R Letter

什么是流行性感冒？

Respiratory syncytial virus (RSV) is a virus that causes both upper and lower respiratory tract infections. Children under 1 year of age, individuals with underlying medical conditions (e.g. chronic cardiac and lung disease), the older population

流感症状

Cold。like symptoms such as rhinorrhoea (runny nose), fever, wheeze, headache and cough are common. Symptoms generally appear 1 to 5 days after exposure and can last 8 to 15 days.

Symptoms may progress to shortness of breath, wheezing, bronchospasm (the sudden tightening of lung muscles) and feeding problems (in children). One third of children develop otitis media (ear infection).

Whilst most infections are mild, bronchiolitis (inflammation of the small airways) and pneumonia (lung infection) can occur, and may lead to hospitalisation for supportive measures such as oxygen therapy and rehydration. It is estimated that bacterial co。infections occur in around 30% of hospitalised patients. In older adults, RSV can exacerbate chronic obstructive pulmonary disease or lead to heart failure.

结核病是如何传播的？

RSV 具有高度传染性，可通过吸入含有病毒的飞沫传播。当人接触受污染的表面，然后再触摸自己的脸时，RSV 也可能被传播。 

People with RSV are generally considered infectious for 3 to 8 days. However, some people continue to spread the virus for up to 4 weeks. 

流行病学

Children and older adults have the highest rates of RSV infection. Almost all children will have experienced infection by the age of 2 years. Aboriginal and Torres Strait Islander adults are at greater risk of RSV。associated hospitalisation than non。Indigenous adults. Reinfection occurs throughout the lifetime since natural infection does not provide long。term immunity.

The Paediatric Active Enhanced Disease Surveillance (PAEDS) network monitors data on children admitted to hospital with RSV infections through enhanced site surveillance in Australia, including RCH and Monash Health in Victoria. This data is updated monthly and can be accessed via PAEDS: Paediatric RSV in Australia.

RSV infections are commonly seasonal, with a peak in cases usually seen over autumn and winter in temperate climates, and during the rainy season in tropical climates.  In recent years, RSV notification rates have increased significantly in Australia.

预防

Previous infection with RSV can provide some immunity but this protection is only short term. Multiple infections can occur within the same year. 

Both monoclonal antibodies and vaccines are available in Australia for RSV prevention, and are recommended for specific populations. Previous infection with RSV is not a contraindication to receipt of preventative products.

Monoclonal antibodies

Monoclonal antibodies are a type of immunoglobulin (immune system protein) that can be administered to provide passive immunity (short。term protection gained from donated antibodies). In Australia, there are two RSV monoclonal antibodies available for use in infants and young children only (from birth to under 2 years):

• Nirsevimab (Beyfortus)
• Palivizumab (Synagis).

Nirsevimab requires a single intramuscular injection which can provide protection for up to 6 months. In Australia, Nirsevimab is funded for some infants through state/territory infant immunisation programs (refer to NCIRS: State and territory nirsevimab (Beyfortus) infant program summary 2025 for information on jurisdictional programs). Palivizumab may be used as an alternative when Nirsevimab is unavailable.

建议

Nirsevimab can be administered from birth, with some jurisdictions offering catch up to older infants (up to 2 years, with the upper limit varying between jurisdictions). It is recommended for all infants: 

• whose mother did not receive RSV vaccination during pregnancy (maternal vaccination)
• born < 2 weeks after maternal RSV vaccination
• at increased risk of severe RSV, regardless of their mother’s vaccination status
• born to mothers with severe immunosuppression (due to the reduced immune response to maternal RSV vaccination)
• whose passive protection from maternal immunisation is ineffective, for example an infant who required extracorporeal membrane oxygenation (ECMO) or cardiopulmonary bypass (CPB), or whose mother required ECMO or CPB after vaccination.

Table 1: Monoclonal antibody recommendations for infants up to 8 months of age

*The 100 mg/mL preparation should never be halved and used for a patient weighing < 5 kg.

Nirsevimab is also recommended for some children aged 8 to 24 months who remain at risk of severe disease (refer to individual state or territory program for recommendations for First Nations children and the Au秒trA升我A

Table 2: Monoclonal antibody recommendations for at-risk children aged 8 to 24 months*

* MVEC acknowledges that these recommendations differ from the dosage guidelines outlined in the Australian 免疫接种 Handbook. 免疫接种 specialist秒 at the Royal Children’s Hospital preferentially recommend that doses of

Additional doses

Children undergoing CPB or ECMO should receive an additional dose of nirsevimab as soon as they are stable. Refer to the Australian Immunisation Handbook: Dose and route for recommended dosages and timing.

