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Q&As on pandemic vaccine

Getting Vaccinated

Can I get vaccinated and where do I get vaccinated?

All people six months of age and older can get this vaccine. Vaccination will be available from a range of locations, including GP offices, vaccination clinics, hospitals and health centres. To check vaccination location in your State or Territory, go to:

Health department websites and phone numbers

WA: call 1800 186 815 or visit http://www.health.wa.gov.au/swine_flu/home/
SA: call 1800 022 222 or visit www.flu.sa.gov.au
VIC: call: 1300 882 008 or visit http://humanswineflu.health.vic.gov.au
TAS: 1800 358 362 (1800 FLU DOC) or visit www.pandemic.tas.gov.au
ACT: call 02 6205 2300 or visit www.health.act.gov.au/flupandemic
NSW: visit www.emergency.health.nsw.gov.au/swineflu/vaccination/index.asp, or call 180 2007 for your local Public Health Unit contact
QLD: 13HEALTH (13 43 25 84) or visit www.health.qld.gov.au/swineflu/html/vacc.asp
NT: call 08 8922 8044 or visit www.swinefluvax.nt.gov.au

Why is the Australian Government making Panvax® H1N1 vaccine available when pandemic (H1N1) 2009 influenza is mild in most cases?

While pandemic (H1N1) 2009 influenza is mild in most cases it has been severe in some people and has led to around 5000 hospitalisations, hundreds of intensive care unit admissions and has been associated with 191 deaths in Australia.

Unlike seasonal influenza which mainly kills the elderly, the current pandemic influenza strain has affected younger people. The median age of Australian deaths from pandemic influenza is 53 years.

This new virus has spread quickly around the world since it was first detected in late April in Mexico. Vaccination affords the best possible protection and our best defence to limit the spread of this new disease.

The Australian Government is making Panvax® H1N1 vaccine, an Australian-developed vaccine, available quickly to protect all Australians, particularly those people who are most at risk of severe disease if they catch this pandemic influenza, such as pregnant women, people with chronic health conditions and Indigenous Australians. Healthcare workers, and parents and guardians of young infants too young to be vaccinated themselves, are also included for priority vaccination.

What has been the impact of Pandemic H1N1 Influenza on children in Australia?

Of the more than 37,000 laboratory-confirmed cases of pandemic influenza recorded in Australia since May 2009, around 7,700 have been in children under 10 years of age. This means one in five people who so far have had laboratory-confirmed cases of pandemic influenza in Australia were under 10 years of age.

In the same period, more than 1,000 children under 10 years of age have been hospitalised in Australia with this virus. Children represent about one quarter of all hospitalisations for pandemic influenza in Australia. More than half of all children hospitalised with pandemic influenza, had no known previous underlying illnesses or medical conditions that made them more vulnerable to this disease. Of those in hospital, around 40 children aged under 10 years required admission into an intensive care unit. Half of these children did not have any known underlying illnesses or medical conditions before contracting H1N1 pandemic influenza.

Sadly, a number of children under 10 years of age with H1N1 pandemic influenza have died, and more than half of those children did not have any previous underlying illnesses or medical conditions.
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It’s not our flu season – isn’t it too early for me to worry about the Panvax® H1N1 vaccine?

It is never too early to gain immunity. Pandemic (H1N1) 2009 influenza has slowed in Australia but it has not stopped. It continues to circulate and could resurge and affect large numbers in the 2010 Australian winter, or even earlier. Countries in the northern hemisphere continued to have many cases of pandemic influenza in their summer months and the pandemic reappeared earlier than the usual flu season. This could happen in Australia. Vaccination affords the best protection against a resurgence of this pandemic influenza.

Is Panvax® H1N1 vaccine safe?

Yes. Panvax® H1N1 vaccine meets the rigorous requirements for registration by Australia’s Therapeutic Goods Administration (it was registered by the TGA on 18 September 2009). The vaccine is made by CSL Limited, which has been producing seasonal vaccines in Australia in the same way for more than 40 years. For further CSL information about the H1N1 vaccine, go to www.h1n1vax.com.au.

