To: / General Practitioners, Practice Nurses, Practice Managers, Health Professionals
From: / Rayoni Keith, Manager, Immunisation
Subject: / National Immunisation Schedule Changes 2014, Rotavirus vaccine, Extended Access for High Risk Groups, Vaccinator Training, Immunisation Week, Measles, Influenza vaccine on the NIR, Managing Cold Chain Failures
National Immunisation Schedule Changes 2014
As 1 July approaches, the Ministry will be keeping you informed about the Schedule changes through these monthly updates. We will also be updating the Ministry website at www.health.govt.nz/our-work/preventative-health-wellness/immunisation over the coming months. The Ministry is developing new resources to support the changes, with vibrant and noticeable new branding. We will let you know when these can be ordered.
Rotavirus vaccine on the National Immunisation Schedule
From 1 July 2014, babies who are under 15 weeks of age will be eligible for funded rotavirus immunisation. This vaccine will be routinely offered at 6 weeks, 3 and 5 months. Babies born from 20 May onwards can receive rotavirus vaccine alongside their other routine immunisations.
Babies who are more than 6 weeks old on 1 July are still eligible to receive the rotavirus vaccine as long as they receive the first dose by the time they are 14 weeks and 6 days old, e.g. babies born between 25 March and 1 April 2014 will need to be vaccinated in the first week of July. If a baby is 15 weeks or older and they have not had the first dose, they are no longer eligible to receive the rotavirus vaccine.
Additional immunisation visits will need to be made over the catch-up period. There is a minimum of 4 weeks between each catch-up dose; the first dose must be before 15 weeks of age (ie 14 weeks and 6 days) and the last dose by 8 months of age (i.e. 8 months and 0 days). Further assistance in scheduling catch-up vaccination will be provided in local immunisation training on the schedule change.
Extended access to funded vaccines for high risk individuals
From 1 July, individuals at increased risk from disease will have extended access to funded vaccines which can be given in general practices and hospitals. Additional vaccines to be funded for special groups (ie children and adults at high risk of some diseases due to other medical conditions) include hepatitis A, human papillomavirus, meningococcal, pneumococcal, pertussis (Tdap), and varicella. The new Chapter 4 (Immunisation for Special Groups) in the Immunisation Handbook 2014 provides tables of funded and non-funded recommended vaccines for high risk individuals. The Immunisation Handbook will be available in mid-late May.
Vaccinator Training
Local immunisation training sessions will be available on the 2014 Schedule – please contact your local Immunisation Coordinator for more information.
Immunisation Week
Immunisation Week will run from 28 April to 2 May – the theme is ‘on time, every time’. Authorised providers will be distributing resource packs to support Immunisation Week in the next few weeks.
Measles
As of 31 March 2014 there have been 115 confirmed measles cases reported in New Zealand. The majority of cases have occurred in Auckland and are linked to international travel, primarily travellers returning from the Philippines.
The Ministry has developed simple resources with key messages for health professionals and the public. These resources are available at www.health.govt.nz/measles. The Ministry is also putting out messages via twitter (twitter.com/minhealthnz) and targeting communications to groups at risk of contracting measles.
Influenza vaccine on the NIR
The Ministry has enabled the influenza vaccine given in general practice to be recorded on the NIR. In the future this information will be a useful measure of influenza vaccine coverage. Individuals will need to be informed about the NIR, agree to their information being collected, and can choose to opt off the NIR (by completing and returning the NIR 2 to the DHB NIR administrator as is done with childhood opt off). A new NIR leaflet has been developed for adults (HE2423) and can be ordered now from your local authorised health education resource provider.
PMS providers have upgraded their programmes to record influenza vaccine on the NIR and all practices should install the latest PMS updates if they have not already done so. When a vaccinator is sending the influenza vaccine information to the NIR, please ensure the provider is noted as the 'GP' and the nurse is the 'vaccinator' as this will reduce the error messages some practices are receiving.
At this stage influenza vaccines given in pharmacies and occupational health settings will not be sent to the NIR as these providers are not currently electronically linked to the NIR. It is expected in the future that all influenza vaccine providers will send this information to the NIR. Pharmacies and Occupational Health providers are expected to notify an individual’s general practice that they have received an influenza vaccine so that the individual’s medical records can be updated.
Managing cold chain failures and unusual vaccine presentation
If you are concerned that you have had a cold chain failure, or a specific vaccine presentation looks unusual (e.g. colour), please contact your local immunisation coordinator with details of the vaccine batch number, temperature range, duration of exposure and your concerns. If you cannot reach your immunisation coordinator refer to your cold chain policy or call IMAC on 0800 466 863. All cold chain failures are dealt with on a case by case basis and it may take some time to provide you with the appropriate course of action. Immunisation Coordinators may seek advice from their IMAC Regional Advisor or ESR. Please do not call the vaccine manufacturers, ESR or PHARMAC directly.
Zika virus
Zika virus is a mild febrile viral illness transmitted by mosquitoes. A few outbreaks have been reported in tropical Africa and in some areas in Southeast Asia and more recently in Oceania.
According to the existing evidence, the infection is reported to be symptomatic in only about one in five cases. When symptomatic, Zika infection usually presents as an influenza-like syndrome, often mistaken with other arboviral infections like dengue or chikungunya. Further information on Zika can be found at www.health.govt.nz/zika
If you have any queries about anything in this update, please email