In adulthood it is important to ensure on-going protection against vaccine preventable diseases. The following information provides advice on specific diseases that are important to be protected against in adulthood.
Shingles is a painful blistering rash caused by reactivation of the varicella zoster virus – the same virus that causes chickenpox. A single dose of shingles vaccine is recommended and funded for adults at 70 years of age. Adults 71-79 years of age are also eligible under a five-year catch up program until 31 October 2021. Certain people may be unable to have the vaccine, particularly those who have a very weakened immune system. Please speak with your general practitioner (GP) for advice. More information is available in a fax sent to GPs, on the Immunise Australia website and in a factsheet from the National Centre for Immunisation Research & Surveillance (NCIRS) and FAQ from NCIRS. The current Immunisation Authority for Registered Nurses and Midwives does not include herpes zoster (shingles) vaccine. Authorised Nurse Immunisers must not independently initiate and administer herpes zoster vaccine (Zostavax) without medical authorisation. A webinar on shingles has been prepared for GPs.
Measles outbreaks occur in some communities mainly as a result of unvaccinated travellers and visitors importing the disease from overseas. It is therefore important to ensure that you are adequately protected and the following should be considered:
- most people born before 1966 will have been exposed to wild measles virus and therefore do not require vaccination
- people born after 1966 require two doses of MMR vaccine (at least one month apart)
It is important that adults are vaccinated against whooping cough to ensure adequate protection against this disease. Despite whooping cough immunisation programs being in place, epidemics can occur every three to four years, but in vaccinated populations the outbreaks are smaller.
Whooping cough vaccination in adults also offers protection for babies who are too young to be immunised in their first few weeks of life. Anyone can be affected but it is more severe (and can be fatal) in small babies.
A history of having this disease does not mean life-long immunity, therefore vaccination is still necessary. All persons who have received a course of diphtheria, tetanus and whooping cough vaccine as a baby (usually given at 6-8 weeks, 4 months and 6 months of age) require booster doses at 4 years, 12 years (in the NSW School Vaccination Program) and 50 years of age. All adults aged over 65 years of age require a booster dose if 10 years have passed since their last dose. If you are unsure, please discuss your vaccination needs with your doctor.
Whooping cough vaccination during pregnancy
Free whooping cough vaccine is available for pregnant women in their third trimester (preferably at 28 weeks) through antenatal clinics, general practitioners (GPs) and Aboriginal Medical Services (AMSs).
International studies have found that whooping cough vaccination during pregnancy is safe and effective for both the mother and baby. Vaccination is best given at 28 weeks to provide time for antibodies to be produced and passed on to the baby to provide protection until it is able to have its own vaccinations from 6 weeks of age.
Family members and carers who will have close contact with babies in their first weeks of life should receive a whooping cough vaccine on prescription at least two weeks before having contact with the baby unless they have received a dose in the previous 10 years and all children should be up to date with their vaccinations. For more information, please see Protect Your Newborn From Whooping Cough.
A single dose of pneumococcal vaccine is recommended for adults at 65 years of age. Adults who have not received a dose at 65 years of age should have a single catch-up dose as soon as possible. Adults who have a medical condition (for example, cardiac, liver and congenital diseases) are at risk of catching this disease and should discuss this with their doctor as soon as possible as they may require additional vaccinations to ensure that they are adequately protected.
Yellow fever is a viral haemorrhagic fever occurring in some regions of Africa, Central and South America. Yellow fever is a quarantinable disease in Australia. People who are one year of age or older must hold an international vaccination certificate if, within six days before arriving in (or returning to) Australia, they have stayed overnight or longer in a declared yellow fever infected country. Travellers should seek medical advice on vaccination for their individual medical circumstances, particularly about the suitability of yellow fever vaccine for infants, pregnant women and those who are immuno-compromised.
Yellow fever vaccinations must be provided by an approved yellow fever vaccination clinic. These clinics will provide a vaccination certificate in the form approved by the World Health Organisation (WHO), and completed according to WHO requirements. The World Health Organisation has recently recommended that a single dose of yellow fever vaccine provides life-long immunity to the disease. The International Health Regulations that currently specify a booster dose is required every ten years, will be amended to reflect the single dose requirement in June 2016.
Australia will adopt the changes as part of the commencement of the Biosecurity Act 2015 on 16 June 2016. Until then, the current legal requirements regarding entry into Australia, will remain in place. Travellers to Australia within 6 days of leaving a country on Australia’s list of yellow fever declared places who do not have a valid certificate are provided with information on yellow fever and are required to promptly seek medical assessment if they develop relevant symptoms within 6 days of leaving the yellow fever declared place. More information relating to these changes is available in the NSW Health letter to providers or from the Australian Department of Health.
The timing of implementation of the new IHR yellow fever vaccination entry requirements may vary by country. It is recommended that the entry requirements for yellow fever vaccination for the countries a traveller intends to enter or transit through be confirmed prior to travel by contacting the country’s foreign missions in Australia.
Immunisation providers wishing to become an approved yellow fever vaccination clinic must contact their local Public Health Unit on 1300 066 055. Only those providers who are approved by the Public Health Unit, and are issued an individually numbered stamp, are authorised to provide yellow fever vaccination.
Further information on yellow fever for travellers and professionals can be found in the Australian Government's Yellow Fever fact sheet. The webpage also contains details for approved yellow fever providers to order the International Certificate of Vaccination or Prophylaxis in the form approved by WHO.
Q Fever is caused by a bacterium, Coxiella burnetii, that can be spread to humans from cattle, sheep and goats. Workers in the meat and livestock industries are most at risk of Q Fever.
More information about Q Fever is available on the Q Fever Facts website, including a dedicated section for health professionals with links to educational resources. Please contact Seqirus Pty Ltd on 1800 008 275 for log-in details to access these resources if you are a health professional.
The Australian Q Fever Register holds information on the Q Fever immune status of individuals, accessible to registered organisations (primarily meat processors and medical practitioners). The Register holds details of Q Fever vaccination providers in a number of Australian states. To find contact details for Q Fever vaccination providers in NSW, contact your local Public Health Unit on 1300 066 055, or the customer service line of the manufacturer/distributor, Seqirus Pty Ltd, on 1800 008 275.