the national immunisation schedule · 2019-12-05 · 10. influenza 11. kidney disease 12. liver...
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The National Immunisation Schedule
Providing the strength within
Anna Smith, IMAC
Rationale behind the NZ Schedule
Designed specifically for New Zealand
Strategies differ for each disease:• Pattern of disease and particular risk factors
eg, pertussis control is focused on infants
• Age and vaccine effectiveness
• Duration of immunity
Convenience of delivery:• Minimise number of injections and visits
Why do we want to stop people catching these diseases?
• Pertussis, measlesNo treatment
• Hib, pneumococcal, meningococcal Treatment can’t
guarantee a good outcome
• Hepatitis B, HPVCancer prevention
• Rotavirus, influenza, varicellaPrevent serious
disease complications
Eligibility for funded vaccines
• All children <18 years of age irrespective of immigration status (includes HPV vaccine)
• Adults >18 years of age funded for New Zealand healthcare (HPV up to age of 27 years)
On time!
4 in a row!
By 4 years & 1 month
Check up to date by 14 years of age - not before!
If all due give at same visit
Pregnant women• Influenza
Annual vaccine in any trimesterPrevents serious complications
• Tdap Diphtheria, tetanus & pertussisTiming: 13-38 weeksEach pregnancy to protect newborns
• Immunisation in pregnancyActive immunity for mumPassive immunity for baby
Every pregnant woman needs to know!
Pertussis in infants• Young infants at highest risk
• Hospitalisations: <1 year 50% of infected and 1-2 per 100 of these die
• 2 in 1,000 children end up with permanent brain damage, paralysis, deafness or blindness
• Little, or no maternal protection
• 3 doses of vaccine required for protection
• Delayed immunisation (>30 days) = 4-6 times higher risk of hospitalisation (Grant et al 2003)
For best protection vaccinate our pregnant mothers and ourselves!
Pertussis containing vaccine 13-38 weekseach pregnancy• Passive protection for baby• Immunity for mum – avoids spread to baby• Coverage needs to be increased!• All health workers involved with babies and young
children should also be vaccinated!
• Vaccinate babies on time!
Pregnancy video
Influenza can be transmitted when no symptoms are present!
SHIVERS influenza research sero-survey showed in 2015:
“4 out of 5 people infected show no symptoms of influenza.”
Adult primary programmesTd Diphtheria, tetanus (Tdap from 2020)
x 3
IPV Inactivated poliox 3
MMR Measles, mumps & rubellax 2
HPV <27 years of ageHuman papillomavirusx 3
Immunisation of special groups
Additional funded vaccines for children and adults with particular complex health issues
20 special groups funded for vaccines1. Asplenia2. Chemotherapy 3. Cochlear Implant4. Error of metabolism5. Stem cell transplant 6. Hepatitis A contact7. Hepatitis B* baby of/contact8. Hepatitis C positive person9. Immune deficient10. Influenza11. Kidney disease12. Liver disease13. Meningococcal disease
contact
14. Needle stick15. Non-consensual sexual
intercourse16. Pneumococcal - increased risk17. Pregnancy 18. Rubella - childbearing women19. Solid organ transplant20. Tuberculosis risk < 5 years of
age*
Hepatitis B vaccine for babies born to HBsAg-positive mothers
There is a protocol for managing infants born to hepatitis B positive mothers
Management of a baby of a HBsAg-positive woman
• Hepatitis B immunoglobulin • Hepatitis B vaccineBirth
• Schedule vaccines that includeDTaP-IPV-Hep B/Hib
6 weeks3 months5 months
• Check serology for hepatitis B disease and immunity9 months
Newborn BCG for tuberculosis
Eligibility for at risk children <5 years:
• Living with someone with TB or TB history
• Parents/household members from high TB incidence country
• Lived/will live >3 months in a high TB incidence country during their first 5 years
Meningococcal vaccinesMeningococcal B
• Bexsero (+ prophylactic paracetamol <2 years old)
Meningococcal (A,C,W,Y)• Menactra• Nimenrix
Meningococcal C • NeisVac-C
Menactra/NeisVac-C are the only ones on the Schedule for:• High risk groups and/or outbreak situations
Others are available for private purchase
Pre-vaccination conversation and check
• To gain informed consent• To ensure a safe vaccination event
We all want to keep babies safe
Resources
Immunisation Handbook 2017www.health.govt.nz
IMAC website, fact sheets and videoswww.immune.org.nz
Introduction to Immunisation Course (IMAC)Online – 2 hours - free
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