▶ Common or very common Febrile disorders . influenza like
▶ Rare or very rare Angioedema . asthenia . hyperhidrosis . paraesthesia
▶ Frequency not known Bronchospasm . circulatory collapse . hypotension
l PRESCRIBING AND DISPENSING INFORMATION Available
from Public Health England’s Centre for Emergency
Preparedness and Response (Porton Down).
l MEDICINAL FORMS There can be variation in the licensing of
different medicines containing the same drug.
EXCIPIENTS: May contain Thiomersal
▶ Anthrax vaccine (Non-proprietary)
Anthrax vaccine (alum precipitated sterile filtrate) suspension for
injection 0.5ml ampoules | 5 ampoule P s
▶ BioThrax (Secretary of State for Health) A
BioThrax suspension for injection 5ml multidose vials | 1 vial P £751.71 | 300 vial P £225,513.09
Bacillus Calmette-Guérin vaccine
l DRUG ACTION BCG (Bacillus Calmette-Guérin) is a live
attenuated strain derived from Mycobacterium bovis which
stimulates the development of immunity to M.
Immunisation against tuberculosis
▶ Child 1–11 months: 0.05 mL, to be injected at insertion of
deltoid muscle onto humerus (keloid formation more
likely with sites higher on arm); tip of shoulder should
▶ Child 1–17 years: 0.1 mL, to be injected at insertion of
deltoid muscle onto humerus (keloid formation more
likely with sites higher on arm); tip of shoulder should
▶ Adult: 0.1 mL, to be injected at insertion of deltoid
muscle onto humerus (keloid formation more likely
with sites higher on arm); tip of shoulder should be
l CONTRA-INDICATIONS Generalised septic skin conditions
CONTRA-INDICATIONS, FURTHER INFORMATION
A lesion-free site should be used to administer BCG
vaccine to patients with eczema.
CAUTIONS, FURTHER INFORMATION When BCG is given to
infants, there is no need to delay routine primary
immunisations. No further vaccination should be given in
the arm used for BCG vaccination for at least 3 months
because of the risk of regional lymphadenitis.
l INTERACTIONS → Appendix 1: live vaccines
▶ Rare or very rare Increased risk of infection . osteitis
l PRE-TREATMENT SCREENING Apart from children under
6 years, any person being considered for BCG
immunisation must first be given a skin test for
hypersensitivity to tuberculoprotein (see tuberculin
purified protein derivative p. 1294). A skin test is not
necessary for a child under 6 years provided that the child
has not stayed for longer than 3 months in a country with
an incidence of tuberculosis greater than 40 per 100 000,
the child has not had contact with a person with
tuberculosis, and there is no family history of tuberculosis
l DIRECTIONS FOR ADMINISTRATION
Intradermal injection technique Skin is stretched between
thumb and forefinger and needle (size 25G or 26G)
inserted (bevel upwards) for about 3 mm into superficial
layers of dermis (almost parallel with surface). Needle
should be short with short bevel (can usually be seen
through epidermis during insertion). Tense raised
blanched bleb showing tips of hair follicles is sign of
correct injection; 7 mm bleb : 0.1 mL injection, 3 mm bleb
: 0.05 mL injection; if considerable resistance not felt,
needle too deep and should be removed and reinserted
l PRESCRIBING AND DISPENSING INFORMATION Available
from health organisations or direct from ImmForm
www.immform.dh.gov.uk (SSI brand, multidose vial with
l MEDICINAL FORMS There can be variation in the licensing of
different medicines containing the same drug.
