ATSI – Vaccinations

Vaccination

ATSI Extra Vaccines

  1. BCG @ birth
  2. Meningococcal B @ 2, 4, 12 months (+6 months for at-risk)
  3. Extra pneumococcal 13V @ 6/12 and 23V at 4 years and 9 years
  4. Influenza yearly indefinitely for > 6/12
  5. Hep A @ 18/12 and 4 years
  6. Pneumococcal @ 50 (13V), 51 (23V), 56 (23V)
  7. Shingrix early @ 50 (2 doses 2-6 months apart)

At Risk Extra Vaccines

  1. 6 months Pneumococcal 13V  (Prevenar 13)
  2. 4, 9 years Pneumococcal 23V (at risk) (Pneumovax 23)
  3. 5 years+ ongoing Influenza

Birth

  • Hep B (Energix B paediatric)
  • TB (live) (BCG)

2 months

  • Diptheria, Tetanus, Pertussis, Hep B, Hib, Polio (Infranrix Hexa)
  • Pneumococcal 13V (Prevenar 13)
  • Rotavirus (live) (Rotrix)
  • Meningococcal B (Bexsero)

4 months (same as 2 months)

  • Diptheria, Tetanus, Pertussis, Hep B, Hib, Polio (Infranrix Hexa)
  • Pneumococcal 13V (Prevenar 13)
  • Rotavirus (live) (Rotrix)
  • Meningococcal B (Bexsero)

6 months

  • Diptheria, Tetanus, Pertussis, Hep B, Hib, Polio (Infranrix Hexa)
  • Influenza (annual)
  • Pneumococcal 13V  (at risk) (Prevenar 13)
  • Pneumococcal 13V (Prevenar 13)
  • Meningococcal B (at risk) (Bexsero)

7 months

  • Influenza (2nd dose)

12 months

  • Measles, Mumps, Rubella (Priorix)
  • Pneumococcal 13V (Prevenar 13)
  • Meningococcal ACWY (Nimenrix)
  • Meningococcal B (Bexsero)

18 months

  • Measles, Mumps, Rubella, Varicella (Priorix-tetra)
  • Diptheria, Tetanus, Pertussis (DTPa) (Infranrix)
  • Hib (Act HIB)
  • Influenza (annual)
  • Hepatitis A (NT, WA, SA, Qld) (Vaqta Paed)

2 1/2 years

  • Influenza

3 1/2 years

  • Influenza

4 years

  • Diptheria, Tetanus, Pertussis, Polio (Infranrix IPV)
  • Pneumococcal 23V (at risk) (Pneumovax 23)
  • Pneumococcal 23V (NT, WA, SA, Qld) (Pneumovax 23)
  • Hepatitis A (NT, WA, SA, Qld) (Vaqta Paed)

4 1/2 years

  • Influenza

> 5 years

  • Cease annual influenza in non-ATSI
  • Influenza (at risk)
  • Influenza (all ATSI)

9 years

  • Pneumococcal 23V (2nd dose) (Pneumovax 23)
  • Pneumococcal 23V (2nd dose) (Pneumovax 23)

12-13 years (Year 7)

  • Human papilloma virus (Gardasil 9)
    • Single dose (6 February 2023 two-dose schedule changed)
    • 3 doses if > 15 at the time of the first dose
  • dTpa (every 10 years) (Boostrix)

14-16 years (Year 10)

  • Meningococcal ACWY (Nimenrix)

Every 10 years (5 years for tetanus-prone wounds)

  • dTpa (Boostrix)

>50 years

  • 50 – Shingles (Shingrix) – 2 doses 2-6 months apart
  • 50 – Pneumococcal 13V (Prevenar 13), then 2-12 months later
  • 51 – Pneumococcal 23V (Pneumovax 23), then 5 years later
  • 56 – Pneumococcal 23V (Pneumovax 23)

>65 years – yearly

  • Influenza (adjuvented) Quadrivalent (Fluad Quad)
  • Shingles (Shingrix) – 2 doses 2-6 months apart
    • Replaces Zostavax (which was at 70)

>70 years

  • Pneumococcal 13 (Prevenar 13)

Pregnant

  • dTpa (for pertussis) @ 20-32/40 (Boostrix, Adacel)
  • Influenza @20-32/40

Asplenia, hyposplenism, complement deficiency and eculizumab

  • All encapsulated organism vaccines (depends on prior immunisations)
    • Pneumococcal
    • Meningococcal ACWY
    • Meningococcal B
    • Hib

Covid-19

The following people are recommended an additional 2023 COVID-19 vaccine dose if 6 months have passed since their last dose:

  • all people aged 75 years and over

The following groups may consider an additional 2023 COVID-19 vaccine dose if 6 months have passed since their last dose and after discussion with their healthcare provider:

  • all people aged 65 to 74 years
  • people aged 18 to 64 years who have severe immunocompromise

Managing Vaccine Hesitancy

The management of vaccine hesitancy in Aboriginal and Torres Strait Islander (ATSI) populations involves a multifaceted approach, addressing the unique cultural, historical, and social factors that influence attitudes towards vaccination. Here are some key strategies:

  1. Cultural Sensitivity and Respect: Understanding and respecting the ATSI cultures, beliefs, and historical experiences are crucial. This includes acknowledging past traumas and mistrust towards healthcare systems due to historical events. Efforts should be made to provide culturally safe care.
  2. Engagement with Community Leaders and Elders: Community leaders and elders play a pivotal role in ATSI communities. Their involvement in vaccine advocacy can greatly influence the community’s acceptance. Collaborating with them can help in disseminating accurate information and addressing concerns effectively.
  3. Education and Communication: Providing clear, accurate, and culturally appropriate information about vaccines is vital. This includes explaining the benefits and risks, addressing myths and misconceptions, and offering information in local languages or through culturally relevant mediums.
  4. Use of Aboriginal Health Workers: Aboriginal Health Workers can play a key role in bridging the gap between healthcare providers and ATSI communities. They can help provide culturally appropriate health education and support and build trust in healthcare services.
  5. Tailored Health Promotion Activities: Developing health promotion activities that are specifically tailored to the ATSI communities can be effective. This could involve community meetings, workshops, or educational materials that resonate with the community’s cultural practices and values.
  6. Accessible and Convenient Vaccination Services: Ensuring that vaccination services are easily accessible to ATSI people is important. This could involve mobile clinics, community-based vaccination centres, or home visits, especially in remote areas.
  7. Patient-Centred Care: A patient-centred approach where individual concerns and questions are addressed respectfully. Encouraging shared decision-making and providing a non-judgmental space for discussion can enhance trust.
  8. Monitoring and Evaluation: Regular monitoring of vaccination rates within ATSI communities and evaluating the effectiveness of various strategies can help in making necessary adjustments and improvements.
  9. Building Trust: Long-term efforts to build trust in the healthcare system among ATSI people are essential. This involves consistent, respectful, and honest communication, as well as actions that demonstrate a commitment to their well-being.
  10. Partnerships with Indigenous Health Services: Collaborating with Indigenous health services, which are often more trusted by ATSI communities, can aid in effective communication and delivery of vaccination programs.

It’s important to recognize that vaccine hesitancy is a complex issue, and a one-size-fits-all approach may not be effective. A nuanced understanding of the specific community’s perspectives and needs is essential in developing and implementing these strategies.