TGA report on Pneumovax 23 following batch recall March 2011.

Dealing with complex immunisation consultations.

As of 1 July 2012 there a a number of changes that will directly impact on families with small children. The incentive payments will be $2100 per child. To aviod any distress to either parents and your practice, please ensure all immunisation records are up to date.

The only way to do this is to clean your immunisation records using a GPII20A report. If your practice is not recieving this please contact CSGPN to find out how Fact sheet for Immunisation changes as of 1 July 2012.

The Prevenar 13 catch up will commence on 1 October 2011 for children ages between 12 months to 35 months. We have a catch up reminder recall postcard to help you recall children for this vaccine.

For more information, a practice visit or to request recall postcards please contact CSGPN on 9799 0933.

Situation update
There is increasing influenza activity in parts of NSW and elsewhere in Australia, and there have been reports of admissions of pregnant women to intensive care in NSW. Because of the possibility of another severe influenza season in 2011, it is important to increase uptake of the seasonal influenza vaccine now, particularly among high risk groups like pregnant women. Below is the release from NSW Health:

• Influenza update for Obstetrician and Maternity Services 21 July 2011
• Mothersafe Factsheet Influenza May 2011
• www.mothersafe.org.au
• NSW Public Health

Latest fact sheets for immunisation providers and consumer information regarding Rotovirus and intussusception, visit the Department of Health and Ageing page here for Rotovirus.

The TGA is advising health professionals not to administer a second or subsequent dose of Pneumovax 23 vaccine pending the outcome of a review of an apparent increased rate of injection site reactions following administration of the second dose.

Health practitioners are advised not to administer Pneumovax 23 vaccine to patients who have previously received a dose of Pneumovax 23 until a review of this matter by the TGA and ATAGI is completed.

Consumers are advised not to seek revaccination with Pneumovax 23 if they have previously received this vaccine until further advice is provided by the TGA and ATAGI.

Consumers who believe they may have suffered an adverse reaction to Pneumovax 23 are advised to see their medical practitioner for review.

Further information from TGA.

The Chief Medical Officer has advised that there is new evidence suggesting a small increased risk of intussusception in infants following rotavirus vaccination. On the basis of the overall risk benefit balance, it is recommend that young infants continue to be offered vaccination against rotavirus and that their parents and carers are made aware of the rare risk of intussusception and how to be alert for the signs and symptoms of the condition.

Communication resources have been developed by NSW Health and a distribution strategy is being implemented to advise parents and providers:

1. NSW Health will be faxing the Chief Medical Officer’s letter and provider fact-sheet directly to all providers, General Practice NSW and Public Health Units. All documents (including a Parent Fact-sheet) will be available via the NSW Health website
2. The Australian Government will be mailing hard copies of the documents directly to providers over the next few weeks
3. The TGA website will have updated information and revised Product Information (PI) for the two rotavirus vaccines (Rotarix® and RotaTeq®)

Release documents

• Chief Medical Officer letter
• Summary factsheet for providers
• Information for Immunisation Providers February 2011
• Information for Parents February 2011
• Report of TGA’s investigation

Queries should be referred to the Immunise Australia website or to the Immunise Australia Information Line on 1800 671 811 (between 8:30am – 5.00pm Eastern Australian Time).

This is a new consumer brochure for your practice to encouage the uptake of vaccination before pregnancy. To order please call Lisa.

When children arrive from overseas, it is often difficult to know which vaccinations they have had. This WHO website will enable you to review vaccinations country by country:

WHO overseas vaccinations

Seasonal flu vaccination for young children can be resumed - see updated advice from the Chief Medical Officer dated 30 July 2010 here on Department of Health website.

By completing this Agreement, you are authorised to receive the General Practice Immunisation Incentives practice report (GPII020A) from the Australian Childhood Immunisation Register (ACIR). This agreement is made by either ‘an individual immunisation provider’ or ‘a medical practice’ and outlines your obligations under section 46E of the Health Insurance Act 1973 regarding the use and storage of the information contained in the report. The GPII020A report is available to practices the children included incentives Program (PIP) and identifies the children included in your practice’s GPII outcomes payment calculation. The order form is on the CSGPN web site to find under immunisation.

If you have any question about the form and support with data cleaning please call Marlen 8752 4918.