Powder and solvent for suspension for injection
InterVax BCG vaccine powder and solvent for suspension for injection
Immunisation against cholera (for travellers to endemic
or epidemic areas on the basis of current
▶ Child 2–5 years: 1 dose every 1–6 weeks for 3 doses, if
more than 6 weeks have elapsed between doses, the
primary course should be restarted, immunisation
should be completed at least one week before potential
▶ Child 6–17 years: 1 dose every 1–6 weeks for 2 doses, if
more than 6 weeks have elapsed between doses, the
primary course should be restarted, immunisation
should be completed at least one week before potential
▶ Adult: 1 dose every 1–6 weeks for 2 doses, if more than
6 weeks have elapsed between doses, the primary
course should be restarted, immunisation should be
completed at least one week before potential exposure
▶ Child 2–5 years: A single booster dose can be given
within 6 months after primary course, if more than
6 months have elapsed since the last vaccination, the
primary course should be repeated
▶ Child 6–17 years: A single booster dose can be given
within 2 years after primary course, if more than
2 years have elapsed since the last vaccination, the
primary course should be repeated
▶ Adult: A single booster dose can be given within 2 years
after primary course, if more than 2 years have elapsed
since the last vaccination, the primary course should be
l CONTRA-INDICATIONS Acute gastro-intestinal illness
l INTERACTIONS → Appendix 1: cholera vaccine
▶ Uncommon Gastrointestinal discomfort. gastrointestinal
l DIRECTIONS FOR ADMINISTRATION
▶ In children Dissolve effervescent sodium bicarbonate
granules in a glassful of water or chlorinated water
(approximately 150 mL). For children over 6 years, add
vaccine suspension to make one dose. For child 2–5 years,
discard half (approximately 75 mL) of the solution, then
add vaccine suspension to make one dose. Drink within
2 hours. Food, drink, and other oral medicines should be
avoided for 1 hour before and after vaccination.
▶ In adults Dissolve effervescent sodium bicarbonate
granules in a glassful of water or chlorinated water
(approximately 150 mL). Add vaccine suspension to make
one dose. Drink within 2 hours. Food, drink, and other oral
medicines should be avoided for 1 hour before and after
l PATIENT AND CARER ADVICE Counselling on
administration advised. Immunisation with cholera
vaccine does not provide complete protection and all
travellers to a country where cholera exists should be
warned that scrupulous attention to food, water, and
personal hygiene is essential.
l MEDICINAL FORMS There can be variation in the licensing of
different medicines containing the same drug.
Dukoral cholera vaccine oral suspension | 2 dose P £31.62 DT =
Haemophilus influenzae type b with
Booster dose (for infants who have received primary
immunisation with a vaccine containing Haemophilus
influenzae type b component) and primary
immunisation against Neisseria meningitidis
▶ Child 12–13 months: 0.5 mL for 1 dose
Immunisation against Neisseria meningitidis in an
▶ Child 1–9 years: 0.5 mL for 1 dose
Booster dose (for children who have not been immunised
against Haemophilus influenza type b)| Booster dose
after recovery from Haemophilus influenzae type b
disease (for index cases previously vaccinated, with low
Hib antibody concentration or if it is not possible to
measure antibody concentration)
▶ Child 1–9 years: 0.5 mL for 1 dose
Booster dose after recovery from Haemophilus influenzae
type b disease (for fully vaccinated index cases with
asplenia or splenic dysfunction, if previous dose
▶ Child 1–17 years: 0.5 mL for 1 dose
Booster dose (for patients diagnosed with asplenia,
splenic dysfunction or complement deficiency at under
▶ Child 2–17 years: 0.5 mL for 1 dose, this booster dose
should be given after the second birthday, this is the
second dose of haemophilus influenzae type B vaccine
combined with meningococcal group C conjugate
vaccine (the first dose is given during the routine
Booster dose (for patients diagnosed with asplenia,
splenic dysfunction or complement deficiency at over
▶ Child 2–17 years: 0.5 mL for 1 dose, this booster dose
should be followed 2 months later by one dose of
meningococcal A, C, W135, and Y conjugate vaccine (in
patients from 11 years of age, this interval can be
▶ Adult: 0.5 mL for 1 dose, this booster dose should be
followed 1 month later by one dose of meningococcal
A, C, W135, and Y conjugate vaccine
l UNLICENSED USE Not licensed for use in patients over
▶ Common or very common Drowsiness
▶ Rare or very rare Abdominal pain . insomnia
▶ Frequency not known Febrile seizure . meningism (but no
evidence that vaccine causes meningococcal C meningitis)
l PRESCRIBING AND DISPENSING INFORMATION Available as
part of the childhood immunisation schedule from
l MEDICINAL FORMS There can be variation in the licensing of
different medicines containing the same drug.
