Special groups - Immunisation Advisory Centre

More information about Immunisation of special groups can be found in Chapter 4 of the Immunisation Handbook.

Vaccination is also recommended, although not funded, for those who are in close contact with individuals who are more vulnerable, or at high risk of complications.

Note: Vaccinators are advised to check the Pharmaceutical Schedule and any online updates (available on the PHARMAC website) for changes to funding decisions for special groups

Vaccination for people who are immunocompromised

People who have a medical condition or are receiving therapies that affect the function of their immune system, are at increased risk from vaccine-preventable disease and complications. Vaccination is highly recommended, but depending on the type and level of immunocompromise, they may not produce as robust a protective response compared to a healthy person. This means they are less protected by a vaccine, or protection can wane at a faster rate.

For further information about immunocompromised vaccination, including vaccination of close contacts, click here.

Vaccination during pregnancy and breastfeeding

Pregnant women are recommended to receive the influenza and COVID-19 vaccine at any stage of pregnancy and the pertussis (whooping cough) vaccine, Boostrix from 16 weeks of pregnancy. Vaccination recommendations differ depending on the stage of pregnancy – for specific recommendations, please click here.

Other special groups

Infants with special immunisation considerations from birth
Chronic disease
Immigrants and refugees
Occupation-related vaccination
Travel

Resources

Funded vaccines for special groups

Funded vaccines for special groups

Vaccine

Individuals eligible for funded vaccine

Hib

Post-HSCT or chemotherapy; pre- or post-splenectomy or with functional asplenia; pre- or post-solid organ transplant (SOT), pre- or post-cochlear implants, renal dialysis and other severely immunosuppressive regimens. Testing for primary immune deficiency.

Hep A

Transplant patients.
Children with chronic liver disease.
Close contacts of hepatitis A cases.

HepB and HBIG

HepB and HBIG at birth for babies of mothers with chronic HBV infection. HepB for: household or sexual contacts of HBsAg-positive patients; children <18 years who have not achieved positive serology and who require additional vaccination; HIV- or hepatitis C-positive patients; following non-consensual sexual intercourse; following immunosuppression; SOT; post-HSCT; following needle-stick injury; dialysis and liver or kidney transplant.

HPV

Individuals aged 9–26 years: with confirmed HIV infection; transplant (including stem cell) patients; post-chemotherapy.

Influenza

Pregnant women.
Individuals aged 6 months to <65 years with certain medical conditions.

MMR

For (re-)vaccination following immunosuppression.

MenC, MenACWY-D and 4CMenB

Pre- or post-splenectomy or with functional asplenia; with HIV, complement deficiency (acquired or inherited) or pre- or post-SOT; close contacts of meningococcal cases; prior meningococcal disease (any group); HSCT patients; prior to planned immunosuppression; following immunosuppression.

Pertussis-containing vaccine

Tdap for pregnant women, recommended from 16 weeks’ gestation of every pregnancy, preferably in the second trimester, but at least two weeks before birth. (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 Specialist Care Baby Unit for more than 3 days.
Tdap, DTaP-IPV-HepB/Hib or DTaP-IPV for (re-)vaccination: post-HSCT or chemotherapy; pre- or post-splenectomy; pre- or post-SOT, renal dialysis and other severely immunosuppressive regimens.

PCV13 and 23PPV

Children and adults with eligible conditions.
PCV13 and 23PPV for testing for primary immune deficiency.

IPV

For (re-)vaccination following immunosuppression.

Tdap

For (re-)vaccination following immunosuppression; boosting of patients with tetanus-prone wounds; testing for primary immune deficiency.

BCG

Infants and children <5 years at increased risk of TB.

Varicella

Non-immune patients: with chronic liver disease who may need a transplant in the future; with deteriorating renal function before transplant; prior to SOT; prior to elective immunosuppression; for post-exposure prophylaxis of immune-competent in-patients.
Patients at least 2 years after bone marrow transplant or 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 specialist.
Patients with inborn errors of metabolism at risk of major metabolic decompensation, with no clinical history of varicella.
Household contacts of paediatric patients who are immunocompromised, or undergoing a procedure leading to immunocompromise, where the household contact has no clinical history of varicella. Household contacts 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.

For details by vaccine and special groups, see the most current IMAC factsheet ‘Funded vaccines for special groups’

Also, see the Pharmaceutical Schedule for the number of funded doses and any changes to the funding decisions.

References

Last updated:

April 2023

Vaccination for special groups