gastrointestinal discomfort. gastrointestinal disorders
tightness (rare in children).temperature sensation altered
(rare in children). vasodilation (rare in children)
▶ Rare or very rare Allergic rhinitis (in children). apathy (in
adults). asthma (in children). ataxia (in children). burping
children). dry mouth (in adults). eye discomfort. gait
children). sweat changes . synovitis (in children).throat
oedema (in adults).tremor (in adults). vertigo (in adults). watering eye (in adults)
▶ Frequency not known Guillain-Barre syndrome . thrombocytopenia
l MEDICINAL FORMS There can be variation in the licensing of
different medicines containing the same drug.
EXCIPIENTS: May contain Neomycin
disposable injection P £217.20
▶ Havrix (GlaxoSmithKline UK Ltd)
Havrix Monodose vaccine suspension for injection 1ml pre-filled
syringes | 1 pre-filled disposable injection P £22.14 DT = £22.14
| 10 pre-filled disposable injection P £221.43
▶ VAQTA (Merck Sharp & Dohme Ltd)
VAQTA Paediatric vaccine suspension for injection 0.5ml pre-filled
syringes | 1 pre-filled disposable injection P £14.74
Hepatitis A with typhoid vaccine
The properties listed below are those particular to the
combination only. For the properties of the components
please consider, hepatitis A vaccine p. 1318, typhoid vaccine
Immunisation against hepatitis A and typhoid infection
▶ Child 15–17 years: 1 mL for 1 dose, the deltoid region is
the preferred site of injection; not to be injected into
the buttock (vaccine efficacy reduced). The
subcutaneous route may be used for patients with
bleeding disorders, booster dose given using single
▶ Adult: 1 mL for 1 dose, the deltoid region is the
preferred site of injection; not to be injected into the
buttock (vaccine efficacy reduced). The subcutaneous
route may be used for patients with bleeding disorders,
booster dose given using single component vaccines
Immunisation against hepatitis A and typhoid infection
▶ Child 16–17 years: 1 mL for 1 dose, the deltoid region is
the preferred site of injection; not to be injected into
the buttock (vaccine efficacy reduced). The
subcutaneous route may be used for patients with
bleeding disorders, booster dose given using single
▶ Adult: 1 mL for 1 dose, the deltoid region is the
preferred site of injection; not to be injected into the
buttock (vaccine efficacy reduced). The subcutaneous
route may be used for patients with bleeding disorders,
booster dose given using single component vaccines
l MEDICINAL FORMS There can be variation in the licensing of
different medicines containing the same drug.
EXCIPIENTS: May contain Neomycin
Immunisation against hepatitis B infection
▶ Child 1 month–15 years: 10 micrograms for 1 dose, then
10 micrograms after 1 month for 1 dose, followed by
10 micrograms after 5 months for 1 dose, deltoid
muscle is preferred site of injection in older children;
anterolateral thigh is preferred site in infants and
young children; not to be injected into the buttock
▶ Child 16–17 years: 20 micrograms for 1 dose, then
20 micrograms after 1 month for 1 dose, followed by
20 micrograms after 5 months for 1 dose, deltoid
muscle is preferred site of injection; not to be injected
into the buttock (vaccine efficacy reduced)
▶ Adult: 20 micrograms for 1 dose, then 20 micrograms
after 1 month for 1 dose, followed by 20 micrograms
after 5 months for 1 dose, deltoid muscle is preferred
site of injection; not to be injected into the buttock
Immunisation against hepatitis B infection (accelerated
▶ Neonate: 10 micrograms every month for 3 doses,
followed by 10 micrograms after 10 months for 1 dose,
anterolateral thigh is preferred site in neonates; not to
be injected into the buttock (vaccine efficacy reduced),
this dose should not be given to neonates born to
hepatitis B surface antigen positive mother.
