एमपॉक्स (मंकीपॉक्स)

यह क्या है?

Mpox is a viral zoonosis (an infection spread from animals to humans). It is caused by a virus that belongs to the ऑर्थोपॉक्सवायरस genus (which also causes the variola virus responsible for smallpox disease and the vaccinia virus, which is used in smallpox vaccines). Mpox was first discovered in 1958 and there have been small outbreaks since, predominantly in Western and Central Africa. Since the eradication of smallpox in 1980, mpox has become the most important orthopoxvirus affecting humans, however, causes less severe disease than smallpox.

क्या ढूँढने के लिए

The incubation period of mpox is usually 7-14 days, but can be as short as 5 days or as long as 21 days. The initial symptoms include fever, headache, backache and muscle aches, fatigue and lymphadenopathy. Lymphadenopathy in this early phase is a key feature of mpox.

1-3 days following the beginning of fever, a rash may develop, often beginning on the mouth and face, and then spreading to other areas of the body. The face is involved in 95% infections, followed by the palms of the hands and soles of the feed (75%). Oral mucous membranes are involved in 70% of cases, and involvement of the genitalia is also common (30%).

The rash is initially characterised as being erythematous (reddened) and macular (flat), which then develops papular features (raised areas) and turns into well-demarcated pustules and vesicles. These then dry into crusts and fall off. The number of lesions is highly variable, ranging from a couple to over a thousand.

The infection is usually self-limiting with symptoms lasting from 2-4 weeks. Complications can include secondary infection such as cellulitis, sepsis, infection of the cornea (which can be threaten vision), bronchopneumonia and encephalitis. The case fatality ratio is between 3-6%. More severe illness can occur in immunocompromised people.

यह कैसे संचारित होता है?

Mpox is spread via either animal-to-human transmission (zoonotic) or human-to-human transmission.

Zoonotic transmission involves direct contact with the bodily fluids, blood, or lesions (cutaneous or mucosal) of infected animals. This is most common for people living near or within forest areas with exposure to infected animals.

Human-to-human transmission involves close contact with respiratory secretions, the skin lesions of an infected person, or a contaminated objects such as linen or clothing. Droplet particle transmission requires prolonged face-to-face exposure, placing household contacts at highest risk. This can be minimised by isolating away from other members of the household.

Healthcare workers caring for individuals with mpox must undertake infection control precautions and handling of laboratory specimens should be by suitably trained staff.

एपिडेमियोलॉजी

Mpox is very common in West and Central Africa, often in areas with tropical rainforests. However, there are currently outbreaks in many other countries across the globe including Australia and parts of Europe and the United Kingdom.

टीके

The vaccinia virus is a poxvirus related to smallpox and mpox and is contained in smallpox vaccines. Historically, smallpox vaccines have been used in the prevention of smallpox infection, however, they are also likely to be effective against mpox.

There are two types of smallpox vaccines available for use in Australia for the prevention of mpox:

  • ACAM2000™ – 2nd generation, live-attenuated vaccine
  • JYNNEOS® – 3rd generation, non-replicating vaccine

Recommendations

Either vaccine can be administered subcutaneously as either primary preventative vaccination (PPV) or post-exposure preventative vaccination (PEPV) based on an individual risk-benefit assessment. ATAGI preferentially recommends JYNNEOS® vaccine due to the ease of administration and decreased likelihood of side effects.

For PPV, administering JYNNEOS® via the intradermal route can be considered in all eligible populations to maximise vaccine supply. In circumstances where vaccine supply is limited severely immunocompromised individuals should be prioritised over other eligible groups such as healthcare workers to receive their second dose of JYNNEOS® (ACAM2000™  is contraindicated in this population). Intradermal vaccination is currently recommended for PPV only.

For PEPV, vaccination within 4 days is recommended to provide optimal protection against the development of mpox infection. Vaccination between 4-14 days following exposure may lessen the severity of disease.

Vaccination is currently recommended for the following groups:

  • those who are categorised by public health authorities as a high-risk mpox contact in the previous 14 days (PEPV)
  • gay, bisexual, and other men, non-binary individuals assigned male at birth, trans men who have sex with men (including cis and trans men) who are the highest risk of infection with mpox. Markers indicating increased risk of infection include:
    • those living with HIV
    • recent history of multiple sexual partners, including group sex or sex on licensed premises
    • other markers including recent sexually transmitted disease or on HIV PrEP due to number of partners
    • recommendations from sexual health clinics
  • sex workers, particularly those with clients who belong to high-risk groups
  • anyone in the above categories planning to travel to a country experiencing a mpox outbreak (immunisation is recommended 4-6 weeks prior to travelling)
  • anyone at greater risk of poorer outcomes due to mpox infection, such as those with severe immunocompromise
  • immunisation providers who are administering ACAM2000™.

Individuals who have a history of confirmed mpox infection should defer vaccination in the short-medium term after recovery due to the immunity gained from natural infection.

एहतियात

Vaccination with JYNNEOS® can be considered in children aged < 18 years where the benefits of vaccination outweigh the risks of disease. Despite limited safety data, there are no theoretical safety concerns surrounding the administration of JYNNEOS® in pregnant or breastfeeding women.

Individuals receiving ACAM2000™ as PPV should consider an interval of 4 weeks between vaccination and administration of COVID-19 vaccines due to the rare risk of मायोकार्डिटिस / पेरिकार्डिटिस.

Individuals with a history of keloid scarring are not recommended to receive JYNNEOS® via the intradermal route, with subcutaneous being preferred.

Contraindications

Anyone with a history of तीव्रग्राहिता to a previous dose of the vaccine to be administered or anaphylaxis to a component of the vaccine to be administered should not be vaccinated.  Due to the risk of vaccine associated disease, ACAM2000™ is contraindicated for those with immunocompromise or those who are गर्भवती.

Individuals with active eczema, atopic dermatitis or other exfoliative skin conditions should not receive ACAM2000™ due to the risk of developing eczema vaccinatum (a reaction to smallpox vaccination experienced by people with eczema/atopic dermatitis resulting in a severe rash and systemic illness).

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*an interval longer than 28 days is acceptable. If supply is limited, severely immunocompromised individuals should be prioritised to receive their 2nd dose as close to 28 days from dose 1 as possible.
§ Using alternate routes of vaccine delivering to complete a primary course is acceptable (eg, intradermal for dose 1 and subcutaneous for dose 2)
€ Intradermal administration is an alternate route of vaccination for pre-exposure prophylaxis. It is not preferred for the first dose of post-exposure prophylaxis and is NOT recommended in people with गंभीर प्रतिरक्षा समझौता
£ Vaccination providers administering intradermally should ensure that they are appropriately trained in intradermal technique. Where a dose of intradermal vaccine is inadvertently administered subcutaneously, a repeat dose of 0.5ml should be administered subcutaneously as soon as possible to ensure that the vaccinee receives an appropriate level of protection
^ Percutaneous administration involves using a bifurcated needle and scarification technique requiring specialised training and accreditation
# for full aftercare instructions, refer the product information
¥ ACAM2000 is a live-attenuated vaccine and therefore as outlined above, it’s use is contraindicated in some patient groups. For a full list of contraindications and precautions refer to the ATAGI clinical guidance on vaccination against Mpox.

Following vaccination

Individuals receiving ACAM2000™ should be advised that 2-5 days after vaccination a papule will form at the injection site. This will progress to a vesicle (blister) then pustule (blister with pus) before scabbing and forming a permanent pitted scar. Individuals are recommended to cover the injection site with a gauze bandage secured with adhesive tape until scabbing occurs, noting that the wound is infectious until the wound dries up.

Common systemic side effects following vaccination with either vaccine include muscle aches, headache, fatigue and nausea. Localised side effects can include injection site itch, pain redness and swelling (and permanent scarring following ACAM2000™.

ACAM2000™ is also associated with a risk of myocarditis and pericarditis as well as other serious side effects noted यहाँ.