Powder and solvent for solution for injection
▶ Menitorix (GlaxoSmithKline UK Ltd)
Menitorix vaccine powder and solvent for solution for injection 0.5ml
vials | 1 vial P £37.76 DT = £37.76
Meningococcal group B vaccine (rDNA,
component, adsorbed) 19-Oct-2017
Immunisation against Neisseria meningitidis, primary
▶ BY DEEP INTRAMUSCULAR INJECTION
▶ Child 2 months: 0.5 mL for 1 dose, injected preferably
into deltoid region (or anterolateral thigh in infants),
for information about the use of paracetamol for
prophylaxis of post-immunisation pyrexia, see
▶ Child 4 months: 0.5 mL for 1 dose, injected preferably
into deltoid region (or anterolateral thigh in infants),
for information about the use of paracetamol for
prophylaxis of post-immunisation pyrexia, see
Immunisation against Neisseria meningitidis, primary
▶ BY DEEP INTRAMUSCULAR INJECTION
▶ Child 12–23 months: 0.5 mL for 1 dose, injected
preferably into deltoid region (or anterolateral thigh in
Immunisation against Neisseria meningitidis, primary
immunisation (in unimmunised patients)
▶ BY DEEP INTRAMUSCULAR INJECTION
▶ Child 6–11 months: 0.5 mL for 2 doses, separated by an
interval of at least 2 months; booster dose of 0.5 mL
given between 1–2 years of age and at least 2 months
after completion of primary immunisation, injected
preferably into deltoid region (or anterolateral thigh in
▶ Child 12–23 months: 0.5 mL for 2 doses, separated by an
interval of at least 2 months; booster dose of 0.5 mL
given 12–24 months after completion of primary
immunisation, injected preferably into deltoid region
(or anterolateral thigh in infants)
▶ Child 2–10 years: 0.5 mL for 2 doses, separated by an
interval of at least 2 months. Injected preferably into
deltoid region (or anterolateral thigh in infants)
▶ Child 11–17 years: 0.5 mL for 2 doses, separated by an
interval of at least 1 month. Injected preferably into
▶ Adult: 0.5 mL for 2 doses, separated by an interval of at
least 1 month. Injected preferably into deltoid region
Immunisation against Neisseria meningitidis, primary
▶ Child 10–17 years: 0.5 mL for 2 doses, separated by an
interval of 6 months, alternatively 0.5 mL for 2 doses,
separated by an interval of at least 1 month, followed
by 0.5 mL as a third dose, given at least 4 months after
the second dose, injected preferably into deltoid
region, a booster dose should be considered for
individuals at continued risk—consult product
▶ Adult: 0.5 mL for 2 doses, separated by an interval of
6 months, alternatively 0.5 mL for 2 doses, separated
by an interval of at least 1 month, followed by 0.5 mL as
a third dose, given at least 4 months after the second
dose, injected preferably into deltoid region, a booster
dose should be considered for individuals at continued
risk—consult product literature
▶ Uncommon Seizures (in children). vascular disorders (in
l MEDICINAL FORMS There can be variation in the licensing of
different medicines containing the same drug.