▶ Child 1 month–15 years: 10 micrograms every month for
3 doses, followed by 10 micrograms after 10 months for
1 dose, deltoid muscle is preferred site of injection in
older children; anterolateral thigh is preferred site in
infants and young children; not to be injected into the
buttock (vaccine efficacy reduced)
▶ Child 16–17 years: 20 micrograms every month for
3 doses, followed by 20 micrograms after 10 months for
1 dose, deltoid muscle is preferred site of injection; not
to be injected into the buttock (vaccine efficacy
▶ Adult: 20 micrograms every month for 3 doses,
followed by 20 micrograms after 10 months for 1 dose,
deltoid muscle is preferred site of injection; not to be
injected into the buttock (vaccine efficacy reduced)
Immunisation against hepatitis B infection, alternative
▶ Child 11–15 years: 20 micrograms for 1 dose, followed by
20 micrograms after 6 months, this schedule is not
suitable if high risk of infection between doses or if
compliance with second dose uncertain, deltoid muscle
is preferred site of injection; not to be injected into the
buttock (vaccine efficacy reduced)
Immunisation against hepatitis B infection (accelerated
schedule in exceptional cases, e.g. for travellers
▶ Adult: 20 micrograms for 1 dose, then 20 micrograms
after 7 days for 1 dose, followed by 20 micrograms after
14 days for 1 dose, followed by 20 micrograms for
1 dose, to be given 12 months after the first dose,
deltoid muscle is preferred site of injection; not to be
injected into the buttock (vaccine efficacy reduced)
Immunisation against hepatitis B infection (in renal
insufficiency, including haemodialysis patients)
▶ Child 1 month–15 years: 10 micrograms every month for
2 doses, followed by 10 micrograms after 5 months for
1 dose, immunisation schedule and booster doses may
need to be adjusted in those with low antibody
concentration, deltoid muscle is preferred site of
injection in older children; anterolateral thigh is
preferred site in infants and young children; not to be
injected into the buttock (vaccine efficacy reduced)
▶ Child 16–17 years: 40 micrograms every month for
3 doses, followed by 40 micrograms after 4 months for
1 dose, immunisation schedule and booster doses may
need to be adjusted in those with low antibody
concentration, deltoid muscle is preferred site of
injection; not to be injected into the buttock (vaccine
▶ Adult: 40 micrograms every month for 3 doses,
followed by 40 micrograms after 4 months for 1 dose,
immunisation schedule and booster doses may need to
be adjusted in those with low antibody concentration,
deltoid muscle is preferred site of injection; not to be
injected into the buttock (vaccine efficacy reduced)
Immunisation against hepatitis B infection (in renal
insufficiency, including haemodialysis patients
▶ Child 1 month–15 years: 10 micrograms every month for
3 doses, followed by 10 micrograms after 10 months for
1 dose, immunisation schedule and booster doses may
need to be adjusted in those with low antibody
concentration, deltoid muscle is preferred site of
injection in older children; anterolateral thigh is
preferred site in infants and young children; not to be
injected into the buttock (vaccine efficacy reduced)
Immunisation against hepatitis B infection in renal
insufficiency (including pre-haemodialysis and
▶ Child 15–17 years: 20 micrograms every month for
3 doses, followed by 20 micrograms after 4 months for
1 dose, immunisation schedule and booster doses may
need to be adjusted in those with low antibody
concentration, deltoid muscle is preferred site of
injection; not to be injected into the buttock (vaccine
▶ Adult: 20 micrograms every month for 3 doses,
followed by 20 micrograms after 4 months for 1 dose,
immunisation schedule and booster doses may need to
be adjusted in those with low antibody concentration,
deltoid muscle is preferred site of injection; not to be
injected into the buttock (vaccine efficacy reduced)
Immunisation against hepatitis B infection
▶ Neonate: 5 micrograms for 1 dose, followed by
5 micrograms after 1 month for 1 dose, then