संसाधन

विक्टोरियन कार्यक्रम की जानकारी

अन्य संसाधन

लेखक: Rachael Purcell (RCH Immunisation Fellow), Francesca Machingaifa (MVEC Education Nurse Coordinator) and Rachael McGuire (MVEC Education Nurse Coordinator)

द्वारा समीक्षित: राचेल मैकगायर (MVEC शिक्षा नर्स समन्वयक)

तारीख: मार्च 23, 2023

नई जानकारी और टीके उपलब्ध होते ही इस अनुभाग की सामग्रियों को अद्यतन किया जाता है। मेलबर्न वैक्सीन एजुकेशन सेंटर (MVEC) कर्मचारी सटीकता के लिए नियमित रूप से सामग्रियों की समीक्षा करते हैं।

आपको इस साइट की जानकारी को अपने व्यक्तिगत स्वास्थ्य या अपने परिवार के व्यक्तिगत स्वास्थ्य के लिए विशिष्ट, पेशेवर चिकित्सा सलाह नहीं मानना चाहिए। टीकाकरण, दवाओं और अन्य उपचारों के निर्णयों सहित चिकित्सा संबंधी चिंताओं के लिए, आपको हमेशा एक स्वास्थ्य देखभाल पेशेवर से परामर्श लेना चाहिए।


अनिवार्य टीकाकरण

पृष्ठभूमि

A vaccine mandate means that proof of vaccination, or an authorised medical exemption, is required in certain settings. Mandating is generally considered a late step in optimising vaccine uptake, as it is important to ensure vaccine access is available in an equitable way, before progressing to a mandate. Vaccine mandates may vary depending on the jurisdiction and there may be some variations around Australia. The following information is specific to Victoria, and refers to COVID-19 and influenza vaccine directions, as well as the ‘no jab, no play’ and ‘no jab, no pay’ policies.

Vaccine specific directions

  • COVID-19

    Vaccination against COVID-19 protects against developing severe disease that may lead to hospital admission, intensive care or even death. Due to the occupational risk for disease exposure and transmission as well as having increased contact with vulnerable groups, workers in the following settings must be fully vaccinated against COVID-19 (regardless of whether they have patient contact or not):

    • public, private and denominational hospitals
    • public health services
    • private day procedure centres
    • ambulance services
    • patient transport services engaged by a health service or Ambulance Victoria
    • residential aged care services that are operated by public health services.

    To be considered fully vaccinated, individuals ≥ 18 years must have completed a primary schedule of COVID-19 vaccination plus a booster dose and those aged < 18 years must have completed a primary schedule.

    For further information refer to DH: Vaccination for healthcare workers.

  • इन्फ्लूएंजा

    इन्फ्लूएंजा vaccination is recommended for all individuals aged 6 months and over. Due to an increased risk of exposure to, and transmission of influenza disease it is mandatory that workers in the following settings are vaccinated against influenza annually (regardless of whether they have patient contact or not):

    • public, private and denominational hospitals
    • public health services
    • private day procedure centres
    • ambulance services
    • patient transport services engaged by a health service or Ambulance Victoria
    • residential aged care services that are operated by public health services
    • Forensicare.

    For further information, refer to DH: Vaccination for healthcare workers.

Policy specific vaccine directions

  • No jab, no play

    “No jab, no play” legislation was introduced by the Victorian State Government on January 1अनुसूचित जनजाति, 2016, in an effort to improve vaccination rates and reduce the spread of vaccine preventable diseases, This legislation requires confirmation of up to date vaccination status according to the National Immunisation Program (NIP) when enrolling in all early childhood education and care services including childcare and kindergarten. This legislation does not apply to enrolment into school.

    A current Immunisation History Statement (IHS) provided by the ऑस्ट्रेलियाई टीकाकरण रजिस्टर (एआईआर) is the only accepted proof of immunisation when enrolling in early childhood education and care services.

  • No jab, no pay

    “No jab, no pay” legislation was introduced by the Federal Government on July 1, 2018, altering Family Tax Benefit (FTB) Part A payments and childcare subsidies if a child is not up to date for age with their scheduled immunisations as per the NIP. Recipients of FTB part A or child-care fee assistance will need to meet these immunisation requirements to ensure that payments are not reduced.

Responsibilities of the employer/service provider and the employee/vaccinee

Employers and service providers are responsible for ensuring that employees/enrolees in early childhood education and care services comply with relevant orders. The employer or service provider is required to sight and store evidence of mandated vaccination status or medical exemption, if applicable.

It is the responsibility of the employee to be vaccinated against mandated vaccines for their profession or have a valid medical exemption.

It is the responsibility of individual receiving Family Tax Benefits and childcare subsidies to ensure that children are up to date with the NIP.

Medical exemptions

Exemption to vaccination can be granted to individuals following assessment by an authorised practitioner who deems deferral of vaccination to be warranted. Exemptions may be permanent or temporary.

All medical exemptions to vaccination will be recorded on the individuals Immunisation History Statement on the ऑस्ट्रेलियाई टीकाकरण रजिस्टर which can be accessed via myGOV.

Individuals who have previously experienced or who are at higher risk of experiencing a serious adverse event following vaccination should be referred to a specialist immunisation service. Individuals who have experienced a previous adverse event following vaccination should also be reported to सैफविक.

  • Permanent medical exemptions

    Anaphylaxis to a previous dose of the same vaccine या anaphylaxis to a component of the same vaccine are the only two absolute contraindications to vaccination and warrant permanent medical exemption. Permanent exemptions to some routine vaccines can also be provided when an individual has documented evidence of natural immunity against that vaccine preventable disease (eg. varicella, measles-mumps-rubella or hepatitis B). In addition, there are a small group of specific medical conditions precluding some individuals from receiving certain COVID-19 vaccine brands.

  • Temporary medical exemptions

    Temporary exemptions to vaccination can also be granted in circumstances such as acute major medical illness, significant immunocompromise of short duration (for live-attenuated vaccines only), the individual is pregnant (live-attenuated vaccines only). Individuals with a confirmed history of COVID-19 infection can have their COVID-19 vaccination deferred for up to 4 months).

    Children on an approved catch-up schedule will be automatically granted a grace period of 6 months to complete their outstanding vaccines and be up to date with the NIP.

  • Authorising providers

    General practitioners defined by the Health Insurance Act 1973 as:

    • fellows of the Royal Australian College of General Practitioners
    • fellows of the Australian College of Rural and Remote Medicine
    • on Medicare’s Vocation Register of General Practitioners

    or:

    • a practice registrar on an approved 3GA training placement
    • a paediatrician
    • a public health physician
    • an infectious diseases physician
    • a clinical immunologist.

लेखक: राचेल मैकगायर (एमवीईसी एजुकेशन नर्स कोऑर्डिनेटर) और फ्रांसेस्का मचिंगाइफा (एमवीईसी एजुकेशन नर्स कोऑर्डिनेटर)

द्वारा समीक्षित: राचेल मैकगायर (एमवीईसी एजुकेशन नर्स कोऑर्डिनेटर) और फ्रांसेस्का मचिंगाइफा (एमवीईसी एजुकेशन नर्स कोऑर्डिनेटर)

तारीख: April 4, 2023

नई जानकारी और टीके उपलब्ध होते ही इस अनुभाग की सामग्रियों को अद्यतन किया जाता है। मेलबर्न वैक्सीन एजुकेशन सेंटर (MVEC) कर्मचारी सटीकता के लिए नियमित रूप से सामग्रियों की समीक्षा करते हैं।

आपको इस साइट की जानकारी को अपने व्यक्तिगत स्वास्थ्य या अपने परिवार के व्यक्तिगत स्वास्थ्य के लिए विशिष्ट, पेशेवर चिकित्सा सलाह नहीं मानना चाहिए। टीकाकरण, दवाओं और अन्य उपचारों के बारे में निर्णय सहित चिकित्सा संबंधी चिंताओं के लिए, आपको हमेशा एक स्वास्थ्य देखभाल पेशेवर से परामर्श लेना चाहिए।


मेनिंगोकोक्सल

यह क्या है?

मेनिंगोकोकल रोग बैक्टीरिया के कारण होने वाली किसी भी बीमारी का गठन करता है नाइस्सेरिया मेनिंजाइटिस। 13 ज्ञात उप-प्रकार (सेरोग्रुप) हैं और इनमें से 5 वर्तमान में टीके रोके जा सकते हैं (बी और ए, सी, डब्ल्यू, वाई)।

इनवेसिव मेनिंगोकोकल रोग (IMD) मेनिन्जाइटिस (मस्तिष्क और रीढ़ की हड्डी को ढकने वाली झिल्ली की सूजन) और सेप्टीसीमिया (रक्त में संक्रमण) के साथ-साथ निमोनिया (फेफड़ों में संक्रमण), गठिया (जोड़ों की सूजन) और अन्य संक्रमणों का कारण बन सकता है। नेत्रश्लेष्मलाशोथ (नेत्र संक्रमण)। मृत्यु दर (मृत्यु) 5-10% जितनी अधिक हो सकती है, जो जीवित रहने वालों में 10-20% में स्थायी आजीवन जटिलताएं होती हैं।

क्या ढूँढने के लिए

The incubation period of meningococcal is 1-7 days, more commonly 3-4 days. People with meningococcal disease can become extremely unwell very quickly. Symptoms can include fever, headache, neck stiffness, nausea, vomiting and photophobia (sensitivity to light). Cool, mottled extremities and leg pain can also occur. Babies can appear irritable or unsettled, have a high-pitched moaning cry, refuse or not wake for feeds and be lethargic (sleepy) or floppy. A petechial or purpuric rash can appear late in the disease progression (within 13-22 hours) or not at all.