EXCIPIENTS: May contain Kanamycin
▶ Bexsero (GlaxoSmithKline UK Ltd)
Bexsero vaccine suspension for injection 0.5ml pre-filled syringes |
1 pre-filled disposable injection P £75.00
Patients with confirmed serogroup C disease (who have
▶ Child 1–17 years: 0.5 mL for 1 dose, dose to be given
before discharge from hospital
▶ Adult 18–24 years: 0.5 mL for 1 dose, dose to be given
before discharge from hospital
▶ Common or very common Anxiety (in children). cough (in
children). increased risk of infection (in children)
▶ Uncommon Chills . eyelid oedema (in children). flushing
(in children). influenza like illness (rare in children). joint
▶ Rare or very rare Circulatory collapse (in children)
▶ Frequency not known Angioedema . apnoea . asthenia
(uncommon in children). dyspnoea . hypotonichyporesponsiveness episode . immune thrombocytopenic
purpura . meningism (but no evidence that vaccine causes
meningococcal C meningitis). musculoskeletal stiffness
(uncommon in children). nasal congestion (uncommon in
children). oedema (uncommon in children). pain (very
common in children).respiratory disorders (uncommon in
children). seizures (uncommon in children). sensation
abnormal (uncommon in children). sleep disorders (very
common in children). Stevens-Johnson syndrome . syncope (uncommon in children)
l PRESCRIBING AND DISPENSING INFORMATION Available as
part of childhood immunisation schedule from
l MEDICINAL FORMS There can be variation in the licensing of
different medicines containing the same drug.
Meningococcal groups A with C and
Primary immunisation against Neisseria meningitidis
▶ Child 13–15 years: 0.5 mL for 1 dose, dose preferably
Immunisation against Neisseria meningitidis in an
▶ Child 10–17 years: 0.5 mL for 1 dose, booster dose is not
▶ Adult 18–24 years: 0.5 mL for 1 dose, booster dose is not
Immunisation against Neisseria meningitidis in those at
risk of exposure to prevent invasive disease
▶ Child 3–11 months: 0.5 mL every month for 2 doses, dose
preferably injected into deltoid region
▶ Child 1–17 years: 0.5 mL for 1 dose, dose preferably
▶ Adult: 0.5 mL for 1 dose, dose preferably injected into
Patients attending university for the first time (who have
not received the routine meningococcal groups A with C
and W135 and Y conjugate vaccine over the age of
▶ Adult 18–24 years: 0.5 mL for 1 dose
Primary immunisation against Neisseria meningitidis
▶ Child 13–15 years: 0.5 mL for 1 dose, to be injected
preferably into deltoid region
Immunisation against Neisseria meningitidis in an
▶ Child 10–17 years: 0.5 mL for 1 dose, booster dose is not
▶ Adult 18–24 years: 0.5 mL for 1 dose, booster dose is not
Immunisation against Neisseria meningitidis in those at
▶ Child 1–17 years: 0.5 mL for 1 dose, to be injected
preferably into deltoid region (or anterolateral thigh
in child 12–23 months), then 0.5 mL after continued→
1 year if required for 1 dose, second dose should be
considered in those who continue to be at risk of
Neisseria meningitidis serogroup A infection
▶ Adult: 0.5 mL for 1 dose, to be injected preferably into
deltoid region, then 0.5 mL after 1 year if required for
1 dose, second dose should be considered in those who
continue to be at risk of Neisseria meningitidis
Patients attending university for the first time (who have
not received the routine meningococcal groups A with C
and W135 and Y conjugate vaccine over the age of
▶ Adult 18–24 years: 0.5 mL for 1 dose
▶ In children Menveo ® is not licensed for use in children
▶ Common or very common Drowsiness
▶ Uncommon Crying . insomnia . numbness . pain in
▶ Frequency not known Extensive swelling of vaccinated limb
l MEDICINAL FORMS There can be variation in the licensing of
different medicines containing the same drug.
