Recurrence risk of a hypotonic hyporesponsive episode in two Australian specialist immunisation clinics.

Background: A hypotonic hyporesponsive episode (HHE) is a well-described adverse event following immunisation (AEFI) in young children. There is limited data regarding recurrence post re-vaccination.

Method: A retrospective analysis of HHEs reported to two tertiary paediatric hospitals in Australia: The Royal Children's Hospital, Melbourne [2006-11] and the Children's Hospital Westmead, Sydney [1997-2014].

Fifty years of immunisation in Australia (1964-2014): the increasing opportunity to prevent diseases.

Medicine has seen dramatic changes in the last 50 years, and vaccinology is no different. Australia has made a significant contribution to world knowledge on vaccine-preventable diseases. Certain deadly diseases have disappeared or become rare in Australia following successful introduction of vaccines.

Clinical epidemiology and predictors of outcome in children hospitalised with influenza A(H1N1)pdm09 in 2009: a prospective national study.

Background: There are few large-scale, prospective studies of influenza A(H1N1)pdm09 in children that identify predictors of adverse outcomes.

Objectives: We aimed to examine clinical epidemiology and predictors for adverse outcomes in children hospitalised with influenza A(H1N1)pdm09 in Australia.

Methods: Active hospital surveillance in six tertiary paediatric referral centres (June-September, 2009).

Establishing intra- and inter-rater agreement of the Face, Legs, Activity, Cry, Consolability scale for evaluating pain in toddlers during immunization.

Background: The Face, Legs, Activity, Cry, Consolability (FLACC) scale is a five-item tool that was developed to assess postoperative pain in young children. The tool is frequently used as an outcome measure in studies investigating acute procedural pain in young children; however, there are limited published psychometric data in this context.

Objective: To establish inter-rater and intrarater agreement of the FLACC scale in toddlers during immunization.

Pain management strategies used during early childhood immunisation in Victoria.

Aim: The study aims to identify pain management practices used during scheduled childhood immunisation.

Methods: A survey of members of the Australian Nurses Federation (Victorian Branch) Immunisation Nurses Special Interest Group. Questions included frequency of use of pain reduction strategies during immunisations for infants, toddlers and children, injection techniques and existence of an articulated pain management policy.

Changes in patterns of hospitalized children with varicella and of associated varicella genotypes after introduction of varicella vaccine in Australia.

Background: Varicella in children, although usually mild, can cause hospitalization and rarely death. This study examined patterns of hospitalized children with varicella, and associated varicella genotypes, in 4 tertiary children's hospitals throughout Australia before and after varicella vaccine was introduced.

Methods: We obtained coded data on discharge diagnoses from each hospital before (1999 to 2001) and after (2007 to 2010) varicella vaccine introduction in 2005, adding active surveillance to capture clinical features, complications and immunization history in the latter period.

Neurologic complications of influenza A(H1N1)pdm09: surveillance in 6 pediatric hospitals.

Objective: We sought to determine the range and extent of neurologic complications due to pandemic influenza A (H1N1) 2009 infection (pH1N1'09) in children hospitalized with influenza.

Methods: Active hospital-based surveillance in 6 Australian tertiary pediatric referral centers between June 1 and September 30, 2009, for children aged <15 years with laboratory-confirmed pH1N1'09.

Results: A total of 506 children with pH1N1'09 were hospitalized, of whom 49 (9.

Respiratory syncytial virus immunoprophylaxis in high-risk infants with heart disease.

Aim: Passive immunisation with palivizumab is recommended in many countries for children with haemodynamically significant cardiac disease. We trialled respiratory syncytial virus (RSV) immunoprophylaxis in such infants during 2008–2009.

Methods: We identified all RSV admissions between 2005–2009 and examined all patients with significant cardiac disease who received palivizumab in 2008–2009.

Ethical issues in preventing mother-to-child transmission of hepatitis B by immunisation.

