Helps protect against the most common diseasecausing serogroup( B) in infants, indicated from 2 months of age 2

Multicomponent Meningococcal group B vaccine( recombinant, adsorbed)

B A C W Y

Multistrain coverage for ACW 135 Y: now the first and only indicated for infants as young as 2 months 1

Following vaccination with Menveo or Bexsero, some of the most common side effects include injection site reactions( pain, redness), fever, malaise and headaches 1, 2

Please review Menveo Product Information and Bexsero Product Information before prescribing. Full Product Information for each product is available at au. gsk. com

PBS Information: These products are not listed on the National Immunisation Program( NIP) or the PBS.

Bexsero ® Minimum Product Information: Multicomponent Meningococcal group B vaccine( recombinant, adsorbed) Indications: Active immunisation against invasive disease caused by N. meningitidis group B from 2 months of age. Contraindications: Hypersensitivity to any vaccine component. Precautions: Bexsero should never be administered intravenously, subcutaneously or intradermally. Postpone vaccination during acute severe febrile illness. Apnoea in very premature infants. Anticipate psychogenic response( syncope, hyperventilation). Anticipate fever( prophylactic paracetamol). Immune response may be reduced in immunocompromised Individuals. No data for use in subjects aged ≥50 years. Limited data in patients with chronic medical conditions. Kanamycin-sensitive individuals. Pregnancy( category B1). Lactation. Safe use in latex sensitive individuals not established. Interactions: Can be given with DTPa, Hib, IPV, HepB, PCV7, MenC-CRM, MMR and V. Immunogenicity of Bexsero or routine vaccines is unaffected by prophylactic paracetamol. Bexsero must be administered at separate injection sites. Adverse reactions: Infants, Toddlers & Children( up to 10 years): eating disorders, sleepiness, unusual crying, diarrhoea, vomiting, rash, fever( ≥39.5 ° C), injection site reactions, irritability. Adolescents( from 11 years) & Adults: headache, nausea, injection site reactions, malaise, myalagia, arthralgia. This is not a full list. Dosage and Administration: Administered by deep intramuscular injection. 0.5ml dose in a pre-filled syringe. Infants( 2-5 months): 3 doses( ≥1 month interval), booster dose at 12-23 months. Unvaccinated infants( 6-11 months): 2 doses( ≥2 month interval), booster dose at 12-23 months( ≥2 month interval between primary series and booster). Unvaccinated toddlers and children( 12 months – 10 years): 2 doses( ≥2 month interval), need for booster not established. 11-50 years: 2 doses( ≥1 month interval), need for booster not established. Storage: Between + 2˚C and 8˚C. DO NOT FREEZE. Protect from light. For further information, please refer to the full PI. [ Bexsero min PI v03 ]

Menveo Minimum Product Information( Meningococcal [ Groups A, C, W-135 and Y ] Oligosaccharide CRM197 Conjugate vaccine). Indication: Active immunisation of infants( from 2 months of age), children, adolescents and adults to prevent invasive disease caused by Neisseria meningitidis serogroups A, C, W135 and Y. Contraindications: Anaphylaxis following previous administration. Hypersensitivity to any vaccine ingredient, diphtheria-containing vaccines, similar components or latex. Acute febrile illness. Precautions: Not for intravascular, subcutaneous or intradermal injection. Refer to the PI regarding bleeding disorders, anticoagulant therapy, immunocompromised patients, pregnancy( category B1), lactation. No data on use for post-exposure prophylaxis. Possible association with Guillain-Barre Syndrome, consider decision to vaccinate in subjects with known history. Anticipate potential syncope. Anaphylaxis. Interactions: Administered in clinical trials with the following antigens( see full PI for further details): Children( 2 – 23 months): DTPa, HBV, IPV, Hib, HAV, PCV-7 and-13, RV5, MMR and V. Children( 2 – 10 years): no data. Adolescents( 11 – 18 years): DTPa, HPV4. Administer concomitant vaccines at different injection sites. Adverse events: Clinical trials: Injection site reaction, gastrointestinal disturbance, rash, fever, persistent crying *, irritability * ^, sleepiness * ^, change in eating * ^, headache^ +#, arthralgia^ +#, malaise +#, myalgia +#, chills #.(* infants < 12 months; ^children 2 – 5 years; + children 6 – 10 years; # adolescents and adults 11-65 years). Dosage and Administration: Administer by intramuscular injection. Reconstitute MenA powder in vial

with MenCWY solution in vial, shake vigorously. Withdraw 0.5mL for administration. Infants 2-6 months: 4 doses( first 3 doses ≥2 months apart, fourth dose between 12 – 16 months of age). Unvaccinated children 7 – 23 months: 2 doses( ≥2 months apart, second dose in 2nd year of life). Children, adolescents and adults(> 2 years): 1 dose. The need for, and timing of a booster dose of Menveo has not yet been determined. Storage: Store between + 2 ° C and + 8 ° C. DO NOT FREEZE. Protect from light. For more information, please refer to the PI. [ Menveo Min PI v2 ]

References: 1. Menveo Approved Product Information. 2. Bexsero Approved Product Information. 3. Australian Government Department of Health. Australian Immunisation Handbook 10th Edition. www. immunise. health. gov. au / internet / immunise / publishing. nsf / content / Handbook10-home ~ handbook10part4 ~ handbook10-4-10. Accessed September 2017. 4. Invasive Meningococcal W Disease National Surveillance Reports. www. health. gov. au / internet / main / publishing. nsf / Content / ohp-meningococcal-W. htm. Accessed September 2017.

For information on GSK products or to report an adverse event involving a GSK product, please contact GSK Medical Information on 1800 033 109. GlaxoSmithKline Australia Pty Ltd. ABN 47 100 162 481. Melbourne, VIC. Trade marks are owned or licensed to the GSK group of companies. © 2017 GSK group of companies or its licensor. AUS / MNV / 0022 / 17. Date of Approval October 2017. MEN0146 / AD.

CLARE PAIN INFANTS who have severe respiratory syncytial virus( RSV) infection are at high risk of asthma in later life, a NSW study shows.

Hospitalisation as a result of RSV before the age of two quadruples the risk of admission for asthma before a child’ s third birthday, compared with not having experienced severe RSV, it shows.

The study included nearly 32,000 children admitted with RSV, and 2405( 7.5 %) of them were later hospitalised with asthma.

The increased risk of asthma was seen in three groups examined in the study: non-Indigenous children at high risk of RSV because they were preterm or had a low birthweight; Indigenous children; and non-Indigenous children at standard RSV risk.

The findings also suggested that severe RSV infection conferred a higher risk of first asthma hospitalisation beyond the age of seven, the investigators said.

The similar levels of risk from RSV in different subgroups of children suggested the infection was a good indicator of the likelihood of subsequent severe asthma, the researchers said.

“ Our interpretation is that once you have an RSV [ infection ] that becomes one of the stronger predictors of whether or not you are going to have asthma,” lead author Dr Nusrat Homaira told Australian Doctor.

Although there was no vaccine for RSV, clinical trials were underway, said Dr Homaira, a paediatric respiratory epidemiologist at the University of NSW and Sydney Children’ s Hospital at Randwick.

An anti-RSV monoclonal antibody, palivizumab, could be given to premature babies or other babies at high risk of RSV to reduce the severity of the infection, but its use was not routine, she said. BMJ Open 2017; online.

8 | Australian Doctor | 24 November 2017 www. australiandoctor. com. au