Powder and solvent for solution for injection
▶ Menveo (GlaxoSmithKline UK Ltd)
Menveo vaccine powder and solvent for solution for injection 0.5ml
Nimenrix vaccine powder and solvent for solution for injection 0.5ml
pre-filled syringes | 1 pre-filled disposable injection P £30.00 DT
conjugate vaccine (adsorbed) 01-May-2019
Primary immunisation against pneumococcal infection
▶ Child 2 months: 0.5 mL for 1 dose, anterolateral thigh is
preferred site of injection in infants under 1 year
Primary immunisation against pneumococcal infection
▶ Child 4 months: 0.5 mL for 1 dose, anterolateral thigh is
preferred site of injection in infants under 1 year
Primary immunisation against pneumococcal infection
▶ Child 1 year: 0.5 mL for 1 dose, anterolateral thigh is
preferred site of injection in infants under 1 year;
deltoid muscle is preferred in older children
Immunisation against pneumococcal infection [in patients
who are unimmunised or partially immunised]
▶ Child 3–11 months: 0.5 mL for 2 doses, given 2 months
apart (interval may be reduced to 1 month to ensure
immunisation schedule is completed), followed by
0.5 mL for 1 dose on their first birthday, given at least
2 months after the last dose. Anterolateral thigh is
preferred site of injection in infants under 1 year
▶ Child 12–23 months: 0.5 mL for 1 dose, deltoid muscle is
preferred site of injection in children
Immunisation against pneumococcal infection
[immunised patients at increased risk]
▶ Child 14 months–17 years: 0.5 mL for 1 dose, given at
least 2 months after primary immunisation booster
dose, deltoid muscle is preferred site of injection in
▶ Adult: 0.5 mL for 1 dose, deltoid muscle is preferred
Immunisation against pneumococcal infection
[unimmunised or partially immunised patients at
▶ Child 3–11 months: 0.5 mL for 2 doses, given 2 months
apart (interval may be reduced to 1 month to ensure
immunisation schedule is completed), followed by
0.5 mL for 1 dose on their first birthday, given at least
2 months after the last dose, followed by 0.5 mL for
1 dose, given at least 2 months after the last dose.
Anterolateral thigh is preferred site of injection in
▶ Adult: 0.5 mL for 1 dose, deltoid muscle is preferred
Immunisation against pneumococcal infection
▶ Child 6 weeks–4 years: Deltoid muscle is preferred site
of injection in young children; anterolateral thigh is
preferred site in infants (consult product literature)
PREVENAR 13 ® The dose in BNF publications may differ
from that in product literature.
l CONTRA-INDICATIONS Concomitant use of high potency
varicella-zoster vaccine (Zostavax ®) with pneumococcal
polysaccharide vaccine (in adults)
▶ Common or very common Drowsiness
▶ Uncommon Apnoea . crying abnormal . extensive swelling
▶ Rare or very rare Angioedema . hypotonichyporesponsiveness episode . Kawasaki disease . seizure
l PRESCRIBING AND DISPENSING INFORMATION
PREVENAR 13 ® Available as part of childhood
immunisation schedule from ImmForm www.immform.dh.
l MEDICINAL FORMS There can be variation in the licensing of
different medicines containing the same drug.
Prevenar 13 vaccine suspension for injection 0.5ml pre-filled syringes
| 1 pre-filled disposable injection P £49.10 | 10 pre-filled
disposable injection P £491.00
▶ Synflorix (GlaxoSmithKline UK Ltd)
Synflorix vaccine suspension for injection 0.5ml pre-filled syringes |
1 pre-filled disposable injection P £27.60
Primary immunisation against pneumococcal infection
▶ Elderly: 0.5 mL for 1 dose, deltoid muscle is preferred
Immunisation against pneumococcal infection [in patients
▶ Child 2–17 years: 0.5 mL for 1 dose, dose should be
administered at least 2 months after the last dose of the
13-valent pneumococcal polysaccharide conjugate
vaccine (adsorbed), deltoid muscle is preferred site of
injection in children and adults
▶ Adult: 0.5 mL for 1 dose, deltoid muscle is preferred
site of injection in adults, primary immunisation with
the pneumococcal polysaccharide vaccine is not
required when these patients reach 65 years of age
Immunisation against pneumococcal infection
[revaccination; booster dose in patients with no spleen,
splenic dysfunction or chronic kidney disease]
▶ Child 7–17 years: 0.5 mL every 5 years, deltoid muscle is
preferred site of injection in children and adults
▶ Adult: 0.5 mL every 5 years, deltoid muscle is preferred
mobility decreased . leucocytosis . lymphadenitis . nerve
disorders . paraesthesia . peripheral oedema . thrombocytopenia
l MEDICINAL FORMS There can be variation in the licensing of
different medicines containing the same drug.
