Kalgoorlie targeted meningococcal W vaccination program FAQs

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1 Kalgoorlie targeted meningococcal W vaccination program FAQs (As of 15 December 2016) What is the targeted vaccination program? The Kalgoorlie Targeted Men W Vaccination Program is a once off vaccination program against meningococcal disease that will be offered to people living in Kalgoorlie-Boulder, Coolgardie and Kambalda. The program is in response to an increase in recent months of meningococcal infection caused by a particular type of the bacteria, serogroup W, in the Kalgoorlie area. This program will be offered to children aged two months to four years and under, and adolescents aged years, because they are most at risk of developing this infection, and vaccinating older teenagers has the greatest chance of achieving immunity in the broader community. The existing childhood meningococcal childhood vaccination program targeting serogroup C will continue. However the meningococcal C vaccine does not protect against serogroup W, which is increasing in WA and nationally. Why is this targeted vaccination program necessary? Although numbers are low, meningococcal W cases have been increasing annually since 2013 with one case notified in that year and 14 cases in Prior to 2013, serogroup W was uncommon with only six cases diagnosed in the 13 year period from 2000 to In the Kalgoorlie area, five cases have been confirmed over a two-month period (October and November 2016), compared to around one per year prior to this. Three of these cases were Aboriginal children aged four years and under from Kalgoorlie. Why is the targeted vaccination program starting now? There has been a significant increase in the number of cases of meningococcal disease recorded in the Kalgoorlie area over the past two months five have been detected when we would normally only see, on average, one case per year. In response, several public health measures are being implemented, including a targeted vaccination program. As soon as the results of laboratory testing showed that the strain of meningococcal W present in cases in Kalgoorlie was genetically linked, it was decided to commence the targeted vaccination program. Which vaccine will be used? The meningococcal ACWY vaccine will be used. This vaccine protects against 4 groups of meningococcal bacteria: A, C, W and Y. Two of the three brands of conjugate meningococcal ACWY vaccine that are registered for use in Australia will be used Menveo (CSL) for those aged 2 months and over, and Nimenrix (GSK) for those aged 12 months and over. What age groups will be targeted? All children aged two months to four years and adolescents aged years.

2 Can the meningococcal ACWY vaccine be given to children aged less than 2 months of age? Babies can have the meningococcal ACWY vaccine from 2 months of age. It cannot be given prior to 2 months of age. Babies from 2 months to 6 months of age require a course of three vaccinations and a booster at months. Babies from 7-11 months will require a two dose course of the vaccine with no booster. All these vaccines for babies who commence the vaccination course during the program will be provided through this program. Are immunocompromised people who live in the Kalgoorlie area able to receive the free vaccine? People of any age who live in the target areas are eligible to receive the free vaccine if they have conditions associated with an increased risk of invasive meningococcal disease. These conditions are: defects in or deficiency of complement components, including factor H, factor D or properdin deficiency current or future treatment with eculizumab (a monoclonal antibody directed against complement component C5) functional or anatomical asplenia HIV infection, regardless of stage of disease or CD4+ count haematopoietic stem cell transplant. What areas will be included in the program? The Kalgoorlie area in the Goldfields region, specifically Kalgoorlie, Boulder, Coolgardie and Kambalda. People requesting MenW vaccination are asked to bring their proof of address and proof of age to the clinic. Why are Esperance and other Goldfields towns not included? Esperance has not experienced an increase in cases of meningococcal disease over the usual, expected rate in that community during Other towns in the Goldfields have not experienced an increase either. Will you be rolling out the program to other parts of the State, if not, why not? The Kalgoorlie Targeted MenW Vaccination Program is being implemented in response to an observed increase in cases in one particular geographical area. There is no plan to roll out the program to other parts of WA. Any additional programs will be based on disease trends across the State. Has this type of intervention been done before, if so where and why? It is standard public health practice to consider meningococcal vaccination to communities in response to meningococcal outbreaks. The aim is to provide direct protection to those who are vaccinated and to prevent people who carry the meningococcal bacteria in the back of their throat, but who don t display symptoms, from passing the bacteria onto other people. Recently in WA, a community-wide vaccination program was implemented in a remote community of several hundred people in response to two cases of meningococcal disease caused by serogroup W that occurred within a fortnight. No further cases have been reported in that community. Who is most at risk from meningococcal disease? Meningococcal disease can affect any age group. However, those most at risk of meningococcal disease are children 4 years and under, particularly Aboriginal children, and adolescents aged years.