Co-administration with vaccines

Nirsevimab or palivizumab can be given on the same day as all vaccines. For advice on giving multiple injections, refer to MVEC: Vaccine administration.

副作用

Side effects from monoclonal antibodies are uncommon but can include injection site tenderness and swelling.

疫苗

There are two RSV vaccines available for use in adults only (not infants/children) within Australia:

• Arexvy
• Abrysvo.

建议

RSV vaccination is available to adults only (vaccines are 不是 registered for use in children). Vaccination is recommended for the following groups, funding varies between groups:

• all adults aged 75 years and over (funded as of 15 May 2026)
• Aboriginal and Torres Strait Islander adults aged 60 years and over (funded as of 15 May 2026)
• adults with specified medical conditions aged 60 to 74 years (not funded)
• pregnant people from 28 weeks’ gestation in every pregnancy, to protect their newborn (funded)  
  • Abrysvo only, Arexvy must not be given to pregnant people.

Clinical trials demonstrate that when vaccinated against RSV during pregnancy the risks of hospitalisation due to severe RSV infection is reduced by 57% for infants less than 6 months of age.

Vaccination can be considered (unfunded) for other groups of adults and is available for private purchase:

• adults aged 50 to 59 years with specified medical conditions
• non-Indigenous adults aged 60 to 74 years with no specified medical conditions.

Table 3: RSV vaccine brand by population group

* If the infant is born less that 2 weeks after maternal vaccination, they will not be adequately protected and should receive nirsevimab at birth.
# Arexvy must not be administered to pregnant people. There is no data on the safety and efficacy of administration of Arexvy in pregnant people. Abrysvo is the only RSV vaccine suitable for use in pregnancy.
^ Vaccination can be considered.
阴影框表示符合条件的个体可在国家免疫计划（NIP）资助下接种的疫苗
阴影框表示未注册用于此年龄组

Co。administration with 其他

It is safe to administer RSV vaccines on the same day as other vaccines. For advice on giving multiple injections, refer to MVEC: Vaccine administration.

副作用

Common side effects following administration of Arexvy 或者 Abrysvo include 注射部位反应 (pain, redness and swelling), malaise, 头痛 and fatigue. These side effects generally occur in the first 48 hours following vaccination and last 1 to 2 days.

A very small number of cases of Guillain-Barre Syndrome (GBS) have been reported in adults aged over 60 years who have recently received RSV vaccination (Arexvy or Abrysvo). GBS is an auto-immune condition, often triggered by a bacterial or viral infection. Given the potential severity of RSV infection in older adults and rare risk of GBS, the benefits of RSV vaccination far outweigh potential risks. Refer to TGA: Updated warnings for Respiratory Syncytial Virus vaccines Arexvy and Abrysvo 了解更多信息。

Precautions and contraindications

RSV vaccines are not registered for use in children and should not be confused with monoclonal antibodies.   

Arexvy must 不是 be administered to pregnant women due to a lack of safety and efficacy data. Should inadvertent administration occur, it should be reported to the adverse event reporting service in your jurisdiction and the patient should be informed using the open disclosure process.

常见问题

资源

• Australian Immunisation Handbook: Respiratory syncytial virus (RSV)
• Raising Children Net: Respiratory syncytial virus (RSV) in babies, children and teenagers
• Raising Children Net: Immunisation: pregnancy and breastfeeding
• RCH Kids health Information: Respiratory syncytial virus
• Immunisation Foundation of Australia: Unite Against RSV
• Australian Government Department of Health and Aged Care: When to get vaccinated – Immunisation for pregnancy
• NCIRS clinical guidance on RSV immunisation product administration errors
• NCIRS: Respiratory Syncytial Virus (RSV): Frequently asked questions (FAQs)
• View-hub by IVAC: Respiratory Syncytial Virus (RSV): Prevention Strategies and Product Introduction
• McNab S, Ha Do LA, Clifford V, et al. Changing Epidemiology of Respiratory Syncytial Virus in Australia – Delayed Re-emergence in Victoria Compared to Western Australia/New South Wales (WA/NSW) After Prolonged Lockdown for Coronavirus Disease 2019 (COVID-19). Clin Infect Dis. 2021;73(12):2365-2366. doi:10.1093/cid/ciab240
• Crawford N, Alafaci A, Clark J, et al. Study of Children Aged Under 2 Years Admitted With RSV at Four Australian Hospitals [2021-2022], J Paediatr Child Health. 2025; 0:1-9. doi:10.1111/jpc.16796
• Carcione D, Spencer P, Pettigre G, et al. Active port-marketing safety surveillance of Nirsevimab administered to children in Western Australia, April-July 2024, The Pediatric Infectious Diseases Journal. 2025. doi:10.1097/INF.0000000000004715 

