On this page
- Changes to the Handbook since 2024
- The National Immunisation Schedule
- Changes to the National Immunisation Schedule in 2024
- Table 1: National Immunisation Schedule, commencing 1 October 2020 (revised 1 March 2023)
- Changes to extended immunisation programme for special groups
- Table 2: Extended immunisation programme for special groups – vaccines funded in addition to the routine schedule
- Eligibility for publicly funded vaccines
- Notifiable diseases
The purpose of the Immunisation Handbook 2024 (the Handbook) is to provide clinical guidelines for health professionals on the safest and most effective use of vaccines in their practice. These guidelines are based on the best scientific evidence available at the time of publication, from published and unpublished literature.
The information contained within the Handbook was correct at the time of publication. This edition of the Handbook will remain current unless amended electronically via the Health New Zealand | Te Whatu Ora website until the next edition or update is published.
Changes to the Handbook since 2024
The following changes have been made for the 2024 edition.
- In the notifiable disease chapters, public health measures have been edited and where relevant referred to the Communicable Disease Control Manual website.
- Chapter 4 Immunisation of special groups – continues to be updated as funded indications change
- Chapter 5 Coronavirus disease (COVID-19) continues to be updated.
- Chapter 9 Hepatitis B, changes to non-responder protocol recommendations to give additional doses of HepB via intradermal administration
- Chapter 12 Measles, infants vaccinated given a first dose of MMR at the age of 11 months (ie from 11 months to under 12 months) are considered to have received MMR dose 1.
- Chapter 13 Meningococcal, access to broader protection for infants aged under 12 months.
- Chapter 18 Respiratory syncytial virus, addition of new chapter
- Chapter 24 Zoster – eligibility for funded vaccine for certain special group
The National Immunisation Schedule
Although funding decisions will be communicated to the sector, vaccinators are advised to regularly check the Pharmaceutical Schedule and any online updates for changes to funding decisions, and the Handbook for the latest immunisation information.
The National Immunisation Schedule (the Schedule) is the series of publicly funded vaccines available in New Zealand (see Table 1). Some vaccines are also offered as part of an extended immunisation programme for targeted special groups in response to a recognised need (see Table 2). See also section 2.1.7 for a summary of the primary immunisation requirements for adults (funded) and other funded and unfunded recommendations for this age group.
On 1 July 2012, the management and purchasing of vaccines transferred from the Ministry of Health to PHARMAC. All publicly funded vaccines are now listed on PHARMAC’s Pharmaceutical Schedule, and the districts are responsible for funding these once PHARMAC has listed them.
PHARMAC considers medicine and vaccine funding applications from pharmaceutical suppliers, health professionals, consumer groups and patients. Usually, manufacturers/suppliers decide whether to make an application for funding. Normally this will follow registration and approval of the medicine or vaccine by Medsafe. PHARMAC will generally only consider an application for a medicine or vaccine to be funded once it has been registered and approved by Medsafe.
Following a vaccine funding application, PHARMAC will assess the vaccine, seek clinical input (for vaccines this may be from the immunisation subcommittee of the Pharmacology and Therapeutics Advisory Committee [PTAC] or from PTAC itself), and conduct an economic analysis. The recommendations from the immunisation subcommittee are then considered by PTAC, which will provide advice to PHARMAC. PHARMAC then decides what priority the application has for funding and consults with Health New Zealand | Te Whatu Ora on capacity and implementation issues that may be associated with introducing a new vaccine. Depending on the outcome of that process, PHARMAC may then negotiate with the supplier. If an agreement is reached, PHARMAC will consult with the health sector on a funding proposal.
Health New Zealand | Te Whatu Ora remains responsible for and manages the National Immunisation Programme, which:
- aims to prevent disease through vaccination and to achieve coverage that prevents outbreaks and epidemics
- is accountable for achieving the Immunisation Coverage targets
- monitors disease burden and those at risk
- provides guidance to the sector on immunisation, cold chain and resources
- ensures immunisation providers deliver services that meet the needs of their population
- implements the National Immunisation Schedule
- delivers trusted and effective vaccine programmes
- provides immunisation resources, including the Immunisation Handbook
- improves information and data systems
- manages the Aotearoa Immunisation Register (AIR) (see section 2.3.5).
Health New Zealand | Te Whatu Ora works with PHARMAC to ensure there is a strong link between vaccine purchasing decisions and the management and implementation of the National Immunisation Programme.
Changes to the National Immunisation Schedule in 2024
Table 1 shows the 2024 National Immunisation Schedule, and Table 2 shows the vaccines funded for special groups at higher risk of some diseases.
Changes to vaccine funding in 2024 are as follows:
- The quadrivalent inactivated influenza vaccine (Influvac Tetra; see chapter 11 ‘Influenza’) will be the Schedule vaccine for eligible individuals, including pregnant women and adults aged 65 years and older.
