Information updates

Shingrix^®  is a varicella zoster virus recombinant vaccine that can provide protection from herpes zoster (shingles) and post-herpetic neuralgia (long-term nerve pain). 

Funding of Shingrix from 1 November 2023 was announced by the hon Mark Butler (Minister for Health and Aged Care) on Sunday 8^th October 2023.  The extended vaccine eligibility for 'high/medium risk' immunocompromised individuals iwill be considered at the November 2023 meeting of the Pharmaceutical Benefits Advisory Committee (PBAC), so an announcement about this will be made after the transition from Zostavax to Shingrix on 1 November 2023.

ASCIA made a submission in January 2023  to support the PBS listing of Shingrix.

For details refer page 22 - https://www.pbs.gov.au/info/industry/listing/elements/pbac-meetings/agenda/november-2023-pbac-meeting  

From 1 November 2023 funding of Shingrix will be available for:

1. All Australians over 65 (and over 50 for First Nation Australians), which includes all immunocompromising conditions above those ages.

2. Immunocompromised adults aged 18 years and over with the following medical conditions;  haemopoietic stem cell transplant, solid organ transplant, haematological malignancy and advanced or untreated HIV.

https://www.health.gov.au/ministers/the-hon-mark-butler-mp/media/shingles-vaccine-now-free-for-nearly-5-million-australians

ASCIA Oral Immunotherapy (OIT) for Food Allergy Frequently Asked Questions (FAQ) for patients and carers has been updated to include more information about safety concerns. The updated FAQ is available on the ASCIA website https://www.allergy.org.au/patients/allergy-treatments/oral-immunotherapy-for-food-allergy

The additions to Q 6 (highlighted below in bold) have been made in response to concerns about:

• Exercising soon after OIT doses, as this increases the risk of allergic reactions (including anaphylaxis).
• Other factors that increase the risk of allergic reactions (including anaphylaxis).

Q 6: Are there any safety concerns about OIT for food allergy?

Safety concerns about food OIT include:

• People on food OIT tend to have more allergic reactions overall than people who are avoiding their allergen, due to allergic reactions caused by the OIT itself.
• People on food OIT can still have allergic reactions due to accidental exposure to food allergens.
• Food OIT may make eosinophilic oesophagitis (EoE) worse, or EoE can develop in patients who did not have EoE prior to food OIT.
• Exercise after an OIT dose can increase the risk of allergic reactions (including anaphylaxis). Doses should be given when a person can rest and be observed by a parent/guardian for at least 2 hours.
• Co-factors such as infections, menstruation, poorly controlled asthma, allergic rhinitis and lack of sleep can also increase the risk of allergic reactions (including anaphylaxis) from an OIT dose.

Another addition is "Impact on daily life" to Q 5 as highlighted below in bold.

Q 5: Is OIT a cure for food allergy?

Current food OIT methods are not a cure for food allergy. Any potential benefits of food OIT need to be considered against the following issues to decide if there is likely to be an overall benefit of OIT:

• Possible side effects such as allergic reactions, including severe allergic reactions (anaphylaxis).
• Impact on daily life, time commitment required and cost of OIT.

• Shingrix Vaccine to Prevent Shingles - September 2024 Update

• New ASCIA Clinical Care Standard for Inborn Errors of Immunity (IEI)/ Primary Immunodeficiencies (PID) 

• New ASCIA Sjögren’s Disease FAQ for patients and carers

• New Activity Based Funding for subcutaneous immunoglobulin (SCIg) therapy

• New treatment for severe lupus listed on PBS 1 July 2024

• New Australian hereditary angioedema (HAE) publication

• ASCIA Quicklinks - developed to improve access to ASCIA website information using QR codes

Recent ASCIA website updates that are relevant to anaphylaxis and allergy include:

ASCIA Oral Immunotherapy (OIT) for Food Allergy Frequently Asked Questions (FAQ) for patients and carers - updated to add statements about impact on daily life and factors that can increase the risk of allergic reactions (including anaphylaxis)

New ASCIA Anaphylaxis Refresher Training video – developed to provide training which is accessible and hands-free learning that takes around 16 minutes to watch. Feedback is welcome by mid October 2024 as minor updates will be made at the end of next month.