Rituximab is becoming a frequently used treatment option for many patients with complex medical needs, including in oncology and rheumatology. It is an immune suppressive medication which greatly impacts the production and functionality of immune cells, including the near complete depletion of B-cells. Once treatment with rituximab has been completed, recovery of immune cell function can take 3-12 months, and even longer in some cases. It may be used as a once-only dose or as a long term therapy.

Due to the effects on lymphocytes, patients on rituximab therapy are considered immune suppressed and are at a greater risk of vaccine preventable diseases. However, recommendations for immunisation of these patients is complicated by the inability to produce an immune response to vaccines without functioning B- and T-cells.

Many patients on rituximab are also receiving concomitant immunoglobulin therapy. As this is a blood product, it further complicates the immunisation recommendations involving live-attenuated vaccines.

Prior to commencing treatment

Where possible please ensure patients are up to date for their age with the current immunisation schedule. Ideally inactivated vaccines should be completed at least 1 week prior, and any live-attenuated vaccines should be completed a minimum of 4 weeks prior to commencing treatment. The same principle also applies to COVID-19 vaccines.

During treatment

Due to lack of immune cell function, all future immunisations should be withheld whilst on rituximab. An immunisation medical exemption form should be completed where appropriate to ensure that the patient is not considered overdue [see resources].

The exception to this, may be for influenza and COVID-19 vaccines. Some studies have indicated that a partial immune response to the influenza vaccine in patients receiving rituximab therapy may occur. For this reason MVEC recommends that patients continue to be immunised against influenza whilst on therapy and receive 2 doses of the age-appropriate vaccine annually, minimum of 4 weeks apart (regardless of age or vaccine history).

Due to the potential risk for severe COVID-19 disease and its complications in this population, which may outweigh the lack of vaccine response, COVID-19 vaccination whilst on rituximab could be considered.

COVID-19 vaccination and rituximab

Studies are still ongoing to determine optimum timing and vaccine efficacy in patients on rituximab. However, based on evidence from other vaccines, the assumption is that there is a diminished response to COVID-19 vaccination.

Therefore, important principles to consider for this group of patients include:

• it is not recommended to delay initiation or disrupt optimum timing of rituximab if being used for cancer treatment
• due to its immunosuppressive effects, patients on rituximab are at higher risk of severe COVID-19 disease and poor COVID-19 disease outcomes.

As such, COVID-19 vaccination could be performed as close to the end of a rituximab cycle as possible, or prior to the initiation of therapy. There is no current data to inform optimum timing of two-dose COVID-19 vaccination regimes and intervals.

参考 MVEC: immunosuppression and vaccines

Immunisation of household contacts

All close contacts should ensure that they are up to date with the routine immunisation schedule, including MMR, varicella and pertussis vaccines. Annual Influenza vaccination is strongly recommended. COVID-19 vaccination is encouraged.

血清学

There is no need to check serology pre- or post-rituximab therapy. There is currently no established immune correlate of protection for COVID-19.

Patients should be aware of their immune suppression and avoid potential exposures to vaccine preventable diseases. The need to continue preventative measures such as social distancing, mask wearing and hand hygiene should be discussed. Medical advice should be sought if exposure does occur [see resources for post-exposure immunoglobulin recommendations].

Post treatment

Post the completion of rituximab therapy, immunoglobulin and B-cell levels should be checked every 3 months. Once both levels have returned to normal AND ≥ 6 months post treatment has lapsed (whichever is later), immunisation with both inactivated and live-attenuated vaccines can recommence. For patients who have received immunoglobulin alongside their rituximab, specific intervals are recommended between the administration of live-attenuated vaccines and blood products/immunoglobulin [refer to MVEC：减毒活疫苗和免疫球蛋白或血液制品]. Any previous vaccine history (routine vaccines) should be disregarded due to the loss of immune memory. There is currently no recommendation for additional booster doses of COVID-19 vaccines.

请参阅 MVEC: Post rituximab therapy immunisation guideline for re-immunisation recommendations.

