Control of vaccine preventable diseases in Australian infants: reviewing a decade of experience with DTPa-HBV-IPV/Hib vaccine

Hum Vaccin Immunother. 2021 Jan 2;17(1):176-190. doi: 10.1080/21645515.2020.1764826. Epub 2020 Jun 23.

Abstract

The combined vaccine against diphtheria, tetanus, pertussis, hepatitis B, poliomyelitis, and Haemophilus influenzae b (DTPa-HBV-IPV/Hib, Infanrix Hexa, GSK) has been used for childhood immunization in Australia according to a two-, four-, six-month schedule since 2009. We reviewed data available in the Australian National Notifiable Diseases Surveillance System, annual vaccination coverage reports, the Database of Adverse Event Notifications, and peer-reviewed literature to assess vaccine coverage rates, incidence of all six vaccine preventable diseases, and the safety profile of DTPa-HBV-IPV/Hib vaccine in Australian infants over a period of ten years of exclusive use. Between 2009 and 2018 vaccine coverage for infants aged 12 months increased from 91.7% to 94.0% and from 84.9% to 92.6% for all and for Indigenous infants, respectively. Over the same time period, there were no reports of poliomyelitis, diphtheria or tetanus in infants <12 months of age. The incidence of hepatitis B among Australian infants <12 months of age remains 10 to 20-fold lower than the national average. Control of Haemophilus influenzae b (Hib) and pertussis disease has continued to be challenging. Timely administration of the primary series, as well as increasing coverage rates, particularly among Indigenous children, has contributed to improvements in Hib and pertussis disease control. The incorporation of additional strategies such as adjustment of the first vaccination encounter to six weeks of age, parental cocooning, and most recently maternal vaccination has further reduced the burden of pertussis, particularly during the first six months of life. The frequency of the ten most common adverse events related to the DTPa-HBV-IPV/Hib vaccine demonstrates an acceptable safety profile. Data collected over ten years of consistent, exclusive use of the DTPa-HBV-IPV/Hib vaccine in Australia highlights combination vaccination as a cornerstone in maintaining infant health.

Keywords: Haemophilus influenzae type b; Australia; DTPa-HBV-IPV/Hib; combination vaccines; coverage; hepatitis B; infant vaccination; pertussis; safety.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Australia / epidemiology
  • Child
  • Diphtheria-Tetanus-Pertussis Vaccine / adverse effects
  • Haemophilus Vaccines* / adverse effects
  • Haemophilus influenzae type b*
  • Hepatitis B Vaccines
  • Hepatitis B virus
  • Humans
  • Immunization Schedule
  • Infant
  • Poliovirus Vaccine, Inactivated / adverse effects
  • Vaccine-Preventable Diseases*
  • Vaccines, Combined / adverse effects

Substances

  • Diphtheria-Tetanus-Pertussis Vaccine
  • Haemophilus Vaccines
  • Hepatitis B Vaccines
  • Poliovirus Vaccine, Inactivated
  • Vaccines, Combined

Grants and funding

GlaxoSmithKline Biologicals S.A. funded this study and all costs related to the development of the publication.