Will I have to pay for the Panvax® H1N1 vaccine?

The Panvax® H1N1 vaccine is free, although there may be a consultation fee from your doctor or immunisation service provider. You can claim your consultation on Medicare. Many doctors will bulk bill consultations.
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Do I need to be a Medicare card holder?

No. You do not have to have a Medicare card to receive the Panvax® vaccine.

I think I’ve had the pandemic (H1N1) 2009 influenza. Do I need to have Panvax® H1N1 vaccine?

If you have definitely had pandemic (H1N1) 2009 influenza it is likely you have immunity and do not need the Panvax® H1N1 vaccine. But, you can only know for certain if you had this pandemic flu if you were tested for it and the test was positive.

If you have had flu, but were not tested, you should get the vaccination to ensure that you have good protection against the pandemic (H1N1) 2009 virus. It is safe to have the Panvax® H1N1 vaccine, even if you are already immune to the virus, just as it is safe to get a seasonal influenza vaccination if you’ve already had seasonal flu.

What does ‘confirmed’ pandemic (H1N1) 2009 influenza mean?

‘Confirmed’ pandemic influenza simply means that a nose and throat swab sample sent to a laboratory for testing and the test is positive for pandemic (H1N1) 2009 influenza.
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If I’ve recently had Tamiflu® or Relenza® for influenza – do I still need to be vaccinated?

Yes, you will need to be vaccinated. Tamiflu® and Relenza® are anti-viral medicines that treat infection. Anti viral drugs do not give long term protection against influenza like a vaccine does.

I was told that I had confirmed H1N1 pandemic influenza and was treated with Tamiflu® /Relenza® - do I still need to be vaccinated?

Yes, you still need to be vaccinated. People who have had pandemic influenza and were treated with antiviral medicines like Tamiflu® and Relenza® are less likely to develop protective immunity following the infection. It is important that you get vaccinated. It does not harm you to have the vaccine, even if you are already immune to the virus.

Antiviral medicines like Tamiflu® and Relenza® do not interfere with the Panvax® vaccine used in Australia but may interfere with some types of influenza vaccines used in other countries.

How many doses of Panvax® H1N1 vaccine are needed?

A single dose is recommended for all people 10 years and older. Children aged from six months to nine years need two doses no less than 28 days apart in line with the process for children’s seasonal flu vaccinations.
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Do I have to pick-up my Panvax® H1N1 vaccine from a chemist first?

No. Your doctor or immunisation service provider will have the vaccine.

How long after getting vaccinated before I am protected, and how long will it last?

Protection after vaccination varies from person to person, but people generally start producing the antibodies that provide protection two weeks after the vaccination. Protection is expected to last for at least one year.

Will I get influenza from the Panvax® H1N1 vaccine?

No. This vaccine does not contain ‘live’ virus and cannot give you influenza.
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I intend to get the seasonal flu vaccination – should I still get the pandemic vaccine?

Yes you should get the pandemic vaccine as soon as possible. The seasonal vaccine will not be available till later in the year and protection from the pandemic strain may be needed earlier. It is safe to have both the seasonal and pandemic vaccines.

Can I still get a seasonal flu vaccine after being vaccinated for pandemic (H1N1) 2009 influenza?

Yes. Panvax® H1N1 vaccine only protects you against the pandemic (H1N1) 2009 influenza virus. You can still be infected by seasonal influenza viruses circulating in the community. To reduce your risk of influenza during Australia’s winter months you should get the seasonal flu vaccine, particularly if you are in a high risk seasonal flu group.

Do I need a referral from my GP?

No. A GP referral is not needed for Panvax® H1N1 vaccine.
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Is there enough Panvax® H1N1 vaccine to vaccinate the whole population?

The Australian Government has purchased 21 million doses of Panvax® H1N1 vaccine. A shortage of the vaccine for those who want to be vaccinated is not expected.

I am in the Australian Defence Force. Will I get vaccination?