यह कैसे संचारित होता है?

Disease can be transmitted from person to person via respiratory droplets (eg. sneezing and coughing). Meningococcal bacteria can also live harmlessly at the back of the nose or throat, resulting in individuals being asymptomatic carriers.

एपिडेमियोलॉजी

Children < 2 years of age have the highest incidence of meningococcal disease in Australia, with another peak of disease among adolescents and young adults (15-24 years). आदिवासी और टोरेस स्ट्रेट आइलैंडर people have a much greater burden of disease than non-Indigenous people.

There are also certain medical conditions and medications that can increase an individual’s risk of IMD. These include (but are not limited to) those with functional asplenia and hyposplenia, complement deficiency and those receiving treatment with eculizamab [see below for specific information for those with increased risk of IMD].

निवारण

MVEC strongly recommends everyone wishing to be protected against ACWY and B strains of meningococcal disease be immunised. Some individuals are eligible for funded vaccines via the National Immunisation Program (NIP). Those aged ≥ 6 weeks of age who do not meet the funding criteria can purchase vaccines privately through some परिषदों, जीपी और फार्मेसियों.

The number of vaccine doses recommended depends on a person’s age and risk factors for IMD.

Meningococcal ACWY vaccines

MVEC recommends 2 conjugate meningococcal ACWY vaccines:

  • Nimenrix®
  • Menveo®

A single dose of Nimenrix® is currently provided for free at 12 months of age and for all adolescents in Year 10 (or age equivalent) with catch up available for those aged 15-19 years. It is also funded for certain individuals of any age with immunocompromising conditions.

  • Meningococcal ACWY primary course and booster doses for healthy individuals

    प्राथमिक पाठ्यक्रम

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    † there is no registered upper age limit for the use of Menveo® or Nimenrix®.
    ¥ completing the course with the same vaccine brand is preferred but may not always be practical. The NIP funded 12 month dose of Nimenrix® may be used as the dose given at ≥ 12 months of age.

    बूस्टर खुराक

    Further booster doses are not routinely recommended for healthy individuals. In circumstances where someone has previously received a primary course of meningococcal ACWY and is offered a further dose in year 10 in line with the NIP, it is acceptable to to receive this dose.

  • Meningococcal ACWY primary course and booster doses for those at increased risk of IMD

    Individuals with specified medical conditions that increase the risk of IMD are recommended and funded to receive additional meningococcal vaccines and booster doses. These groups include:

    • those with defects in, or deficiency of complement components (including factor H, factor D or properdin deficiency),
    • those currently receiving or planning treatment with eculizumab (or biosimilar),
    • those with functional or anatomical asplenia (including sickle cell disease or haemoglobinopathies and congenital or acquired asplenia),
    • anyone with HIV (regardless of disease stage or CD4+ cell count),
    • anyone who previously received a haemopoietic stem cell transplant (HSCT).

    प्राथमिक पाठ्यक्रम

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    † there is no registered upper age limit for the use of Menveo® or Nimenrix®.
    ¥ completing the course with the same vaccine brand is preferred but may not always be practical. The NIP funded 12 month dose of Nimenrix® may be used as the booster dose for those who have commenced the course at < 12 months of age.

    बूस्टर खुराक

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    † there is no registered upper age limit for the use of Menveo® or Nimenrix®.
    § using either Menveo® or Nimenrix® as a booster dose, regardless of the brand used for the primary course, is approriate.

Meningococcal B vaccines

There are currently 2 vaccines available for protection against meningococcal B disease.

  • Bexsero®
  • Trumenba®

Meningococcal B vaccines brands are नहीं विनिमेय।

A primary course of Bexsero® is available on the NIP for Aboriginal and Torres Strait Islander children < 2 years of age, as well as some individuals of any age with immunocompromising conditions.

Paracetamol advice

It is widely recognised that children receiving Bexsero® are more likely to experience बुखार following vaccination. It is for this reason that children < 4 years of age are recommended to receive prophylactic paracetamol (15mg/kg per dose) 30 minutes prior to vaccination (or as soon as possible after), as well as 2 subsequent doses (4-6 hours apart) to reduce the likelihood and severity of fever. This should be administered regardless of whether the child is experiencing a fever or not.

  • Meningococcal B primary course and booster doses for healthy individuals

    प्राथमिक पाठ्यक्रम

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    † Bexsero® is registered for use in those 6 weeks of age and older. Trumenba® is only registered for use in those 10 years of age or older.
    ¥ meningococcal B vaccine brands are नहीं प्राथमिक पाठ्यक्रमों या बूस्टर खुराक के लिए विनिमेय।
    # prophylactic paracetamol is recommended to those < 4 years of age (refer to advice above).
    £ funded on the NIP for Aboriginal and Torres Strait Islander children < 2 years of age and those identified as medically at risk (see recommendations below for further information).
    एन/ए- इस आयु वर्ग में अनुशंसित नहीं है।

    बूस्टर खुराक

    Further booster doses of meningococcal B vaccines are not routinely recommended for healthy individuals.

  • Meningococcal B primary course and booster doses for those with increased risk of IMD

    Individuals with specified medical conditions that increase the risk of IMD are recommended and funded to receive additional meningococcal B vaccines. From December 2022, following an NCIRS-led GRADE review of the evidence, अतगी endorsed an update to the Australian Immunisation Handbook recommendations which now include booster doses of meningococcal B vaccines.

    Eligible individuals include:

    • those with defects in, or deficiency of complement components (including factor H, factor D or properdin deficiency),
    • those currently receiving or planning treatment with eculizumab (or biosimilar),
    • those with functional or anatomical asplenia (including sickle cell disease or haemoglobinopathies and congenital or acquired asplenia),
    • anyone with HIV (regardless of disease stage or CD4+ cell count),
    • anyone who previously received a haemopoietic stem cell transplant (HSCT).

    MVEC strongly encourages the active follow up of individuals who meet these criteria to ensure that appropriate vaccine schedules and their recommended booster doses are administered in line with the updated guidance to optimally protect vulnerable patients.

    प्राथमिक पाठ्यक्रम

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    † Bexsero® is registered for use in those 6 weeks of age and older. Trumenba® is only registered for use in those 10 years of age or older.
    ¥ meningococcal B vaccine brands are नहीं equivalent or interchangeable for primary courses or booster doses.
    # prophylactic paracetamol is recommended to those < 4 years of age (refer to advice above).
    एन/ए- इस आयु वर्ग में अनुशंसित नहीं है।

    बूस्टर खुराक§

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    § refer to GRADE assessment अधिक जानकारी के लिए।
    † Bexsero® is registered for use in those 6 weeks of age and older. Trumenba® is only registered for use in those 10 years of age or older.
    ¥ meningococcal B vaccine brands are नहीं equivalent or interchangeable for primary courses or booster doses.
    एन/ए- इस आयु वर्ग में अनुशंसित नहीं है।

लेखक: Rachael McGuire (MVEC Education Nurse Coordinator), Georgina Lewis (Clinical Nurse Manager, SAEFVIC, Murdoch Children’s Research Institute) and Nigel Crawford (Director SAEFVIC, Murdoch Children’s Research Institute)

द्वारा समीक्षित: राचेल मैकगायर (एमवीईसी शिक्षा नर्स समन्वयक) और निगेल क्रॉफर्ड (निदेशक एसएईएफवीआईसी, मर्डोक चिल्ड्रन रिसर्च इंस्टीट्यूट)

तारीख: 4 जुलाई 2023

नई जानकारी और टीके उपलब्ध होते ही इस अनुभाग की सामग्रियों को अद्यतन किया जाता है। मेलबर्न वैक्सीन एजुकेशन सेंटर (MVEC) कर्मचारी सटीकता के लिए नियमित रूप से सामग्रियों की समीक्षा करते हैं।

आपको इस साइट की जानकारी को अपने व्यक्तिगत स्वास्थ्य या अपने परिवार के व्यक्तिगत स्वास्थ्य के लिए विशिष्ट, पेशेवर चिकित्सा सलाह नहीं मानना चाहिए। टीकाकरण, दवाओं और अन्य उपचारों के बारे में निर्णय सहित चिकित्सा संबंधी चिंताओं के लिए, आपको हमेशा एक स्वास्थ्य देखभाल पेशेवर से परामर्श लेना चाहिए।


COVID-19 टीकों के बाद मायोकार्डिटिस और पेरिकार्डिटिस

Myocarditis is an inflammatory disease of the heart muscle, whilst pericarditis is an inflammatory disease of the lining of the heart muscle. They are rare conditions, most commonly associated with viral infections (including SARS-CoV-2) but can also be triggered by other factors such as medications and autoimmune conditions.