5 micrograms after 5 months for 1 dose, booster doses
may be required in immunocompromised patients with
low antibody concentration, anterolateral thigh is
preferred site in neonates; not to be injected into the
buttock (vaccine efficacy reduced), dose not to be used
for neonate born to hepatitis B surface antigen positive
▶ Child 1 month–15 years: 5 micrograms for 1 dose,
followed by 5 micrograms after 1 month for 1 dose,
then 5 micrograms after 5 months for 1 dose, booster
doses may be required in immunocompromised
patients with low antibody concentration, deltoid
muscle is preferred site of injection in adults and older
children; anterolateral thigh is preferred site in infants;
not to be injected into the buttock (vaccine efficacy
▶ Child 16–17 years: 10 micrograms for 1 dose, followed by
10 micrograms after 1 month for 1 dose, followed by
10 micrograms after 5 months for 1 dose, booster doses
may be required in immunocompromised patients with
low antibody concentration, deltoid muscle is preferred
site of injection in adults and older children; not to be
injected into the buttock (vaccine efficacy reduced)
▶ Adult: 10 micrograms for 1 dose, followed by
10 micrograms after 1 month for 1 dose, followed by
10 micrograms after 5 months for 1 dose, booster doses
may be required in immunocompromised patients with
low antibody concentration, deltoid muscle is preferred
site of injection in adults and older children; not to be
injected into the buttock (vaccine efficacy reduced)
Immunisation against hepatitis B infection (accelerated
▶ Neonate: 5 micrograms every month for 3 doses,
followed by 5 micrograms after 10 months for 1 dose,
booster doses may be required in immunocompromised
patients with low antibody concentration, anterolateral
thigh is preferred site in neonates; not to be injected
into the buttock (vaccine efficacy reduced), dose not to
be used for neonate born to hepatitis B surface antigen
▶ Child 1 month–15 years: 5 micrograms every month for
3 doses, followed by 5 micrograms after 10 months for
1 dose, booster doses may be required in
immunocompromised patients with low antibody
concentration, deltoid muscle is preferred site of
injection in older children; anterolateral thigh is
preferred site in infants; not to be injected into the
buttock (vaccine efficacy reduced)
▶ Child 16–17 years: 10 micrograms every month for
3 doses, followed by 10 micrograms after 10 months for
1 dose, booster doses may be required in
immunocompromised patients with low antibody
concentration, deltoid muscle is preferred site of
injection in older children; not to be injected into the
buttock (vaccine efficacy reduced)
▶ Adult: 10 micrograms every month for 3 doses,
followed by 10 micrograms after 10 months for 1 dose,
booster doses may be required in immunocompromised
patients with low antibody concentration, deltoid
muscle is preferred site of injection; not to be injected
into the buttock (vaccine efficacy reduced)
Neonate born to hepatitis B surface antigen-positive
▶ Neonate: 5 micrograms every month for 3 doses, first
dose given at birth with hepatitis B immunoglobulin
injection (separate site), followed by 5 micrograms after
10 months for 1 dose, anterolateral thigh is preferred
site in neonates; not to be injected into the buttock
Chronic haemodialysis patients
▶ Child 16–17 years: 40 micrograms every month for
2 doses, followed by 40 micrograms after 5 months for
1 dose, booster doses may be required in those with low
antibody concentration, deltoid muscle is preferred site
of injection in older children; not to be injected into
the buttock (vaccine efficacy reduced)
▶ Adult: 40 micrograms every month for 2 doses,
followed by 40 micrograms after 5 months for 1 dose,
booster doses may be required in those with low
antibody concentration, deltoid muscle is preferred site
of injection; not to be injected into the buttock
▶ Common or very common Drowsiness . gastrointestinal
▶ Uncommon Influenza like illness
▶ Rare or very rare Sensation abnormal
l MEDICINAL FORMS There can be variation in the licensing of
different medicines containing the same drug.