The Australian Defence Force (ADF) will make necessary arrangements to vaccinate ADF personnel. Further details can be provided by your local ADF health facility. The vaccine will be made available initially to those identified as being members of priority groups (those identified as vulnerable to more severe influenza and health care workers) and those who are deploying to the northern hemisphere. Vaccination is also being encouraged for any other ADF members who want to be vaccinated.

Can I vaccinate my pets?

No. This is not an animal vaccine and there is no pandemic vaccine for animals. While there is no evidence that the virus affects any domestic pets, people with backyard or pet pigs should make sure visitors wash their hands with soap and water before and after handling pigs. If you notice any suspicious disease symptoms in your pigs immediately consult your local veterinarian or call the Emergency Animal Disease Watch Hotline on 1800 675 888. For more advice on looking after pigs visit www.daff.gov.au .
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Travel & International Borders

If I am travelling overseas should I get this vaccination before I go?

Yes. Anyone travelling overseas should get vaccinated for pandemic (H1N1) 2009 influenza. The pandemic influenza re-emerged in the northern hemisphere. Pandemic influenza has been detected in just about every country on Earth since it first emerged in 2009.

Will the Australian vaccine protect me from the pandemic influenza overseas?

Yes. The Australian Panvax® H1N1 vaccine will provide protection against the same 2009 H1N1 influenza strain circulating in the northern hemisphere and in other countries. It is important to note that Panvax® will only protect against pandemic (H1N1) 2009 influenza strain and will not protect against any other strain of influenza. When you are overseas you should speak to a local doctor about recommended vaccinations for other seasonal influenza strains.

I am an Australian citizen currently residing overseas. Will I be able to gain access to the vaccination even though I’m offshore?

The vaccination program is being provided by Australia state and territory health services, general practitioners and other immunisation providers. There are no plans to deliver the program to Australian tourists and expatriates overseas. Anyone who is overseas and want to get the vaccination will need to return to Australia. Alternatively, pandemic (H1N1) 2009 influenza vaccines may be available from local health providers in other countries.
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Can I take the vaccine out of Australia?

No. The vaccine is only to be administered in Australia by Australian health professionals.

Are overseas students eligible?

Yes. Anyone in Australia is eligible to receive the Panvax® H1N1 vaccine. Vaccination is available to everyone at a range of locations, including GP offices, vaccination clinics, health centres and hospitals.

Can visitors to Australia have the vaccine?

Yes. The vaccine is available on request to temporary residents who are ineligible for Medicare.
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Will international visitors from the northern hemisphere bring in more cases of the influenza?

It is highly likely that there will be an influx of visitors to Australia over the summer months, some of whom may infected with the pandemic influenza. Australian authorities are monitoring the situation overseas.

Will Australia reintroduce Border Protection Measures?

The reintroduction of screening at airports as Australia is not planned. The best protection for Australians is for as many people as possible to get vaccinated and thus limit chances of the virus spreading in the community.
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Targeting/priority groups

Who is being given Panvax® H1N1 vaccine and why?

Vaccine is available to all people six months and older but vaccination is particularly important for people who are at increased risk of severe outcomes if they catch pandemic influenza, including pregnant women, Indigenous Australians and people with underlying medical conditions such as:

heart disease;
asthma and other lung diseases;
cancer;
obesity;
diabetes;
weakened immune system
inherited blood disorder
kidney disease; or
neurological disease.

There are other chronic conditions which may also put people at risk, so it is important that you speak to your GP.

To minimise risk to the community, vaccination is also particularly important to people most likely to be exposed to the disease, such as health care and community care workers. Parents and carers of infants under six months of age should also get the vaccine to reduce the risk to babies too young to be vaccinated.

Who made the decision to give priority to certain groups and why?

While everyone is encouraged to receive their free pandemic vaccine, the Australian Health Protection Committee – comprising Australia’s Chief Medical Officer, Professor Jim Bishop; all State and Territory Chief Health Officers, and a number of public health and emergency management experts – recommends the pandemic vaccine as particularly important for specific groups to protect those at higher risk of exposure (for example, health care workers) and those vulnerable to more severe outcomes including pregnant women, indigenous people and people with underlying medical conditions.

