Background

It is widely recognised that Aboriginal and Torres Strait Islander (ATSI) people have higher rates of some vaccine preventable diseases (VPD) than non-Indigenous people. For this reason, additional vaccines are recommended, some of which are available through the National Immunisation Program (NIP).

The recommendations and funding for additional vaccines for ATSI people, vary from state to state, based on local disease burden. In addition, individual immunisation providers may have varying approaches to non-NIP vaccines, and this should be clarified with the local health service.

Accessing immunisations

Routine and additional immunisations can be administered via GP services, councils, hospitals and local Aboriginal Health Services. [see Resources]

Additional funded vaccines for ATSI people living in Victoria

Hepatitis B

Rates of hepatitis B infection in the ATSI population are up to 3 times higher than that of the non-Indigenous population with notification rates increasing with age.

Hepatitis B vaccination is funded on the NIP with routine doses given at birth, 6-weeks, 4-months and 6-months of age. A booster dose is also given at 12-months of age for those who were born at <32-weeks gestation and/or <2000g birth weight. In addition to this, hepatitis B vaccination is also funded in Victoria for all non-immune ATSI people of any age.

Pneumococcal

Notification and hospitalisation rates of pneumococcal disease are greater in the ATSI population compared with non-indigenous individuals.

Prevenar 13® (13-valent pneumococcal conjugate vaccine) is funded on the NIP at 6-weeks, 4-months and 12-months of age. For those with medical risk factors/<28-weeks gestation [refer to Australian Immunisation Handbook for full list of medical risk factors] an extra dose of Prevenar 13® is given at 6-months of age (= 4 doses in total) as well as a dose of Pneumovax 23® (23-valent pneumococcal polysaccharide vaccine) at 4-years of age.

An additional dose of Pneumovax 23® is then funded from 15-49 years for those ATSI with medical risk factors. A dose of Pneumovax 23® is also recommended from 50-years of age for all ATSI individuals (regardless of medical risk factors). A further dose may then be recommended 5 years later. In total, a maximum of 3 doses of Pneumovax 23®, separated by a minimum of 5 years should be given in a lifetime.

Influenza

Influenza hospitalisation rates are 4 times higher in ATSI people than non-Indigenous people, with hospitalisation rates for influenza and pneumonia combined, being 20 times the rates for influenza alone.

Annual influenza vaccination is funded on the NIP for all ATSI individuals from 6-months of age. This is a new recommendation from the PBAC, coming into effect in 2019 [refer to PBAC recommendations].

Additional vaccines recommended for ATSI people living in Victoria

Meningococcal B and ACWY

In 2017, ATSI people accounted for more than 100 times the number of cases of meningococcal disease than non-Indigenous people across some age groups. The most common strains causing infection were types B and W. Nimenrix® (meningococcal ACWY) is currently funded on the NIP as a single dose at 12 months of age and an adolescent dose at 14-15 years of age (program beginning April 2019).

The recommendation for all ATSI people is immunisation against meningococcal disease from 6-weeks of age.

This recommendation is for both meningococcal ACWY (Nimenrix®) and meningococcal B vaccination (Trumenba® or Bexsero®). Whilst this recommendation is not currently funded on the NIP or the Victorian immunisation schedule, ATSI patients of the Royal Children’s Hospital have funding approval for both meningococcal B and ACWY via the Drug Usage Committee (DUC).

Additional funded vaccines for ATSI people living in other states

Vaccine Age group State
BCG (tuberculosis) Neonates NT, QLD, Northern SA (in high incidence TB areas)
Prevenar 13® (13-valent pneumococcal conjugate vaccine) 6-months NT, QLD, SA, WA
Vaqta® (hepatitis A- 2 dose course) 12-months and 18-months NT, QLD, SA, WA

SA Health- Aboriginal and Torres Strait Islander people immunisation recommendations
QLD Health- Aboriginal and Torres Strait Islander people immunisation recommendations
WA Department of Health- Immunisation schedule

Resources

Aboriginal Health Services

Other resources

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

Date: February 2019

Materials in this section are updated as new information and vaccines become available. The Melbourne Vaccine Education Centre (MVEC) staff regularly reviews materials for accuracy.

You should not consider the information in 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.