Vaccine Preventable Diseases and Vaccination Coverage in Aboriginal and Torres Strait Islander People, Australia, 2003 to 2006

The Australian Standard Vaccination Schedule/National Immunisation Program 2003 to 2006

DISCLAIMER: Produced by the National Centre for Immunisation Research and Surveillance of Vaccine Preventable Diseases and the Australian Institute of Health and Welfare on behalf of the Australian Government Department of Health and Ageing. Published as a supplement to the Communicable Diseases Intelligence journal Volume 32, June 2008.

Page last updated: 30 June 2008

The Australian Standard Vaccination Schedule (ASVS) changed in January 2003, September 2003 and January 2005, and additional vaccines were universally funded from November 2005.

Children

The meningococcal C conjugate vaccine (MenCCV), to be administered at age 12 months, was introduced and funded for all children in January 2003, with a catch-up program for those aged up to 19 years.

In September 2003, the dose of DTP at 18 months of age was no longer recommended. The recommended schedule was also changed to include:

  1. the 7-valent pneumococcal conjugate vaccine (7vPCV) at 2, 4 and 6 months of age for non-Indigenous infants, in addition to the previous recommendation for Indigenous and high-risk infants;
  2. the universal varicella-zoster vaccine at 18 months of age; and
  3. the inactivated poliomyelitis vaccine in place of the oral polio vaccine,
  4. although these recommendations were not funded.

In January 2005, universal 7vPCV was funded. In May 2005, the National Immunisation Program (NIP) Schedule replaced the ASVS (Table 16), with all recommended vaccines to be funded. These included, from November 2005, varicella vaccine and inactivated poliomyelitis vaccine for all infants, and hepatitis A vaccine for Aboriginal and Torres Strait Islander infants in the Northern Territory, Queensland, South Australia and Western Australia. For Hib vaccine, the previous recommendation of Hib PRP-OMP (purified polysaccharide conjugated to the outer membrane protein of the bacteria N. meningitidis) vaccine for all infants was changed to include other Hib vaccines for Indigenous infants in the Australian Capital Territory, New South Wales, Tasmania and Victoria, and all non-Indigenous infants.

Table 16. The Australian National Immunisation Program Schedule for Aboriginal and Torres Strait Islander people, effective 1 November 2005

Age
Vaccine
Birth
Hep B
BCG**
2 months
Hep B*
DTPa
Hib
IPV
7vPCV
4 months
Hep B*
DTPa
Hib
IPV
7vPCV
6 months
Hep B*
DTPa
Hib
IPV
7vPCV
12 months
Hep B*
Hib
MMR
MenCCV
12–18 months
Hep A
18 months
VZV
18–24 months
23vPPV
Hep A
4 years
DTPa
IPV
MMR
15–17 years
dTpa
15–49 years
23vPPV§||
Flu§
≥50 years
dT
23vPPV||
Flu

* Three doses, either at 2, 4 and 6 months or 2, 4 and 12 months of age.

† Hib PRP-OMP: three doses, at 2, 4 and 12 months of age, for Aboriginal and Torres Strait Islander infants in the Northern Territory, Queensland, South Australia and Western Australia. Other infants may receive either PRP-OMP or PRP-T schedules. The Hib PRP-T schedule comprises four doses, at 2, 4, 6 and 12 months of age.

‡ For Aboriginal and Torres Strait Islander children in the Northern Territory, Queensland, South Australia and Western Australia.

§ For Aboriginal and Torres Strait Islander people who have at least one risk factor for which the vaccine is recommended, as per The Australian Immunisation Handbook, 9th edition.

|| Recommendations for repeat doses as per The Australian Immunisation Handbook, 9th edition.

¶ For people recommended to be vaccinated against influenza, vaccination is to be repeated annually.

** For Aboriginal and Torres Strait Islander infants living in specific regions of high incidence only.

Adolescents

From September 2003, the recommendation for the acellular pertussis antigen was added to the adolescent booster of diphtheria and tetanus vaccination. The NIP Schedule recommended catch-up hepatitis B vaccination for adolescents of one cohort within the age range of 10–13 years who had no prior history of disease or vaccination, and the schedule varied with different jurisdictions. Varicella vaccination was included for one cohort of adolescents between 10 and 13 years of age who had no prior history of chickenpox.

Adults

Pneumococcal vaccination for all Australians aged 65 years or more was funded nationally from January 2005.

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Additional or specific recommendations for Aboriginal and Torres Strait Islander people

Of the vaccines listed in Table 16, some are recommended only for Aboriginal and Torres Strait Islander people, due to their higher risks of contracting the respective diseases.

The three-dose primary course of 7vPCV, administered at 2, 4 and 6 months of age, has been recommended and funded for Aboriginal and Torres Strait Islander children since June 2001 (in contrast to this vaccine being recommended for universal use for all Australian infants in September 2003 and funded since January 2005). A booster dose of pneumococcal vaccine using the 23-valent pneumococcal polysaccharide vaccine (23vPPV) is recommended specifically for Aboriginal and Torres Strait Islander children living in the Northern Territory, Queensland, South Australia and Western Australia, at age 18–24 months, following the primary 7vPCV course in infancy.

Regarding the vaccine against Hib infection, the preferred vaccine type for Aboriginal and Torres Strait Islander infants in the Northern Territory, Queensland, South Australia and Western Australia, who have an earlier peak incidence of disease and a higher risk of disease under 6 months of age, is a specific type (Hib PRP-OMP). This vaccine is immunogenic at an earlier age, and requires three doses to be administered at age 2, 4 and 12 months, without a dose required at age 6 months as with other types of Hib vaccine. Either PRP-OMP or other Hib vaccine conjugated to tetanus toxoid (in combination with other antigens) is recommended for other children.

A two-dose course of hepatitis A vaccine, administered six months apart, between ages 12 and 24 months, has been recommended and funded under the NIP Schedule for Aboriginal and Torres Strait Islander children living in the Northern Territory, Queensland, South Australia and Western Australia since November 2005, and since 1999 in northern Queensland.

Vaccination with Bacille Calmette-Guérin (BCG) against tuberculosis is recommended for all Aboriginal and Torres Strait Islander neonates in high incidence areas, primarily northern Australia.

Aboriginal and Torres Strait Islander adults aged 50 years or more, and those aged 15–49 years with medical conditions putting them at high risk of disease or complications,20 are recommended for vaccination against influenza and pneumococcal disease. In the Northern Territory, all Aboriginal and Torres Strait Islander people aged 15 years or more, irrespective of presence of medical or behavioural risk factors, have been recommended for pneumococcal vaccination since 2000. Vaccination is recommended annually for influenza while, for pneumococcal disease, generally re-vaccination is recommended five years after the first dose in Aboriginal and Torres Strait Islander adults (see The Australian Immunisation Handbook 9th edition for more details.)57 These two vaccines have been provided through the National Indigenous Pneumococcal and Influenza Immunisation (NIPII) Program since 1999, and earlier in some jurisdictions. For other (non-Indigenous) adult Australians, the recommended age to receive these two vaccines is 65 years or more, funded through the influenza vaccine program for older Australians since 1999 and the pneumococcal vaccination program for older Australians since January 2005.20