A print friendly PDF version is available from this Communicable Diseases Intelligence issue's table of contents.

Serious Adverse Events Following Vaccination Surveillance Scheme

The Serious Adverse Events Following Vaccination Surveillance Scheme is a national surveillance scheme which monitors the serious adverse events that occur rarely following vaccination. More details of the scheme were published in Commun Dis Intell 1997:21;8.

Acceptance of a report does not imply a causal relationship between administration of the vaccine and the medical outcome, or that the report has been verified as to the accuracy of its contents.

It is estimated that 250,000 doses of vaccines are administered every month to Australian children under the age of six years.

Results for the reporting period 2 September 1998 to 31 January 1999.

There were 320 reports of serious adverse events following vaccination for this reporting period (Table 6). Onset dates were from 1995 to 1998, the majority (92%) being in 1998. Reports were received from Australian Capital Territory (25), New South Wales (38), Northern Territory (9), Queensland (63), South Australia (11), Victoria (43) and Western Australia (131). No reports were received from Tasmania for this period. The majority of reports received from Western Australia were from 1998 (88%).

The most frequently reported events following vaccination were persistent screaming (170 cases, 53%), followed by other reactions (56 cases, 17.5%), temperature of 40.5^o C or more (34 cases, 10.6%) and hypotonic/hyporesponsive episodes (38 cases, 11.9%). One death within 30 days of immunisation was reported from Victoria. The cause of death was unclear according to the coroner's report.

Of the 38 reactions associated with MMR vaccine, 37 were since August 1998 when the measles immunisation campaign was initiated. The reports associated with the measles campaign will be published in CDI at a later date.

Forty of the 320 cases were hospitalised. There were 6 cases that had not recovered at the time of reporting while 303 cases had recovered. There was incomplete information on follow-up on 11 cases.

Two hundred and fifty (78%) cases were associated with Diphtheria-Tetanus-Pertussis (DTP), vaccine either alone or in combination with other vaccines. Of these, 60 per cent of reports were associated with the first dose of DTP and 28 per cent with the second dose.

Table 6. Adverse events following vaccination reported in the period 2 September 1998 to 31 January 1999

Event	Vaccines									Reporting States or Territories2	Total reports for this period2
	DTP	DTP/ Hib	DTP/ OPV/ Hib	DTP /OPV/ MMR	DTP/ OPV	DTP/ OPV/ Hib/ Hep B	MMR	Hep B	Other1
Persistent screaming	82	2	73		2	4			6	ACT, NSW, Qld, Vic, WA	170
Hypotonic/hyporesponsive episode	10	2	21			2	1	1	1	ACT, NSW, Qld, Vic, WA	38
Temperature of 40.5EC or more	26		5			1	2			ACT, Qld, WA	34
Convulsions	1	1	3				4		2	ACT, NSW, Qld, SA, Vic, WA	12
Anaphylaxis			1				3			NSW, NT	4
Shock							1	1		NT, Vic	2
Death			1							Vic	1
Other	3	2	6	2			27	6	7	ACT, NSW, NT, Qld, SA, Vic, WA	56
Not stated
Total	122	7	110	2	2	7	38	8	16		3173

1. Includes influenza, DTPa, CDT, OPV, Hepatitis B, pneumococcal, BCG and ADT vaccines and rabies immunoglobulin (HRIG).
2. Includes 1 event for each of the following vaccines: Hib/other (convulsions), OPV/Hib (persistent screaming), Hib, Hep/other, OPV (other).
3. Three cases have missing events

Top of page

HIV and AIDS Surveillance

National surveillance for HIV disease is coordinated by the National Centre in HIV Epidemiology and Clinical Research (NCHECR), in collaboration with State and Territory health authorities and the Commonwealth of Australia. Cases of HIV infection are notified to the National HIV Database on the first occasion of diagnosis in Australia, by either the diagnosing laboratory (ACT, New South Wales, Tasmania, Victoria) or by a combination of laboratory and doctor sources (Northern Territory, Queensland, South Australia, Western Australia). Cases of AIDS are notified through the State and Territory health authorities to the National AIDS Registry. Diagnoses of both HIV infection and AIDS are notified with the person's date of birth and name code, to minimise duplicate notifications while maintaining confidentiality.