Globally, an increased number of cases above an expected population rate of myocarditis and pericarditis have been reported in individuals who have received COVID-19 vaccines, with the highest rates occurring following administration of COVID-19 mRNA vaccines (eg. कोमिरनेटी (फाइजर) और स्पाइकवैक्स (मॉडर्न)).

Information specific to myocarditis and pericarditis can be found via the below buttons. In addition, frequently asked questions relating to vaccination are also addressed.

मायोकार्डिटिस

  • How is myocarditis following COVID-19 vaccination triggered?

    The exact mechanism behind cardiac inflammation temporally associated with COVID-19 vaccines is currently being investigated. Clinical causes from international and local surveillance data suggest an immune-mediated or hypersensitivity trigger. There are ongoing studies examining the role of the SARS-CoV-2 spike protein, impact of certain cardiac biomarkers and genetic predispositions to this adverse event of special interest (AESI).

  • Who is at risk of myocarditis?

    Myocarditis from any cause, occurs more commonly in males than females. It is also more likely to affect younger adults.

    Reported rates of myocarditis occurring following administration of COVID-19 vaccines vary; however, they are above expected background rates for both sexes. The peak risk group for COVID-19 vaccine related myocarditis is young adult males aged 16-17 years, with a smaller increased risk for males aged between 12-24 years.

    International and local vaccine safety surveillance data have found that it is more commonly associated with administration of a second dose of COVID-19 mRNA vaccine. Myocarditis following other COVID-19 vaccines, third doses or booster doses have also been identified, although reported cases have occurred at lower rates than those identified following either dose of a primary course.

    Although myocarditis AESI has been associated with all of the COVID-19 vaccines used in Australia, there is a higher risk of myocarditis following administration of COVID-19 mRNA vaccines compared to non-mRNA vaccines. Surveillance data from multiple countries have also demonstrated a greater risk with Spikevax (Moderna) compared to Comirnaty (Pfizer).

  • Are children more likely to experience myocarditis following COVID-19 vaccination?

    Available safety data from local और international sources suggest there is a significantly lower risk of children developing myocarditis following vaccination. Thus far, data shows that the risk of COVID-19 vaccine myocarditis decreases as age decreases.

    ATAGI recommends an interval of 8 weeks between vaccine doses in a primary course for age-eligible children (≤ 11 years) for maximum efficacy and safety. This extended interval is based on international data suggesting a longer time interval between dose 1 and 2 may reduce the risk of myocarditis. This extended interval also allows more time to observe international vaccine safety data and identify any signals for rare adverse events.

    Very few cases of myocarditis in children <6 years of age have been reported in available worldwide surveillance data to date.

    For more information on COVID-19 vaccination in individuals < 18 years please refer to COVID-19 vaccination in children and adolescents.

  • Pre-existing cardiac conditions and COVID-19 vaccination

    Individuals with the following cardiac conditions can safely receive COVID-19 vaccines without the need for additional monitoring or precautions:

    • coronary artery disease
    • myocardial infarction
    • stable heart failure
    • arrhythmias
    • rheumatic fever
    • rheumatic heart disease
    • kawasaki disease
    • most congenital heart disease
    • those with implanted cardiac devices
    • congenital heart disease
    • cardiac transplant
    • cardiomyopathy.

    Those with a history of the following conditions can also receive COVID-19 vaccines; however should consult their treating specialist to determine the appropriate timing for vaccination:

    • recent (within 3 months) or current inflammatory cardiac conditions (including myocarditis, pericarditis and endocarditis)
    • acute rheumatic fever or acute rheumatic heart disease
    • acute decompensated heart failure.

    Patients with ongoing cardiac inflammation should have vaccination deferred. In some instances, vaccination with वैक्सजेव्रिया (एस्ट्राजेनेका) या नुवाक्सोविड (नोवावैक्स) may be considered due to the lower associated risk of developing myocarditis.

  • What are the symptoms of myocarditis?

    Myocarditis presents similarly to pericarditis, with a range of symptoms including:

    • chest pain, pressure or discomfort
    • pain with breathing (pleuritic chest pain)
    • सांस लेने में कठिनाई
    • धड़कन
    • syncope (faint)
    • other non-specific symptoms such as fatigue, dizziness, abdominal pain.

    In individuals who have received COVID-19  vaccines, symptoms of myocarditis have most commonly been reported within 2-7 days of second dose vaccination.

  • How is myocarditis after COVID-19 vaccination diagnosed and investigated?

    If there is suspicion of myocarditis, particularly in the first week following vaccination, timely medical review is important. Those who appear unwell should be referred to an emergency department for examination and the following primary investigations:

    • blood tests for cardiac biomarkers, such as troponin
    • electrocardiogram (ECG).

    Other tests should be considered if the patient is unwell or the tests above are abnormal:

    • chest X-ray (CXR)
    • other tests related to investigating differential diagnoses such as inflammatory markers (C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR)
    • bedside or formal ultrasound/echo
    • cardiac MRI.

    Consistent findings of myocarditis may include elevated troponin, ECG changes (ST or T-wave abnormalities, premature atrial or ventricular complexes) as well as abnormal echocardiogram or cardiac MRI.

    Individuals who are investigated for myocarditis following vaccination should avoid high-intensity exercise until symptoms have resolved is recommended.

    Cardiologist advice and followup is strongly recommended.

  • How is myocarditis after COVID-19 vaccination treated?

    Current data shows that most cases of myocarditis following COVID-19 vaccination have mild symptoms and recover well. Information on long term sequelae is not yet available.

    Treatment of these conditions is managed by a cardiologist and include in-patient supportive therapies. In the rare severe or complicated cases, specific management for arrythmias, decreased cardiac function or congestive cardiac failure with pharmacological agents such as ACE-inhibitors and beta-blockers or mechanical support may be necessary.

  • I have specific questions around my risk of myocarditis following COVID-19 vaccination. Help!

    Although uncommon, myocarditis is most often seen after COVID-19 mRNA vaccines. Please refer to our specific FAQs on COVID-19 mRNA vaccines for further information. This includes answers on:

    • impact of dose intervals between 1अनुसूचित जनजाति and 2रा doses of vaccine
    • risk of developing myocarditis from COVID-19 disease vs the vaccine
    • exercise after COVID-19 vaccination
    • impacts of medications and drugs such as clozapine, stimulants, amphetamines on developing myocarditis.

  • What are the implications for future doses (including third and booster doses)?

    For individuals where the cause of inflammation is attributed to COVID-19 vaccination, a report to सैफविक is indicated and a referral to a cardiologist and/or specialist immunisation service (eg. VicSIS) is recommended.

    Please refer to the below algorithm for recommendations relating to further doses of COVID-19 vaccines in patients who have been diagnosed with myocarditis following vaccination.

    *Brighton Level refers to Brighton Collaboration criteria for classifying myocarditis
    PDF version of the above diagram available यहाँ.

    ATAGI currently recommends that individuals diagnosed with myocarditis following vaccination defer any further doses and are referred to a specialist immunisation clinic.

  • What is the risk/benefit ratio for vaccination for the young adult age group?

    It is important to discuss your individual circumstances with a health care provider in order to make an informed decision.

    The level of COVID-19 community transmission in Australia can change quickly. Factors to consider include age, potential for exposure to the virus (including in the workplace), high rates of global transmission, the emergence of new variants of the virus, as well as the potential for future changes to Australia’s border controls.

    Whilst COVID-19 infection can sometimes result in myocarditis, its incidence following COVID-19 vaccination is comparatively extremely rare. Most individuals diagnosed with myocarditis following COVID-19 vaccination have responded well to treatment.

