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 World Health Organization (WHO), including
immunisation schedules by country. See the
Australian Immunisation Handbook1 for specific information on catch-up vaccination, vaccine preventable diseases (VPD), the
Australian National Immunisation Program (NIP) Schedule, and guidance on catch-up for <10 years and 10 years and older.
Please also see the Victorian Immunisation Schedule.
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.
2nd dose due at 3.5 - 4 years if
<3.5 years at first dose.
MMR (*given IM) is now available combined with Varicella Vaccine (VV) as MMR-V (*given SC) - although 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 in this setting.
Recent changes (April 2019) have lowered the recommended age at which infants can receive MMR in special circumstances - from 9 months to 6 months. Infants 6 months and older can receive MMR as post-exposure prophylaxis, or during outbreaks (or for travel to endemic areas).
4 doses* 4 years and older
*Normally given at age 12 months, disease has bimodal peaks in incidence of
<5 years and 15-24 years, MenC catch-up previously funded to 19 years (born>1987). Consider providing MenACWY if previous meningococcal vaccination was provided as MenC.
**Nimenrix = 1 dose, Menveo/Menactra = 2 doses, 8 weeks apart.
15-19 years (year 10 or equivalent) 1 dose
Also provided for year 10 students (and available in Victoria for those aged 15-19 years, State-based program).
doses of meningococcal ACWY vaccine recommended in asplenia
Required in children <5 years of age. Not required 5 years and older, unless special circumstances, including asplenia but may be given as part of combination vaccines. Children
<10 years generally receive multiple doses of Hib through the use of combination vaccines (e.g. hexavalent DTPa/IPV/HiB/HepB).
Refer to Immunisation Handbook for catch-up schedule in younger children - <7 months - 3 doses then booster at 18 months, 7-11 months 2 doses then booster at 18 months, 12-17 months 1 dose then booster at 18 months or 2 months after last dose (whichever is later). If a child has received PRP-OMP Hib vaccine for the first 2 doses, they do not require a 3rd dose but should still have a booster at 18 months.
Now given at 2,4 and 12 months of age in NIP, with an extra dose at 6m for children with medical risk factors.
Required in all children
<5 years of age, and 5 years and older if medical risk factors. If providing catch-up for children who have medical risk factors: <12 months - 4 doses required, and 12-59 months - 2 doses required. 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 (and preferably two doses 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 (0,6-12 months) and *3-dose course 15 years and older or immunocompromised (0, 2, 6 months). Also see Immunisation Handbook .
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 and funded in Victoria funded for MSM population until 31 October 2019. 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 and formulation - 0.25 ml age 6 months to
<3 years (FluQuadri Junior); 0.5 ml age 6 months and older (Fluarix Tetra), 0.5 ml 3 years and older (FluQuadri), 0.5 ml 18 years and older (Afluria Quad, Influvac Tetra). Different formulations funded for adults 65 years and older (Fluad, Fluzone High-Dose, both 0.5 ml). *If aged <9 years at the time of first administration - 2 doses minimum 1 month apart. Check Immunisation Handbook.
Oral 1.5 ml
IM = intramuscular, SC = subcutaneous, ID = intradermal, LAV = Live Attenuated Vaccine (consider pregnancy, and dosing interactions), MSM = men who have sex with men
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 needs to be up to date or children/families may lose Centrelink payments.
No-one arriving as a refugee or asylum seeker will be vaccinated and up to date according to the Australian National Immunisation Program (NIP) Schedule, due to differences in
country of origin schedules and/or issues with health service access.
All refugees and asylum seekers will require catch-up vaccinations - they 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. Updated April 2019. Contact: firstname.lastname@example.org