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Information for Health Professionals on various immunisation-related topics.

This page contains information for Health Professionals on various immunisation and vaccination-related topics. Disease-specific publications for Health Professionals can be accessed from the Publications & Resources page.

Vaccine preparation, administration, storage and handling

Only persons suitably trained and qualified are permitted to administer vaccines.

For further information on vaccine procedures, refer to the Australian Immunisation Handbook 9th Edition 2008 (NHMRC).

Vaccines that are transported, stored, prepared and administered safely will minimise harm to individuals, health care professionals and the community.

It is important to ensure vaccines are prepared according to manufacturers’ instructions. Providers should be vigilant in correctly preparing vaccines that require reconstitution prior to administration.

National vaccine storage guidelines: Strive for 5 outlines the basic principles for safe vaccine management. It is a concise, practical, user-friendly guide to vaccine storage and is aimed at Australian vaccination service providers.

The technology for vaccine storage is changing rapidly. If you are purchasing equipment it is recommended that you thoroughly investigate the item. The material in Strive for 5 may help you with your investigations. For further information contact your State or Territory Health Department.

Due to the Australian context and an evolution in technology, knowledge and vaccines, there are differences between the National vaccine storage guidelines: Strive for 5 and the World Health Organization’s documents and the Australian Immunisation Handbook 9th Edition 2008 (NHMRC).

This World Health Organization publication provides information about vaccine safety - Immunization in practice: A practical resource guide for health workers.

Schedule splitting and catch-up doses

Schedule splitting

Schedule splitting, where one or more vaccines are not administered at the age schedule point as recommended, is not encouraged in Australia.

Research shows vaccines that have been delayed due to schedule splitting do not achieve as high coverage as vaccines administered at the appropriate age point.

Vaccines that have been scheduled to be given at the same age schedule point have been demonstrated to be safe and effective when given at the same visit.

Catch-up doses

Some children may miss doses of routine childhood vaccines and they should be vaccinated using an appropriate catch up schedule as soon as possible. For technical information please refer to the Australian Immunisation Handbook 9th Edition 2008 (NHMRC).

South Australian Immunisation Calculator

Developed by the South Australian Government, SA Immunisation Calculator is a national resource for health care providers to work out an appropriate catch-up schedule for Australian children up to their 7th birthday, according to the National Immunisation Program (NIP) Schedule.

Using a child's immunisation history record to enter required information, the Calculator generates a 'catch-up' vaccination schedule appropriate for the state or territory of residence of the child.
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Adverse Events Following Immunisation (AEFI)

An adverse event following immunisation (AEFI) is an unwanted or unexpected event occurring after the administration of vaccine(s). Such an event may be caused by the vaccine(s) or may occur by chance after vaccination (i.e. it would have occurred regardless of vaccination). Most vaccines can cause minor adverse events such as low-grade fever, pain or redness at the injection site and parents/patients should be counselled on how to manage these events should they occur.

Vaccines are extensively tested for safety and efficacy before being made available by suppliers. Nevertheless, careful surveillance must be maintained to improve knowledge about adverse reactions.

Several sections of the Australian Immunisation Handbook 9th Edition 2008 (NHMRC) contains information on AEFI including Post-vaccination procedures, a Quick guide of commonly observed AEFI and Definitions of AEFI.

Managing AEFI

Observation after vaccination

Recipients of vaccines should remain under observation for a short interval to ensure that they do not experience an immediate adverse event. It is recommended that recipients remain in the vicinity of the place of vaccination for at least 15 minutes. Severe anaphylactic reactions usually have a rapid onset; most life-threatening adverse events begin within 10 minutes of vaccination.

The most serious immediate AEFI is anaphylaxis. However, in adults and older children, the most common immediate adverse event is a vasovagal episode (fainting), either immediately or soon after vaccination. Because fainting after vaccination can lead to serious consequences, anyone who complains of giddiness or light-headedness before or after vaccination should be advised to lie down until free of symptoms. Most faints following vaccination occur within 5 minutes, and 98% occur within 30 minutes. Adults should, therefore, be warned of the risk of driving or operating machinery for at least 30 minutes after vaccination.

What to do to manage injection site discomfort

Many vaccine injections may result in soreness, redness, itching, swelling or burning at the injection site for 1 to 2 days. Paracetamol might be required to ease the discomfort. Sometimes a small, hard lump may persist for some weeks or months. This should not be of concern and requires no treatment.