पेरिकार्डिटिस

  • How is pericarditis following COVID-19 vaccination triggered?

    The exact mechanism behind cardiac sac inflammation temporally associated with COVID-19 vaccination is currently being investigated. Clinical causes from international surveillance data suggest an immune-mediated or hypersensitivity trigger.

  • Who is at risk of pericarditis?

    Pericarditis from any cause occurs in similar rates amongst males and females. It is also more likely to affect younger adults.

    Reported rates of pericarditis occurring following administration of a COVID-19 vaccine vary; however, they are above expected background population rates. Available surveillance data suggests the risks for pericarditis after a mRNA vaccine are higher than non-mRNA vaccines.

    International and local data indicate that pericarditis following COVID-19 vaccines is more common in the 18-39 year old age group for both males and females. Pericarditis following third doses or booster doses have also been identified in a small number of individuals. Reported cases have occurred at significantly lower rates than those identified following either dose of a primary course.

  • Are children more likely to experience pericarditis following COVID-19 vaccination?

    Available safety data from local और international sources suggest there is a significantly lower risk of children developing pericarditis following COVID-19 vaccination.

    ATAGI recommends an interval of 8 weeks between vaccine doses in a primary course for age-eligible children (≤ 11 years) for maximum efficacy and safety. This extended interval is based on international data suggesting a longer time interval between dose 1 and 2 may reduce the risk of myocarditis – which in principle may also extend to pericarditis. This extended interval also allows more time to observe international vaccine safety data and identify any signals for rare adverse events.

    For more information on COVID-19 vaccination in individuals < 18 years please refer to COVID-19 vaccination in children and adolescents.

  • Pre-existing cardiac conditions and COVID-19 vaccination

    Individuals with the following cardiac conditions can safely receive COVID-19 vaccines without the need for additional monitoring or precautions:

    • coronary artery disease
    • myocardial infarction
    • stable heart failure
    • arrhythmias
    • rheumatic fever
    • rheumatic heart disease
    • kawasaki disease
    • most congenital heart disease
    • those with implanted cardiac devices
    • congenital heart disease
    • cardiac transplant
    • cardiomyopathy.

    Those with a history of the following conditions can also receive COVID-19 vaccines; however should consult their treating specialist to determine the appropriate timing for vaccination:

    • recent (within 3 months) or current inflammatory cardiac conditions (including myocarditis, pericarditis and endocarditis)
    • acute rheumatic fever or acute rheumatic heart disease
    • acute decompensated heart failure.

    Patients with ongoing cardiac inflammation should have vaccination deferred. In some instances, vaccination with वैक्सजेव्रिया (एस्ट्राजेनेका) या नुवाक्सोविड (नोवावैक्स) may be considered due to the lower associated risk of pericarditis.

  • What are the symptoms of pericarditis?

    Pericarditis presents similarly to myocarditis, with a range of symptoms including:

    • chest pain, pressure or discomfort
    • pain with breathing (pleuritic chest pain)
    • सांस लेने में कठिनाई
    • धड़कन
    • syncope (faint)
    • other non-specific symptoms such as fatigue, dizziness, abdominal pain.

  • How is pericarditis after COVID-19 vaccination diagnosed and investigated?

    If there is suspicion of either of these conditions, particularly in the first 2-3 weeks following vaccination, timely medical review is important. Those who appear unwell should be referred to an emergency department for the following investigations:

    • blood tests for cardiac biomarkers, such as troponin
    • electrocardiogram (ECG)

    Other tests should be considered if the patient unwell or the tests above are abnormal:

    • chest X-ray (CXR)
    • other tests related to investigating differential diagnoses such as inflammatory markers (C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR)).

    Consistent findings of pericarditis include a pericardial rub on auscultation, widespread ST-elevation or PR depression on ECG, as well as pericardial effusion on imaging.

    Individuals who are investigated for pericarditis following vaccination should avoid high-intensity exercise until symptoms have resolved is recommended. Those experiencing ongoing symptoms should return for review in 1-2 days time. Cardiologist advice is recommended if clinical suspicion is high, regardless of normal investigations.

  • How is pericarditis after COVID-19 vaccination treated?

    Current data shows that most cases of pericarditis following COVID-19 vaccination have mild symptoms and recover well.

    In some scenarios, there have been reports of pericarditis causing prolonged and recurrent symptoms but with functionally normal investigations including cardiac imaging. Information on long term sequelae is still being collected.

    Treatment of these conditions is managed by a cardiologist and include in-patient supportive therapies, often with anti-inflammatory medications or colchicine. In the rare severe or complicated cases, specific management for arrhythmias, decreased cardiac function or congestive cardiac failure with pharmacological agents such as ACE-inhibitors and beta-blockers or mechanical support may be necessary.

  • What are the implications for future doses (including third and booster doses)?

    For individuals where the cause of inflammation is attributed to COVID-19 vaccination, a report to सैफविक is indicated and a referral to a cardiologist and/or specialist immunisation service (eg. VicSIS) is recommended.

    Please refer to the below algorithm for recommendations relating to further doses of COVID-19 vaccines in patients who have been diagnosed with pericarditis following vaccination.

    *Brighton Level refers to Brighton Collaboration criteria for classifying pericarditis
    Access a pdf version of this guide यहाँ.

    In particular, the groups which are at lower risk (green in algorithm), could proceed with further doses of COVID-19 vaccination as per above suggested instructions.

  • What is the risk/benefit ratio for vaccination for the young adult age group?

    It is important to discuss your individual circumstances with a health care provider in order to make an informed decision.

    The level of COVID-19 community transmission in Australia can change quickly. Factors to consider include age, potential for exposure to the virus (including in the workplace), high rates of global transmission, the emergence of new variants of the virus, as well as the potential for future changes to Australia’s border controls.

    Whilst COVID-19 infection can sometimes result in pericarditis, its incidence following COVID-19 vaccination is comparatively extremely rare. Most individuals diagnosed with pericarditis following COVID-19 vaccination have responded well to treatment.

Frequently asked questions

  • I am taking certain medications that have myocarditis listed as an uncommon side effect. Am I at greater risk of developing myocarditis/pericarditis after COVID-19 vaccination?

    Taking medications that have myocarditis listed as an uncommon side effect (e.g. antipsychotic drugs and biological chemotherapeutic agents) is not a contraindication to COVID-19 vaccination. Individuals taking these medications can be safely vaccinated in the community with no need for additional precautions or monitoring.

  • Are there impacts of other substances on the development of myocarditis/pericarditis after COVID-19 vaccines?

    The use of recreational stimulants (particularly amphetamines) is discouraged especially in the week following vaccination to limit the potential for developing myocarditis/pericarditis.

  • Should exercise be limited after receiving COVID-19 vaccines to reduce the chance of myocarditis/pericarditis?

    Exercise is not thought to increase the risk of developing मायोकार्डिटिस / पेरिकार्डिटिस following COVID-19 vaccination. It is therefore not necessary to reduce or avoid exercise in the post-vacccination period.

    However, if patients develop myocarditis/pericarditis post vaccination there is a concern that exercise may be pro-arrhythmic (eg. will exacerbate) the condition.

  • As myocarditis/pericarditis following COVID-19 vaccination is thought to be immune mediated, would those with pre-existing autoimmune diseases be at an increased risk compared to the general public?

    Myocarditis/pericarditis following COVID-19 vaccination appears to be idiosyncratic at this stage, with no clear risk factors. Thus, there is no indication of increased risk in those with underlying autoimmune disease.

लेखक: Rachael McGuire (MVEC Education Nurse Coordinator), Francesca Machingaifa (MVEC Education Nurse Coordinator), Daryl Cheng (MVEC Medical Lead) and Nigel Crawford (Director SAEFVIC, Murdoch Children’s Research Institute)

द्वारा समीक्षित: Daryl Cheng (MVEC Medical Lead) and Julia Smith (Immunisation Fellow, Royal Children’s Hospital)

तारीख: अक्टूबर 27, 2022

नई जानकारी और टीके उपलब्ध होते ही इस अनुभाग की सामग्रियों को अद्यतन किया जाता है। मेलबर्न वैक्सीन एजुकेशन सेंटर (MVEC) कर्मचारी सटीकता के लिए नियमित रूप से सामग्रियों की समीक्षा करते हैं।

आपको इस साइट की जानकारी को अपने व्यक्तिगत स्वास्थ्य या अपने परिवार के व्यक्तिगत स्वास्थ्य के लिए विशिष्ट, पेशेवर चिकित्सा सलाह नहीं मानना चाहिए। टीकाकरण, दवाओं और अन्य उपचारों के बारे में निर्णय सहित चिकित्सा संबंधी चिंताओं के लिए, आपको हमेशा एक स्वास्थ्य देखभाल पेशेवर से परामर्श लेना चाहिए।


बहु-खुराक की शीशियाँ

What are they?

