What were the changes?

  • Pneumococcal (Prevenar 13): The third dose of pneumococcal vaccine (previously provided at 6 months) is now given at 12 months of age. The first and second doses of pneumococcal vaccine will continue to be given at 6 weeks and 4 months (two dose primary course) followed by a booster dose at 12 months of age. Children with medical conditions associated with an increased risk of invasive pneumococcal disease (IPD) will still receive an additional dose of Prevenar 13 at 6 month of age; that is, they will continue to have a three dose primary course followed by a booster at 12 months of age.
  • Meningococcal ACWY (Nimenrix): Previously children received a combined meningococcal C-Hib vaccine (Menitorix) at 12 months. From 1 July 2018 children now receive a meningococcal vaccine (Nimenrix) at 12 months of age that protects against 4 serogroups including A, C, W and Y.
  • Haemophilus influenzae type b (Act-HIB): Children now receive their fourth dose of Haemophilus influenzae type b (Hib) vaccine as a monovalent vaccine (Act-HIB) at 18 months of age (no longer combined with meningococcal C at 12 months). They continue to receive their Hib primary schedule doses at 6 weeks, 4 months and 6 months (Infanrix Hexa).

Frequently asked questions (FAQs)

Pneumococcal

What is pneumococcal disease?

Pneumococcal disease is caused by infection with the bacteria Streptococcus pneumoniae. Infection can cause a variety of diseases including: pneumonia (infection of the lungs), otitis media (infection of the middle ear) and meningitis (infection of the membranes around the brain and spinal cord).

What changed in regards to the pneumococcal vaccine on 1 July 2018?

The third dose of pneumococcal vaccine (Prevenar 13) previously given at 6 months of age is now given at 12 months of age (from 1 July 2018) – Prevenar 13 is given at 6 weeks, 4 months and 12 months.

Children with medical conditions associated with an increased risk of invasive pneumococcal disease still receive the 6 month dose as an additional dose - given at 6 weeks, 4 months, 6 months and 12 months. A list of these conditions is available from The Australian Immunisation Handbook

Why did the schedule change in relation to the pneumococcal vaccine for children?

The Australian Technical Advisory Group on Immunisation (ATAGI) recommended a change in the timing of the pneumococcal vaccine (Prevenar 13) doses to ensure that the National Immunisation Program (NIP) is aligned with disease patterns. Since the introduction of the pneumococcal vaccine there has been a large reduction in cases of invasive pneumococcal disease (IPD), however in recent years there has been an increase in the number of cases of IPD in children beyond 12 months of age. A dose of pneumococcal vaccine in the second year of life is expected to improve the protection provided by the childhood vaccination program, and reducing the primary course from three to two doses is not expected to increase the risk of IPD in infants under 12 months of age.

Where can I get more information about pneumococcal disease?

See the pneumococcal disease fact sheet for more information.

Meningococcal ACWY

What is meningococcal disease?

Invasive meningococcal disease (IMD) is a rare but serious infection caused by the bacteria Neisseria meningitidis that usually causes meningitis (inflammation of the lining of the brain and spinal cord) and/or septicaemia (blood poisoning). Up to 10 per cent of IMD infections are fatal even with appropriate antibiotic treatment and survivors may be left with long-term complications. There are several serogroups of Neisseria meningitidis which cause invasive disease in Australia: A, B, C, W and Y.

What changed in reagards to the meningococcal vaccine on 1 July 2018?

Before 1 July 2018 children received a combination meningococcal C, Haemophilus influenzae type b (Hib) vaccine at 12 months of age. To broaden the protection of children against the bacteria that causes meningococcal infection, a vaccine (Nimenrix) that protects against 4 serogroups of the bacteria is now given to children at 12 months of age from 1 July 2018. These serogroups are A, C, W and Y. The Hib component of the previous vaccine is now given as a monovalent vaccination (Act-HIB) at 18 months.

Why did the meningococcal vaccine change?

Prior to 1 July 2018 the meningococcal containing vaccine given to children at 12 months of age only provided protection against serogroup C of the bacteria that causes meningococcal infection.

In recent years there has been an increase in the number of cases of meningococcal infection caused by serogroups of the bacteria other than the C serogroup. Therefore from 1 July 2018 children now receive a meningococcal vaccine at 12 months of age which protects against an additional 3 serogroups of the bacteria. The vaccine (Nimenrix) protects against serogroups A, C, W and Y serogroups.

Who is eligible for the meningococcal ACWY vaccine?

Meningococcal ACWY will be given to all children who are eligible for their 12 month vaccinations from 1 July 2018 onwards.

