P Letter

Lý lịch

Postural tachycardia syndrome (POTS) is a syndrome where individuals experience a cluster of symptoms including an inappropriate level of tachycardia (rapid heartbeat) upon standing. The condition is more common in females, especially adolescents and young adults. There can be a number of associated symptoms, including dizziness, weakness, vision changes, difficulty concentrating, sleep disturbances or nausea.

Although the pathophysiology of POTS is yet to be fully understood, it is thought to be due to an abnormal autonomic nervous system response. When changing positions from sitting to standing, gravity sends blood to the legs and pelvis activating the sympathetic (fight or flight) nervous system, releasing noradrenaline. This tightens bloods vessels in the lower body so that blood is moved back to the heart, slightly increasing the heart rate, usually all in under a second, keeping blood pressure and bloody supply to the brain stable. In individuals with POTS, this process does not work as well as it should and the brain compensates by increasing the heart rate.

POTS can have an impact on quality of life, with many people experiencing both physical symptoms as well as other effects on mood, cognition and sleep. However, most cases can be successfully managed with lifestyle modifications. Medications are only required in rare circumstances.

POTS and vaccines

A diagnosis of POTS is not a contraindication to receiving vaccinations. In fact, some cases of POTS are thought to occur following an acute infection, some of which are vaccine-preventable. Therefore it is important that any individual who has a diagnosis of, or is concerned about, POTS should receive all recommended vaccinations.

Vi rút u nhú ở người (HPV)

There have been concerns previously after a small number of case reports described POTS being diagnosed following human papillomavirus (HPV) vaccination. However, this has been thoroughly assessed by the Centers for Disease Control and Prevention (CDC) and after examining the data from more than 80 million doses of vaccines, no causal link has been established between HPV vaccines and POTS.

COVID-19

There has not been an established link between COVID-19 vaccines and an increased risk of developing POTS. In fact, there have been reports of POTS developing after COVID-19 infection and POTS has been recognised as a post-covid condition (colloquially known as long COVID). Therefore being vaccinated against COVID-19 is recommended for individuals concerned about developing this condition.

Summary 

For individuals with a previous diagnosis of POTS who are concerned for a worsening of their condition after vaccination, it is important to consider that most vaccine side effects are mild and transient. Overall the benefits of vaccination are likely to far outweigh the risks. However, any concerns should be discussed with an individual’s treating healthcare practitioner.

Nguồn tài liệu

• Baker Heart and Diabetes Institute: Orthostatic intolerance
• CDC: Questions about HPV Vaccine Safety
• CDC: Evaluating and Caring for Patients with Post-COVID Conditions: Interim Guidance
• Immunologic Research: Postural orthostatic tachycardia syndrome (POTS) and other autonomic disorders after COVID-19 infection: a case series of 20 patients

Bệnh lao là gì?

Bệnh bại liệt (bại liệt) là do nhiễm trùng đường tiêu hóa (ruột) với một trong 3 loại vi rút bại liệt (serotype 1, 2 hoặc 3). Poliovirus là RNA enterovirus từ Picornaviridae gia đình.

Once an individual is infected, the poliovirus replicates in the gut and enters the bloodstream via lymphoid tissue where it can then cause symptoms in the central nervous system.

Triệu chứng cần nhận biết

Approximately 70% of polio infections are asymptomatic or present as a non-specific febrile illness. In symptomatic cases an individual may experience fever, headache, gastrointestinal disturbance (nausea and vomiting) or malaise. In severe infections muscle pain and stiffness of the neck and back can occur.

Paralysis typically presents asymmetrically and can be life threatening when the respiratory and swallowing muscles are affected. The extent of paralysis is usually seen within 3-4 days of symptom onset and any existing paralysis present after 60 days is likely to be permanent. It is estimated that flaccid paralysis occurs in less than 1 percent of all polio cases.

A recurrence of muscle weakness in the years after an initial polio infection is known as post-polio syndrome. It is attributed to a progressive loss or dysfunction of motor neurons as opposed to a persistent or reactivated infection.