I have been identified in a priority group – do I have to get Panvax® H1N1 vaccine?

No. Panvax® H1N1 vaccine is offered on a voluntary basis, but is strongly recommended for people in the priority groups.

Why are Indigenous Australians identified in the priority group?

Indigenous Australians are approximately 10 times more likely than non-Indigenous Australians to be hospitalised for pandemic (H1N1) 2009 influenza. Due to the presence of underlying chronic disease, some of which is undiagnosed, and the higher level of social disadvantage, Indigenous Australians, as a group, are more vulnerable to severe disease and complications from the pandemic influenza virus.
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Can children have Panvax® H1N1 vaccine?

Yes. Panvax® H1N1 vaccine is approved for use in children from six months of age.

Can I get the vaccine if I am not in an initial priority group?

Yes. The Australian Government has purchased enough vaccine for the entire population. The initial focus on priority groups was designed to quickly protect people who could get very ill if they caught this influenza. By getting vaccinated you are not only protecting yourself, you are also protecting the community.
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Can I buy Panvax® H1N1 vaccine privately?

No. Panvax® H1N1 vaccine is available free as part of the Australian governments’ pandemic vaccination program, and cannot be purchased through pharmacies or via the internet.

Why is the priority group for Panvax® H1N1 vaccine different from the seasonal flu priority group?

This new pandemic influenza is different from seasonal flu. The pandemic (H1N1) 2009 influenza experience has shown that the most vulnerable groups include pregnant women and people who have certain underlying chronic health conditions. Health care workers looking after people in vulnerable groups are also targeted because of their likely exposure to infection and the risk of spread. In contrast, the most severe health outcomes from seasonal influenza are generally seen in older people. In a normal flu season, more than 92 per cent of deaths from seasonal flu are in Australians aged 65 years and older. This year’s pandemic influenza strain has infected and killed a greater number of younger people.

Why are older Australians not included?

Older people with underlying health conditions are included in the priority groups for vaccination. Healthy older people appear to have had less infection with pandemic (H1N1) 2009 influenza, but we continue to watch this closely. Seasonal influenza vaccine is provided free of charge to all Australians aged 65 years and over and all Indigenous Australians aged 15 years and older.
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How can I find out about the vaccination?

Information on the vaccination program is available through local pharmacies and GP surgeries as well as via www.healthemergency.gov.au.

You can also call the Pandemic Hotline on 180 2007 for information about the program and where to get vaccinated.
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Specific Groups

Health care workers getting vaccinated

Why have I been identified as a priority?

You are at risk of getting influenza because you care for sick people and have a much higher chance of being exposed to an infectious person with pandemic influenza. If you get influenza you are likely to pass it on to other vulnerable people whom you care for, as well as your family. Vaccination not only protects you from getting influenza from patients, it also stops you transmitting the virus to patients, which is especially important for those patients vulnerable to severe outcomes. As a heath care worker, you are in the frontline of the health system.

Indigenous

Why am I in the priority group?

AYou are in the priority group for the first vaccinations because evidence shows that, as a group, Indigenous Australians are more likely to suffer from severe disease and complications if they get pandemic (H1N1) 2009 influenza. Indigenous Australians are about 10 times more likely than non-Indigenous Australians to be hospitalised for pandemic influenza. Around 13 per cent of all pandemic influenza deaths in Australia in the first months of the outbreak were Indigenous Australians.

You should get vaccinated against pandemic influenza regardless of whether you live in remote or urban community.
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How will I get Panvax® H1N1 vaccine?

You will most likely get Panvax® H1N1 vaccine through your usual immunisation service provider, such as your primary health care provider at the local Aboriginal Medical Services /Aboriginal Community Controlled Health Service, community clinic or your general practice.

Remote area health services may hold special clinics. The exact arrangements will vary from place to place.

Will Indigenous children be vaccinated?

Yes, the vaccine is available for all Indigenous children six months and older.

