In this section
Vaccine preventable diseases are endemic and/or epidemic in countries of origin of refugee families, and disruptions to health care may affect vaccine quality and access to vaccination. Information on vaccination coverage and disease status in country of origin is available from the
WHO website, including
immunisation schedules by country. See the
Australian Immunisation Handbook for specific information on catch up vaccination, and the
Australian immunisation schedule.
Information is available on
recent clinical updates. Upcoming Victorian schedule changes are (March 2018):
Victorian Immunisation Schedule. This guideline has been updated (March 2018) to include recent changes, and to cover all age groups.
Up to 3 doses of dTpa may now be used (previously dTpa, dT, dT), then 10-year and 20-year booster dTpa. dTpa is now available combined with IPV (dTpa-IPV).
dTpa is also recommended for
pregnant women from 28 weeks gestation in every pregnancy; partners of women
who are at least 28 weeks gestation if no booster for 10 years, and parents
of children <6 months if no booster for 10 years.
4 years and older
15-16 years (year 10) 1 dose
Required in children
< 5 years of age, additional doses for children with medical risk factors, including prematurity.
*Dosing interval is 1 month for
<12 months age or 2 months for 12 months of age and older.
People with medical risk factors require extra doses of 13vPCV and 23vPPV
(minimum 8 weeks apart) see Immunisation Handbook.
Age 65 years and older
People with medical risk factors as above. See Immunisation Handbook.
18 months - 13 years
14 years and older*
<14 years should have at least one dose of VV, usually given as either VV or MMR-V at 18 months. Prior varicella infection is not a contraindication. If varicella containing vaccine is given
<12 months of age, the dose should be repeated at 18 months. MMR-V is not recommended as the first dose of MMR containing vaccine in children <4 years, due to increased risk of fever/febrile convulsions,
and is not recommended in those aged 14 years and older.
*VV is recommended in non-immune adolescents/adults 14 years and older (no clinical history and negative serology). People 14 years and older with a reliable history of varicella should be considered immune; check serology if no clinical history of
70-79 years 1 dose
15 years and older* 3 doses
From 2018, 9-valent HPV given to all year 7 students (or age equivalent 12-13 years). 2-dose course
<15 years (0,6-12m) and *3-dose course 15 years and older or immunocompromised (0, 2, 6m). Also see Immunisation Handbook and
9-valent HPV funded up to and including age 19 years. HPV vaccines not recommended during pregnancy, can be given during breastfeeding. 4-valent HPV recommended for immunocompromised adults (including due to HIV infection) and in Victoria funded for MSM population until 31 December 2018. Licensed for females age 9-45 years and males 9-26 years.
<9 years 1 or 2 doses*
9 years and older 1 dose
Now recommended annually for all people 6 months and older. In Victoria, funded for children
<5 years (from 2018), adults 65 years and older, and age 5 years and older with medical risk factors.
Dose and formulation vary with age - 0.25 ml age 6 months to
<3 years; 0.5 ml age 3 years and older. Different formulations funded for adults 65 years and older. *If aged <9 years at the time of first administration - 2 doses minimum 1 month apart. Check Immunisation Handbook and
IM = intramuscular, SC = subcutaneous, ID = intradermal, LAV = Live Attenuated Vaccine (consider pregnancy, and dosing interactions), MSM = men who have sex with men
In 2016, there were significant changes 'No Jab, No Pay' legislation (see
Department of Health information,
Department of Human Services information,
Department of Social Services summary). Children and young people (
<20 years) need to be up to date for their immunisations OR be on a vaccine catch-up schedule OR have a medical exemption to be eligible to receive certain family assistance payments from Centrelink (
Child Care Benefit,
Child Care Rebate and
Family Tax Benefit Part A-end of year supplement). In mid-2018 - the payments affected will change - families will lose part of the regular fortnightly family tax benefit payment if their children do not meet immunisation criteria.
Centrelink uses the Australian Immunisation Register (AIR) to establish whether vaccinations are up to date (by antigen). The vaccines that are linked to family assistance payments are: DTPa/dTpa, IPV, MMR and hepatitis B. When the first dose of vaccines covering all the overdue antigens is entered into AIR, the child is recorded as being up to date until the next set of vaccines becomes overdue (usually 3 months later).
Medical exemptions can be completed by
relevant health professionals (i.e. for immunity) and are factored into establishing whether vaccinations are up to date.
All children and young people (<20 years of age) need an assessment of their immunisation status to: clarify their immunisation history, enter information into AIR if it has not been recorded, and provide catch-up vaccines if needed. AIR information will need updating or families will lose these Centrelink payments.
In Victoria, the state 'No Jab, No Play' legislation was introduced in 2016 - children need to be up to date with vaccinations or have commenced an immunisation catch-up plan to enrol in childcare or kindergarten in Victoria. Children who arrived in Australia as a refugee or asylum seeker are eligible for a 16-week grace period to start catch-up vaccinations after they enrol in childcare. See
further information, and
resources for early childhood services. Upcoming changes mean only the patient AIR record will be accepted as evidence of immunisation (not the health provider view). This is likely to lead to substantial difficulties and delays for people without Medicare, recent arrivals, or children waiting for overseas records to be entered onto AIR.
No-one arriving as a refugee or asylum seeker will be vaccinated and up to date according to the Australian immunisation schedule, due to differences in
country of origin schedules and/or issues with health service access.
Refugees and asylum seekers should be vaccinated so they are up to date according to the Australian immunisation schedule; equivalent to an Australian-born person of the same age.
For families outside the initial stage of settlement - remind them to plan early for travel immunisations. Many families subsequently travel and may be at increased risk when visiting friends/relatives in their area of origin.
National Immunisation Program Schedule in Victoria for secondary students includes:
Vaccines for refugees/asylum seekers are supplied though several government immunisation initiatives:
The following list has been compiled based on vaccine programs in Victoria, and calculates the birth year for Victorian-born people accessing the relevant recent programs - to help calculate vaccinating refugee/asylum seeker arrivals equivalent to an Australian-born person of the same age.
Immigrant health clinic resources. Initial: Georgie Paxton and Jim Buttery. Revisions: Georgie Paxton and Rachel Heenan. Updated March 2018. Contact: firstname.lastname@example.org