Bệnh lây truyền qua đường nào

Wild polio is transmitted through contact with the faeces or saliva of an infected person and is most often associated with conditions of poor sanitation.

The incubation period of polio is 3-35 days, with a person infectious during the 7-10 days prior to the onset of symptoms. Following acute infection, a person can continue to excrete the polio virus for up to 6 weeks in their faeces, or 2 weeks in saliva.

Dịch tễ học

Polio infection predominantly occurs in children with the greatest burden of disease affecting those less than 5 years of age (80-90% of cases).

Global vaccination programs and high rates of immunisation have shown great success with the near eradication of wild polio worldwide. A total of 350,000 infections were reported in 1988 across 125 countries and in 2021 this was reduced down to 6 reported cases across countries including Pakistan and Afghanistan. The COVID-19 pandemic has greatly impacted these vaccination programs and since 2022 a resurgence of case across many countries (including the United States and the UK) have been reported, largely in pockets of unimmunised communities.

Phòng ngừa

Vaccination remains the most effective measure in disease prevention with protection available in Australia through the administration of a course of inactivated vaccines. Polio vaccination is funded on the National Immunisation Program (NIP) as a combination vaccine for children at:

• 6 weeks, 4 months and 6 months – Infanrix® hexa/Vaxelis®
• 4 years – Infanrix® IPV/Quadracel®

Individuals who missed a dose or who have an incomplete vaccine history should be offered immunisation to ensure that they are protected. Catch up vaccines are funded for some individuals.

Completing a primary course of vaccination generally provides life-long protection and booster doses are not routinely indicated for the broader population. However, they may be indicated for travellers visiting countries with known cases of polio.

Các biện pháp phòng ngừa

The oral live-attenuated polio vaccine is no longer available in Australia due to the potential low risk (1 case per 2.4 million doses) of Vaccine Associated Paralytic Poliomyelitis (VAPP), also known as Vaccine Derived Poliovirus (VDPV). Following receipt of the oral polio vaccine some of the vaccine virus may be shed in a person’s faeces for up to 6 weeks. In areas of low vaccine coverage this has the potential to cause disease in an unvaccinated individual.

Nguồn tài liệu

• Australian Immunisation Handbook: Poliomyelitis
• CDC: Vaccines and Preventable Diseases – Vaccine Derived Poliovirus
• The Blue Book: Guidelines for the control of infectious diseases
• Bộ Y tế và Chăm sóc Người cao tuổi của Chính phủ Úc: Những thay đổi đối với lịch trình của Chương trình Tiêm chủng Quốc gia từ ngày 1 tháng 7 năm 2023

Lý lịch

Bệnh phế cầu khuẩn là do Phế cầu khuẩn (phế cầu), một loại vi khuẩn có thể sống trong mũi và họng (mũi hầu) của người khỏe mạnh và trong hầu hết các trường hợp không gây bệnh tật hoặc bệnh tật. Tuy nhiên, trong một số trường hợp, vi khuẩn có thể phát triển và lây lan sang các bộ phận khác của cơ thể. Bệnh phế cầu khuẩn xâm lấn (IPD) có thể biểu hiện như viêm màng não, viêm phổi, viêm xoang, viêm tai giữa (nhiễm trùng tai), viêm tủy xương (nhiễm trùng xương), nhiễm trùng khớp và nhiễm trùng huyết (nhiễm trùng máu). Mức độ nghiêm trọng của bệnh có thể khác nhau, với bệnh nặng cần nhập viện, gây ra bệnh nặng và thậm chí tử vong. Một số cá nhân mắc các bệnh lý cụ thể (tuổi cao, được xác định là Thổ dân và dân đảo Torres Strait, lá lách v.v.) có thể được coi là có nguy cơ mắc IPD cao hơn và do đó cần được bảo vệ bổ sung.

vắc xin phế cầu khuẩn

Hiện tại có hai loại vắc-xin phế cầu khuẩn đa giá được cung cấp miễn phí trong Chương trình Chủng ngừa Quốc gia (NIP).