Pregnant Women and Breast feeding mothers

Why am I identified as a priority?

As a pregnant woman, you are more susceptible to complications of the pandemic (H1N1) 2009 influenza than the general population. This puts both you and your baby at risk. Around the world, and in here in Australia, some pregnant women who have caught this disease have miscarried, gone into premature labour or died.
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Am I getting Panvax® H1N1 vaccine to protect myself or my baby?

Both; vaccination will protect you and your baby. If you are vaccinated during pregnancy your baby will have protective antibodies for the first few months after birth.

Is it safe to be vaccinated at any stage in my pregnancy?

Yes. Influenza vaccines are safe during all stages of pregnancy. With seasonal flu, vaccination is normally offered in advance to women planning a pregnancy, and to pregnant women.

As a pregnant woman, you are at risk of severe complications if you catch the pandemic (H1N1) 2009 influenza, so vaccination is strongly recommended.
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What are the risks to my baby and what are the risks to me?

Like all individuals receiving a vaccine, expectant mothers may experience similar side-effects, including a sore red arm, slight headache or mild temperature. Panvax® H1N1 vaccine is not a ‘live’ vaccine and cannot give you or your baby influenza, and is no greater risk to you or your unborn baby than seasonal vaccine.

Should I get vaccinated if I'm breast feeding?

Yes, by getting vaccinated you are reducing your chances of getting this flu and of passing it to your baby. There is no evidence that the vaccine affects breast milk, and because it contains no live virus you will not get flu. Your immunity after vaccination will not be passed to your baby through your breast milk.

I've heard there is a preservative called thiomersal in Panvax® H1N1 vaccine. Is it safe if I'm pregnant?

Yes. There is no evidence that thiomersal is harmful to pregnant women or their babies. Thiomersal is a commonly used preservative in multi-dose medicines such as Panvax® H1N1 vaccine, which contains a small amount of thiomersal to keep it safe in the vials.

Pregnant women are strongly encouraged to protect themselves and their baby by getting the vaccine.
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Safety

Should some people not be given Panvax® H1N1 vaccine?

People should not be given Panvax® H1N1 vaccine or any other influenza vaccines if they:

have experienced anaphylaxis, a severe form of a generalised allergic reaction, following a previous dose of any influenza vaccine;
have experienced anaphylaxis following receipt of any vaccine component, including neomycin or polymyxin antibiotics; or
have a severe allergy to eggs, including people who have experienced swelling of the lips or tongue, or had acute breathing problems or convulsions, after eating eggs.

People with milder forms of egg allergy may be able to be vaccinated and should talk to their doctor about the vaccine.

People who are moderately or severely ill with a fever should usually wait until they recover before getting the vaccine. People with a mild illness can usually get the vaccine.

The vaccine should not be given to children under six months of age.

What about people taking other medicines?

People taking other medicines should always tell their immunisation provider what other medication they are taking. Your immunisation provider should advise you about any possible effects the vaccination may have in respect of those medications.

What if I have had another vaccine recently?

If you have had any other vaccine in the four weeks prior to getting the Panvax® H1N1 vaccine, you should discuss this with your immunisation service provider.
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Is Panvax® H1N1 vaccine similar to seasonal flu vaccine?

Yes. Panvax® H1N1 vaccine has been manufactured using the same processes as for seasonal influenza vaccine.

Why is the pandemic vaccine being produced in multi-dose vials

Multi-dose vials have been used to ensure the vaccine was available for use in Australia in the shortest possible time. It would take many more months to manufacture enough single-dose syringes to ensure enough vaccine for every Australian citizen.

Multi-dose vials have been part of Australia’s pandemic planning for some years. The United States uses multi-dose vials in delivering its normal seasonal vaccine and has done so safely for the past 30 years. Just about all countries in the world that will have pandemic vaccination programs will use multi-dose vials to ensure rapid delivery of vaccine to their populations.

Why does Panvax® H1N1 vaccine contain thiomersal?

