The Australian National Immunisation Program schedule as of 20 April 2015 are the vaccines funded by the Australian government as a significant public health intervention to prevent the spread of many diseases that may result in hospitalisation or serious health issues.
Let’s take a look at an update on the important vaccines specific to your life stages:
Prior to becoming sexually active
Human papillomavirus (HPV) (1) vaccines help prevent genital warts and several cancers (including cervical cancers) associated with HPV strains contracted through sexual intercourse. Most genital HPV infections have no symptoms and are cleared by the body within 12-24 months. However, in about 3-10% of infections the virus persists which can progress towards cancer. Pap smears every 2 years are highly effective in detecting cervical cell changes, however the vaccine was developed to provide immunity to two high risk HPV types linked to genital cancers, and two HPV types commonly associated with genital warts, prior to sexual activity when it is more effective. There are two HPV vaccines registered for use in Australia, both with 3 doses over 6 months. These are indicated for women between 9 and 45 years of age, and one vaccine is indicated for males aged 9-26, both of which commence in school programs. In women who are already sexually active, the HPV vaccination will not treat an existing HPV infection or prevent disease with an existing HPV type infection, but may still provide benefit against new infections with HPV strains in the vaccine.
At present, a two dose HPV regime is currently being studied.
Pregnancy Planning
Prior to pregnancy it is important to know if you have immunity to chickenpox (varicella) and German measles (rubella).
This is important because an infection during pregnancy could result in congenital abnormalities in the baby, so to avoid this, we check your history and confirm your immunity on blood tests.
Prior to pregnancy, if you are not immune to chicken pox you will be given two doses of the varicella vaccine (2) at least 4 weeks apart. If you are not immune to rubella, you will be given the MMR (measles-mumps-rubella) (3) vaccine with your immunity retested to confirm 6-8 weeks later. These vaccines can not be given during pregnancy, and also pregnancy should also be avoided for 28 days after vaccination.
If not given prior to pregnancy, Diptheria, tetanus and acellular pertussis (whooping cough) dTpa (4) is now given in the third trimester of pregnancy (not funded). This was introduced to protect both the mother and the newborn against whooping cough, as immunity is passed from the mother to the newborn via the placenta to protect it against infection prior to the baby being vaccinated at 2 months. This was introduced after recent outbreaks of whooping cough in Australia which caused some devastatingly severe symptoms and even death in the newborns who were contracting it.
The seasonal influenza vaccine (flu shot) (5) is safe and can be given at any time during the pregnancy. The influenza vaccine is funded under the national immunization program for pregnant women as they are at greater risk of complications of influenza including hospitalisation requiring intensive care. The influenza vaccine needs to be given annually because the actual type of circulating flu virus changes each year.
The influenza vaccine is publicly funded for:
- People aged 65 years and over
- Aboriginal and Torres Strait Islander (ATSI) peoples aged six months to less than 5 years or 15 years and over
- Individuals aged six months and over with medical conditions such as severe asthma, lung or heart disease, low immunity or diabetes that can lead to complications from influenza.) (5)
Over 50 years
Herpes zoster vaccine (shingles) (6), (not funded), is currently recommended for adults aged 60 years and over to prevent the reactivation of the chicken pox virus herpes zoster (shingles) and it’s complications which can include a chronic pain syndrome, meningitis, and pneumonia after the infection.
This vaccine can be given at the same time with influenza vaccine in different injection sites, but recommended to be given at 4 weeks apart from the Pnemococcal vaccine (see below).
The vaccine can be used from aged 50, but is not routinely recommended, as the likelihood of developing complications following herpes zoster in this age group is much lower, than in those older than 60 years.
The Pnemococcal vaccination (23vPVV) (7) is offered under the national program to anyone aged 65 years and over, and Aboriginal and Torres Straight Islander peoples earlier aged 50 and over, to protect from infections caused by the bacterium Streptococcus Pneumonia. This bacteria is easily spread via repiratory droplets in the air (for example when an infected person sneezes or coughs), however, these groups are at a much higher risk of developing severe symptoms or complications of the disease such as pneumonia, meningitis and blood infections that can be life threatening, so the vaccine can be highly protective. A single dose of 23vPPV is recommended at age 65 years of age, and two doses for ATSI peoples, one at aged 50, then a second dose 5 years later.
For more information visit Immunise Australia or take a look at the Australian Immunisation Handbook 10th edition 2013 (updated January 2014)
To discuss or receive any of these vaccines, visit your local doctor or immunisation provider.
References:
(3) https://www.immunise.health.gov.au/internet/immunise/publishing.nsf/Content/immunise-rubella
(5) https://www.immunise.health.gov.au/internet/immunise/publishing.nsf/Content/immunise-influenza