1. Prevenar 13® (13vPCV) – vắc-xin kết hợp, bảo vệ chống lại 13 týp huyết thanh khác nhau của phế cầu khuẩn (1, 3, 4, 5, 6A, 7F, 9V, 14, 18C, 19A, 19F, 23F). Nó có sẵn trên NIP cho các cá nhân > 6 tuần tuổi.
2. Pneumovax 23® (23vPPV) – vắc-xin polysacarit, bảo vệ chống lại 23 týp huyết thanh của phế cầu khuẩn (1, 2, 3, 4, 5, 6B, 7F, 8, 9N, 9V, 10A, 11A, 12F, 14, 15B, 17F , 18C, 19F, 19A, 20, 22F, 23F và 33F). Nó có sẵn trên NIP như một khuyến nghị bổ sung cho những người > 4 tuổi có nguy cơ mắc IPD cao hơn (không khuyến nghị cho những người <2 tuổi do khả năng sinh miễn dịch kém trong nhóm dân số này).

Phối hợp với các loại vắc-xin khác

13vPCV và 23vPPV có thể được sử dụng đồng thời với các loại vắc-xin khác trong NIP, bao gồm cả vắc-xin hóa trị bốn Vắc-xin cúm (QIV), vắc xin sống giảm độc lực (MMR/thủy đậu/Zostavax®) và vắc xin COVID-19.

Xem xét các vị trí tiêm khác nhau nếu có thể khi sử dụng đồng thời phế cầu khuẩn và QIV ở người lớn do tăng nguy cơ phản ứng tại chỗ tiêm.

Tác dụng phụ thường gặp của vắc-xin phế cầu khuẩn

• sốt
• cáu gắt
• thờ ơ
• đau tại chỗ tiêm
• phản ứng tại chỗ tiêm (đỏ, nóng, sưng và đau)
• nhức mỏi cơ thể

Lưu ý – Ở trẻ em, các phản ứng tại chỗ tiêm thường được báo cáo là xảy ra trong vòng 24-48 giờ sau khi chủng ngừa. Ở người lớn, phản ứng tại chỗ tiêm có thể xảy ra >3 ngày sau khi tiêm liều 13vPCV ở độ tuổi >70, đặc biệt ở những người trước đó đã tiêm 23vPPV [xem tài nguyên]. Ở cả hai nhóm tuổi, tiền sử có phản ứng cục bộ lớn tại chỗ tiêm sau khi tiêm vắc-xin phế cầu khuẩn trước đó không phải là chống chỉ định cho các liều tiếp theo.

Các khuyến nghị về phế cầu khuẩn hiện tại kể từ tháng 7 năm 2020

Các nhóm dân số cụ thể có nguy cơ mắc IPD cao hơn. Lời khuyên ATAGI cập nhật liên quan đến các nhóm dân cư này bao gồm:

• Trẻ em và người lớn mắc các bệnh làm tăng nguy cơ mắc bệnh phế cầu khuẩn
• Tất cả người lớn tuổi Thổ dân và dân đảo Torres Strait (tuổi ≥50)
• Tất cả người lớn tuổi không phải người bản địa (tuổi ≥70)

Điều quan trọng đối với các nhà cung cấp dịch vụ tiêm chủng là phải tự làm quen với các khuyến nghị về vắc xin phế cầu khuẩn dành riêng cho từng bệnh nhân, nhận biết các khác biệt trong các khuyến nghị dành cho các nhóm tuổi khác nhau, các tình trạng y tế có nguy cơ và tình trạng của Thổ dân và Dân đảo Torres Strait.

