Illness, frequent moving, or a disrupted home life can mean that a child, young person or adult may miss a scheduled immunisation. Many vaccines require more than one injection before they can offer protection, so it is important to receive all booster shots. Refugees and other recently arrived people may also have missed out on immunisations routinely given in Australia.
Any immunisation given after the recommended age is called a ‘catch-up’ immunisation. If a doctor is not sure if you have been immunised because there are no written records, the general rule is to go ahead and have the vaccine. For most vaccines (except Q fever), there are no serious adverse events associated with additional doses if you are already immune.
Immunisations and HALO
The immunisations you may need are decided by your health, age, lifestyle and occupation. Together, these factors are referred to as HALO.
Talk to your doctor or immunisation provider if you think you or someone in your care has health, age, lifestyle or occupation factors that could mean immunisation is necessary. You can check your immunisation HALO using the Immunisation for Life infographic
(pdf) downloadable poster.
Confirming immunisation history
Ideally, a catch-up immunisation plan should be based on written records that show which immunisations you’ve had. Your memory may be unreliable. However, it is not always possible to access medical records, especially for refugees or people separated from their families or newly arrived from another country.
If there is doubt about your immunisation status, suggestions include:
- Try to locate any immunisation records your family may have. Documents such as the Victorian Child Health Record or My Health and Development Record allow parents to keep track of their child’s immunisations.
- Use the Australian Childhood Immunisation Register (ACIR) to find the immunisation status of people born after 1996.
- Contact your local council for any school-based vaccines.
- If you had vaccines given by a doctor or by a local council, you will need to contact the service that gave those vaccines to see if they still hold the records.
- Your age may be a guide – for example, you may not have been the recommended age when a vaccine became available.
- A blood test can check a person’s immunity against certain diseases (such as chickenpox, measles, mumps, rubella and hepatitis B). This can help the doctor decide if immunisation is appropriate.
- If you do not have written records of which vaccines you have had, a doctor may look for scars. For example, the BCG (tuberculosis) vaccine leaves an identifiable mark on the skin in at least 75 per cent of people.
Planning a catch-up immunisation schedule
Depending on your HALO and immunisation history, your catch-up schedule may be different to the National Immunisation Program Schedule. For example:
- The time between doses may be shortened.
- If a person has missed more than one vaccine, catch-up doses may be given all at the same time in different arms or legs. This does not overload the immune system and ensures protection is provided as early as possible.
- An older child may receive a different vaccine than the one they should have received at the recommended age. For example, a child aged 10 years and over may receive the adult and adolescent form of the diphtheria, tetanus, whooping cough (pertussis) (three-in-one) vaccine as a booster shot.
- A person can skip certain doses or vaccines. For example, the hib (Haemophilus influenzae type B) vaccine is not needed for a child over the age of five years.
If you are concerned that your catch-up schedule is different from the National Immunisation Program schedule, ask your doctor or immunisation provider for more information.
Catch-up vaccinations for new arrivals
Some diseases that can be prevented by immunisation are common in other countries. Issues that new arrivals and their doctors should consider include:
- Certain vaccines are not available overseas, but may be available in Australia. For example, people who had a measles vaccine overseas will be given a measles, mumps and rubella (MMR) combination vaccine for catch-up.
- Women of childbearing age who do not have protection against rubella should have two doses of a free MMR vaccine before pregnancy or shortly after delivery.
- Some vaccines are not free for people holding certain visas.
- Refugees and asylum seekers are eligible to receive catch-up vaccines for free.
- Under the National Immunisation Program, combined vaccines offered in childhood are not registered for use in adolescents or adults. A new arrival’s catch-up immunisation schedule may be different from the national program. Ask your doctor or immunisation provider for further information.
Where to get immunised
Doctors and local health clinics can immunise you and your family. Victorian local councils also run immunisation sessions for vaccines recommended by the National Immunisation Program. Many of the vaccines listed under the schedule are provided free of charge or at a cost to specific groups or people. Your immunisation provider can advise you of any costs involved.
