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
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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
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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
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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)
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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
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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!
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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)
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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!
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Pregnancy video
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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.”
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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
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Immunisation of special groups
Additional funded vaccines for children and adults with particular complex health issues
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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*
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Hepatitis B vaccine for babies born to HBsAg-positive mothers
There is a protocol for managing infants born to hepatitis B positive mothers
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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
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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
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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
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Pre-vaccination conversation and check
• To gain informed consent• To ensure a safe vaccination event
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We all want to keep babies safe
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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