▶ Pneumococcal polysaccharide vaccine (Non-proprietary)
Pneumococcal polysaccharide vaccine solution for injection 0.5ml vials
▶ Pneumovax 23 (Merck Sharp & Dohme Ltd)
Immunisation against typhoid fever in children at high
▶ Child 12–23 months: 0.5 mL for 1 dose, dose should be
given at least 2 weeks before potential exposure to
typhoid infection, response may be suboptimal
Immunisation against typhoid fever
▶ Child 2–17 years: 0.5 mL for 1 dose, dose should be given
at least 2 weeks before potential exposure to typhoid
▶ Adult: 0.5 mL for 1 dose, dose should be given at least
2 weeks before potential exposure to typhoid infection
▶ Child 6–17 years: 1 capsule every 2 days for 3 doses (on
▶ Adult: 1 capsule every 2 days for 3 doses (on days 1, 3,
▶ With intramuscular use in children Not licensed for use in
▶ With oral use Acute gastro-intestinal illness
l INTERACTIONS → Appendix 1: live vaccines
▶ With oral use Gastrointestinal discomfort. influenza like
▶ With oral use Asthenia . back pain . chills . flatulence . paraesthesia
▶ With parenteral use Abdominal pain . asthma . shock . syncope
l DIRECTIONS FOR ADMINISTRATION Capsule should be
taken one hour before a meal. Swallow as soon as possible
after placing in mouth with a cold or lukewarm drink.
▶ With oral use It is important to store capsules in a
▶ With oral use Patients or carers should be given advice on
how to administer and store typhoid vaccine capsules.
l MEDICINAL FORMS There can be variation in the licensing of
different medicines containing the same drug.
Salmonella typhi Vi capsular polysaccharide 50 microgram per
1 ml Typhim Vi 25micrograms/0.5ml vaccine solution for injection
pre-filled syringes | 1 pre-filled disposable injection P £11.16 DT
= £11.16 | 10 pre-filled disposable injection P £111.60 DT =
CAUTIONARY AND ADVISORY LABELS 25
Vivotif vaccine gastro-resistant capsules | 3 capsule P £14.77 DT
Combinations available: 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, hepatitis B
Immunisation against hepatitis A and hepatitis B infection
▶ Child 1–15 years: Initially 1 mL for 1 dose, then 1 mL
after 6–12 months for 1 dose, the deltoid region is the
preferred site of injection in older children;
anterolateral thigh is the preferred site in infants; not
to be injected into the buttock (vaccine efficacy
reduced), subcutaneous route used for patients with
bleeding disorders (but immune response may be
Immunisation against hepatitis A and hepatitis B infection
▶ Child 16–17 years: Initially 1 mL every month for
2 doses, then 1 mL after 5 months for 1 dose, the
deltoid region is the preferred site of injection; not to
be injected into the buttock (vaccine efficacy reduced),
subcutaneous route used for patients with bleeding
disorders (but immune response may be reduced)
▶ Adult: Initially 1 mL every month for 2 doses, then
1 mL after 5 months for 1 dose, the deltoid region is the
preferred site of injection; not to be injected into the
buttock (vaccine efficacy reduced), subcutaneous route
used for patients with bleeding disorders (but immune
response may be reduced) continued→
Immunisation against hepatitis A and hepatitis B
infection—accelerated schedule for travellers departing
▶ Child 16–17 years: Initially 1 mL for 1 dose, then 1 mL
after 7 days for 1 dose, then 1 mL after 14 days for
1 dose, then 1 mL for 1 dose given 12 months after the
first dose, the deltoid region is the preferred site of
injection; not to be injected into the buttock (vaccine
efficacy reduced), subcutaneous route used for patients
with bleeding disorders (but immune response may be
▶ Adult: Initially 1 mL for 1 dose, then 1 mL after 7 days
for 1 dose, then 1 mL after 14 days for 1 dose, then
1 mL for 1 dose given 12 months after the first dose, the
deltoid region is the preferred site of injection; not to
be injected into the buttock (vaccine efficacy reduced),
subcutaneous route used for patients with bleeding
disorders (but immune response may be reduced)
Immunisation against hepatitis A and hepatitis B infection
▶ Child 1–15 years: Initially 0.5 mL every month for
2 doses, then 0.5 mL after 5 months for 1 dose, the
deltoid region is the preferred site of injection in older
children; anterolateral thigh is the preferred site in
infants; not to be injected into the buttock (vaccine
efficacy reduced), subcutaneous route used for patients
with bleeding disorders (but immune response may be
l PRESCRIBING AND DISPENSING INFORMATION
TWINRIX ® PAEDIATRIC Primary course should be
completed with Twinrix ® (single component vaccines
given at appropriate intervals may be used for booster
TWINRIX ® ADULT Primary course should be completed
with Twinrix ® (single component vaccines given at
appropriate intervals may be used for booster dose).
