Surveillance of adverse events following immunisation in Australia annual report, 2017

This report summarises Australian passive surveillance data for adverse events following immunisation (AEFI) for 2017 reported to the Therapeutic Goods Administration and describes reporting trends over the 18-year period 1 January 2000 to 31 December 2017. There were 3,878 AEFI records for vaccines administered in 2017; an annual AEFI reporting rate of 15.8 per 100,000 population. There was a 12% increase in the overall AEFI reporting rate in 2017 compared with 2016. This increase in reported adverse events in 2017 compared to the previous year was likely due to the introduction of the zoster vaccine (Zostavax®) provided free for people aged 70­79 years under the National Immunisation Program (NIP) and also the state- and territory-based meningococcal ACWY conjugate vaccination programs. AEFI reporting rates for most other individual vaccines in 2017 were similar to 2016. The most commonly reported reactions were injection site reaction (34%), pyrexia (17%), rash (15%), vomiting (8%) and pain (7%). The majority of AEFI reports (88%) described non-serious events. Two deaths were reported that were determined to have a causal relationship with vaccination; they occurred in immunocompromised people contraindicated to receive the vaccines.

Public health management of increased incidence of meningococcal disease in the Australian Capital Territory: 2003 to 2004.

This paper describes a sudden increase of meningococcal notifications in the Australian Capital Territory within a 3 month period, and the public health strategies used to manage it. There were 15 cases of meningococcal disease notified to the Communicable Disease Control (CDC) section, Australian Capital Territory Health (ACT Health), between 6 November 2003 and 5 February 2004. This was much higher than the annual average of 6 cases. The cases were notified in 2 clusters. The first cluster of 8 cases, all serogroup C, was notified between 6 November to 8 December 2003. Seven of these cases had an identical phenotype C:2a:P1.4 suggesting a common source. The second cluster of 7 cases was notified between 30 December 2003 and 5 February 2004. Of these, 5 were serogroup B, 1 was serogroup W-135 and 1 was serogroup C, whose phenotype (C:2a:P1.4) was identical to the phenotype of the first cluster of serogroup C cases. Phenotypes were not available for the serogroup B cases. There were 4 main interventions developed to manage the increased incidence based on the epidemiology of the cases; these were implemented concurrently. Factors that supported investigation and management were good surveillance systems, quick turnover of laboratory tests, regular communication with relevant health agencies and maintaining public awareness. As the number of cases notified was much higher than the annual average, the possibility of a community outbreak was considered. The Guidelines for the Early Clinical and Public Health Management of Meningococcal Disease in Australia (national guidelines) were consulted to determine whether there was an outbreak and the influence this had on management is also discussed.

An evaluation of public health interventions during a pertussis outbreak in the ACT, 2003.

OBJECTIVE: To assess whether issuing information alerts increased the proportion of pertussis cases notified within the 21-day infectious period during a pertussis outbreak in the Australian Capital Territory (ACT) in 2003. METHOD: The study included all persons resident in the ACT for whom a notification of pertussis was received with onset of disease between 1 March and 31 December 2003. Cases notified within 21 days of onset were called 'early notifications'. The effectiveness of information alerts was assessed by comparing the proportion of early notifications before and after each alert and over the course of the outbreak. MAIN OUTCOME MEASURE: The proportion of early notifications. RESULTS: The proportion of early notifications ranged from 1/36 (2.7%) prior to the first intervention to 29/52 (55.7%) after the final intervention (p < 0.001). CONCLUSIONS: This study supports the hypothesis that information alerts by ACT Health increase the proportion of cases notified within the infectious period of 21 days. IMPLICATIONS FOR PUBLIC HEALTH PRACTICE: Early diagnosis of pertussis cases (within the infectious period) has the potential to limit transmission and protect susceptible infants.