Most doses of Panvax® H1N1 vaccine are provided in multi-dose vials that also contain a small amount of thiomersal – a preservative, which keeps the vaccine safe in the vial. Thiomersal is an antibacterial and anti fungal, meaning it stops bacteria and fungi growing in a medicine and has been used in many medical products and vaccines for more than 60 years.
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Is thiomersal in vaccines safe?

TThiomersal has been used in medical products and vaccines for more than 60 years and is the most commonly used preservative in multi-dose vials. It has a very long safety record.

There is no evidence anywhere in the world that thiomersal in vaccines has caused any developmental or neurological abnormalities, such as Attention Deficit Hyperactivity Disorder (ADHD), autism or any other health problem.

Thiomersal, which contains a small amount of mercury, was removed from vaccines given to young children in Australia simply as a precaution to reduce the theoretical risk of exposure to mercury in babies, particularly those of very low birth weight. Pre filled syringes, which do not require the preservative, are available for vaccination of children aged six months to 35 months.

What about mercury in the vaccine?

Thiomersal contains a small amount of mercury. The Australian Technical Advisory Group on Immunisation (ATAGI) has looked at this issue and has advised that influenza vaccines containing thiomersal are safe for infants, children, adolescents and adults (including pregnant women). The full advice from ATAGI and further information about thiormersal can be found at www.healthemergency.gov.au under the individuals and households and the health professionals menus.

Does getting the vaccination hurt?

As vaccination is given via a needle there may be a short-lived stinging associated with the needle piercing the skin, as you would expect with any injection.

What are the potential side-effects of the Panvax® H1N1 vaccine?

The vast majority of vaccinations occur without any side effects. Every year in Australia millions of influenza vaccines are administered, yet in the five years from 2004 to 2008, only 655 suspected adverse reactions to the vaccinations were reported to the TGA. The vast majority of these reactions were minor.

All medicines can have unwanted side-effects. It is common (around one in 10 people) with influenza vaccines to have some swelling, redness and/or pain where the injection is given. Other symptoms such as fever, tiredness, headaches and muscle aches are less common. These side-effects can start within a few hours of vaccination and may last for one to two days. Some people may get side effects like nausea or occasionally vomiting.

Allergic reactions are uncommon after vaccination, but can be severe in some people. These reactions are due to an allergy to egg protein or to other components of the vaccine, including the antibiotics neomycin and polymyxin, which are in the vaccine in small amounts.

Some allergic reactions can happen within 15 minutes of vaccination, so it is important that you wait in the surgery or clinic for this time so that you can be observed.

What do I do if I feel unwell or experience a side-effect after the Panvax® H1N1 vaccine?

If you have pain at the injection site you can take paracetamol or apply a cold compress to ease the discomfort.

If you have fever after vaccination you should drink extra fluids and rest. Paracetamol can also be used to reduce fever. If the fever persists, or you are worried about any reaction you are experiencing, contact your doctor or healthcare provider as soon as possible, or go to a hospital.

If you suspect you have experienced an adverse reaction you can report it to the Therapeutic Goods Administration online at www.tga.gov.au or by calling the Pandemic Hotline on 180 2007.

What is Guillain-Barré syndrome and will I get it from Panvax® H1N1 vaccine?

Guillain-Barré syndrome (GBS) is a rare and sometimes severe condition affecting the body’s nerves. What causes GBS is not clear, but it generally happens after infections such as stomach bugs, coughs and colds. It is thought to be due to the immune system mistakenly attacking the body’s own nerves. This results in muscle weakness and sometimes paralysis, which can last for weeks to months. Most people recover completely, but the consequences can be severe in some.

There have been reports overseas of a possible association between influenza vaccinations and GBS but the overwhelming evidence collected by experts shows us that GBS is four to seven times more likely after an attack of the actual flu than after the influenza vaccine.

The pandemic H1N1 influenza vaccine registered in Australia is made using the same techniques used for seasonal influenza vaccines for more than 40 years. Australian health authorities do not anticipate vaccination will be associated with an increased risk of GBS, or any other neurological disorder.
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