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Influenza vaccination update

Article from the Joint ANF/RCNA Pandemic Influenza Working Group.

Nurses and midwives will be aware of recent reports of high levels of fever and febrile convulsions after seasonal influenza vaccination, originally0 identified as a result of mandatory reporting of adverse events following immunisation in the Western Australia paediatric vaccination program.
Subsequent similar notifications were also identified in several other states and territories, including a death in Queensland that was originally attributed to vaccination but has now been determined as an incidence of SIDS.

Following these reports, on the advice of the Chief Medical Officer (Professor Bishop AO) and pending an evaluation by an expert panel of the Therapeutic Goods Administration (TGA), the state and territory health departments moved swiftly to suspend the influenza vaccination program across the country for all children under the age of six years.

This investigation included monitoring information and clinical data of recipients of the 2010 trivalent seasonal influenza vaccines for children (Fluvax/Fluvax JR, Influvac and Vaxigrip), and the monovalent H1N1 vaccine (Panvax).

The extensive TGA investigation confirmed the increase in the rate of febrile convulsions in children under five years of age in the 24 hour period following vaccination with a particular trivalent seasonal influenza vaccine (Fluvax). However, a cause for this increase has not yet been identified, and testing is ongoing.

In a letter to ‘immunisation providers’ dated 30 July 2010, Professor Bishop AO advised:
As a result of these investigations, we recommend that children from 6 months to less than 5 years of age may be vaccinated with Vaxigrip and Influvac following a discussion of the risks and benefits of these vaccines with parents and guardians. This includes both children at risk of medical complications of influenza and healthy children. Vaccination of children in this age group with Fluvax and Fluvax Junior is not recommended due to the identified increased risk of febrile convulsions.

Nurses and midwives should note that the recommendation to avoid Fluvax is limited to children aged six months to less than five years of age. There has been no change to the recommendations for the use of seasonal influenza vaccine including Fluvax in children five years and older and in adults.

The foregoing information has been provided for our members so that you can help to disseminate accurate information about vaccination for seasonal and pandemic influenza viral strains. The resultant publicity in the wake of incidences of adverse reactions, described above in WA and Queensland, had the potential for there to be a reduction in vaccination programs as a whole. This could have had a flow on effect of compromising the ability to achieve herd immunity both against the influenza virus (seasonal and H1N1) and in other areas, for example measles. Nurses and midwives play a vital role in health promotion both as direct immunisation providers and as sources of information for the public.

The Immunise Australia website: www.immunise.health.gov.au carries all up-to-date information on influenza vaccines.

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