Gippsland PHN DHHS Immunisation Update 10 May 2018

Gippsland PHN - DHHS Immunisation Update 10 May 2018 Chelsea Taylor Senior Policy Advisor – Immunisation, DHHS

Childhood vaccine coverage –PHN and State AIR data reports: Annualised 2017

Improved access to AIR overdue reports Collaborative strategy between DHHS and PHNs to improve provider access to 11 A (overdue children) Report • Providers’ access to the reports appear to impact coverage 1. Access to 11 A reports in current format from AIR unusable – requires manipulation 2. Provider access ad hoc based on capacity/motivation 3. Lack of consistency/monitoring of how reports are used by providers to follow-up overdue children • Centralised process (either by state or by Register) to manipulate (DHHS) & communicate (PHNs) 11 A report

Proposed scope of project Amalgamation of 11 A reports Immunisation Section to distribute relevant reports to 6 PHNs – identified by last immunisation provider PHNs to distribute relevant reports to local immunisation providers Local strategies for imm’n providers to data cleanse & notify parents/carers of O/D children Filtered by children measured in next coverage reporting period

No Jab No Play – Legislative change 28 February 2018 • Under this legislation, only an Immunisation History Statement from the Australian Immunisation Register (AIR) will be accepted when confirming the enrolment of a child in early childhood and care services. • Documents produced by GPs or other immunisation providers will no longer be accepted as proof of immunisation. • Provide prompt and accurate information to the AIR following immunisations to ensure children’s records are up to date and Immunisation History Statements can be accessed from the AIR. • Parents or carers can get a printed copy of their child’s Immunisation History Statement via their individual my. Gov account, by calling the AIR on phone 1800 653 809 or by visiting a Medicare or Centrelink office. Online provider version of child’s statement can also be printed and used for entry to childcare • Families who do not hold a Medicare card must call the AIR, phone 1800 653 809 to request an Immunisation History Statement be sent by post. Online provider version of child’s statement can also be printed and used for entry to childcare • Further information, including a downloadable information sheet for immunisation providers

No Jab No Pay Commonwealth legislative change • 1 May 2017 the Commonwealth Minister for Health announced the Australian Government would be changing the structure of tax benefit payments impacted by No Jab No Pay policy • Effective 1 July 2018, the fortnightly Family Tax Benefit Part A payment will be reduced by $28 per fortnight, rather than withholding the supplement at the end of the year as occurs at present, for each child who does not meet the immunisation requirements. • Commonwealth announcement – No Jab No Play

Victorian secondary school vaccine program – percentage adolescents vaccinated by LGAs 2017 Enrolment Figures: Year 7: 72936 Year 10: 72389 Year 11: 68495 Year 12: 60965

Invasive meningococcal disease Serogroup and Year Victoria: 2013 to 2018 Q 1 Not further typed B C W Y 100 Number of Notified Cases 90 80 17 9 70 60 36 9 50 48 40 1 4 30 20 1 1 10 20 0 1 2013 27 1 2014 17 8 1 29 18 1 2016 2015 Year 26 1 2017 6 1 3 1 2018 Q 1

Invasive meningococcal disease Age group and Serogroup Victoria: 2015 to 2018 Q 1 Not further typed B C W Y 45 Number of Notified Cases 40 35 30 25 20 15 10 5 0 0 -9 10 -19 20 -29 30 -39 40 -49 50 -59 Age (years) 60 -69 70 -79 80 -89 90 -99

2018 school vaccine program • Gardasil® 9 will replace Gardasil® in Year 7 (catch-up to 19 years) • d. Tpa continues in Year 7 (catch-up to 19 years) • Meningococcal ACWY Year 10 (age equivalent 15 -16 years) to 31 Dec 2018 • New meningococcal ACWY factsheet Immune Hero resources available to promote adolescent vaccines http: //immunehero. health. vic. gov. au/ 10 March 2021

Gardasil® 9 – Jan 2018 (Commonwealth program) • Includes the HPV types covered by Gardasil® (6, 11, 16 and 18) plus an additional five - (31, 33, 45, 52 and 58). • Two dose interval 6 to 12 months apart. • If second dose (any HPV vaccine) is accidentally administered < 5 months after first, a third dose is required. • If the second dose (any HPV vaccine) is inadvertently received at <6 months but ≥ 5 months after the first dose, a third dose is not required. • Immunocompromised individuals (see ATAGI advice) and those initiating course ≥ 15 years require three doses to attain adequate protection at 0, 2, 6 month interval. • Re-vaccination with Gardasil® 9 is not routinely recommended for individuals who have already completed a full schedule with either 10 March 2021 Gardasil® or Cervarix® vaccine.