Without intervention, a pregnant woman who is a chronic hepatitis B carrier is at risk of transmitting hepatitis B and of her infant becoming a chronic carrier and having a significantly increased lifetime risk of developing liver cancer or cirrhosis. Hepatitis B vaccine and immunoglobulin reduce the risk of the baby becoming a carrier, but with only a short window period after birth to deliver this potentially life-saving intervention. We reviewed the evidence on the magnitude of the risk.

Recurrent apnoea post immunisation: Informing re-immunisation policy.

Background: Preterm infants should receive immunisations according to their chronological, rather than gestational, age however concern about possible adverse events following immunisation (AEFI) in this group often means routine immunisations are delayed. A small number of infants may have apnoea with or without bradycardia temporally associated with immunisation. The risk factors for, and recurrence rate of apnoea with subsequent immunisations are unknown, which makes planning for subsequent immunisations for these highly vulnerable infants difficult.

Recurrence of extensive injection site reactions following DTPa or dTpa vaccine in children 4-6 years old.

Objectives: The aim of this study was to compare the immunogenicity and reactogenicity of a lower dose diphtheria, tetanus and pertussis vaccine (dTpa) with the recommended vaccine (DTPa) given as a fifth dose to 4-6-year old children who previously experienced an extensive injection site reaction (ISR).

Material And Methods: Children aged 4-6 years who had experienced an extensive ISR following a 4th dose of DTPa were recruited and randomly assigned to receive either the recommended DTPa or the lower dose dTpa vaccine. Parents recorded local reactions and systemic events for 15 days following vaccination.

Syncope and seizures following human papillomavirus vaccination: a retrospective case series.

Objective: To quantify and characterise the reports of syncope and seizures following quadrivalent (4v) human papillomavirus (HPV) vaccination.

Design And Setting: Retrospective case series of notifications to SAEFVIC (Surveillance of Adverse Events Following Vaccination In the Community), May 2007 - April 2009.

Main Outcome Measures: Incidence of syncope and seizure following 4vHPV vaccination; clinical outcomes.

Optimizing immunization in pediatric special risk groups.

This article analyzes the current recommended practices and evidence in the immunization of pediatric 'special risk groups'. Special risk group patients are at higher risk of vaccine-preventable diseases and hence require additional strategies to maximize protection against these diseases. The special risk groups include those with an underlying chronic disease, some of whom are on immunosuppressive therapy to treat that condition.

Immunisation rates of children with cystic fibrosis using the Australian Childhood Immunisation Register.

Aim: The Australian Immunisation Handbook (ninth edition) recommends children with cystic fibrosis (CF) receive routine scheduled immunisations plus annual influenza vaccine and an additional pneumococcal vaccine at both 12 months and 4-5 years. Adherence with these recommendations is unknown. This study aimed to determine the immunisation status of children with CF attending the Royal Children's Hospital (RCH), Melbourne.

Hypersensitivity reactions to human papillomavirus vaccine in Australian schoolgirls: retrospective cohort study.

Objective: To describe the outcomes of clinical evaluation, skin testing, and vaccine challenge in adolescent schoolgirls with suspected hypersensitivity to the quadrivalent human papillomavirus vaccine introduced in Australian schools in 2007.

Design: Retrospective cohort study.

Setting: Two tertiary paediatric allergy centres in Victoria and South Australia, Australia.

A simple intervention to improve hospital antibiotic prescribing.

Objective: To evaluate changes in prescribing behaviour after distribution of antibiotic guidelines printed on a 9 x 6 cm laminated card suitable for clipping to a hospital identification badge.

Intervention: Guidelines for appropriate antibiotic prescribing for 20 common and important paediatric infections were printed on a laminated 9 x 6 cm card suitable to clip to a hospital identification badge and distributed to all medical staff.

Design: We collected data from medical records for three marker conditions (tonsillitis, pneumonia, and orbital/periorbital cellulitis) on samples of patients from the six-month periods either side of the month in which the cards were distributed.