Aboriginal and Torres Strait Islander peoples immunisation recommendations

Background

It is widely recognised that Aboriginal and Torres Strait Islander peoples have higher rates of some vaccine preventable diseases (VPD) than non-Indigenous persons. This is not necessarily due to being of Aboriginal and/or Torres Strait Islander background, but rather due to the higher rates of underlying chronic health conditions and social circumstances that can lead to an increase in disease burden. 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 Aboriginal and Torres Strait Islander peoples 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, local Aboriginal Health Services and some pharmacies.

Additional funded vaccines for Aboriginal and Torres Strait Islander people living in Victoria

Hepatitis B

Rates of hepatitis B infection in Aboriginal and Torres Strait Islander peoples population are up to 3 times higher than the non-Indigenous 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 Aboriginal and Torres Strait Islander peoples of any age.

Pneumococcal

The risk of invasive pneumococcal disease (IPD) is greatest in young children and older adults. Rates of IPD are 6–7 times higher in Aboriginal and Torres Strait Islander people.

Aboriginal and Torres Strait Islander children living in Australian Capital Territory (ACT), New South Wales (NSW), Tasmania (Tas) or Victoria (Vic) are funded for 1 dose of Prevenar 13® (13vPCV) at ages 6 weeks, 4-months and 12-months (3 doses in total). For those with a risk condition/< 28-weeks gestation an extra dose of 13vPCV is given at 6-months of age (4 doses in total) as well as a dose of Pneumovax 23® (23vPPV) at 4-years of age.

Aboriginal and Torres Strait Islander children in Northern Territory (NT), Queensland (Qld), South Australia (SA) and Western Australia (WA) are funded to receive an extra dose of pneumococcal vaccine at age 6 months followed by two further doses of 23vPPV at age 4-years and at least 5 years later.

All Aboriginal and Torres Strait Islander individuals aged > 12 months with risk conditions are recommended to receive 1 additional dose of 13vPCV unless they have previously received a total of 4 doses of 13vPCV (according to the routine schedule for Aboriginal and Torres Strait Islander infants in NT, Qld, SA and WA) followed by two doses of 23vPPV. These doses are funded for some but not all risk conditions.

All Aboriginal and Torres Strait Islander adults ≥ 50 years of age are eligible for 1 dose of 13vPCV and two doses of 23vPPV.

The maximum number of doses of 23vPPV received in a lifetime is two.

For more information please refer to MVEC: Pneumococcal.

Influenza

Aboriginal and Torres Strait Islander people are three times more likely than non-Indigenous people to be admitted to hospital for influenza and pneumonia.

Annual influenza vaccination is funded on the NIP for all Aboriginal and Torres Strait Islander peoples from 6 months of age.

Meningococcal B and ACWY

In 2019, Aboriginal and Torres Strait Islander people had a 10-fold increased incidence of meningococcal disease than non-Indigenous people across some age groups. The most common strains causing infection were types B and W. The recommendation for all Aboriginal and Torres Strait Islander peoples is immunisation against meningococcal disease from 6 weeks of age.

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 (Year 10 equivalent).

Meningococcal B vaccine (Bexsero®) is free and recommended under the NIP for Aboriginal and Torres Strait Islander infants at 2, 4, and 12 months of age.  An additional dose at 6 months of age is required for Aboriginal and Torres Strait Islander infants with certain medical risk conditions.

Meningococcal B and meningococcal ACWY vaccines are also funded under the NIP for people of all ages with specified medical risk conditions that increase their risk of IMD.

For more information refer to MVEC: Meningococcal.

COVID-19 vaccines

A primary course of COVID-19 vaccines are recommended for all Aboriginal and Torres Strait Islander person > 5 years of age. Additional booster doses are also recommended for certain age groups. Aboriginal and Torres Strait Islander people are prioritised for immunisation as there is an increased risk of severe COVID-19 disease and death due to a number of factors. This includes a higher prevalence of underlying medical conditions, as well as a greater likelihood of living in communities where other preventative measures (social distancing, mask wearing and hand hygiene) cannot be maintained.

Please refer to COVID-19 vaccination – ATAGI clinical guidance on COVID-19 Vaccine in Australia in 2021 and COVID-19 vaccination information for Aboriginal and Torres Strait Islander people.

Additional funded vaccines for Aboriginal and Torres Strait Islander people living in other states

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 ATAGI clinical advice on hepatitis A vaccine

Resources

Aboriginal health services

• Victorian Aboriginal Health Services

Other resources

• Australian Immunisation Handbook: Vaccination for Aboriginal and Torres Strait Islander people
• National Aboriginal Community Controlled Health Organisation: COVID-19 Vaccine Updates and Information
• ATAGI clinical advice on vaccination recommendations for Aboriginal and Torres Strait Islander people from 1 July 2020
• ATAGI clinical guidance for COVID-19 vaccine providers
• National Immunisation Program schedule for all Aboriginal and Torres Strait Islander people
• NCIRS: Aboriginal and Torres Strait Islander Immunisation