Immunisations - catch-ups

Illness, frequent moving, or a disrupted home life can mean that a child, teenager 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 generally 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.

Immunisation and HALO

The immunisations you may need are decided by your health, age, lifestyle and occupation. Together, these factors are referred to as HALO.

HALO is defined as:

• Health – some health conditions or factors may make you more vulnerable to vaccine-preventable diseases. For example, premature birth, asthma, diabetes, heart, lung, spleen or kidney conditions, Down syndrome and HIV will mean you may benefit from additional or more frequent immunisations.
• Age – at different ages you need protection from different vaccine-preventable diseases. Australia’s National Immunisation Program sets out recommended immunisations for babies, children, older people and other people at risk, such as Aboriginal and Torres Strait Islanders. Most recommended vaccines are available at no cost to these groups.
• Lifestyle – lifestyle choices can have an impact on your immunisation needs. Travelling overseas to certain locations, planning a family, sexual activity, smoking, and playing contact sport that may expose you directly to someone else’s blood, will mean you may benefit from additional or more frequent immunisations.
• Occupation – you are likely to require additional or more frequent immunisations if you work in an occupation that exposes you to vaccine-preventable diseases or puts you into contact with people who are more susceptible to problems from vaccine-preventable diseases such as babies or young children, pregnant women, the elderly, and people with chronic or acute health conditions. Workers in aged care, childcare, healthcare, emergency service or sewerage repair and maintenance need to discuss their immunisation needs with their doctor. Some employers help with the cost of relevant vaccinations for their employees.

Ways to check if you have been immunised

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 a person’s medical records, especially if they have been separated from their family, are a refugee or are 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 allow parents to keep track of their child’s immunisations.
• Use the Australian Childhood Immunisation Register (ACIR) to find the immunisation status of a child born after 1996.
• Contact the 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). 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.

Catch-up schedules may differ

Depending on the person’s age and immunisation history, their 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 eight years and over may receive the adult/adolescent form of the DTPa (diphtheria, tetanus, pertussis) vaccine as a booster shot.
• A person may 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 to the National Immunisation Program Schedule, your doctor or immunisation provider will be happy to explain further.

Catch-up vaccinations for new arrivals

Some diseases that can be prevented by immunisation are common in other countries. Issues for a new arrival and their doctor to 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 child-bearing 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.
• Refugee 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 teenagers 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 recommended target groups. Your immunisation provider can advise of any costs involved.

Before immunisation

To avoid the risk of unwanted side effects and to make sure 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
• Are pregnant
• Are planning pregnancy or anticipating parenthood
• Are a parent, grandparent or carer of a newborn
• Have had any vaccine in the past month
• Have had an injection of immunoglobulin or received any blood products or a whole blood transfusion within the past year
• Have a disease that lowers immunity (such as leukaemia, cancer or HIV/AIDS)
• Are receiving treatment that causes low immunity (for example, oral steroid medicines such as cortisone or prednisone, radiotherapy or chemotherapy)
• Live with someone who has a disease or is having treatment that causes low immunity
• Have a past history of Guillain-Barre syndrome
• Have a chronic illness
• Have a bleeding disorder
• Identifies as an Aboriginal and/or Torres Strait Islander person
• Does not have a functioning spleen
• Is prone to fainting at the sight of needles.

You will also need to inform them if your child has had intussusception, or was a preterm baby born at less than 32 weeks gestation, or weighed less than 2000g at birth.

Reducing side effects

Some people may experience a reaction to a vaccine and there is a very small risk of a serious allergic reaction to any vaccine. This is why it is important to stay at the clinic where the immunisation was given for 15 minutes after you are immunised.

If reactions occur, they are usually mild and may last up to two days after immunisation. Mild side effects can be reduced by:

• Pressing a cold, moistened cloth against the injection site to reduce discomfort
• If there is a fever, drinking extra fluids and not overdressing
• Taking paracetamol to reduce pain, inflammation and fever – take strictly as directed, especially for children.
• If you are concerned about any reaction to the vaccine, contact your doctor or hospital.

Reactions from ‘extra’ 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 gets an extra dose when they didn’t need it. There is no increased risk of side effects if a person has an extra vaccine for:

• Hepatitis B
• Meningococcal
• Chickenpox
• Measles, mumps, rubella (MMR)
• Poliomyelitis (polio).

Extra doses of some vaccines may increase the risk of side effects like soreness, redness and swelling at the injection site. These vaccines include:

• Diphtheria
• Tetanus
• Pneumococcal polysaccharide.

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 polio viruses can take two to three months 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
• Your local community health centre
• Your local maternal and child health nurse
• Immunisation Section - Department of Health Victoria, Tel. 1300 882 008
• NURSE-ON-CALL Tel. 1300 606 024 – for expert health information and advice (24 hours, 7 days)
• Travel clinic
• Australian Childhood Immunisation Register Tel. 1800 653 809
• National Immunisation Infoline Tel. 1800 671 811

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.

You might also be interested in:

• Immune system.
  
• Immunisation - childhood.
  
• Travel vaccinations.
  
• Vaccines.
  

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Last reviewed: July 2011

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Catch-up immunisations are important if you've missed out on some vaccines. Any vaccine given after the recommended age is called a 'catch-up' immunisation. Ideally, a catch-up immunisation plan should be based on written records that show which vaccines you've had.

Content on this website is provided for education and information purposes only. Information about a therapy, service, product or treatment does not imply endorsement and is not intended to replace advice from your qualified health professional. Content has been prepared for Victorian residence and wider Australian audiences, and was accurate at the time of publication. Readers should note that over time currency and completeness of the information may change. All users are urged to always seek advice from a qualified health care professional for diagnosis and answers to their medical questions.

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