EXCIPIENTS: May contain Thiomersal
▶ Engerix B (GlaxoSmithKline UK Ltd)
Hepatitis B virus surface antigen 20 microgram per 1 ml Engerix
B 10micrograms/0.5ml vaccine suspension for injection pre-filled
syringes | 1 pre-filled disposable injection P £9.67 DT = £9.67
£12.99 | 10 pre-filled disposable injection P £129.92
▶ Fendrix (GlaxoSmithKline UK Ltd)
Hepatitis B virus surface antigen 40 microgram per 1 ml Fendrix
20micrograms/0.5ml vaccine suspension for injection pre-filled
syringes | 1 pre-filled disposable injection P £38.10 DT = £38.10
▶ HBVAXPRO (Merck Sharp & Dohme Ltd)
Hepatitis B virus surface antigen 10 microgram per
1 ml HBVAXPRO 5micrograms/0.5ml vaccine suspension for injection
pre-filled syringes | 1 pre-filled disposable injection P £8.95 DT =
Hepatitis B virus surface antigen 40 microgram per
1 ml HBvaxPRO 40micrograms/1ml vaccine suspension for injection
vials | 1 vial P £27.60 DT = £27.60
Prevention of premalignant genital lesions and cervical
▶ Child 9–14 years (female): 0.5 mL for 1 dose, followed by
0.5 mL after 5–7 months for 1 dose, if second dose
administered earlier than 5 months after the first, a
third dose should be administered, dose to be
administered into deltoid region, if the course is
interrupted, it should be resumed (using the same
vaccine) but not repeated, even if more than 24 months
have elapsed since the first dose or if the girl is then
▶ Child 15–17 years (female): 0.5 mL for 1 dose, followed by
0.5 mL after 1–2.5 months for 1 dose, then 0.5 mL after
5–12 months from the first dose for 1 dose, dose to be
administered into deltoid region, if the course is
interrupted, it should be resumed (using the same
vaccine) but not repeated, allowing the appropriate
interval between the remaining doses.
▶ Adult (female): 0.5 mL for 1 dose, followed by 0.5 mL
after 1–2.5 months for 1 dose, then 0.5 mL after
5–12 months from the first dose for 1 dose, dose to be
administered into deltoid region, if the course is
interrupted, it should be resumed (using the same
vaccine) but not repeated, allowing the appropriate
interval between the remaining doses.
Prevention of premalignant genital (cervical, vulvar and
vaginal) and anal lesions, cervical and anal cancers, and
▶ Child 9–14 years (female): 0.5 mL for 1 dose, followed by
0.5 mL after 6 months for 1 dose, if the second dose is
administered earlier than 6 months after the first dose,
a third dose should be administered, dose to be
administered preferably into deltoid region or higher
anterolateral thigh, if the course is interrupted, it
should be resumed (using the same vaccine) but not
repeated, even if more than 24 months have elapsed
since the first dose or if the girl is then aged 15 years or
▶ Child 15–17 years (female): 0.5 mL for 1 dose, followed by
0.5 mL for 1 dose, second dose to be given at least
1 month after the first dose, then 0.5 mL for 1 dose,
third dose to be given at least 3 months after the
second dose, schedule should be completed within
12 months of the first dose, dose to be administered
preferably into deltoid region or higher anterolateral
thigh, if the course is interrupted, it should be resumed
(using the same vaccine) but not repeated, allowing the
appropriate interval between the remaining doses.
▶ Adult (female): 0.5 mL for 1 dose, followed by 0.5 mL for
1 dose, second dose to be given at least 1 month after
the first dose, then 0.5 mL for 1 dose, third dose to be
given at least 3 months after the second dose, schedule
should be completed within 12 months of the first
dose, dose to be administered preferably into deltoid
region or higher anterolateral thigh, if the course is
interrupted, it should be resumed (using the same
vaccine) but not repeated, allowing the appropriate
interval between the remaining doses.