Tabulations of diagnoses of HIV infection and AIDS are based on data available three months after the end of the reporting interval indicated, to allow for reporting delay and to incorporate newly available information. More detailed information on diagnoses of HIV infection and AIDS is published in the quarterly Australian HIV Surveillance Report, available from the National Centre in HIV Epidemiology and Clinical Research, 376 Victoria Street, Darlinghurst NSW 2010. Telephone: (02) 9332 4648 Facsimile: (02) 9332 1837.

HIV and AIDS diagnoses and deaths following AIDS reported for 1 to 31 August 1998, as reported to 30 November 1998, are included in this issue of Commun Dis Intell (Tables 7 and 8).

Table 7. New diagnoses of HIV infection, new diagnoses of AIDS and deaths following AIDS occurring in the period 1 to 31 August 1998, by sex and State or Territory of diagnosis

		State or territory								Totals for Australia
		ACT	NSW	NT	Qld	SA	Tas	Vic	WA	This period 1998	This period 1997	Year to date 1998	Year to date 1997
HIV diagnoses	Female	0	4	0	1	0	0	2	1	8	6	60	46
	Male	0	25	1	2	0	0	13	2	43	52	425	483
	Sex not reported	0	0	0	0	0	0	0	0	0	0	6	11
	Total1	0	29	1	3	0	0	15	3	51	58	491	541
AIDS diagnoses	Female	0	0	0	0	0	0	0	0	0	1	7	20
	Male	0	4	0	2	0	0	3	0	9	31	120	217
	Total1	0	4	0	2	0	0	3	0	9	32	127	237
AIDS deaths	Female	0	0	0	1	0	0	0	0	1	0	6	9
	Male	0	2	0	0	1	0	3	0	6	19	64	160
	Total1	0	2	0	1	1	0	3	0	7	19	70	170

Table 8. Cumulative diagnoses of HIV infection, AIDS and deaths following AIDS since the introduction of HIV antibody testing to 31 August 1998, by sex and State or Territory

		ACT	NSW	NT	Qld	SA	Tas	Vic	WA	Australia
HIV diagnoses	Female	22	563	7	131	54	4	197	95	1,073
	Male	183	10,396	99	1,841	637	77	3,699	866	17,798
	Sex not reported	0	259	0	0	0	0	24	0	283
	Total1	205	11,237	106	1,978	691	81	3,933	964	19,195
AIDS diagnoses	Female	8	160	0	45	20	2	64	23	322
	Male	82	4,392	32	768	323	41	1,554	337	7,529
	Total1	90	4,563	32	815	343	43	1,625	362	7,873
AIDS deaths	Female	2	113	0	29	15	2	46	16	223
	Male	62	3,063	23	533	220	27	1,216	241	5,385
	Total1	64	3,183	23	564	235	29	1,268	258	5,624

Top of page

Childhood immunisation coverage

Tables 9 and 10 provide the latest quarterly report on childhood immunisation coverage from the Australian Childhood Immunisation Register (ACIR).

The data show the percentage of children fully immunised at age 12 months for the cohort born between 1 July and 30 September 1997 and at 24 months of age for the cohort born between 1 July and 30 September 1996, according to the Australian Standard Vaccination Schedule (Tables 9 and 10).

A full description of the methodology used can be found in Commun Dis Intell 1998;22:36-37.