Table 1: National Immunisation Schedule, commencing 1 October 2020 (revised 1 March 2023)
Antigen(s) |
DTaP-IPV-HepB/Hib |
PCV13 |
MenB |
RV1 |
MMR |
Hib-PRP |
VV |
DTaP-IPV |
Tdap |
HPV9 |
Influenza |
rZV |
---|---|---|---|---|---|---|---|---|---|---|---|---|
Brand |
Infanrix-hexa |
Prevenar 13 |
Bexsero |
Rotarix |
Priorix |
Hiberix |
Varivax |
Infanrix-IPV |
Boostrix |
Gardasil 9 |
Influvac Tetra |
Shingrix |
Manufacturer |
GSK |
Pfizer |
GSK |
GSK |
GSK |
GSK |
MSD |
GSK |
GSK |
Seqirus/MSD |
Viatris |
GSK |
Pregnancy |
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●a |
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6 weeks |
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●b |
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3 months |
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●c |
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5 months |
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● |
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12 months |
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15 months |
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●d |
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4 years |
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11 or 12 yearse
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● 2 dosese |
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45 years |
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●f |
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65 years |
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a. Tdap is for women during every pregnancy, from 16 weeks’ gestation, preferably in the second trimester. b. For infants at high risk of pneumococcal disease, an additional dose of PCV13 is given at age 3 months. c. An alternative approved schedule for MenB can be offered at ages 8 weeks, 4 months and 12 months. d. VV is funded for children born on or after 1 April 2016. e. HPV is funded for individuals aged 26 years and under: 2 doses are recommended for individuals who receive the first dose before their 15th birthday, even if they are 15 years or older at the time of the second dose; 3 doses are recommended for those aged 9–26 years with certain medical conditions, plus an additional dose post-chemotherapy. f. Funded for adults from 45 years who have not received 4 previous doses of tetanus vaccine. All individuals aged from 5 years are eligible to receive a primary course of a COVID-19 vaccine. Additional doses are also available to certain groups (see Chapter 5). |
Changes to extended immunisation programme for special groups
Vaccines funded for special groups are described in Table 2 below. Changes to existing programmes in 2024 are as follows.
- A single dose of meningococcal ACWY vaccine (MenACWY) and two doses of meningococcal B vaccine (MenB) are funded for individuals aged between 13 and 25 years entering or in their first year of living in boarding school hostels, tertiary education halls of residence, military barracks, youth justice residences or prisons. This includes children who turn 13 years while living in boarding school hostels.
- Meningococcal B vaccine (MenB) and quadrivalent meningococcal vaccine (MenACWY) are funded for certain special groups at increased risk of meningococcal disease, including those who have previously had meningococcal disease of any group. MenC vaccine has been replaced with MenACWY vaccine for certain infants aged 6 weeks to under 12 months.
- Zoster vaccine, certain individuals aged from 18 years with severe immunocompromise are eligible for funded vaccine.
- DTaP-IPV-HepB/Hib is funded for the revaccination of children up to age 18 years post-haematopoietic stem cell transplantation.
Table 2: Extended immunisation programme for special groups – vaccines funded in addition to the routine schedule
Note: Vaccinators are advised to regularly check the Pharmaceutical Schedule and any online updates for changes to funding decisions for special groups. See also chapter 4 ‘Immunisation of special groups’.
Vaccine |
Individuals eligible for funded vaccine |
---|---|
Haemophilus influenzae type b (Hib-PRP) |
For (re)vaccination of patients who are:
For use in testing for primary immune deficiencya |
Hepatitis A (HepA) |
Transplant patients Children with chronic liver disease Close contacts of hepatitis A cases |
Hepatitis B (HepB) |
Household or sexual contacts of patients with acute or chronic hepatitis B virus (HBV) infection Babies of mothers with chronic HBV infection need both hepatitis B vaccine (HepB) and hepatitis B immunoglobulin (HBIG) at birth Children aged under 18 years who have not achieved positive serology and who require additional vaccination HIV-positive patients Hepatitis C-positive patients Following non-consensual sexual intercourse Prior to any planned immunosuppressionb Patients following immunosuppressionb Solid organ transplant patients, including liver or kidney transplant Post-HSCT patients Following needle-stick injury Dialysis patients |
Human papillomavirus (HPV) |
People aged 9 to 26 years inclusive who are:
|
Annual influenza vaccine |
Patients aged 6 months to <65 years who:
|
(Re)vaccination of patients prior to planned or following immunosuppressionb |
|
Meningococcal conjugate quadrivalent vaccine (MenACWY) and meningococcal B vaccine (MenB) |
|
Pertussis-containing vaccines |
Pregnant women – recommended to be given from 16 weeks’ gestation of every pregnancy, preferably in the second trimester. (Funded when given any time in second or third trimester) Tdap is funded for parents or primary caregivers of infants admitted to a neonatal intensive care unit or special care baby unit for more than 3 days, who had not been exposed to maternal vaccination at least 14 days prior to birth (Re)vaccination of patients who are:
|
13-valent pneumococcal conjugate vaccine (PCV13) and 23‑valent pneumococcal polysaccharide vaccine (23PPV) |
For (re)vaccination of high-risk children, PCV13 for patients aged under 5 years and 23PPV for patients aged under 18 years:
PCV13 and 23PPV for (re)vaccination of patients aged 5 years and older:
PCV13 and 23PPV for use in testing for primary immune deficiency.a |
Inactivated polio vaccine (IPV) |
(Re)vaccination of patients prior to planned or following immunosuppressionb |
Tetanus, diphtheria and pertussis (Tdap) |
(Re)vaccination of patients prior to planned or following immunosuppressionb Boosting of patients with tetanus-prone wounds For use in testing for primary immune deficiencya |
Bacillus Calmette–Guérin (BCG) |
For infants at increased risk of tuberculosis (TB):
|
Varicella vaccine (VV) |
Non-immune patients:
Patients at least 2 years after bone marrow transplantation, on advice of their specialist. Patients at least 6 months after completion of chemotherapy, on advice of their specialist. HIV-positive patients with mild or moderate immunosuppression who are non-immune to varicella, on advice of their HIV specialist. Patients with inborn errors of metabolism at risk of major metabolic decompensation, with no clinical history of varicella. Household members of paediatric patients who are immunocompromised, or undergoing a procedure leading to immunocompromise, where the household member has no clinical history of varicella. Household members of adult patients who have no clinical history of varicella and who are severely immunocompromised or undergoing a procedure leading to immunocompromise, where the household contact has no clinical history of varicella. |
Zoster (rZV) (chapter 24) |
Individuals aged from 18 years, including those aged 66 years and over,
|
a. Upon the recommendation of an internal medicine physician or paediatrician. b. The period of immunosuppression due to steroid or other immunosuppressive therapy must be longer than 28 days. c. PCV13 is funded pre- or post-HSCT or chemotherapy. 23PPV is only funded post-HSCT or chemotherapy. d. Only PCV13 is funded for these indications; 23PPV is recommended but not funded. |
Eligibility for publicly funded vaccines
Only vaccines given according to the Schedule are available free of charge, unless there is a specific funded programme in response to a recognised need (see Table 2). The immunisation benefit is paid by districts to providers for the administration of:
- all childhood Schedule vaccines
- influenza vaccine to eligible children and adults (ie, those at higher risk of disease)
- zoster vaccine to individuals aged 65 years
- tetanus-diphtheria-pertussis (Tdap) boosters given at ages 45 and 65 years (now funded)
- hepatitis A, hepatitis B, Hib-PRP, human papillomavirus (HPV), inactivated polio vaccine (IPV), MMR, meningococcal conjugate, pertussis, pneumococcal conjugate and/or polysaccharide, varicella and zoster vaccines only, for eligible children and adults (ie, at higher risk of disease) as part of an extended immunisation programme for special groups.
The Health and Disability Services Eligibility Direction 2011 (the Eligibility Direction) issued by the Minister of Health sets out the eligibility criteria for publicly funded health and disability services in New Zealand. Only people who meet the eligibility criteria defined in the Eligibility Direction can receive publicly funded (ie, free or subsidised) health and disability services.
Regardless of their immigration and citizenship status, all children aged under 18 years are eligible to receive Schedule vaccines, and providers can claim the immunisation benefit for administering the vaccines. All children are also eligible for Well Child Tamariki Ora services.
Non-residents who were aged under 18 years when they commenced HPV vaccination are currently funded to complete the course, even if they are aged 18 years or older when they complete it.
Further information on eligibility can be found on the Health New Zealand | Te Whatu Ora website.
As part of the COVID-19 pandemic response the preferred vaccine, mRNA-CV, is available for certain children aged 6 months to 4 years, all children aged from 5 years and all adults in New Zealand, regardless of eligibility for publicly funded health and disability services.
Notifiable diseases
It is a legal requirement (under the Health Act 1956) that health professionals notify their local medical officer of health of any notifiable disease they suspect or diagnose so that appropriate action (eg, public health prevention and control activities) can be undertaken.
All diseases preventable by vaccines on the Schedule (or as part of a targeted programme) are notifiable, except for HPV, seasonal influenza, rotavirus, varicella and herpes zoster.
Note: Rotavirus infections presenting as gastroenteritis are notifiable as acute gastroenteritis.
Notification processes, and the diseases to which they relate, have been updated in the Health Act and supporting Health (Infectious and Notifiable Diseases) Regulations 2016. See the Ministry of Health’s 2017 document Guidance on Infectious Disease Management under the Health Act 1956 for an explanation, as well as the processes and forms for notifiable diseases.
The case definitions used by the medical officer of health to classify the notified case for surveillance purposes (and to assist in identifying appropriate prevention and control activities) and the laboratory tests required to confirm the diagnosis can be found in the Communicable Disease Control Manual. For the most up-to-date information, refer to the online version.