Reference: www.medicareaustralia.com.au

Up to 800 000 patients received their first dose of pneumococcal vaccine in 2005 and these patients are now due for their 5 year booster. Act now to identify and vaccinate all eligible patients aged over 70years before winter. The National Pneumococcal Vaccination Program for Older Australians commenced in January 2005 and provides free pneumococcal polysaccharide vaccine (Pneumovax23®) to adults aged 65 years or older. People aged 65 years or over should discuss vaccination with their doctor or health care provider.

Adults aged 65 years or over are at higher risk of contracting pneumococcal disease than the rest of the population, with the majority of deaths from this disease occurring in this age group.

2 doses of vaccine are given, with the second dose given 5 years after the first dose. For technical information or information about vaccines, refer to the Pneumococcal section of the Australian Immunisation Handbook 9th Edition 2008 (NHMRC).
Reference:
www.racgp.org.au/ff/21

Australians are travelling overseas in ever-increasing numbers. Whatever your age and destination, properly preparing before you leave and staying in good health while travelling can help you to have a happy and enjoyable trip. This information provides travel tips and health information to help you prepare for a safe and healthy journey.

For more information visit the following sites:

• www.traveldoctor.com.au
• www.smartraveller.gov.au

 

MMR is the combined vaccine against measles, mumps and rubella. It contains live, weakened measles, mumps and rubella viruses. Measles, mumps and rubella are infectious diseases that are caused by three different viruses. They are spread when the viruses are passed from an infectious person to someone who is not immune to them. Rubella is also known as “German measles”. Two doses of the vaccine are usually recommended to be given early in life. This decision aid has been designed to help you decide whether to immunise your child with the measles-mumps-rubella (MMR) vaccine.

This decision aid is for you if:

• You are a parent or caregiver of a child approaching their due date for MMR vaccination.
• You want more information about MMR vaccination.

Using this decision aid will help you:

• Learn about measles, mumps and rubella diseases.
• Learn about the possible benefits and possible harms of MMR vaccination.
• Clarify what is important to you in making a decision about MMR vaccination.
• Make a decision about whether to vaccinate your child.

Reference:
www.ncirs.edu.au/immunisation/education/mmr-decision/index.php

 

Downloads

• H1N1 Flu Clinic Vaccination Guide

Please see the following attachments and guidelines for the national H1N1 vaccine roll out.

Timelines

• The vaccine will start to be delivered to those who have pre-ordered from TUESDAY 22 SEPTEMBER. The PROGRAM WILL START ON WEDNESDAY 30 SEPTEMBER
• See press release from Minister Roxon and DoHA
• The product was approved by the TGA for people 10 years of age and older.

Multi Dose Vial Guidelines

You will find the PDF MDV Guidelines as endorsed by ATAGI. These will also be available via the NSW Health H1N1 Vaccination website shortly.

IMPORTANT NOTE

• CSL tested the MDV and found that using the blunt drawing up needles produced “coring” (bits of bung in the vaccine) and jeopardised the integrity of the vial
• Hence a blunt 19G needle can only be used in the mass clinic setting where all doses are being drawn up and administered
• Otherwise 23G needle should be used to draw up the vaccine for individual doses. The VacPacs contain a long 23G needle that could be used for this purpose
• Panvax® will be distributed in packs (of varying sizes) of either 5mL (10 dose) OR 10mL (18 dose) MDV’s.

Vaccine eligibility

The vaccine is available for anyone who wants it over the age of 10.

Patient information sheet

A patient information sheet will be distributed with the vaccine and be available via the NSW Health H1N1 Vaccination website.

Consent form

This is optional as the vaccine is now TGA approved. If you still wish to use one, here is the Consent form PDF version.

Maternity guidelines

Further information will be available via the NSW Health H1N1 Vaccination website in the near future.

Indemnity

Please find a statement from the AMA for its members about indemnity for the H1N1 vaccination program.

Standing order

There will be no standing order developed. Authorised nurse immunisers do not need a standing order as this vaccine is to be regarded as an influenza vaccine (ie covered off in the Authority) and once the vaccine is licensed a PI (Product Information) will be available and included in all vaccine deliveries.

Indigenous communications

AMSs will receive a tailored poster from DoHA. The vaccine will be heavily marketed through Koori Radio.