Prevention of premalignant genital (cervical, vulvar, and
vaginal) and anal lesions, cervical and anal cancers, and
genital warts (alternative schedule)
▶ Child 9–14 years (female): 0.5 mL for 1 dose, followed by
0.5 mL for 1 dose, second dose to be given at least
1 month after the first dose, then 0.5 mL for 1 dose,
third dose to be given at least 3 months after the
second dose, schedule should be completed within
12 months of the first dose, dose to be administered
preferably into deltoid region or higher anterolateral
thigh, if the course is interrupted, it should be resumed
(using the same vaccine) but not repeated, allowing the
appropriate interval between the remaining doses.
GARDASIL ® Two dose schedule not licensed for use in
▶ Common or very common Pain in extremity
▶ Rare or very rare Bronchospasm
▶ Frequency not known Acute disseminated
encephalomyelitis . asthenia . chills .Guillain-Barre
syndrome . immune thrombocytopenic purpura . syncope
l PREGNANCY Not known to be harmful, but vaccination
should be postponed until completion of pregnancy.
l PRESCRIBING AND DISPENSING INFORMATION To avoid
confusion, prescribers should specify the brand to be
l MEDICINAL FORMS There can be variation in the licensing of
different medicines containing the same drug.
▶ Cervarix (GlaxoSmithKline UK Ltd)
▶ Gardasil (Merck Sharp & Dohme Ltd)
Annual immunisation against seasonal influenza
▶ Child 6 months–17 years: 0.5 mL for 1 dose
▶ Adult 18–59 years: 9 micrograms for 1 dose, dose to be
▶ Adult 60 years and over: 15 micrograms for 1 dose, dose
to be injected into deltoid region
▶ BY INTRANASAL ADMINISTRATION
▶ Child 2–17 years: 0.1 mL for 1 dose, dose to be
administered into each nostril
Annual immunisation against seasonal influenza (for
children in clinical risk groups who have not received
seasonal influenza vaccine previously)
▶ Child 6 months–8 years: 0.5 mL for 1 dose, followed by
0.5 mL for 1 dose, after at least 4 weeks
▶ BY INTRANASAL ADMINISTRATION
▶ Child 2–8 years: 0.1 mL for 1 dose, followed by 0.1 mL
for 1 dose, after at least 4 weeks. 0.1 mL dose to be
l UNLICENSED USE The Joint Committee on Vaccination and
Immunisation advises offering a second dose of vaccine for
annual immunisation against seasonal influenza to
children in clinical risk groups only.
l CONTRA-INDICATIONS Preparations marketed by Pfizer, or
CSL Biotherapies in child under 5 years— increased risk of
FLUENZ TETRA ® Active wheezing . concomitant use with
antiviral therapy for influenza . severe asthma
CONTRA-INDICATIONS, FURTHER INFORMATION
▶ Concomitant use with antiviral therapy for influenza Avoid
influenza antiviral agents for at least 2 weeks after
immunisation; avoid immunisation for at least 48 hours
after stopping the influenza antiviral agent.
l CAUTIONS Increased risk of fever in child 5–9 years with
preparations marketed by Pfizer or CSL Biotherapies—use
alternative influenza vaccine if available
l INTERACTIONS → Appendix 1: live vaccines
▶ With intradermal use Chills . local reactions . pain
▶ With intranasal use Nasal complaints
▶ With intradermal use Hyperhidrosis
▶ With intramuscular use Cough (in adults)
▶ With intranasal use Epistaxis . face oedema
▶ With intradermal use Nerve disorders . paraesthesia
▶ With intramuscular use Vasodilation (in adults)
▶ With intranasal use Guillain-Barre syndrome
l ALLERGY AND CROSS-SENSITIVITY Individuals with a
history of egg allergy can be immunised with either an egg
free influenza vaccine, if available, or an influenza vaccine
with an ovalbumin content less than 120 nanograms/mL
(facilities should be available to treat anaphylaxis).
Vaccines with an ovalbumin content more than
120 nanograms/mL or where content is not stated should
not be used in individuals with egg allergy. If an influenza
vaccine containing ovalbumin is being considered in those
with a history of anaphylaxis to egg or egg allergy with
uncontrolled asthma, these individuals should be referred
l PREGNANCY Inactivated vaccines not known to be
FLUENZ TETRA ® Avoid in pregnancy.
l BREAST FEEDING Inactivated vaccines not known to be
FLUENZ TETRA ® Avoid in breast-feeding.
l PRESCRIBING AND DISPENSING INFORMATION The
literature for the individual vaccines.