Table 9. Percentage of children immunised at 1 year of age, preliminary results by disease and State for the birth cohort 1 July to 30 September 1997; assessment date 30 September 1998

Vaccine	State or Territory								Australia
	ACT	NSW	NT	Qld	SA	Tas	Vic	WA
Total number of children	1,055	22,820	889	12,522	4,771	1,610	15,738	6,438	65,843
DTP (%)	89.1	84.5	80.1	88.3	87.5	85.8	86.9	85.4	86.1
OPV (%)	89.5	84.2	79.3	87.2	87.6	86.1	87.1	85.4	85.9
Hib (%)	89.0	83.8	83.2	88.6	87.5	85.8	86.8	85.4	86.0
Fully Immunised (%)	88.6	82.5	75.3	85.9	86.6	85.1	86.0	84.3	84.5
Change in fully immunised since last quarter (%)	+3.6	+0.2	-0.7	+0.1	+1.3	-1.1	-0.2	+1.1	+0.2

Table 10. Proportion of children immunised at 2 years of age, preliminary results by disease and State for the birth cohort 1 July to 30 September 1996; assessment date 30 September 1998

Vaccine	State or Territory								Australia
	ACT	NSW	NT1	Qld	SA	Tas	Vic	WA
Total number of children	1,135	22,836	929	12,623	4,864	1,753	15,987	6,624	66,751
DTP (%)	82.2	79.3	66.3	84.0	80.6	78.7	80.4	77.6	80.2
OPV (%)	87.4	83.3	77.1	89.1	85.7	85.9	86.6	79.1	85.0
Hib (%)	80.4	79.4	71.6	84.0	80.8	79.2	80.7	77.9	80.4
MMR (%)	85.9	83.0	77.4	89.5	83.9	84.8	86.9	80.6	85.0
Fully Immunised (%)2	75.4	66.8	54.8	75.9	67.2	67.7	70.0	61.6	68.8
Change in fully immunised since last quarter (%)	+5.7	+3.0	+4.1	+3.1	+1.6	+0.7	+2.3	+2.4	+2.7

1. The 12 months age data for this cohort was published in Commun Dis Intell 1998;22:123.
2. These data relating to 2 year old children should be considered as preliminary. The proportions shown as 'fully immunised' appear low when compared with the proportions for individual vaccines. This is at least partly due to poor identification of children on immunisation encounter forms.
Acknowledgement: These figures were provided by the Health Insurance Commission (HIC), to specifications provided by the Commonwealth Department of Health and Aged Care. For further information on these figures or data on the Australian Childhood Immunisation Register please contact the Immunisation Section of the HIC: Telephone 02 6203 6185.

Sentinel Chicken Surveillance Programme

Sentinel chicken flocks are used to monitor flavivirus activity in Australia. The main viruses of concern are Murray Valley encephalitis (MVE) and Kunjin which cause the potentially fatal disease Australian encephalitis in humans. Currently 26 flocks are maintained in the north of Western Australia, seven in the Northern Territory, nine in New South Wales and ten in Victoria. The flocks in Western Australia and the Northern Territory are tested year round but those in New South Wales and Victoria are tested only from November to March, during the main risk season.

Results are coordinated by the Arbovirus Laboratory in Perth and reported bimonthly. For more information see Commun Dis Intell 1998;22:7

AK Broom,¹ J Azoulas,² JS Mackenzie,³ L Melville,⁴ DW Smith⁵ and PI Whelan⁶

1. Department of Microbiology, The University of Western Australia
2. Veterinary Research Institute, Victoria
3. Department of Microbiology, The University of Queensland
4. Berrimah Agricultural Research Centre, Northern Territory
5. PathCentre, Western Australia
6. Department of Health and Community Services, Northern Territory

November/December 1998

Sentinel chicken serology was carried out for 24 of the 27 flocks in Western Australia in November and December 1998. There were no seroconversions to flaviviruses recorded during this period.

Serum samples from 5 of the 7 Northern Territory sentinel chicken flocks were tested in our laboratory in October and November 1998. Samples from four flocks were tested in December 1998. There were no seroconversions to flaviviruses recorded during this period.

The sentinel chicken programme in Victoria commenced at the beginning of November 1998. There were no seroconversions to flaviviruses recorded in November or December 1998.

* Details of the locations of all chicken flocks are given in Commun Dis Intell 1998;22:7-8.


This article was published in Communicable Diseases Intelligence Volume 23, No 1, 21 January 1999.