Adverse events reporting

In contrast to usual procedures, providers are to be encouraged to report any AEFI of Panvax® directly to ADRAC as soon as possible after the event either by:
–      Electronic reporting
–      Blue Form:
If assistance is required contact your local Public Health Unit (PHU). PHU’s will record serious AEFI information supplied to them onto NDD and undertake any follow up required.

PENS

It’s recommended to write the date of opening onto the MDV; however this cannot be done with “ordinary” pens. CSL has kindly provided AGPN “Panvax® vial friendly” pens. These will be distributed to you via CSGPN as soon as they are received.

Further information

Please contact the Immunisation project office on 8752 4902 for further information.

From Monday 17 August 2009, all maternity units in Sydney South West Area Health Service (SSWAHS) will be offering vaccination with dTpa (Boostrix) to all mothers during the postnatal stay in hospital.

The objective of this policy is to reduce the risk and incidence of pertussis in newborns. As you will see from the 2 attached documents, this has the support of NSW Health and NCIRS. A brochure outlining the role of this injection will be given to each mother.

As General Practitioners usually take on the overall responsibility for vaccination records for their patients, it would be helpful if you ensure that your pregnant women are aware of this initiative and the implications of the new program.

Also could you please check with your postnatal patients whether they have been given the vaccination and ensure that there is a record of the vaccination being given as well as answer any questions they may have.

Dr Andrew Child AM
Clinical Director, Women’s Health and Neonatology
12 August 2009

Ph:   9515 8416
Fax:  9565 1595
Executive Unit
RPA Women and Babies

• Pertussis fact sheet
• Pertussis vaccination flyer
• Pregnant women info dtpa

Downloads

• GP update 9
• Oseltamivir suspension

Download

• TGA safety advice regarding GARDASIL HPV vaccine.

Current status

Human cases of a new form of influenza virus have been identified in the United States and Mexico. The virus is a type of influenza A virus that is usually seen in pigs (“swine influenza”).

No cases of swine influenza have been confirmed in New South Wales or Australia. 27.4.2009

The World Health Organisation has declared the swine influenza situation to be a public health event of international significance.

Pandemic alert levels have not been raised by the World Health Organisation or by the Australian Government.

This event is of concern because:
• Swine influenza is derived from an animal influenza virus, which means that humans are likely to have little or no immunity to the virus
• There has been rapid spread to multiple communities overseas
• Swine influenza is affecting unusual age groups (healthy, young adults)
• The swine influenza virus is thought to be sensitive to the latest antiviral drugs oseltamivir (Tamiflu) and zanamivir (Relenza)

For the most up-to-date information on the number of overseas confirmed cases of swine influenza please see:
• The World Health Organisation website
• and the United States CDC website

New South Wales is performing enhanced surveillance for the new swine influenza virus, by encouraging testing of people presenting with influenza-like illness or pneumonia who have recently returned from affected areas in the United States and Mexico.

NSW Health is working very closely with State and Commonwealth Government agencies to investigate and respond to this situation.

What you can do?

Influenza is spread from person-to-person through coughing or sneezing of infected people. There are many things you can do to prevent getting and spreading influenza:
• Cover your mouth when you cough, and wash your hands regularly.
• Cover your nose and mouth with a tissue when you cough or sneeze. Throw the tissue in the garbage bin after you use it.
• Wash your hands often with soap and water, especially after you cough or sneeze. Alcohol-based hands cleaners are also effective.
• Avoid touching your eyes, nose or mouth. Germs spread that way.
• Try to avoid close contact with sick people.
• Influenza is spread from person-to-person through coughing or sneezing. Stay away from people who are sick.
• If you get sick, stay home from work or school and limit contact with others to avoid infecting them.

For more information, see the swine flu fact sheet.

Advice for recently returned travellers

If you have returned from the United States or Mexico within the last 7 days, and are feeling unwell with any flu-like symptoms, such as cough, fever, headache, joint aches and pains, fatigue, nausea, vomiting or diarrhoea, please contact your local Public Health Unit, or go to your nearest hospital emergency department and tell them that you have recently returned from overseas and may have flu.