资源

• MVEC: Post Rituximab therapy immunisation guideline
• MVEC：流感疫苗建议
• DHHS: Medical exemption forms
• Australian Immunisation Handbook: Post-exposure prophylaxis for people non-immune to hepatitis B
• Australian Immunisation Handbook: Post exposure prophylaxis for people non-immune to measles
• Australian Immunisation Handbook: Post exposure prophylaxis for people non-immune to varicella
• Australian Immunisation Handbook: Post exposure prophylaxis for people non-immune to tetanus
• Cheng D, Barton R, Greenway A, Crawford N Rituximab and protection from vaccine preventable diseases; applying the evidence to pediatric patients. Expert Review of Vaccines 2016 Volume 15(12): 1567-1574

什么是流行性感冒？

Rotaviruses belong to the genus 轮状病毒 (in the family Reoviridae) which comprises eight species, referred to as A, B, C, D, E, F, G and H. Group A rotaviruses are responsible for most rotavirus infections in humans, although people have also been infected with groups B and C. Like in influenza viruses, the structure of rotaviruses enables them to mutate rapidly to produce new strains.

Rotavirus infections are the leading cause of dehydrating gastroenteritis in young children.

流感症状

Rotavirus disease can present with a spectrum of symptoms, from asymptomatic or mild infection to severe disease. Clinical signs can include:

• 发烧
• vomiting
• abdominal pain
• watery diarrhoea.

Severe cases, if left untreated, can result in significant dehydration leading to electrolyte imbalance, hypotensive shock and death.

The incubation period for developing disease is usually between 24 and 72 hours. The diarrhoea usually lasts from 3 to 7 days.

结核病是如何传播的？

Rotaviruses are mainly transmitted through the faecal–oral route, through close person-to-person contact, contaminated food and water, and via fomites (e.g. toys and other surfaces contaminated by faeces). Rotaviruses are also transmitted through respiratory droplets (e.g. through coughing, sneezing, talking). Spread is common in families, hospitals and childcare settings.

Viral replication occurs in the villous epithelium of the small intestine.  The virus can be transmitted during the acute illness. Excretion for more than 30 days has been reported to occur.

Asymptomatic infected individuals can transmit the virus unknowingly.

流行病学

Worldwide, rotaviruses are the most common cause of dehydrating diarrhoea among children under 5 years of age. Despite the availability of a vaccine, rotavirus continues to result in over 200,000 deaths per year. Deaths due to rotavirus are rare in Australia due to access to health care services.  

Rotavirus vaccines were added to the Australian National Immunisation Program (NIP) in 2007. Since then, there has been an estimated 64% decrease in hospitalisations for children aged under 3 years, and case numbers have fallen. In 2022, notification rates were lowest in Tasmania (at 11 per 100,000) and highest in the Northern Territory and Queensland (at 47 per 100,000). 

Compared with their non-Indigenous peers, Aboriginal and Torres Strait Islander infants and children are hospitalised with rotavirus gastroenteritis about 3 to 5 times more often, and are younger at age of hospitalisation. 

Without vaccination, most children will experience at least one rotavirus infection before the age of 3 years. Repeated infections can occur.  

In temperate areas of Australia infections are more common in the winter months. However, in the tropical/arid regions of Australia there is no seasonal pattern.  

预防

Rotavirus spread can be mitigated through: 

• effective hand hygiene measures 
• effective decontamination of fomites 
• vaccination.

疫苗

Vaccination is approximately 88% effective in preventing rotavirus infection. There are 2 vaccines registered for use in Australia: 

• Rotarix  
• Rotateq. 

Both rotavirus vaccines are live-attenuated vaccines requiring oral administration (by mouth). A 2-dose course of Rotarix is currently provided on the NIP at 6 weeks and 4 months of age.  

There is limited data on the safety and efficacy of rotavirus vaccination when given outside of specific age groups. For this reason, rotavirus vaccines must be administered within the recommended timeframe, with particular attention paid to the upper age limits. If adherence to the recommended timeframes for administration is not possible, vaccination should be withheld indefinitely.  

Infants who receive a first dose of either vaccine should complete the entire course of vaccination using the same oral rotavirus vaccine. However, if an infant inadvertently received one of each, give a 3rd dose of either rotavirus vaccine. The upper age limits and minimum intervals between doses must still be met.

* Preterm infants are recommended to receive vaccines based on chronological age, not corrected age.
^Dose 2 is ideally administered before turning 28 weeks to allow for dose 3 to be given 4 weeks later (before the infant turns 33 weeks). If dose 2 is administered later than 28 weeks, a 4 week interval is not possible, and dose 3 must not be administered.
shaded boxes indicate live-attenuated vaccines.
Rotateq is not routinely used in Australia.