Bảng 1: Tóm tắt các khuyến nghị về vắc-xin phế cầu khuẩn cho mọi nhóm tuổi và các nhóm nguy cơ

*Lượng 23vPPV tối đa trong đời là 2 liều
^ Tham khảo cụ thể phế cầu khuẩn bắt kịp lời khuyên nếu bắt đầu chủng ngừa muộn/chậm trễ bao gồm cả Bàn. Lịch cập nhật về 13vPCV cho trẻ em Thổ dân và dân đảo Torres St Eo sống ở NSW, Vic, Tas hoặc ACT, và tất cả trẻ em không có (các) tình trạng nguy cơ mắc bệnh phế cầu khuẩn, ở độ tuổi <5 tuổi Và Bàn. Lịch tiêm kịp thời cho 13vPCV dành cho trẻ em Thổ dân và Dân đảo Torres St Eo sống ở CHỈ NT, Qld, SA hoặc WA và tất cả trẻ em có (các) tình trạng nguy cơ mắc bệnh phế cầu khuẩn, ở độ tuổi <5 tuổi
§ Đối với những người đã tiêm liều 23vPPV, 13vPCV phải được tiêm ≥12 tháng sau liều 23vPPV
# Vào tháng 7 năm 2020, 13vPCV đã thay thế 23vPPV trước đây được tài trợ với thời hạn > 65 năm. Vẫn nên tiêm 13vPCV ngay cả khi đã tiêm 23vPPV trước đó. Trong các tình huống mà 23vPPV được tiêm trước, nên có khoảng thời gian tối thiểu là 12 tháng trước khi tiêm 13vPCV

Nguồn tài liệu

• Cẩm nang Chủng ngừa Úc: Bệnh phế cầu khuẩn
• Cẩm nang Chủng ngừa Úc: Danh sách. Điều kiện nguy cơ mắc bệnh phế cầu khuẩn
• Lời khuyên lâm sàng của TAGI về những thay đổi trong khuyến nghị sử dụng và tài trợ cho vắc xin phế cầu khuẩn từ ngày 1 tháng 7 năm 2020 
• NCIRS: Vắc-xin phế cầu khuẩn- những câu hỏi thường gặp
• Kênh Sức Khỏe Tốt Hơn: Bệnh phế cầu khuẩn
• Vắc xin cho người và liệu pháp miễn dịch: Sử dụng đồng thời vắc xin phế cầu khuẩn liên hợp 13 hóa trị và vắc xin cúm bất hoạt hóa trị 4 ở người lớn trước đây đã được chủng ngừa bằng vắc xin phế cầu khuẩn polysacarit 23: một thử nghiệm lâm sàng ngẫu nhiên

Lý lịch

Pharmacist immunisers are registered pharmacists who have completed additional training that allows them to administer approved vaccines to specified patient groups. This improves vaccine accessibility for the community which is particularly important to limit the spread of vaccine preventable diseases.

Pharmacist immuniser requirements

In addition to completing an immunisation program recognised by the Chief Health Officer, pharmacist immunisers are required to display their certificate of completing said training, hold current First Aid and CPR certificates, and ensure that another suitably qualified staff member is on site when immunising in pharmacy settings. Completion of further training modules are required prior to administering some vaccines (COVID-19, monkeypox and Japanese encephalitis)

Pharmacist immunisers are bound by the policies and procedures of their local jurisdiction. For more information on requirements of pharmacists in Victoria, refer to the Victorian Pharmacist-Administered Vaccination Program Guidelines.

Which vaccines can pharmacist immunisers administer in Victoria?

In Victoria, pharmacist immunisers are authorised to administer the following vaccines:

• cúm vaccines to those aged ≥ 5 years
• bạch hầu– uốn ván–ho gà vaccines to those aged ≥ 12 years
• bệnh sởi-mumps-rubella vaccines to those aged ≥ 15 years
• não mô cầu ACWY vaccines to those aged ≥ 15 years
• COVID-19 vaccines under a time limited approval
• u nhú ở người vaccines to those aged ≥ 12 years
• phế cầu khuẩn vaccines to those ≥ 50 years
• herpes zoster vaccines to those ≥ 50 years
• mpox vaccines to eligible individuals aged ≥ 5 years
• Bệnh viêm não Nhật Bản vaccines to eligible individuals aged ≥ 5 years.