3 Of the 27 meningococcal W cases diagnosed in WA since 2000, the majority (37%) of cases were children aged 4 years and under, and 22% were adolescents aged years. Where can people access their vaccine? The WA Country Health Service Goldfields Public Health team are working with local health services to ensure that the meningococcal W vaccination program is able to reach the target group as quickly as possible. Vaccine will be made available through Population Health at Ware Street, Kalgoorlie, from Block 18 at the Kalgoorlie Health Campus, community Health Clinics in Kambalda and Coolgardie, Bega Aboriginal Medical Service and participating General Practices. The local community can call healthdirect on to find out about vaccine clinic times and other health services that will have the free vaccine available. Can my child receive the vaccine at the local GP? Participating GPs in the Kalgoorlie area will have vaccine for the Kalgoorlie Targeted MenW Vaccination Program - call to enquire with your local GP. What is the cost of immunisations by GPs? The vaccination is free to people in the target group (all children aged two months to four years and adolescents aged years). Your GP may charge a consultation fee please discuss possible charges with GP reception staff at the time of booking an appointment. Can my child have the vaccination if they are a visitor to Kalgoorlie? The program is targeted at people who are residents of Kalgoorlie-Boulder, Coolgardie and Kambalda. People who are visitors to the area should contact a local health provider in Kalgoorlie-Boulder, Coolgardie or Kambalda. If people are residents of Kalgoorlie but away when this vaccination campaign starts, can they have the vaccination elsewhere in Western Australia? No, the vaccine will be available in the Kalgoorlie area until 31 March 2017, so they can have the vaccination at their own cost, or access the free vaccine on their return to the Kalgoorlie area. What are other hot spots for meningococcal cases in WA? Meningococcal W cases have occurred in regional areas and in the Perth metropolitan area. Two cases were reported earlier in 2016 in a remote community of several hundred people, and a community vaccination program helped to control this. No other hot spot areas have been identified in WA. How at risk is the Kalgoorlie community? Meningococcal disease remains a very uncommon disease in Kalgoorlie. The rise in cases that has been observed in 2016 means that the community needs to be aware of early signs and symptoms of the disease and seek medical attention if they are concerned. Those most at risk of developing meningococcal disease in Kalgoorlie will have access to the Kalgoorlie Targeted MenW Vaccination Program. How effective is the meningococcal ACWY vaccine? The vaccine is safe and effective. Studies have shown that the effectiveness of the meningococcal ACWY vaccines is between 80 to 85% in adolescents and greater than 90% in infants. Meningococcal ACWY vaccination programs have been implemented in adolescents aged years in the UK since 2015, and adolescents aged years in the US since 2005, and have been found to be safe and effective. The community still needs to be mindful of the early signs and symptoms of meningococcal disease and seek medical attention if they are concerned.

4 How long does it take for immunity to develop after having the vaccine? It takes approximately 10 to 14 days for immunity to develop. What serogroups will the vaccine cover? The vaccine protects against the meningococcal serogroups A C W and Y. Serogroup W is the one that has been responsible for the recent cases in the Kalgoorlie area. If my child has recently received another vaccination, can they have the Meningococcal ACWY vaccine now? It is recommended that there is a 14 day interval between receiving the MenACWY vaccine and any previous vaccinations. However, for this targeted vaccination program, there may be reasons to have the MenACWY vaccine within a shorter time period of receiving previous vaccines, such as when the child is unlikely to re-present for vaccination, or there is an immediate increased risk in the context of household, day-care or school cases. If the spacing is less than two weeks between vaccinations, there may be an increased likelihood of mild reactions. For more specific advice regarding your child s vaccinations contact your immunisation provider. How much will this program cost? To vaccinate the target group of all children aged 2 months to 4 years and adolescents aged years living in the Kalgoorlie area, it is estimated that the provision of the vaccines only, will cost ~ $300,000. There will be additional costs for extra staff and medical consumables. When will it start? Within days of receiving the first vaccines at Kalgoorlie, which is expected to be at the start of the week beginning 12 December. What about other children that are not aged four and under or years who are living in these areas, or children living outside these areas? Should they be immunised? Whilst free vaccinations will only be provided to the target group, as it is this group who are most likely to be affected by meningococcal disease, it is possible to have the vaccination privately (cost is typically less than $100). Please contact your GP to discuss this. It may take a few days for your GP or pharmacy to get the vaccine for you. What do I do if the doctor has given me a prescription for the vaccine but the pharmacy has run out of vaccine? There are three different brands of MenACWY vaccine (Menveo, Nimenrix and Menactra ), so ask your doctor for a prescription that covers the three different brands. If your pharmacy doesn t currently have any vaccine, try different pharmacies in your area or ask your pharmacy to order the vaccine for you. You will need to wait a few days for more stock to arrive. I have heard there is a shortage of meningococcal vaccinations. Is there are chance you will run out? There is a world-wide shortage of vaccinations for meningococcal serotype B. The Kalgoorlie Targeted MenW Vaccination Program will vaccinate against meningococcal A C W and Y. We have enough vaccinations for the targeted program. When will the targeted vaccination program start? Clinics will become available within days of receiving the first vaccines at Kalgoorlie, during the week starting 12 December 2016.

5 For how long will the campaign run? Free clinics will be held every day from Monday, 12 December 2016 until Saturday 17 December 2016 and Monday 19 December 2016 until Thursday, 22 December After this the vaccination will remain available by appointment until 31 March Who do I ring to find out about clinic times and locations? A special hotline has been set up to provide information. The number to call is between 8:00am and 8:00pm. Are there any public health clinics which could immunise children outside the age but the parents pay for the dose? The public health clinics are unable to immunise children outside the age; people need to discuss this with their GP or Aboriginal Medical Service. What about Aboriginal people and people with a disability? Aboriginal people who are in the target group are able to access the vaccination at the WACHS clinics or at Bega AMS, or through the private GPs. People with a disability are able to access the clinic at all WACHS public health facilities. Can a pregnant woman have meningococcal ACWY vaccine? Meningococcal ACWY vaccines are not routinely recommended for pregnant women, but can be given where there is a strong clinical indication, such as increased risk of meningococcal disease. Can the vaccine cause meningococcal disease? No. Only the Neisseria meningitidis bacterium can cause meningococcal disease. The vaccine does not contain any live bacteria. What are the symptoms of meningococcal disease? The symptoms of meningococcal disease can include: fever, headache, neck stiffness, muscle or joint pains, drowsiness, confusion, nausea and vomiting and a rash of red-purple spots or bruises. Common symptoms of meningococcal disease in babies include: fever, rapid breathing, rash, vomiting, irritability, drowsiness, and pale skin. If you or someone you know develops symptoms or signs consistent with meningococcal disease consult your family doctor or the Emergency Department of the closest hospital immediately. This document can be made available in alternative formats on request for a person with a disability. Department of Health 2016

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