New ASCIA Management Summary for Allergic Conditions - developed for health professionals to complete, to support continuity of care including transition from paediatric to adult medical care.

ASCIA Anaphylaxis Checklist for Young Adults - updated to make it easier to read and to include a link to Allergy 250K for young adults.

How to position a person having anaphylaxis - updated to include new ASCIA infographic showing how to position a person when adrenaline is given.

ASCIA Quicklinks - developed to improve access to ASCIA website information using QR codes.

ASCIA Anaphylaxis Facts for Parents and Carers – updated to include current information and make it easier to read.

New peanut allergy treatment program for babies in Australia - ten paediatric hospitals across five states have introduced a global first nation-wide peanut oral immunotherapy (OIT) program.

ASCIA application for MBS item for supervised oral food challenges - ASCIA has lodged an application for an MBS item number to improve access to supervised oral food challenges.

ASCIA anaphylaxis e-training reports - for the first time since ASCIA anaphylaxis e-training was introduced in 2010, reports have been developed based on mandatory feedback surveys. 

ASCIA Guidelines - Adrenaline (Epinephrine) Injector Prescription and ASCIA Guidelines - Acute Management of Anaphylaxis - updated to include EpiPen® Jr, EpiPen® and Anapen® 500 devices.

Request for initial adrenaline injector to be provided on PBS Authority prescription by clinical immunology/allergy specialist - updated to make the form easier to find on the ASCIA website.

ASCIA Adverse Reactions to Complementary and Alternative Medicine FAQ - updated to include information about allergic reactions to Andrographis paniculata.

ASCIA Guide for Milk Substitutes in Cow’s Milk Allergy - updated due to Alfaré^® extensively hydrolysed formula being discontinued in Australia and removed from the PBS from 1 August 2024.

ASCIA is facilitating education and training initiatives to upskill health professionals, as part of the National Allergy Council Shared Care for Allergy project, funded by the Australian Government.

ASCIA invited Expressions of Interests (EOI) from ASCIA members (that were due by 8 May 2024) for funding of initiatives to improve access and timely delivery of allergy education and training for health professionals. ASCIA conducted the EOI process to try to best utilise the expertise and ideas of ASCIA members, as we believe it is the optimal way of allocating funding to provide programs for a range of health professionals. The quality of EOIs was very high, and the selection panel evaluated a range of elements in their decision making, including target audience, budget, impact and skill of the team.

A total of 18 EOIs were received and reviewed by a selection panel, with the following 5 initiatives selected for funding in the 2024 EOI round:

• Associateship of Clinical Allergy (ACA) and Rural and Regional Clinical Allergy Network (R2CAN); Dr Melanie Wong, Dr Peter Goss (Budget - $100,000) 

• The Regional and Rural Maternal Child Health Nurses Allergy Education Program; Dr Paxton Loke, Marianne Tomlin, Elizabeth Steven-Smith (Budget - $69,430)

• Develop ASCIA Food Allergy Dietitian Recognition Program and Certification Model; Corrina Michael, Caroline South, Prof Michaela Lucas (Budget - $64,650)

• A Comprehensive Mental Health Training Program for Allergy Health Professionals; Monique Kerr, Emma Warner, Dr Richard Nolan (Budget - $57,279)

• Virtual Immunology Clinic for General Practice Rural Initiative for Practice Education (VIC-GP RIPE); Prof Dominic Mallon, Dr Michael O’Sullivan, Dr Jack Bourke, Terri Williams (Budget - $20,760)

Total amount awarded - $312,119

For more details about these initiatives go to https://www.allergy.org.au/national-allergy-strategy

Important Dates

• Call for EOIs opened: 14 March 2024
• Call for EOIs closed: 8 May 2024
• Funding announced: 26 August 2024
• Progress reports due: March, July and September 2025
• Final report due: March 2026

The allergy education/training initiatives were selected based on the following criteria:

• Provide standardised, evidence-based and best practice postgraduate allergy education and training for one or more of the following health professions;

• General Practitioners
• Paediatricians
• Other Medical Practitioners (other than clinical immunology/allergy specialists and trainees)
• Dietitians
• Nurses
• Pharmacists
• Psychologists

• Improve access to postgraduate allergy education and training for health professionals, including those in regional, rural and remote areas
• Have a budget of $10,000 up to $100,000 AUD per initiative
• Be piloted within 18 months (by March 2026)
• Have the potential to be scaled up
• Have measurable outcomes
• Involve at least one Full ASCIA member 

All EOIs needed to outline how initiatives can fund education and training of multiple health professionals.