Advice for clinicians

Clinicians should consider the possibility of swine influenza A virus (H1N1) infection in patients who have:

a) an influenza-like illness (fever and cough and fatigue) and who have travelled to Mexico or United States of America within the past seven days

or

b) pneumonia and who have travelled to Mexico or United States of America within the past seven days.

If swine flu is suspected, please isolate the patient, notify your local Public Health Unit, safely obtain a viral nose and throat swab for swine influenza testing and send it immediately to ICPMR at Westmead Hospital, or SEALS at Prince of Wales Hospital.

Please see the advice to clinicians from the Chief Medical Officer.

Three Key points for GPs

1. The pertussis epidemic continues in NSW. Babies who are too young to be fully vaccinated are most at risk
2. For a limited time, dTpa vaccine will be provided free for all new parents, grandparents and any other adults who regularly care for infants
3. DTPa (Infanrix-hexa) can be given to babies from 6 weeks of age

Timely immunisation of infants is important because unvaccinated infants are at highest risk of infection and are also at high risk of complications. Because pertussis immunity wanes over time, many older children and adults are susceptible to infection and can be the source of new infections in infants.

For a limited time, FREE dTpa vaccine will be available for all new parents, grandparents and any other adults who will regularly care for infants less than 12 months of age.

GPs should advise all new parents to:
• Vaccinate their baby on time.
• Keep their baby away from anyone with a cough.

For new parents, GPs should:
• Check the immunisation status of new parents and other children and provide catch-up vaccination.
• Offer FREE dTpa vaccine to new parents, grandparents and any other adults who regularly care for infants.
• Consider vaccinating infants at 6 weeks if the opportunity arises. Infanrix-hexa, Prevenar and Rotarix are all licensed for use in infants from 6 weeks of age. The next scheduled vaccines should be given at 4 and 6 months of age.

Who is eligible for the FREE dTpa vaccine?
• Couples who are planning a pregnancy (both parents).
• New parents (mothers should be vaccinated as soon as possible after childbirth).
• Grandparents and other adults who will regularly care for the infant.

Ordering FREE dTpa vaccine for adults
Fax order form to the NSW Vaccine Centre on 1800 041 528. Download:
Pertussis outbreak response order form.
Additional guidelines for ordering free dTpa vaccine

For further information, GPs can call the Public Health Unit at Camperdown on 9515 9420.

Previously Bali was considered rabies free; hence this presents a new risk to Australians visiting Bali.

The Indonesian media have also reported that several people with rabies-like clinical signs and symptoms have died after being bitten by dogs. There is at present no indication that the disease has spread to animals other than dogs. However any animal should be considered to pose a potential risk.

NSW Health recommends that all adults and children visiting Bali should avoid contact with wild and domestic animals, including dogs, cats and monkeys, even if the animal appears well.

“Anyone who is bitten or scratched by an animal in a rabies-affected area, including Bali should immediately wash the wound well with soap and water, apply an antiseptic such as povidone iodine to the wound and see a doctor as soon as possible,” Dr Andrew Marich, Acting Director of NSW Health’s Communicable Diseases Branch, said.

“A course of injections is sometimes needed to prevent rabies infection developing after a bite or scratch,” he said.

NSW Health advises that anyone who has been bitten or scratched by any animal in Bali since 1 August 2008 should see their general practitioner for advice. People bitten or scratched by an animal before this time are not thought to be at risk of rabies.

Rabies is transmitted when viruses in a rabid animal’s saliva get into nerve cells through a wound – usually following a bite or a scratch. While many rabid animals will be sick and may go on to die, some appear well.

Symptoms in humans may include headache, fever, feeling unwell, sensory changes around the site of the bite or scratch, excitability, an aversion to fresh air and water, weakness, delirium, convulsions, and coma.

If rabies infection has occurred, symptoms in humans normally begin within several weeks but sometimes the symptoms begin years after infection. Death usually follows several days after the onset of symptoms.

There is no treatment for rabies once the symptoms have started however treatment of infected people before they develop symptoms can be effective.

The Governor of Bali has temporarily banned the import or export of dogs, cats, monkeys and other animals declaring the island under official quarantine until further notice. Officials are also endeavouring to create a perimeter of vaccinated animals in the areas immediately surrounding those areas in which rabies has been confirmed, aiming to isolate and eventually eliminate the disease.

For a copy of the fact sheet on rabies go to NSW Health Fact Sheet.