to purchase the vaccine.

Rotavirus vaccine has been included on the National Immunisation Program schedule since 1 July 2007.  RotaTeq® is an oral vaccine. There is no catch up for this vaccination. 

It is important that the following schedule is adhered to for administering RotaTeq®

* The upper age limit for receipt of the first dose of Rotateq is 12.9 weeks, that is up to the anniversary of the 13th week of age. The 2nd dose of vaccine should preferably be given by 28 weeks of age to allow for minimum interval of 4 weeks prior to receipt of 3rd dose, and the upper age limit for either the second or third doses is 32.9 weeks, that is by the anniversary of the 33rd week.

For more detailed information on rotavirus vaccines:
NCIRS Fact Sheet - Rotavirus Vaccines - Information for GPs & Immunisation Providers (June 2007)

The calculator is a computer-based system that uses the National Immunisation Program schedule. It recommends doses of vaccine be given at specific ages. If doses of vaccine are delayed or missed, the calculator will assist in providing a 'catch-up' schedule for future vaccine doses.

Who is it for?

The calculator is for Australian children up to their 7th birthday and on the funded component of the National Immunisation Program Schedule.

Click here to view the SA Catch-up Calculator website: CURRENTLY OFFLINE UNTIL FURTHER NOTICE

Information for calculating catch up immunisations.
 

The following resources have been developed for use by divisions to assist them with data logging.  The guidelines and the consent form are available in Word format to enable individual divisions to adapt the resources to their own needs.
NOTE:  When changing the resources please ensure that GPNSW is acknowledged as the original developer of the resources. 

• Data Logging  Guidelines, Nov 2008
• Data Logging Consent Form, Nov 2008
• Choosing a data logger, Nov 2008

From 1 January 2009, the Maternity Immunisation Allowance will be paid in a 50/50 split at 18 months and 4y 3m age.  Payment will be made to parents when their child is 18-24 months age for part 1, and again at 4yrs 3 months to 5 years age for part 2.

The children affected by the change are:

• Those born from July 2007 onwards;
• Those born from Jan 2007 to June 2007 who have not claimed the allowance by 31/12/2007.
  

Children in group 1 will reach ACIR Cohort 3 (60-63 months age measure) in the December 2012 quarter.
Children in group 2 will reach ACIR Cohort 3 (60-63 months age measure) in the June 2012 quarter.

Japanese encephalitis vaccine used in Australia is no longer being manufactured therefore supplies will be limited.  The Torres Strait communities will be covered but the important messages for general practice and travellers are:

• Vaccine is only being provided through recognised travel vaccination organisations and to them through pharmacy wholesalers.  Travellers are also prioritised on an assessment of risk of exposure – highest risk being for those spending a month or more in a rural area in an endemic country with certain extra conditions and the first priority will be those Australian citizens required to travel on government business or on behalf of the government.
• Prevention, prevention, prevention - use insect repellent, wear protective clothing, avoid the outdoors when mosquitos are at their most active, ensure mosquito nets/insect screens are well-fitted.

Please click here to get more information.

• Queensland Health - Immunisation 
• For Queensland Health Publications call 07 3234 1053
• Immunise Australia Program

General Practice Immunisation Incentives Scheme - Medicare Australia

The General Practice Immunisation Incentives (GPII) Scheme was introduced in 1998 to support the central role GPs play in preventive health care through immunisation.

The GPII Scheme provides financial incentives to GPs who provide immunisation services to children under the age of seven years, according to the National Immunisation Program (NIP).

One of the primary aims of the GPII Scheme is to encourage at least 90% of practices to fully immunise 90% of children below seven years of age attending their practice.

Through Medicare Australia, the GPII Scheme provides statistical reports for both practices and Divisions of General Practice.  These reports are a valuable tool that can be used to develop strategies aimed at increasing immunisation coverage rates for practices and for Division program staff.  Practices can contact their local Division of General Practice for assistance and Division program staff can contact the General Practice Queensland Immunisation Program.

A range of statistical reports are available at http://www.medicareaustralia.gov.au/provider/patients/acir/statistics.jsp

The National HPV Vaccination Program

Vaccine:
Gardasil®  is a quadrivalent human papillomavirus (types 6, 11, 16, 18) recombinant vaccine.

Gardasil PI has been updated to include approval for vaccination for women aged from 12 to 45 years.  Please note the funded vaccine is only available to females aged 12 to 26 years of age.

Q & As for providers

Administration:
3 doses administered intramuscularly with the first dose at an elected date, second dose 2 months later and third dose 6 months from the first dose.

Vaccination Program:
In 2009, girls in Year 8 will be vaccinated as an ongoing program.  Girls in Year 8 who missed the vaccination at school are still able to be vaccinated by their local GP.  Practices should ensure these girls are eligible by checking their immunisation history with VIVAS prior to vaccination.

Until end of 2009, GPs can vaccinate all women aged between 18 & 26 years.  To meet the requirements for the funded vaccine women aged 18 to 26 years of age must receive their first dose before 30 June 2009 and complete the remaining 2 doses before the end of December 2009.  Women accessing the vaccine after December 2009 must pay for the vaccine privately. 

The National HPV Register:
 The objectives of the register are:

GPs will be paid $6 for each HPV vaccination encounter reported to the National HPV Register.  This payment will be made through Medicare with GPs being required to register their provider details and bank account details to facilitate these payments.

Obtaining Consent & Notifying VIVAS:
As HPV data will be sent via VIVAS, it is important that consent is also received for patient data to be sent to the Register.  To enable this, practices can either:

• Record the vaccination AND consent on their practice software and send to VIVAS for collection
• Complete the Qld Health HPV Vaccination Encounter and the Register Consent Form and send to VIVAS.

Patients must consent to both vaccination and to having their data sent to the Register.  This consent must be collected for each vaccination encounter.

HPV Vaccination & Pap Smears:
Women vaccinated against HPV are still required to have regular Pap smears.  For more information: Cervical Screening Program

• Over 1,500 Australians die each year from complications caused by influenza.
  
• Less than half the people most at risk of developing life threatening complications from influenza are being vaccinated annually.
  
• Only 20-50% of health care workers are being vaccinated. Their occupations put them at risk of either getting or spreading influenza.
  
• Influenza is not a cold. It is a highly contagious disease that kills the same number of people who die on our roads each year.
  
• Influenza vaccine for people aged 65 and over - common questions and answers for providers

National Centre for Immunisation Research and Surveillance
The NCIRS provides useful resources for immunisation service providers, patients and anyone working in the area of immunisation.