Multi-dose vials contain more than one dose of a medicine/vaccine in a single vial. Whilst all vaccines on the National Immunisation Program are single-use preparations, BCG vaccines and COVID-19 vaccines are available in multi-dose vials in Australia. Multi-dose vials are more economical, take less time to manufacture and require less storage space than single-use preparations, however, there is an increased risk of infection control breaches associated with their use.

Infection control principles

There is an increased risk of blood-borne viruses or bacterial contamination with the use of multi-dose vials due to an increased risk of cross contamination. These risks can be mitigated by:

  • Maintaining standard principles of infection control and strict aseptic technique when accessing multi-dose vials
  • Preparing doses of vaccines from multi-dose vials in a clean, designated medication preparation area
  • Cleaning the stopper with an alcohol swab and allowing to dry every time the vial is accessed
  • Using a new, sterile syringe and needle each time the vial is accessed. Needles should never be left inside the vial
  • Discarding a multi-dose vial if the vaccine’s integrity or sterility is compromised

Storage and usage

  • Follow the manufacturer’s recommendations for refrigeration, storage, usage timeframes and expiry dates. Protect from sunlight and freezing where required.
  • Always label a multi-dose vial with the date and time of first access or reconstitution
  • The expiry date is the date after which an unused multi-dose vial should be discarded
  • The use by date is the date after which a multi-dose vial that has been accessed should no longer be used. A use by date supercedes the expiry date
  • Check reconstituted vaccines for signs of deterioration, such as a change in colour or clarity. If there are signs of deterioration, refer to the vaccine product information. Do not use the vaccine

Multi-dose vials that require reconstitution

  • Only the recommended diluent should be used to reconstitute a multi-dose vial
  • Introduce the diluent down the side of the vial to avoid foaming or potentially denaturing the vaccine. Mix gently with a careful swirling motion. Do not shake
  • Give reconstituted vaccines as soon as practicable after reconstituting. This is because reconstituted vaccines may deteriorate rapidly
  • Once accessed, label the multi-dose vial with the date and time of reconstitution

Pre-filling syringes

Pre-preparing syringes with vaccines is not recommended for several reasons:

  • The uncertainty of vaccine stability
  • The risk of contamination
  • Increased risk of potential errors in administration
  • Potential vaccine wastage

If you are in a setting where pre-preparing multiple doses is required, then only draw up the number of doses necessary to keep the immunisation session running efficiently. These doses must be labelled with the date and time the vial was accessed and should be used as soon as possible, ensuring that the cold chain is maintained.

Principles of administration

  • Attach a new, sterile, disposable injecting needle of appropriate size and length to administer the vaccine
  • Be careful not to prime the needle with any of the vaccine as this can increase the risk of injection site reactions
  • Administer the vaccine as soon as practicable after drawing it up
  • Discard multi-dose vials at the end of an Immunisation session/6 hours after accessing (whichever is sooner) or according to manufacturer’s guidelines
  • Refer to the product information to determine the specified timeframe the vaccine must be used by once the vial has been accessed

संसाधन

लेखक: फ्रांसेस्का मचिंगाइफा (एमवीईसी एजुकेशन नर्स कोऑर्डिनेटर) और राचेल मैकगायर (एमवीईसी एजुकेशन नर्स कोऑर्डिनेटर)

द्वारा समीक्षित: Francesca Machingaifa (MVEC Education Nurse Coordinator)

तारीख: March 2022

नई जानकारी और टीके उपलब्ध होते ही इस अनुभाग की सामग्रियों को अद्यतन किया जाता है। मेलबर्न वैक्सीन एजुकेशन सेंटर (MVEC) कर्मचारी सटीकता के लिए नियमित रूप से सामग्रियों की समीक्षा करते हैं।

आपको इस साइट की जानकारी को अपने व्यक्तिगत स्वास्थ्य या अपने परिवार के व्यक्तिगत स्वास्थ्य के लिए विशिष्ट, पेशेवर चिकित्सा सलाह नहीं मानना चाहिए। टीकाकरण, दवाओं और अन्य उपचारों के बारे में निर्णय सहित चिकित्सा संबंधी चिंताओं के लिए, आपको हमेशा एक स्वास्थ्य देखभाल पेशेवर से परामर्श लेना चाहिए।


MTHFR gene

पृष्ठभूमि

एमethylenetetrahydrofolate reductase (MTHFR) is an enzyme that helps the body to break down folate. The MTHFR enzyme is made by the MTHFR gene. Harmless changes in the MTHFR gene, polymorphisms, are very common. Importantly, MTHFR polymorphisms do नहीं cause any significant health problems. MTHFR gene variants or mutations are different to gene polymorphisms और are very rare. For more information about the MTHFR gene, refer to the resource below [Resources: VCGS MTHFR].

MTHFR gene polymorphisms and vaccines

People who have MTHFR gene polymorphisms can safely receive vaccines. There is no increased risk of adverse events following immunisation (AEFI).

MTHFR gene polymorphism testing

There is no clinical indication for MTHFR polymorphism testing before vaccination.

संसाधन

लेखक: Nigel Crawford (Director SAEFVIC, Murdoch Children’s Research Institute) and Margie Danchin (Senior Research Fellow, Murdoch Children’s Research Institute)

Reviewed by: Katie Butler (MVEC Education Nurse Coordinator) और Sally Gordon (MVEC Senior Research Fellow)

तारीख: October 2023

नई जानकारी और टीके उपलब्ध होते ही इस अनुभाग की सामग्रियों को अद्यतन किया जाता है। मेलबर्न वैक्सीन एजुकेशन सेंटर (MVEC) कर्मचारी सटीकता के लिए नियमित रूप से सामग्रियों की समीक्षा करते हैं।

You should not consider the information on this site to be specific, professional medical advice for your personal health or for your family’s personal health. For medical concerns, including decisions about vaccinations, medications and other treatments, you should always consult a healthcare professional.


गर्भावस्था के दौरान मातृ टीकाकरण

गर्भावस्था के दौरान टीकाकरण मूल्यांकन स्वास्थ्य देखभाल का एक अत्यंत महत्वपूर्ण पहलू है। गर्भावस्था की योजना बनाते समय, अपने स्वास्थ्य देखभाल प्रदाता से उन टीकों के बारे में बात करें जिनकी आपको पहले से आवश्यकता हो सकती है। गर्भधारण से कम से कम एक महीने पहले जीवित-क्षीण टीके दिए जाने चाहिए।

अनुशंसित टीके

इन्फ्लुएंजा, पर्टुसिस और COVID-19 टीके केवल गर्भवती महिलाओं के लिए नियमित रूप से अनुशंसित टीके हैं। उन्हें राष्ट्रीय टीकाकरण कार्यक्रम (एनआईपी) के माध्यम से मुफ्त में प्रदान किया जाता है।

कुछ अन्य टीकों को विशेष परिस्थितियों में प्रशासित किया जा सकता है लेकिन नियमित रूप से अनुशंसित नहीं किया जाता है। को देखें ऑस्ट्रेलियाई टीकाकरण पुस्तिका अधिक जानकारी के लिए।

इन्फ्लूएंजा

इन्फ्लूएंजा रोग से होने वाली जटिलताओं से बचने के लिए गर्भवती महिलाओं के लिए इन्फ्लुएंजा टीकाकरण सुरक्षित और दृढ़ता से अनुशंसित है। इसे गर्भावस्था के किसी भी चरण में प्रशासित किया जा सकता है और इसका उद्देश्य न केवल गर्भवती मां को बीमारी से बचाना है, बल्कि शिशु को निष्क्रिय सुरक्षा प्रदान करना भी है।

गर्भवती महिलाओं को गैर-गर्भवती महिलाओं की तुलना में इन्फ्लूएंजा रोग से रुग्णता और मृत्यु दर का अधिक खतरा होता है। इन्फ्लुएंजा वाले अन्य लोगों की तुलना में इन्फ्लुएंजा रोग के साथ अस्पताल में भर्ती होने की संभावना दोगुनी से अधिक है।