Considerations

If an infant spits out a small amount of the dose of vaccine, it is still considered a valid dose and does not need repeating. If they spit out most of the dose of vaccine within minutes of receiving it, a repeat dose should be administered at the same visit.

Infants who have an enteral feeding tube (e.g. orogastric, nasogastric, gastrostomy, or jejunal tube) can receive rotavirus vaccines via their tube. Rotavirus vaccines should never be injected.

Rotavirus vaccination is not required for a child to be considered up to date with their routine vaccines. It is not mandatory for the purposes of the No Jab No Pay or No Jab No Play legislation.

疫苗副作用

Several large studies have showed that vaccinated infants had no increase in vomiting, diarrhoea or fever compared with unvaccinated infants. However, anecdotally, infants may be more fussy or gassy within the first 7 days following vaccination. Supportive therapies such as paracetamol and additional fluids (breastmilk/formula) can help manage symptoms.  

Good hand hygiene practices are particularly important when handling soiled nappies during this period to minimise the risk of transmission as the virus can shed in stools for 7 to 10 days following immunisation. 

Some Australian and international studies have shown a very small increase in risk of intussusception post rotavirus vaccine. The baseline risk of intussusception for Australian infants is around 80 cases per 100,000 infants. A 2013 study found 6 additional cases of intussusception for every 100,000 infants vaccinated. This equates to 14 more cases per year in Australia.

Intussusception is a rare condition where the bowel slides or telescopes inside itself causing a blockage. Infants with intussusception may show signs of lethargy, intermittent pain or distress, associated with episodes of pallor. They may pull up their legs, vomit and/or have diarrhoea. Jelly-like or bloody stools is a late sign. Immunisation providers should inform parents and carers to be alert for symptoms and the very rare risk of intussusception.

Precautions and contraindications

There is a theoretical risk of vaccine-associated gastroenteritis if vaccines are administered to infants with immunocompromise. However, for some infants with less severe immunocompromise (including those with HIV who are asymptomatic and have adequate CD4+ count) the benefits of vaccine-induced protection may outweigh this risk. Further clarification on the degree of immunocompromise may be sought from specialist immunisation services.  

Infants living in households with persons who have an immunodeficiency disorder or impaired immune status can still be vaccinated. Counselling on hand hygiene and disposing of soiled nappies to minimise the risk of vaccine virus transmission is recommended.  

Infants with severe combined immunodeficiency (SCID) must not receive rotavirus vaccines due to the risk of vaccine-associated gastroenteritis.  

Infants born to mothers who received bDMARDs (biological disease-modifying anti-rheumatic drugs) during pregnancy can receive rotavirus vaccines. Refer to MVEC: Immunosuppression in pregnancy 了解更多信息。  

Rotavirus vaccines must not be given to any infant with a previous history of intussusception or a congenital bowel abnormality which predisposes them to intussusception.

Co-administration with other vaccines

Rotavirus vaccines can be safety administered with other vaccines including other live-attenuated vaccines, such as BCG.

资源

• Australian Immunisation Handbook: Rotavirus
• US Centers for Disease Control and Prevention (CDC), Pinkbook: Rotavirus
• RCH Kids Health Info: Gastroenteritis
• RCH Clinical Guidelines (Nursing): Enteral feeding and medication administration
• GSK Rotarix Dosing and Administration Wheel (Rotarix Wheel) ERRORS
• MVEC：早产儿免疫接种

什么是流行性感冒？

Rabies 是 an acute viral encephalomyelitis (inflammatory disease of the brain and/or spinal cord) caused by infection with the rabies virus, a type of lyssavirus. Other lyssaviruses include Australian bat lyssavirus (ABLV) and the European bat lyssavirus (EBLV).

Rabies is transmitted to humans via bites or scratches from animals infected with the virus. Infection with 这 rabies virus, and other lyssaviruses, result秒 in A progressive inflammation of the brain and spinal cord. Without vaccination

流感症状

The incubation period of rabies is generally between 3 and 12 weeks, but the onset of symptoms has occurred as early as days after exposure or as long as 19 years later.   