FLUARIX TETRA ® Ovalbumin content less than
FLUENZ TETRA ® Avoid close contact with severely
immunocompromised patients for 1–2 weeks after
l MEDICINAL FORMS There can be variation in the licensing of
different medicines containing the same drug.
EXCIPIENTS: May contain Gelatin, gentamicin
▶ Fluenz Tetra (AstraZeneca UK Ltd)
Fluenz Tetra vaccine nasal suspension 0.2ml unit dose | 10 unit
EXCIPIENTS: May contain Gentamicin, kanamycin, neomycin, polymyxin
▶ Influenza vaccine (non-proprietary) A
Trivalent influenza vaccine (split virion, inactivated) High Dose
suspension for injection 0.5ml pre-filled syringes | 5 pre-filled
Influenza vaccine (split virion, inactivated) suspension for injection
0.5ml pre-filled syringes | 10 pre-filled disposable injection P £65.90
Quadrivalent influenza vaccine (split virion, inactivated) suspension for
injection 0.5ml pre-filled syringes | 1 pre-filled disposable
injection P £8.00 | 10 pre-filled disposable injection P £80.00
Influenza Tetra MYL vaccine suspension for injection 0.5ml pre-filled
syringes | 1 pre-filled disposable injection P £8.00 | 10 pre-filled
Influenza MYL vaccine suspension for injection 0.5ml pre-filled
syringes | 1 pre-filled disposable injection P £6.59 | 10 pre-filled
▶ Fluad (Seqirus Vaccines Ltd)
▶ Fluarix Tetra (GlaxoSmithKline UK Ltd) A
Fluarix Tetra vaccine suspension for injection 0.5ml pre-filled syringes
| 1 pre-filled disposable injection P £9.94 | 10 pre-filled
▶ Flucelvax Tetra (Seqirus Vaccines Ltd) A
Flucelvax Tetra vaccine suspension for injection 0.5ml pre-filled
syringes | 1 pre-filled disposable injection P £9.94 | 10 pre-filled
Influvac Sub-unit vaccine suspension for injection 0.5ml pre-filled
syringes | 1 pre-filled disposable injection P £5.22 | 10 pre-filled
Influvac sub-unit Tetra vaccine suspension for injection 0.5ml pre-filled
syringes | 1 pre-filled disposable injection P £9.94 | 10 pre-filled
Japanese encephalitis vaccine 22-Feb-2019
Immunisation against Japanese encephalitis
▶ Child 2–35 months: 0.25 mL every 28 days for 2 doses,
alternatively 0.25 mL every 7 days for 2 doses,
anterolateral thigh may be used as the injection site in
infants; deltoid muscle is preferred site in older
children, immunisation should be completed at least
1 week before potential exposure
▶ Child 3–17 years: 0.5 mL every 28 days for 2 doses,
alternatively 0.5 mL every 7 days for 2 doses, deltoid
muscle is preferred site in older children,
immunisation should be completed at least 1 week
▶ Adult: 0.5 mL every 28 days for 2 doses, alternatively
0.5 mL every 7 days for 2 doses, deltoid muscle is
preferred site of injection, immunisation should be
completed at least 1 week before potential exposure
▶ Adult: 0.5 mL after 1–2 years, deltoid muscle is
preferred site of injection, for those at continued risk,
the booster dose should be given 1 year after
▶ Elderly: 0.5 mL after 1 year, for those at continued risk,
deltoid muscle is preferred site of injection
▶ Adult: 0.5 mL after 10 years, for those at continued risk,
deltoid muscle is preferred site of injection
▶ When used for Immunisation against Japanese encephalitis The
rapid schedule administered at days 0 and 7 is not licensed
▶ Common or very common Influenza like illness (frequency
▶ Uncommon Abdominal pain (frequency not known in
children). asthenia (in adults). chills (in adults).