Gardasil® 9 – Jan 2018 (Commonwealth program) • Gardasil® 9 available to order using the updated Government vaccine order form. • Leftover Gardasil® 4 vaccine should be clearly labelled and separated from the new Gardasil® 9 vaccine stock in your vaccine fridge. • Gardasil® 4 vaccine can be used for the time limited, men who have sex with men (MSM), HPV vaccine program ending 31 December 2018 • Gardasil® 4 vaccine can also be offered opportunistically and for free to those > 19 years who did not previously access/complete the course of vaccine • Order Gardasil® 4 stock using the updated Government vaccine order form. 10 March 2021

Targeted vaccine programs (Vic State program) Hepatitis A vaccine • Until 31 December 2018, all men who have sex with men (MSM) who live in Victoria, and all men and women who have injected drugs in the past 12 months and live in Victoria, and all homeless rough sleepers can access a free, 2 dose vaccine course of hepatitis A Meningococcal vaccine • Until 31 December 2018, all MSM living in Victoria can access free meningococcal ACWY vaccine HPV vaccine • Until 31 December 2018, all MSM, up to 26 years of age, living in Victoria can access free HPV 3 dose vaccine course (Gardasil® 4). Hepatitis B vaccine • Ongoing - remains free to all MSM and all men and women who inject drugs living in Victoria. New funded population: people born in priority hepatitis B 10 March 2021

Hepatitis B targeted programs for people at-risk (Vic State program) • Ongoing - as a long-term approach to protect against liver disease and liver cancer • • All Aboriginal and Torres Strait Islander people – hepatitis B non-immune • New funded population: people born in priority hepatitis B endemic countries and arrived in Australia in the last 10 years. (Priority countries include China, Philippines, Malaysia, Vietnam, Afghanistan, Thailand, South Korea, Myanmar (Burma) Indonesia, Singapore, Hong Kong, Taiwan and Cambodia). Household contacts and sexual partners of people living with hepatitis B People who inject drugs or are on opioid substitution therapy People living with Hepatitis C all MSM People living with HIV Prisoners and Remandees and people no longer in custodial setting who commenced but did not colete a free vaccine course while in custody 10 March 2021

Eligibility & age recommendations for the 2018 funded influenza vaccine program – Victoria Who is eligible? • All children aged 6 months to <5 years (Victorian government funded program) • People aged 5 years and over who have a medical risk factor that increases their risk of complications from influenza • All Aboriginal people aged 15 years and over • All pregnant women anytime during pregnancy • All adults aged 65 years and older 10 March 2021

Funded influenza vaccine brands – Victoria 65 years of age and over Trivalent — Fluad® or Fluzone® High-Dose All people aged 65 years and over Higher-immunogenicity influenza vaccine 6 months to less than 3 years of age Quadrivalent — Flu. Quadri™Junior All children* aged 6 months to less than 3 years *2 doses spaced by a minimum of 1 month in the first year of flu vaccination 3 years to less than 65 years Quadrivalent — Flu. Quadri™ or Fluarix. Tetra® All people* aged 3 years to less than 65 years *Eligible children aged less than 9 years, 2 doses spaced by a minimum of 1 month in the first year of flu vaccination 18 years to less than 65 years Quadrivalent — Afluria Quad®, or Flu. Quadri™ or Fluarix. Tetra® Afluria Quad® - only use from 18 years of age (not registered for use less than 18 years of age) 10 March 2021

Influenza vaccine distribution Distribution for people aged 65 years and over commences the week of Monday 2 April 2018. All GP clinics, Community Health Centres and Aboriginal Clinics included on the pre-allocation list will have vaccine by mid-April. Check your clinic is on the pre-allocation list by looking up your account number on the preallocation list. Pre-allocation stock will only consist of new higher-immunogenicity trivalent influenza vaccine for those aged 65 years and over. Once pre-allocation is received, you can order further influenza vaccine for people 65 and over and other eligible groups. Vaccine formulation for children aged 6 months to less than 3 years will not be available to order until mid April. Other providers may place orders now by downloading the latest vaccine order form. Deliveries during flu season will take longer than normal. Please assess other vaccine needs when placing flu orders to minimise delivery costs and 10 March 2021 timing.