Nguồn tài liệu

Pharmacist Immuniser Training Programs

• Pharmaceutical Society of Australia: Manage the delivery and administration of injections and immunisations- Victoria
• Pharmacy Guild of Australia, Victoria: Delivering immunisation in a community pharmacy setting

Các nguồn lực khác

• DHHS: Pharmacist immunisers
• DHHS: Pharmacist-administered vaccination services
• Victorian COVID-19 Vaccination Guidelines
• Victorian Pharmacist-Administered Vaccination Program Guidelines

A number of families and health care providers may wonder if immunisations are permitted based on religious beliefs, given the presence of gelatin derived from pork in some vaccines.

Leaders of the Jewish faith have declared that pork derived additives in medicines are permitted for those observant of the Jewish faith. Rabbi Abraham Adler, from the Kashrus and Medicines Information Service in the United Kingdom has advised:
“It should be noted that according to Jewish laws, there is no problem with porcine or other animal derived ingredients in non-oral products. This includes vaccines, injections, suppositories, creams and ointments”

Scholars of the Islamic Organization for Medical Sciences have also determined that the process by which the original pork product is transformed into gluten, alters it enough whereby it is permitted for observers of Muslim faith to receive vaccines. A 2001 letter from the World Health Organization Regional Office for the Eastern Mediterranean reported:
“the gelatin formed as a result of the transformation of the bones, skin, and tendons of a judicially impure animal is pure, and it is judicially permissible to eat”
Grand Mufti of Australia has also released supportive statements noting that the use of vaccines containing gelatin derived from pork is permitted for observant Muslims.

Seventh-Day Adventists are not forbidden to use pork derivatives in medical products.

If there are any queries regarding porcine products in vaccines please contact [email protected]

Nguồn tài liệu

• Australian Government Department of Health: Questions about vaccination
• Institute for Vaccine Safety: Religious leaders approval of use of vaccines containing porcine gelatin
• NCIRS: Vaccine components fact sheet

Prematurity, particularly extreme prematurity (< 28-weeks gestation) and low birth weight infants often have associated chronic (special risk) medical conditions. This can be associated with prolonged hospitalisation and frequent clinic visits. These are some of the reasons premature infants are at a greater risk of vaccine preventable diseases (VPDs) and their complications. Preterm infants may also not respond as well to some vaccines (e.g. Hepatitis B).

khuyến nghị tiêm chủng

Infants should be immunised according to the recommended immunisation schedule based on their chronological age as opposed to their corrected age. This is because it is important to minimise the window preterm infants are not protected from VPDs. Specific special risk medical conditions, as well as birth weight need to be taken into account as extra vaccines may be required .

It should be noted that the Rotavirus immunisation must be given within a strict time frame, with the first dose required before turning 15-weeks (chronological age) and the second dose before 25-weeks of age.

Additional vaccines recommended:

< 28-weeks gestation

vắc xin phế cầu khuẩn

• Infants born at < 28-weeks gestation are recommended to receive 4 doses of 13vPCV and 2 doses of 23vPPV
  • 13vPCV in a 4-dose schedule at 2, 4, 6 and 12-months of age (the first dose may be given as early as 6-weeks of age)
  • 2 doses of 23vPPV; 1 dose at 4-years of age and another dose at least 5 years later

< 32-weeks gestation and/or < 2000g birth weight

Bệnh viêm gan B

• Hepatitis B vaccine should be given at 12-months of age

Additional risk condition vaccine recommendations

• Influenza vaccine should be given annually from 6 months of age
• Meningococcal vaccines (MenB and MenACWY) are now funded under the NIP for people of all ages with medical conditions associated with the highest risk of invasive meningococcal disease

Tài nguyên:

• ATAGI Clinical advice on changes to recommendations for pneumococcal vaccines from 1 July 2020
• ATAGI Clinical advice on vaccination recommendations for people with risk conditions from 1 July 2020

Địa chỉ liên hệ hộ gia đình

It is recommended that family members of premature infants be fully up to date with their immunisations including influenza and pertussis boosters. This concept of ‘cocooning’ will help protect vulnerable preterm infants from VPDs.