Funding is not available to support education and training of individuals, such as fees for established courses.  

We thank ASCIA members for responding to this call for EOIs and look forward to reports on the progress of initiatives that have been funded in the 2024 EOI round.

The ASCIA Annual Conference includes an Allergy Update meeting that is specific to dietitians, in addition to the food allergy sessions in the main program on Wednesday: 

• The ASCIA 2024 Conference Allergy Update Day for Dietitians was held on Friday 6th September at the Adelaide Convention Centre, South Australia
• The ASCIA 2025 Conference Allergy Update for Dietitians will be held on Thursday 4th September at the Brisbane Convention and Exhibition Centre, Queensland and registration will open at https://ascia2025.com/ in May 2025.
• The ASCIA 2026 Conference Allergy Update for Dietitians will be held on Thursday 3rd September at the Christchurch Convention Centre, New Zealand and registration will open in May 2026.

ASCIA is currently planning to host the next two ASCIA Food Allergy and Adverse Food Reactions courses in conjunction with ASCIA Annual Conferences as follows:

• Friday 5th to Saturday 6th September at the Brisbane Convention and Exhibition Centre, Queensland.
• Friday 4th to Saturday 5th September at the Christchurch Convention Centre, New Zealand.

This course has trained over 200 dietitians since the course commneced in 2018.  The course has been held in Adelaide (May 2024), Sydney (November 2023), Melbourne* (March 2023), Perth** (September 2019), Brisbane* (March 2019) and Canberra* (September 2018).  

This course has an interactive in-person program that is focused on medical nutrition therapy in food allergy and intolerance

More information is available at https://www.allergy.org.au/members/dietitians

Due to the interactive nature of this course, it is only held liive and in-person only (not recorded).

In response to requests from ASCIA members and feedback from other health professionals, QR codes have been added to the ASCIA website to improve access and reduce the need for printing of ASCIA Information for patients and carers. 

More than 100 topics have been updated in 2024 as part of the National Allergy Council Shared Care for Allergy project, to make them easier to read, and to promote patient/carer organisations, with weblinks at the top of each document. 

New ASCIA Quicklinks A4 documents include QR codes and are available at www.allergy.org.au/about-ascia/quick-links

ASCIA PC QR Code Quicklinks1.71 M

Each of the following webpages include a QR code directly below the instructions "Scan the QR codes below to view ASCIA information on a mobile phone:"

Allergy and anaphylaxis

Allergic rhinitis (hay fever) and sinusitis

Allergy prevention

Allergy and immunology testing

Allergy treatments

Asthma and allergy

Autoimmunity

Drug allergy

Food allergy

Food - other adverse reactions

Immunisation

Immunodeficiencies

Insect allergy (bites and stings)

Other allergies

Skin 

The following subheading, infographic and wording have now been added to the ASCIA webpage "How to position a person having anaphylaxis" to provide guidance on how a person should be positioned  when adrenaline is given to them, or self-administered.

How to position a person when adrenaline is given 

When an adrenaline (epinephrine) injector device is being given (or self-administered) the person having anaphylaxis should be laying flat, in the recovery position or sitting with their legs outstretched. They should remain in this position (not standing or walking) after the device has been given, until they have fully recovered.  

Instructions on how to use adrenaline devices is available at https://www.allergy.org.au/hp/anaphylaxis/how-to-give-injector

As a recent ASCIA meeting, specific requests were made by members for ASCIA to use more infographics and images on the ASCIA website (not just in ASCIA plans and e-training courses).  This is the first webpage (of many to come) to be updated with this principle in mind.

The wording above has also been added to the following ASCIA webpages:

https://www.allergy.org.au/hp/anaphylaxis/how-to-give-injector

https://www.allergy.org.au/hp/anaphylaxis/how-to-give-epipen

https://www.allergy.org.au/hp/anaphylaxis/how-to-give-anapen