To avoid the risk of unwanted side effects and to make sure that you get the correct vaccine dosage, it is important to tell the nurse or doctor whether you or your child:
- are unwell on the day of immunisation (temperature over 38 ˚C)
- have had a severe reaction following any vaccine
- have any severe allergies
- have had any vaccine in the past month
- are pregnant
- are planning pregnancy or anticipating parenthood
- are a parent, grandparent or carer of a newborn
- was a pre-term infant born less than 32 weeks gestation, or weighing less than 2,000 g at birth
- as a baby, has had an intussusception (a blockage caused by one portion of the bowel sliding into the next piece of bowel like the pieces of a telescope)
- have had an injection of immunoglobulin or received any blood products or a whole blood transfusion within the past year
- live with someone with a disease or who is having treatment that causes lower immunity – examples include leukaemia, cancer or human immunodeficiency virus (HIV) or acquired immunodeficiency syndrome (AIDS), oral steroid medications, radiotherapy or chemotherapy
- have a disease which lowers immunity (such as leukaemia, cancer or HIV/AIDS) or are having treatment that causes low immunity (such as oral steroid medications, radiotherapy or chemotherapy)
- have a past history of Guillain-Barre syndrome
- have a chronic illness
- have a bleeding disorder
- identify as an Aboriginal and Torres Strait Islander person
- do not have a functioning spleen
- are prone to fainting at the sight of needles.
Side effects after immunisation
Immunisations are effective and safe, although all medication can have unwanted side effects. Some children and adults may experience a reaction to a vaccine. In virtually all cases, immunisation side effects are not as serious as the symptoms a child would experience if they were to contract the disease.
Common side effects following immunisation are usually mild and temporary (occurring one to two days after vaccination). Specific treatment is not usually required. Side effects can include a mild fever and pain at the injection site. For specific information about side effects from different doses of vaccine, ask your doctor or healthcare professional.
Managing fever after immunisation
There are a number of treatment options that can reduce the common side effect of fever after a vaccine, including:
- giving extra fluids to drink and not overdressing if there is a fever
- although routine use of paracetamol after vaccination is not recommended, if fever is present, paracetamol can be given – check the label for the correct dose or speak with your pharmacist, (especially when giving paracetamol to children).
Managing injection site discomfort
Many vaccine injections may result in soreness, redness, itching, swelling or burning at the injection site for one to two days. Paracetamol might be required to ease the discomfort.
Concerns about side effects
If the side effect following immunisation is unexpected, persistent or severe, or if you are worried about yourself or your child’s condition after a vaccination, see your doctor or immunisation nurse as soon as possible or go directly to a hospital. Immunisation side effects may be reported to SAEFVIC, the Victorian vaccine safety and central reporting service.
In other states or territories, you can discuss with your immunisation provider how to report adverse events. It is also important to seek medical advice if you (or your child) are unwell, as this may be due to other illness rather than because of the vaccination.
Rare side effects
There is a very small risk of a serious allergic reaction (anaphylaxis) to any vaccine. This is why you are advised to stay at the clinic or medical surgery for at least 15 minutes following immunisation in case further treatment is required.
Reactions from extra vaccine doses
Generally, if there is no way to be sure whether you have been immunised, a catch-up immunisation will be recommended. Sometimes, this could mean that a person has an extra dose when they didn’t need it.
There is no increased risk of side effects if a person has an extra vaccine dose for:
- hepatitis B
- measles, mumps, rubella (MMR)
- poliomyelitis (polio).
Extra doses of some vaccines may increase the risk of mild side effects like soreness, redness and swelling at the injection site. This includes vaccines for:
- pneumococcal disease.
It is important to discuss these risks with your doctor.
Protection is not always immediate and long-lasting
Some vaccines take time to give you protection. They also may not provide lifelong immunity. This is why, in most cases, a course of injections is offered over time to build up your immunity against the disease. In some cases, you may need booster shots.
For example, immunity to all three types of poliovirus can take two to three months to develop after immunisation. This may be a problem if you plan to travel to a country where polio is common.
Booster shots of the polio vaccine are recommended every 10 years for adults who travel to places where polio is common or for those who work with people who have contracted the disease. Speak to your doctor or immunisation provider if you have any concerns.
Where to get help
- Your doctor
- In an emergency, always call triple zero (000)
- Emergency department of your nearest hospital
- Your local government immunisation service
- Maternal and Child Health Line (24 hours) Tel. 132 229
- NURSE-ON-CALL Tel. 1300 60 60 24 – for expert health information and advice (24 hours, 7 days)
- Immunisation Program, Department of Health & Human Services, Victorian Government Tel. 1300 882 008
- National Immunisation Information Line Tel. 1800 671 811
- Australian Childhood Immunisation Register Tel 1800 653 809
- SAEFVIC Tel. 1300 882 924 – the line is attended between 10 am and 3.30 pm and you can leave a message at all other times
Things to remember
- Any immunisation given after the recommended age is called a ‘catch-up’ immunisation.
- A catch-up immunisation plan should be based on written documentation of a person’s immunisation status, if available.
- Depending on the person’s age and immunisation history, their catch-up schedule may be different to the National Immunisation Program Schedule.