The whooping cough (pertussis) vaccine is free and recommended for pregnant women and can be given anytime between 20-32 weeks of each pregnancy. It should be given as early as possible (from 20 weeks) to women who have been identified as being at high risk of early delivery to protect baby in the first months of life when they are too young to be vaccinated.

Influenza vaccination in pregnancy is safe and strongly recommended in avoiding complications of influenza disease. It can be administered at any stage of pregnancy and not only aims to protect the expectant mother from disease, but also to provide protection to the infant once born. Babies less than 6-months of age are at greatest risk of disease and death from influenza and maternal vaccination will provide protection to babies for the first few months of life until they can be immunised against influenza from 6-months of age.

Nguồn tài liệu

• MVEC: Khuyến nghị vắc-xin cúm
• MVEC: Vi-rút Rota
• MVEC: Chủng ngừa cho các bà mẹ trong lúc mang thai
• Ordering Preterm infant stickers for child healthcare books 
• MVEC: Special risk chapter of the Australian Immunisation Handbook

Các Dịch vụ tổng hợp ung thư nhi khoa (PICS) is a statewide initiative supported by Cancer Australia, with guidelines endorsed by the Australian and New Zealand Childrens Haemotology/Oncology Group (ANZHOG).

The PICS immunisation resources detail vaccines to consider during cancer therapy [e.g. influenza (flu)], as well as highlighting the vaccines that are required after completion of chemotherapy. These resources cross-link with the MVEC Cancer immunisation guidelines (see Resources below).

The PICS Immunisation information sheets have been translated into a number of different languages.

Nguồn tài liệu

• Paediatric Integrated Cancer Service (PICS): Immunisation Resources
• MVEC: Cancer immunisation guideline- chemotherapy and post haematopoietic stem cell transplant

Bệnh lao là gì?

Pertussis (whooping cough) is a highly contagious, respiratory disease caused by an infection with the bacterium Bordetella ho gà. The bacteria attach to the cilia (tiny, hair-like structures) that line the upper respiratory system. The bacteria release toxins, which damage the cilia and cause airways to swell. Pertussis infection is usually more serious in infants under 6 tháng, but it can affect people of any age.

Triệu chứng cần nhận biết

Symptoms begin 6 to 20 days after exposure and initially include rhinorrhoea (runny nose), malaise and a non-specific cough (the catarrhal phase). Approximately one week later, periods of coughing increase with intensity (the paroxysmal phase). A characteristic deep gasp (or “whoop”) may be heard on inspiration, but this is not present in all infections.

During or just following an episode of paroxysmal coughing, babies may have a period of apnoea where they stop breathing for a short period. This may be associated with some colour changes where their skin may appear blue or dusky, especially around the mouth.

Complications of pertussis in infants can include vomiting and difficulty feeding due to prolonged paroxysmal coughing episodes. Rare complications of pertussis in infants include pneumonia and encephalitis, which can be fatal. Complications in older children and adults can include fainting episodes, sleeplessness and rib fractures due to paroxysmal coughing episodes.

Bệnh lây truyền qua đường nào

Transmission of pertussis is through the inhalation of infected respiratory secretions that have been made airborne by coughing, sneezing and speaking. Pertussis is highly contagious, with one infected individual likely to transmit infection to 70–100% of their household members. Some people with mild symptoms of pertussis may be unaware they are infected, but can still spread the bacteria to others. Humans are the only known reservoir for pertussis.

The incubation period is 1 to 3 weeks. Without treatment, people with pertussis are considered infectious just prior to symptom onset and for 21 days thereafter. The infectious period is reduced to 5 days if a course of targeted antibiotics is completed.