Early signs of infection involve non-specific symptoms, such as loss of appetite, cough, fever, headache, discomfort and fatigue, nausea and vomiting, and sore throat. There also may be discomfort, paraesthesia (prickling or itching sensation) and fasciculations (muscle twitching) at the site of the scratch or bite. A person may show signs of anxiety, confusion and agitation. These initial symptoms last 1 to 4 days. Following this, symptoms progress to: 

• delirium and bizarre behaviour 
• disorientation
• hallucinations 
• hypersalivation, hyperthermia and hyperventilation (signs of autonomic instability) 
• hydrophobia (fear of water) 
• paralysis 
• insomnia.

The disease progresses rapidly. Once clinical signs have developed, the person’s neurological status will deteriorate over a period of up to 12 days, resulting in death. There is no specific treatment for rabies.

结核病是如何传播的？

Rabies is a zoonotic disease (spread between animals and humans). Dog species (including wolves, coyotes, foxes and jackals) are the main source of infection for humans. Skunks, raccoons, monkeys and bats can also harbour infection.  

Human exposure occurs primarily through the scratch or deep bite of an infected animal. Transmission can also occur if saliva of an infected animal comes into direct contact with a person’s mucosal surface (nose, eyes or mouth).  

The virus travels from the site of the injury to the brain by moving along nerve pathways.

流行病学

Rabies is found in animals on all continents of the globe except Antarctica. Australia is currently rabies free. However, ABLV has been known to occur in fruit bats and insectivorous bats. It is difficult to determine the disease burden in animals, due to the impracticalities of testing wild and domestic animals. 

Each year, rabies infection causes approximately 59,000 human deaths worldwide, 95% of these occurring in Africa and Asia. The burden of disease in humans is higher in rural, low-income populations. Children are more likely to be infected due to their size and proximity to the ground, being less likely to appreciate an animal’s temperament, and their tendency to make sudden movements or loud noises which are intimidating to animals. 

预防

According to the World Health Organization, vaccinating dogs in rabies-prone regions is the most cost-effective strategy for preventing rabies in people.

People who will be travelling to, or living in, rabies-prone regions should take preventative measures. These include:

• avoiding close contact with wild and domestic animals (this is especially important for children)
• not feeding, patting or playing with animals
• getting vaccinated.

Vaccination

Vaccines can be administered either before potential exposure (pre-exposure prophylaxis), or after exposure has occurred (as part of post-exposure prophylaxis). 

Pre-exposure vaccination requires fewer vaccine doses and eliminates the need for immunoglobulin if exposed (except for those who are severely immunocompromised). Immunoglobulin may be expensive and difficult to source in developing countries.  

There are 2 rabies vaccines available in Australia: 

• Verorab 
• Rabipur 

Both Verorab and Rabipur are inactivated vaccines and can be administered via the intramuscular (IM) route or the intradermal (ID) route.  

It is preferable but not essential to use the same brand of vaccine for the entire course. If using the same brand is not possible, vaccination should not be delayed, and the alternate brand should be used. 

Boosters and serology 

Recommendations for vaccine boosters and serology (blood testing to check antibody levels) vary on a case-by-case basis. Individuals should seek personalised advice from their healthcare provider (e.g. immunisation provider, travel medicine adviser or other specialist consultant). 

It is especially important for individuals in the following groups to speak with their health provider for specific advice on boosters and serology: 

• immunocompromised individuals 
• laboratory workers who work with live lyssaviruses 
• people with ongoing exposure to bats or potentially rabid mammals. 

Table 2: 免疫接种 Handbook 秒erology recommendations

* Or, receive a booster dose every 3 years without checking serology.

A single IM booster dose is recommended for people with significant ongoing exposure risk: 

• when serology is < 0.5 IU/mL   
• 12 months after dose 1 of primary course of vaccination (whether pre- or post-exposure) then every 3 years after first booster (may check serology first).

防范措施

People with anaphylaxis to egg should receive Verorab instead of Rabipur. 

People with latex allergy should receive Rabipur instead of Verorab.  

Co-administration with other vaccines

Verorab and Rabipur can be co-administered with other vaccines, using separate injection sites.  

Tetanus vaccination status should also be considered after a bite or scratch from an animal, see MVEC: Tetanus. 

疫苗副作用

Common side effects following rabies vaccination include nausea, headache, injection site pain and myalgia (muscle aches). 

Due to the seriousness of disease, post exposure vaccination should never be delayed, even in those who have experienced an unpleasant side effect or who have a history of allergic reactions. A specialist immunisation service should be contacted for specific advice. 

资源

• Australian Immunisation Handbook guideline 
• RCH post-exposure Clinical Practice Guideline
• Overseas post-exposure prophylaxis guidelines
• Ordering vaccines online 
• DOH notification requirements