6 महीने से कम उम्र के शिशुओं को इन्फ्लूएंजा से बीमारी और मृत्यु का सबसे बड़ा खतरा होता है और मातृ टीकाकरण जीवन के पहले कुछ महीनों तक शिशुओं को सुरक्षा प्रदान करेगा, जब तक कि 6 महीने की उम्र से उन्हें इन्फ्लूएंजा के खिलाफ प्रतिरक्षित नहीं किया जा सकता।

काली खांसी

गर्भावस्था के दौरान पर्टुसिस (काली खांसी) टीकाकरण मां की सुरक्षा और नवजात शिशु की बीमारी को रोकने का एक सुरक्षित और प्रभावी तरीका है। यह अनुशंसा की जाती है कि गर्भावस्था के 20 से 32 सप्ताह के बीच प्रत्येक गर्भावस्था में टीके की एक खुराक दी जाए, जिसमें गर्भावस्था भी शामिल है जो बहुत कम दूरी पर है।

पर्टुसिस के खिलाफ मातृ एंटीबॉडी शिशुओं को तब तक सुरक्षा प्रदान करते हैं जब तक कि उन्हें अपने स्वयं के पर्टुसिस युक्त टीके की कम से कम 2 खुराक नहीं मिल जाती (6 सप्ताह और 4 महीने की उम्र में दी जाती है)। 6 महीने से कम उम्र के शिशुओं को पर्टुसिस से गंभीर बीमारी और मृत्यु का सबसे बड़ा खतरा होता है।

कोविड-19 टीके

गर्भवती महिलाओं और उनके अजन्मे बच्चों के लिए गंभीर परिणामों के बढ़ते जोखिम के कारण यह अनुशंसा की जाती है कि गर्भवती महिलाओं को नियमित रूप से COVID-19 टीके दिए जाएँ। गर्भावस्था के किसी भी चरण में टीके दिए जा सकते हैं।

mRNA COVID-19 टीकों के प्रशासन पर अंतर्राष्ट्रीय डेटा की निगरानी (कोमिरनेटी (फाइजर) या स्पाइकवैक्स (मॉडर्न)) गर्भवती महिलाओं के लिए माँ या बच्चे के लिए कोई महत्वपूर्ण सुरक्षा चिंताएँ नहीं दिखाई गई हैं। साक्ष्य दर्शाता है कि एंटीबॉडी मां के दूध और गर्भनाल रक्त में प्रवेश कर सकते हैं जो निष्क्रिय प्रतिरक्षा के माध्यम से शिशुओं को सुरक्षा प्रदान कर सकते हैं।

नुवाक्सोविड (नोवावैक्स) शायद प्रशासित गर्भवती और स्तनपान कराने वाली महिलाओं के लिए हालांकि इस रोगी समूह में इसके उपयोग पर कोई प्रतिरक्षाजनकता या सुरक्षा डेटा नहीं है।

गर्भवती महिलाओं को उसी उम्र की गैर-गर्भवती महिलाओं की तुलना में कोविड-19 से संक्रमित होने पर गहन देखभाल इकाई में भर्ती होने और यांत्रिक वेंटिलेशन की आवश्यकता का जोखिम बढ़ा हुआ दिखाया गया है।

जो महिलाएं गर्भावस्था की योजना बना रही हैं या जो स्तनपान करा रही हैं, उन्हें सुरक्षित रूप से COVID-19 वैक्सीन मिल सकती है। टीकाकरण से पहले या बाद में आपको स्तनपान बंद करने की आवश्यकता नहीं है।

अधिक जानकारी के लिए निम्नलिखित देखें:

प्रतिबंधित टीके

सभी जीवित-क्षीण टीके हैं contraindicated गर्भावस्था के दौरान अजन्मे बच्चे को संभावित जोखिम के कारण [नीचे तालिका 1 देखें]। ज्यादातर परिस्थितियों में जोखिम काल्पनिक होता है, हालांकि, इस रोगी समूह में टीकाकरण का समर्थन करने के लिए अपर्याप्त सबूत हैं। एमएमआर और वैरीसेला टीकों जैसे लाइव-क्षीण वायरल टीकों के अनजान प्रशासन से सीमित सुरक्षा डेटा आश्वस्त है।

तालिका 1: लाइव-एटेन्यूएटेड टीके गर्भावस्था में contraindicated हैं

बीमारी ब्रांड का नाम
रोटावायरस रोटारिक्स®, रोटेटेक®
एमएमआर (खसरा-कण्ठमाला-रूबेला) प्राथमिकता®, एमएमआर II®
एमएमआरवी (खसरा-कण्ठमाला-रूबेला-वैरीसेला) प्रायोरिक्स-टेट्रा®, प्रोक्वाड®
वैरिकाला (चिकनपॉक्स) वैरीलिक्स®, वैरीवैक्स®
ज़ोस्टर (दाद) ज़ोस्टावैक्स®
क्षय रोग बीसीजी (विभिन्न ब्रांड)
पीला बुखार स्टैमरिल®
आंत्र ज्वर^ विवोतिफ®
जापानी मस्तिष्ककोप इमोजेव®

^मौखिक टीका

संसाधन

मोनाश स्वास्थ्य प्रतिरक्षण संसाधन

एमवीईसी संसाधन

लेखक: मिशेल जाइल्स (संक्रामक रोग सलाहकार, मोनाश स्वास्थ्य) और राचेल मैकगायर (एमवीईसी शिक्षा नर्स समन्वयक)

द्वारा समीक्षित: राचेल मैकगायर (एमवीईसी एजुकेशन नर्स कोऑर्डिनेटर) और फ्रांसेस्का मचिंगाइफा (एमवीईसी एजुकेशन नर्स कोऑर्डिनेटर)

तारीख: 30 मई 2022

नई जानकारी और टीके उपलब्ध होते ही इस अनुभाग की सामग्रियों को अद्यतन किया जाता है। मेलबर्न वैक्सीन एजुकेशन सेंटर (MVEC) कर्मचारी सटीकता के लिए नियमित रूप से सामग्रियों की समीक्षा करते हैं।

आपको इस साइट की जानकारी को अपने व्यक्तिगत स्वास्थ्य या अपने परिवार के व्यक्तिगत स्वास्थ्य के लिए विशिष्ट, पेशेवर चिकित्सा सलाह नहीं मानना चाहिए। टीकाकरण, दवाओं और अन्य उपचारों के बारे में निर्णय सहित चिकित्सा संबंधी चिंताओं के लिए, आपको हमेशा एक स्वास्थ्य देखभाल पेशेवर से परामर्श लेना चाहिए।


खसरा

यह क्या है?

Measles, also known as rubeola, is a highly contagious viral illness. It is caused by the measles virus which belongs to the मसूरिका परिवार।

क्या ढूँढने के लिए

Infection usually begins with 3-4 days of fever, malaise, cough, coryza (runny nose) and conjunctivitis. Small white spots, known as Koplik spots, are also present on the buccal mucosa (mucosal surface of the cheeks) of an infected person.

3-4 days later a maculopapular rash (red with a combination of flat and raised areas) then develops, often beginning on the face before becoming more generalised and can last up to 7 days. Very rarely does a measles infection occur in the absence of a rash.

Complications of a measles infection include pneumonia and otitis media (ear infection). Approximately 1 in 1000 people will develop encephalitis (brain inflammation) which carries a mortality rate of 10-15%. Sub-acute sclerosing panencephalitis (SSPE) is a rare progressive neurological disorder that can develop 2-10 years after an initial measles infection. It is characterised by encephalitis and demyelination (loss of the protective covering of the nerve fibres) causing behaviour changes, seizures and muscle rigidity. SSPE is fatal in all cases.

Measles infections during pregnancy can result in miscarriage and prematurity.

यह कैसे संचारित होता है?

Measles can be spread by an infected person coughing or sneezing respiratory droplets or through the direct contact with infected nasal or throat secretions. An environment can remain infectious for up to 2 hours after an infectious person has been present.

The incubation period is 7 to 18 days (more commonly 10 days), with a person able to transmit disease for up to 5 days prior to the onset of the rash, and as long as 4 days after the rash develops.

Humans are the only reservoirs for the measles virus.

एपिडेमियोलॉजी

Prior to the introduction of vaccination in 1963, measles infections contributed to 2.6 million deaths globally each year. Despite extensive vaccination campaigns worldwide, measles infection still carries a significant burden in some countries contributing to 142 000 deaths globally in 2018.