AMBIRIX ® Primary course should be completed with
Ambirix ® (single component vaccines given at appropriate
intervals may be used for booster dose).
l MEDICINAL FORMS There can be variation in the licensing of
different medicines containing the same drug.
EXCIPIENTS: May contain Neomycin
▶ Ambirix (GlaxoSmithKline UK Ltd)
Ambirix vaccine suspension for injection 1ml pre-filled syringes |
1 pre-filled disposable injection P £31.18 DT = £31.18
▶ Twinrix (GlaxoSmithKline UK Ltd)
Twinrix Paediatric vaccine suspension for injection 0.5ml pre-filled
syringes | 1 pre-filled disposable injection P £20.79 DT = £20.79
Twinrix Adult vaccine suspension for injection 1ml pre-filled syringes
Immunisation against hepatitis A infection
▶ Child 16–17 years: Initially 0.5 mL for 1 dose, then
0.5 mL after 6–12 months, dose given as booster;
booster dose may be delayed by up to 3 years if not
given after recommended interval following primary
dose, the deltoid region is the preferred site of
injection. The subcutaneous route may be used for
patients with bleeding disorders; not to be injected
into the buttock (vaccine efficacy reduced)
▶ Adult: Initially 0.5 mL for 1 dose, then 0.5 mL after
6–12 months, dose given as booster; booster dose may
be delayed by up to 3 years if not given after
recommended interval following primary dose, the
deltoid region is the preferred site of injection. The
subcutaneous route may be used for patients with
bleeding disorders; not to be injected into the buttock
Immunisation against hepatitis A infection
▶ Child 1–15 years: Initially 0.5 mL for 1 dose, then 0.5 mL
after 6–12 months, dose given as booster; booster dose
may be delayed by up to 3 years if not given after
recommended interval following primary dose, the
deltoid region is the preferred site of injection. The
subcutaneous route may be used for patients with
▶ Child 16–17 years: Initially 1 mL for 1 dose, then 1 mL
after 6–12 months, dose given as booster; booster dose
may be delayed by up to 3 years if not given after
recommended interval following primary dose, the
deltoid region is the preferred site of injection. The
subcutaneous route may be used for patients with
▶ Adult: Initially 1 mL for 1 dose, then 1 mL after
6–12 months, dose given as booster; booster dose may
be delayed by up to 3 years if not given after
recommended interval following primary dose, the
deltoid region is the preferred site of injection. The
subcutaneous route may be used for patients with
Immunisation against hepatitis A infection
▶ Adult: Initially 1 mL for 1 dose, then 1 mL after
6–18 months, dose given as booster, the deltoid region
is the preferred site of injection. The subcutaneous
route may be used for patients with bleeding disorders
(but immune response may be delayed)
Immunisation against hepatitis A infection
▶ Child 1–17 years: Initially 0.5 mL for 1 dose, then 0.5 mL
after 6–18 months, dose given as booster, the deltoid
region is the preferred site of injection. The
subcutaneous route may be used for patients with
bleeding disorders (but immune response may be
▶ Common or very common Asthenia (uncommon in
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