Immunisations – catch-ups and boosters

COVID-19 vaccines: For information about COVID-19 vaccines, see COVID-19 vaccination.

About catch-up immunisation

Any immunisation given after the recommended age is called a ‘catch-up’ immunisation. Catch-up immunisations aim to provide optimal protection against disease as quickly as possible by completing the age-appropriate vaccinations recommended.

Children, young people and adults may miss a scheduled immunisation for a number of reasons, and need to start a catch-up immunisation program.

Many vaccines require more than one injection to offer protection from a disease, 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.

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 there are no serious adverse events associated with additional doses if you are already immune. An exception to this rule is Q fever and oral cholera vaccine.

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 downloadable poster.

Confirming immunisation history

Ideally, a catch-up immunisation plan should be based on written records that show which immunisations you’ve had. However, it is not always possible to access medical records, especially for refugees, 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 My Health, Learning and Development book (previously the My Health and Development Record, or the Child Health Record) allow parents to keep track of their child’s immunisations.
• Use the Australian Immunisation Register (AIR) to find the immunisation status of people born after 1996.
• Contact your local council for records of any school-based vaccines given.
• If you had vaccines given by a doctor or by a local council, 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% of people.

Read more about How to find your vaccination records.

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 interval 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 5 years.
• Adults and children with medical risk factors may need extra doses of vaccine incorporated in their catch-up schedule.

Your doctor or immunisation provider are able to notify the Australian Immunisation Register that you are on a planned catch up for overdue vaccines.

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.

Who can get free catch-up immunisations?

Victoria has a schedule of vaccines provided free under the National Immunisation Program (NIP) and Victorian immunisation programs.

Free catch-up vaccines are available for:

• all people under 20 years of age
• people aged 25 years and under who have missed human papillomavirus (HPV) vaccination
• refugees, asylum seekers and other humanitarian entrants of any age

People 20 years of age and over who have not received all vaccines may still benefit from a catch-up schedule; however some vaccinations may not be funded under the NIP or Victorian state funded programs. A private prescription will be required if a vaccine is not available on the NIP or Victorian catch-up program.

Your doctor or immunisation provider will be able to provide you with further information on what vaccines you require, and which you are able to receive for free.

Catch-up vaccinations for people who have recently arrived to Australia

Each country has its own vaccination schedule that may be different from Australia’s, and some infectious diseases may be common overseas but rare or not present in Australia.

When people arrive to live in Australia, they may need catch-up vaccinations to be considered up-to-date on the National Immunisation Program. This is important to protect them from infectious diseases, and in some cases is needed to access government payments and early childhood education services.

Some things for doctors and people who have recently arrived in Australia should consider are that:

• certain vaccines are not available overseas, but may be available in Australia.
• some vaccines are not free for people holding certain visas.
• all refugees and asylum seekers of any age are eligible to receive catch-up vaccines for free.

Measles, mumps and rubella (MMR) vaccine

The MMR combination vaccine is available in Australia, and is available for:

• people who had a measles containing vaccine only overseas
• women and people before pregnancy or shortly after delivery if they do not have existing protection from rubella (two doses of MMR needed).
• people born during or since 1966 without evidence of two doses of valid MMR vaccine, or without a blood test showing evidence of immunity to measles, mumps and rubella.
• one or two doses of MMR vaccine are available, and if two are required they should be given 28 days apart.

A newly arrived person’s catch-up immunisation schedule may be different from the national program, depending on their age and what vaccines have been missed.

Immunisation providers can access the catch-up calculator to assist in creating a catch-up schedule.

For more information, visit immunisation for special-risk groups.

Information about catch-up vaccinations for refugees and asylum seekers in Victoria can be found on the Health Translations directory in languages other than English.

Where to get immunised

Doctors, some pharmacies 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.

Pharmacist immunisers can currently vaccinate to protect people with the following vaccinations:

• 5years of age and older:
  • influenza
• 12 years of age and older:
  • whooping cough (pertussis)
  • Diphtheria
  • Tetanus
  • HPV
• 15 years of age and older:
  • measles, mumps, rubella (MMR)
  • meningococcal ACWY
• 50 years of age and older:
  • Pneumococcal
  • Herpes zoster/varicella zoster

Note: There are some exceptions – talk to your GP or pharmacist immuniser for more information.

Your immunisation provider can advise you of any costs involved.

Pre-immunisation checklist

To avoid the risk of unwanted side effects and to make sure that you get the correct vaccine dosage, please tell your doctor or nurse if you or the person about to be immunised:

• is unwell
• has a disease which lowers immunity (for example, leukaemia, cancer, HIV, severe combined immunodeficiency (SCID) or is having treatment which lowers immunity (for example, oral steroid medicines such as cortisone and prednisone, disease-modifying anti-rheumatic drugs (DMARDs), radiotherapy, chemotherapy)
• is an infant of a mother who was receiving highly immunosuppressive therapy – for example, biological disease modifying anti-rheumatic drugs (bDMARDs) – during pregnancy
• has had a severe reaction following any vaccine
• has any severe allergies (to anything)
• has had any vaccine in the past month
• has had an injection of immunoglobulin, or received any blood products, or a whole blood transfusion in the past year
• is pregnant
• is planning a pregnancy or anticipating parenthood
• is a parent, grandparent or carer of an infant aged up to 6 months
• has a past history of Guillian-Barré syndrome
• was a preterm baby born at less than 32 weeks gestation, or weighing less than 2000 g at birth
• is a baby who has had intussusception, or a congenital abnormality that may predispose to intussusception
• has a chronic illness
• has a bleeding disorder
• does not have a functioning spleen
• lives with someone who has a disease which lowers immunity (for example, leukaemia, cancer, HIV) or lives with someone who is having treatment which lowers immunity (for example, oral steroid medicines such as cortisone and prednisone, disease modifying anti-rheumatic drugs [DMARDs] radiotherapy, chemotherapy)
• identifies as an Aboriginal and/or Torres Strait Islander person
• is planning travel
• has an occupation or lifestyle factor/s for which vaccination may be needed.

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 an individual would experience if they were to contract the disease.

Common side effects following immunisation are usually mild and temporary (occurring one to 2 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:

• having 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 taken – 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 2 days. A cold compress to the injection site and 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
• meningococcal
• chickenpox
• 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:

• diphtheria
• tetanus
• 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 3 types of poliovirus can take 2 to 3 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

• In an emergency, always call triple zero (000)
• Your GP (doctor)
• Emergency department of your nearest hospital
• Your local council immunisation service – visit Find Your Council
• Maternal and Child Health Line Tel. 13 22 29 (24 hours, 7 days)
• Nurse-on-Call Tel. 1300 60 60 24 – for expert health information and advice (24 hours, 7 days)
• Immunisation Unit, Department of Health, Victorian Government Email: immunisation@health.vic.gov.au
• National Immunisation Information Line Tel. 1800 671 811
• Australian Immunisation Register Tel 1800 653 809
• Pharmacist
• SAEFVIC Tel. 1300 882 924 (select option 1)
• Coronavirus (COVID-19) Victoria