▶ Rare or very rare Dyspnoea (in adults). eyelid oedema (in
▶ Frequency not known Cough (in children)
l PREGNANCY Although manufacturer advises avoid
because of limited information, miscarriage has been
associated with Japanese encephalitis virus infection
acquired during the first 2 trimesters of pregnancy.
l MEDICINAL FORMS There can be variation in the licensing of
different medicines containing the same drug.
▶ Japanese encephalitis vaccine (Non-proprietary)
Japanese encephalitis GCVC vaccine solution for injection 1ml vials | 1 vial s
Japanese encephalitis GCVC vaccine solution for injection 20ml vials |
Japanese encephalitis GCVC vaccine solution for injection 10ml vials | 1 vial s
Measles, mumps and rubella vaccine,
Primary immunisation against measles, mumps, and
▶ BY INTRAMUSCULAR INJECTION, OR BY DEEP SUBCUTANEOUS
▶ Child 12–13 months: 0.5 mL for 1 dose
Primary immunisation against measles, mumps, and
▶ BY INTRAMUSCULAR INJECTION, OR BY DEEP SUBCUTANEOUS
▶ Child 40 months–5 years: 0.5 mL for 1 dose
Rubella immunisation (in seronegative women,
susceptible to rubella and in unimmunised, seronegative
▶ BY INTRAMUSCULAR INJECTION, OR BY DEEP SUBCUTANEOUS
▶ Females of childbearing potential: (consult product
literature or local protocols)
Children presenting for pre-school booster, who have not
received the primary immunisation (first dose)|
Immunisation for patients at school-leaving age or at
entry into further education, who have not completed
the primary immunisation course | Control of measles
outbreak | Immunisation for patients travelling to areas
where measles is endemic or epidemic, who have not
completed the primary immunisation
▶ BY INTRAMUSCULAR INJECTION, OR BY DEEP SUBCUTANEOUS
▶ Child 6 months–17 years: (consult product literature or
▶ Adult: (consult product literature or local protocols)
▶ In children Not licensed for use in children under 9 months.
MMR VACCINATION AND BOWEL DISEASE OR AUTISM
Reviews undertaken on behalf of the CSM, the Medical
Research Council, and the Cochrane Collaboration, have
not found any evidence of a link between MMR
vaccination and bowel disease or autism. The Chief
Medical Officers have advised that the MMR vaccine is
the safest and best way to protect children against
measles, mumps, and rubella. Information (including
fact sheets and a list of references) may be obtained from
l CAUTIONS Antibody response to measles component may
be reduced after immunoglobulin administration or blood
transfusion–leave an interval of at least 3 months before
▶ Administration with other vaccines MMR vaccine should not
be administered on the same day as yellow fever vaccine;
there should be a 4-week minimum interval between the
vaccines. When protection is rapidly required, the vaccines
can be given at any interval and an additional dose of MMR
MMR and varicella-zoster vaccine can be given on the
same day or separated by a 4-week minimum interval.
When protection is rapidly required, the vaccines can be
given at any interval and an additional dose of the vaccine
given second may be considered.
l INTERACTIONS → Appendix 1: live vaccines
▶ Uncommon Increased risk of infection .rhinorrhoea
aseptic . nerve deafness . nerve disorders . oculomotor
disorders . seizures . Stevens-Johnson syndrome . subacute
sclerosing panencephalitis . syncope .throat pain . thrombocytopenia . vasculitis
SIDE-EFFECTS, FURTHER INFORMATION Malaise, fever, or a
rash can occur after the first dose of MMR vaccine–most
commonly about a week after vaccination and lasting
Febrile seizures occur rarely 6 to 11 days after MMR
vaccination (the incidence is lower than that following
Idiopathic thrombocytopenic purpura Idiopathic
thrombocytopenic purpura has occurred rarely following
MMR vaccination, usually within 6 weeks of the first dose.
