Pertussis (Whooping Cough) - Information for GPs [27 March 2024]

There has been a rise in Pertussis (‘whooping cough’) cases in NSW after circulating at very low levels during the pandemic.

Pertussis is caused by Bordetella pertussis and spreads mainly through respiratory droplets.

Pertussis outbreaks usually occur every few years as population immunity wanes. Notifications of people with pertussis in NSW are starting to increase from a very low level and are expected to increase further.

Infants aged under 6 months are at greatest risk of severe disease, hospitalisation and death.

Consider pertussis and order a PCR test for people with a compatible illness, even if fully vaccinated.

Ensure that all patients are up to date with recommended vaccinations; this is especially important for:

• pregnant women, who should be vaccinated between 20-32 weeks gestation (ideally at 28 weeks) to provide antibodies to their infant for protection in the first few months of life
• infants and their siblings
• adults who care for infants under 6 months who have not received a booster in the last 10 years.
• Refer to the Australian Immunisation Handbook for details.

The Authorised Nurse Immuniser and Authorised Midwife Immunisers Policy Directive (PD2024_004) has been rescinded and replaced with the newly developed NSW Authorised Registered Nurse/Midwife Vaccination Standards (the Standards). Authority and Standards for RNs and Midwifes

Key updates

• The mandatory conditions which Authorised Nurse/Midwife Immunisers (ANIs) must comply with to ensure effective and efficient immunisation service delivery are now outlined in the Standards. These conditions have not changed for ANIs working in NSW Health, the requirements in the Standards remain consistent with the previous policy.
• The rescinding of PD2024_004 and the creation of the Standards mandate that all ANIs in NSW including those working in primary care or private practice, who initiate and administer a vaccine comply with both the Authority and the Standards.
• The updated Authority and new Standards include products that protect against respiratory syncytial virus (RSV) including the new RSV vaccines and RSV monoclonal antibodies (mAbs), Beyfortus ™ (nirsevimab). ANIs must comply with the requirements in the Australian Technical Advisory Group on Immunisation (ATAG) recommendations when administering these immunisations. Information on the NSW RSV vulnerable babies program is available on the NSW Health webpage: https://www.health.nsw.gov.au/immunisation/Pages/respiratory-syncytial-virus.aspx

World Immunisation Week 2024: Humanly Possible: Immunization for All

World Immunization Week 2024 (who.int)

2024 seasonal influenza vaccination information for immunisation providers

If you're planning a trip away this Easter or school holidays, protect yourself and others from illnesses like COVID-19 and influenza.

Remember to practise protective behaviours such as:

• getting vaccinated

• washing your hands regularly

• coughing or sneezing into your elbow or a tissue

• staying home and rescheduling visits to family and friends when you're unwell.

If you do get sick these holidays, you can book an appointment with a GP using the Healthdirect Service Finder.

For more information on COVID-19 and influenza, visit the Department of Health and Aged Care website.

Learn more about COVID-19 and Influenza

Beyfortus^™ (nirsevimab) – NSW Health RSV (Respiratory Syncytial Virus) vulnerable babies program

NSW Health RSV (respiratory syncytial virus) vulnerable babies program will be implemented in a phased approach that prioritises the most vulnerable babies and infants.

Infants who are vulnerable to severe illness from RSV are eligible for a free monoclonal antibody Beyfortus^™ (nirsevimab) immunisation. RSV monoclonal antibodies are a passive immunisation that provides antibodies directly to the infant so they have immediate protection against RSV. The trade name of nirsevimab is Beyfortus^™.

Beyfortus^™ (nirsevimab) will be initially offered to hospitalised infants in 2024 who meet the following eligibility criteria:

• babies born before 37 weeks gestation and after 31 October 2023
• Aboriginal and Torres Strait Islander babies born after 31 October 2023
• other infants living with specific chronic and complex health conditions.

https://www.health.nsw.gov.au/immunisation/Pages/respiratory-syncytial-virus.aspx

The Australian Immunisation Handbook has been updated with information about COVID-19, vaccines and recommendations for vaccination.

Link: COVID-19 | The Australian Immunisation Handbook (health.gov.au)

Influenza 2024 Resources

• Influenza Vaccination Provider Toolkit (NSW Health) This toolkit assists providers in rolling out and implementing their NIP influenza vaccination programs.
• 2024 seasonal influenza vaccination information for immunisation providers (NSW Health). Information on ordering influenza vaccines through the NSW Vaccine Centre, vaccine strains, influenza vaccines (available in 2023), influenza and COVID-19 vaccination
• 2024 Influenza vaccines (NSW Health) A visual guide to the presentation and free vaccine eligibility of influenza vaccines
• 2024 influenza vaccination – Program advice for health professionals Program advice for vaccination providers (Department of Health)
• ATAGI statement on the administration of seasonal influenza vaccines in 2024
• Influenza fact sheet (NSW Health)
• Influenza information for pregnant women (NSW Health)

Clinical resources

• The Australian Immunisation Handbook The Australian Immunisation Handbook provides clinical guidelines for healthcare professionals about using vaccines safely and effectively.
• NSW Immunisation schedule (NSW Health) Vaccines funded under the National Immunisation Program
• Winter Planning Toolkit RACGP Winter Planning Toolkit which highlights key priorities and principals of infection prevention and control; workforce protection and planning; processes for patient management; and managing the risk of cross-infection.
• Infection Prevention and Control Practice Handbook Clinical Excellence Commission handbook which includes practical day-to-day guidance to support the implementation of NSW Health Infection Prevention and Control Policy directive.

The Australian Technical Advisory Group on Immunisation (ATAGI) has recently published new advice for 2024 on COVID-19 vaccines https://www.health.gov.au/our-work/covid-19-vaccines/getting-your-vaccination/booster-doses

In 2024, those aged 75 years and over continue to be recommended a dose of COVID-19 vaccine every six months.

• Those aged over 65 years of age, and adults with severe immunocompromise, continue to be eligible to receive a COVID-19 vaccine dose every 6 months.

• All other adults can receive a single dose this year.

Clinical recommendations for COVID-19 vaccines can be found in the COVID-19 chapter of the Australian Immunisation Handbook (the Handbook). The Handbook is in the process of being updated to reflect updates in 2024, with updates available in the coming weeks.

Recommended COVID-19 vaccine doses

COVID-19 Vaccines in Australia – A3 poster

Updated FAQs for practitioners about vaccination and immunisation have been published on the Ahpra website.

This follows Ahpra and the National Boards recently consulting with key stakeholders about what information would be helpful for registered health practitioners about vaccination and immunisation, taking into account public health advice and the high rates of vaccination against COVID-19 in Australia.

The NMBA’s Position statement on nurses and midwives and vaccination will also be reviewed in line with current advice.

The updated information about vaccination and immunisation draws from the National Boards’ regulatory tools, including:

• codes of conduct
• social media guidance, and
• Guidelines for advertising a regulated health service.