Children who received their 12 month vaccines (including meningococcal C-Hib) before 1 July 2018 are not eligible to receive the meningococcal ACWY vaccine under the National Immunisation Program (NIP). Meningococcal ACWY-containing vaccines can be purchased from the private market however there should be a minimum interval of 8 weeks between the meningococcal C vaccination and administration of the meningococcal ACWY vaccine.

Can Nimenrix be administered before 12 months of age?

Nimenrix is registered for use from 12 months of age however the Australian Technical Advisory Group on Immunisation (ATAGI) advise that it can be used from 6 weeks of age. In order to be considered fully immunised the 12 month dose should not be given before 11 months of age.

If a child who has not received their 12 month vaccinations presents for catch up after 1 July 2018 should they receive the meningococcal ACWY vaccine?

If a child presents for their 12 month vaccinations late, administer the vaccines according to the current schedule.

What if a parent wants to initiate meningococcal ACWY vaccination prior to 12 months of age?

Parents who wish to initiate meningococcal ACWY vaccination prior to their child’s first birthday can purchase this from the private market.

Should a child who commenced or completed a vaccination course for meningococcal ACWY prior to 12 months of age be vaccinated at 12 months? Is it funded?

Yes. A single dose of meningococcal ACWY vaccine is recommended and funded to be given at 12 months of age for all children regardless of whether they have previously received meningococcal ACWY vaccine prior to 12 months of age. However, there should be a minimum interval of 8 weeks from their last meningococcal ACWY dose before the 12 month dose is given.

Why is the meningococcal B vaccine not included on the schedule?

In contrast to vaccines for meningococcal serogroups A, C, W & Y, the cost-effectiveness of the meningococcal B vaccine has not been demonstrated. Further, year on year meningococcal B cases in Australia have been decreasing, and while still a very serious disease, the circulating strains of meningococcal B disease do not show the same levels of mortality as is seen with meningococcal W disease. Meningococcal B vaccine is however available for purchase from the private market.

Can a child receive the meningococcal ACWY vaccine at the same time as meningococcal B vaccine?

Yes. Meningococcal B vaccine (Bexsero or Trumenba) can be administered at the same time as meningococcal ACWY vaccine, however prophylactic administration of paracetamol is recommended before and after administration of Bexsero in children aged <2 years. Meningococcal B vaccine is not funded under the National Immunisation Program. If people wish to vaccinate their child against meningococcal B they will need to purchase it from the private market.

Which injection sites should be used for children 12 months and over who require 3 or more vaccines?

The vaccination site selection advice in The Australian Immunisation Handbook should be followed. For children who are 12 months of age or older the deltoid is the preferred site. However the ventrogluteal area is an alternative site for IM vaccination of these children. The vastus lateralis in the anterolateral thigh may also be used in children 12 months or older. If this site is used, the less locally reactogenic vaccines (e.g. MMR) should be given in the thigh.

When three or four IM vaccines are to be given to a child at the same visit, the options will depend on the muscle mass of the child’s deltoid.

  • If the deltoid mass is adequate, give a further injection into each deltoid muscle (separated by 2.5 cm from the initial injection site).
  • If the deltoid muscle mass is small:
    • give further injections into either anterolateral thigh (2.5 cm apart if two vaccines are given in the same thigh), or
    • give one injection into each ventrogluteal area.

Where can I get more information about meningococcal disease?

See the meningococcal disease fact sheet for more information about meningococcal disease.

Haemophilus Influenzae type b

What is Haemophilus influenzae type b?

Haemophilus Influenzae type b (Hib) disease is caused by infection with Haemophilus influenzae type b bacteria.

Infection can cause:

  • meningitis (infection of the membranes around the brain and spinal cord)
  • epiglottitis (severe swelling of the epiglottis at the back of the throat)
  • pneumonia (infection of the lungs)
  • osteomyelitis (infection of the bones and joints)
  • cellulitis (infection of the tissue under the skin, usually on the face).

These conditions can develop quickly, and meningitis and epiglottitis can sometimes be fatal.

What changed in regards to Haemophilus influenzae type b vaccine on 1 July 2018?

Before 1 July 2108 children received the fourth dose of Haemophilus influenzae type b (Hib) in a combination vaccine with meningococcal C at 12 months of age (Menitorix). From 1 July 2018 the Hib component of the vaccine is now given as a monovalent vaccination (Act-HIB) at 18 months.

Why was there a change to the Haemophilus influenzae type b vaccine (Hib)?

In order to facilitate required changes to the Immunisation Schedule, the Australian Technical Advisory Group on Immunisation (ATAGI) reviewed evidence regarding the Hib vaccine and recommended that the fourth dose be moved to 18 months of age as it was safe and effective to do so.

Where can I get more information about Haemophilus influenzae type b disease?

See the haemophilus influenzae type b fact sheet for more information about Hib disease.

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Page Updated: Thursday 14 March 2019
Contact page owner: Immunisation