Immunisation Update

1
ImmunisationUpdate
2

Changes to the immunisation schedule Contraindicat
ions and precautions to vaccination Epidemic
update
3

• Three significant changes to the immunisation
  schedule in 2008
• New pneumococcal vaccine for infants
• MeNZB vaccine programme
• HPV vaccine programme

4
New pneumococcal vaccine for infants

• PCV7 (Prevenar) vaccine has been added
• Effective in children lt 2 years
• Previous vaccine 23PPV (Pneumovax?23) not
  effective in infants
• Given at 6 weeks, 5 and 15 months
• Children at high risk still have PCV7 23PPV

5
MeNZB vaccine programme

• ? in cases group B meningococcus
• MeNZB now removed from National immunisation
  schedule

6
Contraindications and precautions to vaccination
7
Vaccine Contraindications
All Vaccines Anaphylactic type reaction to a previous dose of that vaccine, or to anyvaccine component (not trace element)
Pertussis-containing vaccines Previous encephalopathy within seven days after a previouspertussis-containing vaccine Evolving (undiagnosed) neurological problem
Measles, Mumps, Rubella, MMR,Varicella, Yellow Fever, Oral Polio Immunosuppressed individuals If blood, plasma or immunoglobulin were given in the last 11 months Pregnancy
Influenza, Yellow Fever Anaphylactic reaction to chickens, including eggs, egg protein, feathers etc
8
Precautions

• There are a number of precautions to vaccination
• Giving a live vaccine less than four weeks after
  another live vaccine
• Pregnancy.
• Allergy to Vaccine components
• History of Guillain Barré Syndrome
• Thrombocytopenia or history of thrombocytopenic
  purpura and MMR
• Haemophilia and related bleeding disorders

9
False contraindications

• The following conditions or circumstances are not
  contraindications to vaccination
• Minor infections without significant fever or
  systemic upset
• Asthma, hayfever, eczema, snuffles
• Food or medications allergy
• Treatment with antibiotics or locally acting
  steroids
• Pregnancy in the childs mother
• A child who is breastfeeding
• Neonatal jaundice
• Low weight in an otherwise healthy child
• (continued on next slide)

10
False contraindications (..contd)

• The child being over the usual age for
  immunisation
• Family history of vaccine reactions, seizures or
  Sudden Infant Death Syndrome
• Prematurity in an otherwise well infant who is
  not in hospital
• Established neurological conditions such as
  cerebral palsy or Down syndrome
• Contact with an infectious disease
• Clinical history of pertussis, measles, mumps or
  rubella (clinical history without laboratory
  confirmation can not be taken as proof of
  immunity)

11
Epidemic update

• Pertussis
• Measles

12
Pertussis

• New Zealand has a pertussis epidemic every four
  to five years currently in early phases
• Infants are vulnerable to disease
• The best way to contain an epidemic is
  immunisation and effective management of
  confirmed cases
• Exclude confirmed cases from school or work
• Pertussis is a notifiable disease to MOH

13
Measles

• ? in cases since start of 2009
• 95 of popn must be immunised to avoid outbreaks
• Difficult as efficacy of measles vaccine is
  90-95
• All children should be vaccined at 15 months and
  4 years