Dịch tễ học

Australia has historically experienced pertussis epidemics every 3 to 4 years. There is a seasonal pattern to pertussis infections with most cases reported in the spring and summer months.

Infants under 6 months of age have the highest rates of hospitalisation and death from pertussis infection. Aboriginal and Torres Strait Islander children under 5 years have higher rates of pertussis infection and hospitalisation compared with non-Indigenous children of the same age.

With the introduction of the maternal pertussis vaccination program in 2015, there has been a significant reduction in young infants infected with pertussis and a substantial reduction in both morbidity and mortality associated with infection. In Australia, the incidence of pertussis infections in all age groups has continued to decline. Between 2016 and 2018, infants under 2 months of age had the lowest incidence of disease, and children aged 9 to 11 years had the highest incidence of disease.

Phòng ngừa

Vaccination against Bordetella ho gà is the most effective public health measure for the prevention of pertussis for both vaccine recipients (direct effect), and among unimmunised populations (indirect ‘herd’ effect).  Vaccination of có thai people Mộtlso provideS short-term, passive protection to infants through the transplacental transfer of antibodies.

Pertussis vaccination is only available in Australia in combination with diphtheria and tetanus. Vaccines may also include protection against poliomyelitis, hepatitis B and haemophilus influenzae type B.

The pertussis vaccines available in Australia are acellular, meaning they are made using pertussis toxin and/or components of pertussis bacterium. In contrast, whole-cell pertussis vaccines are first generation pertussis vaccines that are made using an entire bacterium that has been inactivated. While whole cell pertussis vaccines are still available internationally, they were phased out in Australia in 1997, in favour of acellular pertussis vaccines.

khóa học chính

As per the National Immunisation Program (NIP), a primary course of pertussis vaccination is given at 6 weeks, 4 months, and 6 months of age (Infanrix hexa/Vaxelis).

tên lửa đẩy

Booster doses are scheduled to be administered at:

• 18 months (Infanrix/Tripacel)
• 4 years (Infanrix-IPV/Quadracel)
• 12 to 13 years of age/Year 7 high school program (Boostrix)
• Pregnant people at 20–32 weeks gestation (every pregnancy, regardless of how closely spaced).

In addition, pertussis vaccination is recommended (but not funded) for:

• Cha mẹ/người giám hộ của trẻ dưới 6 tháng tuổi (nếu họ chưa tiêm một liều nào trong 10 năm qua)
• Adults aged 65 years and older who have not received a pertussis-containing vaccine in the last 10 years
• Any adult who wishes to be protected against pertussis infection who has not received a dose in the last 10 years (including healthcare workers, travellers, and early childhood educators and carers).

Grey shaded boxes – Not routinely recommended for use in this age group.
* ATAGI recommends the use of Infanrix hexa Và Vaxelis in children aged < 10 years. However, the Royal Children’s Hospital (RCH) preferentially uses them up to < 18 years in instances where multiple vaccines are required (e.g. catch up, post chemotherapy/post HSCT). 

Tác dụng phụ của vắc-xin

Common side effects from pertussis vaccination include phản ứng tại chỗ tiêm, fever, lethargy, headache and irritability in infants and young children. Rare side effects include allergic reaction and hypotonic-hyporesponsive episode (HHE) in infants. There has been a decrease in the incidence of HHE following the change from whole-cell pertussis to acellular pertussis vaccines on the NIP.

Nguồn tài liệu

• Better Health Channel: Whooping cough
• Cẩm nang Tiêm chủng Úc: Chương bệnh ho gà
• MVEC: Tiêm chủng cho bà mẹ khi mang thai
• RCH: Kids health info fact sheet
• The Immunisation Foundation of Australia
• The Raising Children Net Whooping Cough Guide
• National Notifiable Diseases Surveillance System (NNDSS)
• Australian vaccine preventable disease epidemiological review series: Pertussis, 2013-2018
• RCH: Clinical Practice Guideline Whooping cough