There are several vaccines available that are not currently part of the National Immunisation Schedule, but are available
for purchase by parents. Varicella (chicken pox) and rotavirus vaccines are not presently funded, but are used in many
other countries schedules and are predicted to be part of the New Zealand immunisation schedule in the future (although
they will not be on the next schedule change in 2011).
Meningococcal C vaccine, which is used in many other Western countries (as part of their immunisation schedules) is
available for purchase in New Zealand. Travel vaccines such as hepatitis A may be given but check the age for licensure
e.g. typhoid vaccine is not given under age two.
Varicella zoster virus (human herpes virus type 3), otherwise known as chickenpox, affects an estimated 90% of children
in New Zealand. It has a peak incidence between age five to nine years, although with more children attending pre-school
and day care facilities, peak incidence may now be occurring at an even younger age. Varicella is highly infectious and
can be transmitted to around 85% of those who have close contact with an infected person.10
Varicella causes fever, general unwellness and an itchy, full body rash lasting for one to two weeks. The disease is
usually mild but it can cause serious illness and complications such as cerebellitis, aseptic meningitis and pneumonia
in some children (even in previously healthy children). Varicella is usually more severe for adolescents, adults, people
who are immunosupressed (including taking oral steroids), people with skin conditions or recent sunburn, people with
asthma or other lung conditions and smokers/smoking households.10
Contracting varicella during pregnancy is associated with some significant risks to the foetus. Varicella during weeks
eight to twenty of pregnancy is associated with a 0.7–2% risk of congenital varicella syndrome. This can result in scarring,
blindness, growth retardation, limb and cranial malformations, delayed development, mental retardation, spontaneous abortion
or foetal death. If the mother has varicella during weeks 25 to 36 of pregnancy, there is a 0.8–1.7% risk of the child
developing herpes zoster infection (shingles) during infancy. In addition, there is a 17–30% risk of serious disease
for a newborn if the mother has varicella in the period ranging from five days before to two days after birth.10
Therefore, reasons to consider varicella vaccination include the potential risk of serious complications of the disease,
and the subsequent risks to non-immune adults, particularly pregnant women and people who are immunocompromised.
Varicella vaccination may be administered in children aged nine months to 13 years (single dose), who have not previously
had the illness. It may be given at the same time as other vaccines including MMR, DTaP, hepatitis B and meningococcal
C conjugate. Children aged 14 years or older and adults receive two doses of the vaccine.
Immunocompromised children (e.g. undergoing treatment for cancer) cannot be given varicella vaccine as it is a live
vaccine, however these children are at particularly high risk and it is important to offer vaccination to close contacts.
As with all live vaccines, varicella vaccine is contraindicated during pregnancy and if not given simultaneously with
other live vaccines e.g. MMR, it should be given at least four weeks apart.
The cost of the vaccine is approximately $90 per dose.
Tetravalent vaccines including measles, mumps, rubella and varicella (MMRV) are currently available overseas and are
likely to be available in New Zealand within the next few years.
Rotavirus infections are the most common cause of diarrhoea in children aged under two years. It is estimated that
almost all children will be infected by age three years.10
Symptoms include watery diarrhoea, vomiting, fever and abdominal pain, lasting for up to eight days. Significant dehydration
and metabolic acidosis occur in approximately 1–2% of infected children.10
Children do not become immune after infection with rotavirus, but subsequent infections are usually less severe. Most
adults infected with rotavirus do not have any symptoms.10
Rotarix and RotaTeq are oral rotavirus vaccines currently available in New Zealand. The first dose is given between
age six and fourteen weeks and the second dose given around four weeks later (but before age 24 weeks). The vaccine is
administered orally, to the inside of the cheek, using an applicator. The dose may be repeated if the child spits or
regurgitates most of the liquid. Rotavirus vaccine may be administered at the same time as DTaP, Hib, IPV, Hep B and
pneumococcal conjugate (i.e. routine paediatric vaccines).
Rotavirus vaccine does not protect against non-rotaviral gastroenteritis or diarrhoea due to other causes.
The cost of the vaccine is approximately $140 per dose.