Within Australia, however, high rates of vaccine coverage led to the WHO declaring Australia “measles-free” in 2014. Measles infections are still seen in non-immune individuals travelling internationally, placing unimmunised Australians at risk of infection.

निवारण

Live-attenuated measles-containing vaccines are highly effective in protecting against disease. A 2-dose course of vaccination is routinely provided on the National Immunisation Program (NIP) for children as combination vaccines at:

  • 12 months of age – Priorix®/M-M-R®II (measles- mumps- rubella (MMR))
  • 18 months of age – Priorix-Tetra®/ProQuad® (measles-mumps-rubella-varicella (MMRV))

In addition, babies aged between 6 months and 11 months travelling overseas, non-immune women planning pregnancy or non-immune women after delivery, and any person born since 1966 who does not have evidence of 2 doses of vaccination/is seronegative is eligible to receive funded measles-containing vaccines.

Due to high rates of circulating measles virus in the years preceding 1966 and the life-long immunity invoked by natural infection, those born during this time are considered already immune and generally do not require vaccination.

Contraindications

Live-attenuated vaccines such as measles-containing vaccines are contraindicated in individuals with immune compromise due to the risks of adverse events and the chance of developing vaccine-related disease.

Additionally, प्रेग्नेंट औरत should not receive measles-containing vaccines due to the potential risks to the unborn baby. Instead, vaccination at least 4 weeks prior to pregnancy or vaccination in the postnatal period is recommended.

एहतियात

Specific intervals between the administration of immunoglobulins or other blood products and administration of measles-containing vaccines are recommended. This is due to the potential for any circulating donated antibodies affecting the immune response to vaccination.

दुष्प्रभाव

7-10 days following MMR vaccination, individuals may experience fever, malaise, and a non-infectious rash lasting 2-3 days.

MMRV vaccines are not recommended as a first dose of a measles-containing vaccine in children < 4 years of age due to the increased risk of fever and febrile seizures.

एक्सपोज़र के बाद प्रोफिलैक्सिस

If a non-immune individual is exposed to measles, immunisation with MMR or MMRV is recommended to occur within 72 hours of exposure to reduce the likelihood of infection (provided immunisation is not a contraindication).

Infants ≤ 5 months of age born to non-immune mothers or mothers with < 2 documented doses of measles vaccination, individuals of any age with immune compromise, and pregnant women, may be recommended to receive Normal Human Immunoglobulin (NHIG) if exposed to disease [refer to resources].

संसाधन

लेखक: राचेल मैकगायर (SAEFVIC रिसर्च नर्स, मर्डोक चिल्ड्रन रिसर्च इंस्टीट्यूट)

द्वारा समीक्षित: राचेल मैकगायर (एमवीईसी एजुकेशन नर्स कोऑर्डिनेटर) और फ्रांसेस्का मचिंगाइफा (एमवीईसी एजुकेशन नर्स कोऑर्डिनेटर)

तारीख: दिसम्बर 8, 2022

नई जानकारी और टीके उपलब्ध होते ही इस अनुभाग की सामग्रियों को अद्यतन किया जाता है। मेलबर्न वैक्सीन एजुकेशन सेंटर (MVEC) कर्मचारी सटीकता के लिए नियमित रूप से सामग्रियों की समीक्षा करते हैं।

आपको इस साइट की जानकारी को अपने व्यक्तिगत स्वास्थ्य या अपने परिवार के व्यक्तिगत स्वास्थ्य के लिए विशिष्ट, पेशेवर चिकित्सा सलाह नहीं मानना चाहिए। टीकाकरण, दवाओं और अन्य उपचारों के बारे में निर्णय सहित चिकित्सा संबंधी चिंताओं के लिए, आपको हमेशा एक स्वास्थ्य देखभाल पेशेवर से परामर्श लेना चाहिए।


एमएमआर टीका और आत्मकेंद्रित

Some families have concerns around the measles-mumps-rubella (MMR) vaccine and the diagnosis of autism. At MVEC we encourage parents to find the best available evidence to help them make a decision around vaccinating their child. The MMR live-attenuated vaccine is recommended on the National Immunisation Program at 12-months of age and combined with the varicella vaccine (MMRV) at 18-months of age.

A great resource for addressing MMR concerns is a decision aid developed by the National Centre for Immunisation Research and Surveillance (NCIRS) in Sydney. It is targeted at:

  • Parents or caregivers of a child approaching their due date for MMR vaccination.
  • Anyone who would like more information about MMR vaccination

Note: this guide provides general information only, and is not intended as a substitute for consultations with qualified health professionals. For specific queries talk with your local doctor or immunisation provider, or contact us at [email protected] or Telephone: 1300 882 924

Resource

लेखक: Nigel Crawford (Director, SAEFVIC, Murdoch Children’s Research Institute) and Rachael McGuire (SAEFVIC Research Nurse, Murdoch Children’s Research Institute)

द्वारा समीक्षित: राचेल मैकगायर (SAEFVIC रिसर्च नर्स, मर्डोक चिल्ड्रन रिसर्च इंस्टीट्यूट)

तारीख: जुलाई 2020

नई जानकारी और टीके उपलब्ध होते ही इस अनुभाग की सामग्रियों को अद्यतन किया जाता है। मेलबर्न वैक्सीन एजुकेशन सेंटर (MVEC) कर्मचारी सटीकता के लिए नियमित रूप से सामग्रियों की समीक्षा करते हैं।

आपको इस साइट की जानकारी को अपने व्यक्तिगत स्वास्थ्य या अपने परिवार के व्यक्तिगत स्वास्थ्य के लिए विशिष्ट, पेशेवर चिकित्सा सलाह नहीं मानना चाहिए। टीकाकरण, दवाओं और अन्य उपचारों के निर्णयों सहित चिकित्सा संबंधी चिंताओं के लिए, आपको हमेशा एक स्वास्थ्य देखभाल पेशेवर से परामर्श लेना चाहिए।


मोनाश स्वास्थ्य टीकाकरण सेवा

यह क्या है?

The Monash Health Immunisation Service was established in 2012.

It is a nurse-led, all-age immunisation drop-in service, with adult and paediatric immunisation physician support and clinics. The service provides immunisation education and management for high risk groups including oncology, renal, diabetic, respiratory and cardiac, transplant, hyposplenic and asplenic patients. It provides opportunistic immunisation for inpatients and outpatients according to the National Immunisation Program (NIP), influenza vaccines, and antenatal immunisations.

Monash Immunisation Service provides assistance with complex immunisation issues, catch-up immunisation advice, immunisation adverse event management and supports an outpatient immunisation clinic. The service also has a dedicated BCG clinic for children aged 0-5 years (GP referral required).

Monash Health Immunisation Service is part of the VicSIS network. The VicSIS network provides specialist vaccination services for people who have experienced an adverse event following immunisation (AEFI) with a COVID-19 vaccine, or those who are identified as at risk of an AEFI (for example, people with a history of anaphylaxis). For further information refer to MVEC: The VicSIS Network.

Contact

Telephone: 1300 882 924 (option 4)

Pager: 4488 via switchboard 9594 6666

Email: [email protected]

Facsimile: 03 9594 6325

Location

Suite I, Jessie McPherson Private Consulting Suite
Level 2, Monash Medical Centre, Clayton

संसाधन

लेखक: Joanne Hickman (NUM Monash Immunisation, Monash Health), Jim Buttery (Paediatrician/ ID physician, Monash Health) and Rachael McGuire (SAEFVIC Research Nurse, Murdoch Children’s Research Institute)

द्वारा समीक्षित: फ्रांसेस्का मचिंगाइफा (एमवीईसी शिक्षा नर्स समन्वयक)

तारीख: March 2021

नई जानकारी और टीके उपलब्ध होते ही इस अनुभाग की सामग्रियों को अद्यतन किया जाता है। मेलबर्न वैक्सीन एजुकेशन सेंटर (MVEC) कर्मचारी सटीकता के लिए नियमित रूप से सामग्रियों की समीक्षा करते हैं।

आपको इस साइट की जानकारी को अपने व्यक्तिगत स्वास्थ्य या अपने परिवार के व्यक्तिगत स्वास्थ्य के लिए विशिष्ट, पेशेवर चिकित्सा सलाह नहीं मानना चाहिए। टीकाकरण, दवाओं और अन्य उपचारों के बारे में निर्णय सहित चिकित्सा संबंधी चिंताओं के लिए, आपको हमेशा एक स्वास्थ्य देखभाल पेशेवर से परामर्श लेना चाहिए।