Managing fever after immunisation

Give extra fluids to drink. Do not overdress an infant if hot. Although the routine use of paracetamol at the time of vaccination is no longer necessary, it may be required if, for example, an infant or child has a high fever following vaccination. The dose of paracetamol is 15 mg/kg of paracetamol liquid, up to a maximum daily dose of 90 mg/kg per day.

Reporting AEFI

AEFI are notifiable directly to the relevant health authority in Australian Capital Territory, New South Wales, Northern Territory, Queensland, South Australia, Victoria and Western Australia. These States and Territories then notify the Adverse Drug Reactions Advisory Committee (ADRAC) of the Therapeutic Goods Administration. In Tasmania, AEFI should be reported directly to ADRAC using the ADRAC blue card.

ADRAC receives reports of unexpected and serious adverse events for all medicines, including vaccines. Any person (medical or non-medical) can report an AEFI to ADRAC.
To report any serious or unexpected reactions refer to Reporting problems with medicines (Therapeutic Goods Administration).

Adverse event services

Services for people who have experienced a serious adverse event following immunisation have been established in Australia.

The aim of these services is to:

review people who have had a serious adverse event following immunisation to determine the relationship between vaccination and the event;
determine whether or not remaining scheduled vaccinations should be administered; and
provide an environment in which further vaccinations can be given, including:
- close observation;
- information about risk and benefits of vaccination; and
- specialist treatment in the event an adverse event recurs.

For more information about adverse event services contact your State or Territory Health Department.

Vaccination of children who have had a serious AEFI

Children who have had a serious AEFI (other than a contraindication, such as anaphylaxis) may be subsequently vaccinated under close medical supervision. Not all States and Territories offer an adverse event immunisation clinic. However, in States or Territories where there are no clinics, there is often a paediatrician or infectious diseases specialist who will review families who have concerns regarding future vaccinations following a previous adverse event. For more information about adverse event services contact your State or Territory Health Department.
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Immunisation Registers

The Australian Childhood Immunisation Register (ACIR) is a national register administered by Medicare Australia that records details of vaccinations given to children under seven years of age who live in Australia. It was established in 1996 in response to a decline in childhood immunisation in Australia and an increase in preventable childhood diseases.

The National HPV Vaccination Program Register is administered by the Victorian Cytology Service (VCS). It records details of HPV vaccine doses given, sends completion of vaccination statements to all individuals who have received the vaccine and sends reminders to individuals who are overdue for vaccination within the school-based program. Because the Australian Childhood Immunisation Register only accepts vaccination data for children aged up to 7 years, the HPV Register is administered as a separate entity.

Vaccination and disease surveillance data

The Department of Health and Ageing, Medicare Australia and the National Centre for Immunisation Research and Surveillance (NCIRS) collate information about vaccination coverage surveillance data and Vaccine preventable disease surveillance data, including historical trends.

Medicare Australia operates the Australian Childhood Immunisation Register (ACIR), which is tasked with:

providing an accurate measure of the immunisation coverage of children in Australia under 7 years of age
providing an effective management tool for monitoring immunisation coverage and service delivery.

For more information about vaccination coverage surveillance data, see the ACIR statistics website. Secure site reports can be accessed by authorised immunisation providers.

NCIRS conducts research and provides independent expert advice about all aspects of diseases which can be prevented by vaccination, particularly in children, including a national perspective on social and other issues related to immunisation. For more information and research reports see NCIRS Surveillance Reports and NCIRS Fact Sheets.

Communicable Diseases Network Australia (Department of Health and Ageing) provides surveillance of notifiable communicable diseases. Data can be accessed via the National Notifiable Diseases Surveillance System (NNDSS) (Department of Health and Ageing).

More information about monitoring notifiable diseases can be found at Surveillance systems for communicable diseases in Australia (Department of Health and Ageing).

General Practice Immunisation Incentives (GPII) Scheme

The General Practice Immunisation Incentives (GPII) Scheme provides financial incentives to general practices for monitoring, promoting and providing appropriate immunisation services to children under the age of seven years.

The GPII aims to encourage at least 90 per cent of practices to fully immunise 90 per cent of children under seven years of age attending their practices.

The GPII is administered by Medicare Australia on behalf of the Australian Government Department of Health and Ageing.

For more information, see GPII Scheme on the Medicare Australia website.

Immunisation for Health Care Workers

People in certain occupations should consider vaccination to protect them from occupationally acquired vaccine-preventable diseases. For more information refer to the Australian Immunisation Handbook 9th Edition 2008 (NHMRC).

Page last modified: 05 May, 2009