Cold Chain - National Vaccine Storage Guidelines • Aimed at vaccine service providers • Outlines the basic principles of safe vaccine management If we don’t protect our vaccines they won’t protect our community 10 March 2021

Cold Chain - Vaccine storage Vaccines are temperature sensitive biological substances that become less effective or destroyed if they are: • Frozen • Allowed to get too hot • Exposed to direct sunlight or fluorescent light • The loss of vaccine effectiveness is cumulative and cannot be reversed 10 March 2021

Cold chain breach – fridge magnet 10 March 2021

Influenza vaccine cold chain requirements Important changes to managing your influenza vaccine when a cold chain breach occurs: All cold chain breaches involving seasonal influenza vaccine outside the recommended range of 2°C to 8°C, (excluding fluctuations up to 12°C lasting less than 15 minutes) must be managed as follows: Always contact the manufacturer for guidance with every cold chain breach involving seasonal influenza vaccine: - Fluad and Afluria. Quad - Seqirus Medical Information (1800 642 865) or email medinfo. aust@csl. com. au - Fluzone High-Dose and Flu. Quadri Junior - Sanofi Pasteur on Medical line Ph 1800 829 468 or email Vaxihelp. Australia@sanofi. com - Fluarix Tetra - GSK Medical line on Ph 1800 033 109 or email mel. australiamedinfo@gsk. com 10 March 2021

Shingles vaccine program • Shingles vaccine (Zostavax®) commenced 1 November 2016 • Eligibility criteria: ongoing program for 70 year olds plus a five-year catch-up program for people aged 71 – 79 years. Eighty year olds that were age eligible from 1 November but missed a dose due to supply constraints can still receive a free dose Reminder: • This vaccine is contraindicated in immunocompromised people • Adverse events are reported to SAEFVIC and must include if the person is immunocompromised • NCIRS fact sheet: http: //www. ncirs. edu. au/assets/provider_resources/fact-sheets/zoster-vaccinefact-sheet. pdf 10 March 2021

Pharmacist administered vaccine program 26 November 2015, the Minister for Health announced Pharmacist. Administered Vaccination Program • Program commenced in June 2016 and 657 pharmacists have upskilled to provide vaccinations in 268 pharmacy locations across Victoria. • Approval for Pharmacist-administered influenza vaccine and pertussis containing vaccine • 18 years of age and over • People eligible for the NIP schedule and the Victorian parent pertussis program • Pharmacists must be registered and complete an immunisation course of training • For a list of services providing vaccine in your area, visit https: //www 2. health. vic. gov. au/servicesearchresults? se=282 B 113969814 FD 695 A 26968 BCD 4255 A&nm=Tru e

What’s Coming…meningococcal ACWY (Commonwealth program) 2 February 2018 – Commonwealth announced Men. ACWY vaccine program will be added to the NIP ahead of the next peak meningococcal season. What we know: • Nimenrix® vaccine will be used • will replace Menitorix at 12 month schedule point • expected to start second half of 2018. • this will be in addition to Victoria’s adolescent Men ACWY Year 10 or age equivalent program in 2018 What we don’t know: • exact start date in 2018 • how the Haemophilus influenzae type b vaccine will be administered. • whethere is a catch-up meningococcal vaccine program for any other age group. 10 March 2021

What’s Coming…On the horizon • Change to Hib dose at 12 month • Change to childhood pneumococcal (Prevenar 13) schedule • Potential NIP maternal pertussis-containing vaccine • Unknown implications for state-funded new parent pertussis program • Changes to AIR – entering of Men ACWY data, real-time notification entry by providers, updated provider online view of pt history, electronic overdue letters to parents with My. Gov, merging of HPV data to AIR 10 March 2021

Refugee immunisation project • $2. 3 million has been allocated by Vic government to support development of a model to ensure catch-up immunisation for newly arriving humanitarian entrants • Commonwealth government have committed to additional 12, 000 humanitarian placements (in addition to annual general program of 13, 750). • Approx 4, 000/12, 000 to be settling in Victoria – anticipated in Hume/Whittlesea areas • Collaboration amongst LGAs, refugee health & settlement services, DET and Refugee Health Network to develop and pilot a model for improved access and follow-up of immunisation. 10 March 2021

Hume/Whittlesea refugee immunisation project 10 March 2021

Resources DHHS Victoria Immunisation Section https: //www 2. health. vic. gov. au/public-health/immunisation DHHS Victoria Immunisation Resources https: //www 2. health. vic. gov. au/public-health/immunisation-resources-order-form Immunise Australia Program http: //www. immunise. health. gov. au/internet/immunise/publishing. nsf/content/home Australian Immunisation Handbook http: //www. immunise. health. gov. au/internet/immunise/publishing. nsf/Content/Handbook 10 -home National Centre for Immunisation Research & Surveillance http: //www. ncirs. edu. au/ Cancer Council Australia – HPV http: //www. hpvvaccine. org. au/ Immune Hero – Victoria School Vaccination http: //immunehero. health. vic. gov. au/ 10 March 2021

Thank you Immunisation Section enquiries Call: 1300 882 008 (M to F 9 am-12 pm & 2 pm-3 pm) Email: immunisation@dhhs. vic. gov. au Web: www. health. vic. gov. au/immunisation