The risk of idiopathic thrombocytopenic purpura after
MMR vaccine is much less than the risk after infection with
wild measles or rubella virus. Children who develop
idiopathic thrombocytopenic purpura within 6 weeks of
the first dose of MMR should undergo serological testing
before the second dose is due; if the results suggest
incomplete immunity against measles, mumps or rubella
then a second dose of MMR is recommended. Samples
should be sent to the Virus Reference Laboratory of the
Frequency of side effects Adverse reactions are
considerably less frequent after the second dose of MMR
l ALLERGY AND CROSS-SENSITIVITY MMR vaccine can be
given safely even when the child has had an anaphylactic
reaction to food containing egg. Dislike of eggs, refusal to
eat egg, or confirmed anaphylactic reactions to eggcontaining food is not a contra-indication to MMR
vaccination. Children with a confirmed anaphylactic
reaction to the MMR vaccine should be assessed by a
l CONCEPTION AND CONTRACEPTION Exclude pregnancy
before immunisation. Avoid pregnancy for at least
l PRESCRIBING AND DISPENSING INFORMATION Available as
part of childhood immunisation schedule from health
organisations or ImmForm www.immform.dh.gov.uk.
l MEDICINAL FORMS There can be variation in the licensing of
different medicines containing the same drug.
Powder and solvent for suspension for injection
EXCIPIENTS: May contain Gelatin, neomycin
▶ M-M-RVAXPRO (Merck Sharp & Dohme Ltd)
M-M-RVAXPRO vaccine powder and solvent for suspension for injection
0.5ml pre-filled syringes | 1 pre-filled disposable injection P £11.00
Powder and solvent for solution for injection
EXCIPIENTS: May contain Neomycin
▶ Priorix (GlaxoSmithKline UK Ltd)
▶ Child: 1 mL for 2 doses (on days 0 and 7), followed by
1 mL for 1 dose (on day 28), to be administered in
deltoid region or anterolateral thigh in infants, for
those at continuous risk, measure plasmaconcentration of antirabies antibodies every 6 months
and give a booster dose if the titre is less than
0.5 units/mL, final dose may be given from day 21, if
insufficient time before travel
▶ Adult: 1 mL for 2 doses (on days 0 and 7), followed by
1 mL for 1 dose (on day 28), to be administered in
deltoid region, for those at continuous risk, measure
plasma-concentration of antirabies antibodies every
6 months and give a booster dose if the titre is less than
0.5 units/mL, final dose may be given from day 21, if
insufficient time before travel
Pre-exposure prophylaxis booster dose (for patients at
▶ Child: 1 mL after 1 year for 1 dose, to be given 1 year
after primary course is completed, then 1 mL every
3–5 years, to be administered in deltoid region or
anterolateral thigh in infants, the frequency of booster
doses may alternatively be determined according to
plasma-concentration of antirabies antibodies
▶ Adult: 1 mL for 1 dose, to be given 1 year after primary
course is completed, then 1 mL every 3–5 years, to be
administered in deltoid region, the frequency of
booster doses may alternatively be determined
according to plasma-concentration of antirabies
Pre-exposure prophylaxis booster dose (for patients at
▶ Child: 1 mL for 1 dose, to be given 10 years after
primary course is completed, administered in deltoid
region or anterolateral thigh in infants
▶ Adult: 1 mL for 1 dose, to be given 10 years after
primary course is completed, administered in deltoid
Post-exposure prophylaxis of fully immunised individuals
▶ Child (administered on expert advice): 1 mL for 1 dose,
followed by 1 mL after 3–7 days for 1 dose, to be
administered in deltoid region or anterolateral thigh in
infants, rabies immunoglobulin is not necessary
▶ Adult (administered on expert advice): 1 mL for 1 dose,
followed by 1 mL after 3–7 days for 1 dose, to be
Comments
Post a Comment
اكتب تعليق حول الموضوع