Vaccines - Update

Submitted by amh10 on 21 March, 2007 - 17:31
Licensed Vaccines
Vaccine Type Notes
Diphtheria Toxoid Schick test to check immunity
Tetanus Toxoid  
Pertussis Killed Bordetella pertussis Vaccination should be deferred if there is an acute neurological condition
Poliomyelitis Live, attenuated Oral. Killed parenteral vaccine also available.
Haemophilus influenzae b (Hib) Conjugate capsular polysaccharide Can also be used in outbreaks
MMR Live, attenuated Side effects occur due to individual virus components
BCG Live attenuated M. bovis Less effective in endemic areas
Influenza Disrupted virus or subunit Triple vaccine containing strains circulating in that year
Pneumococcus Capsular polysacharide Polyvalent with 23 capsular types
Hepatitis A Inactivated  
Hepatitis B Recombinant HBsAg  
Rabies Inactivated Used post-exposure usually
Cholera Inactivated Inaba and Ogawa serotypes  
Typhoid Inactivated or capsular polysaccharide (Vi) or live attenuated (TY21a)  
Yellow fever Live, attenuated  
Meningococcus Polysaccharide Only effective against types A and C
Japanese encephalitis B Inactivated For travellers to Far East
Tick-borne encephalitis Inactivated For travellers to forested areas
Anthrax Antigen  
Vaccinia Live attenuated  
Varicella-zoster virus* Live attenuated

Bacterial vaccines

Live attenuated

Killed inactivated

BCG

Anthrax

Cholera (oral)

Cholera

Typhoid (oral)

Diphtheria

Haemophilus Influenza B

Meningococcal A & C

Pertussis

Plague

Pneumococcal

Tetanus

Typhoid Vi Poly

Viral vaccines

Live attenuated

Killed inactivated

OPV (oral polio)

Hepatitis A

Measles

IPV (injectable polio)

MMR

Influenza A & B

Mumps

Japanese B encephalitis

Yellow Fever

Rabies

Varicella

Tick-borne encephalitis

Human Immunoglobulin

Normal

Hyper-immune
(used as treatment for exposure)

Hepatitis A

Tetanus

Measles

Rabies

Rubella

Hepatitis B

Varicella

Some things require further discussion:

1) Varicella Vaccine:

  • This is licenced in the UK, and there are two preparations.
  • 10% of the UK population are not immune and also 10% of HCWs.
  • The vaccine is for HCWs in GP or hospital who are VZV IgG (-).
  • Non-immune HCWs should receive two doses of live attenuated varicella vaccine 4-8 weeks apart. Routine post-vaccination serological testing is not advised.
  • HCWs should be told at the time of vaccination that they may experience a local rash around the site of injection or a more generalised rash in the month after vaccination. In either case they should report to their occupational health department for assessment. If the rash is generalised and consistent with a vaccine-associated rash (papular or vesicular) the HCW should avoid patient contact until all the lesions have crusted. HCWs with localised vaccine rashes that can be covered with a bandage and/or clothing should be allowed to continue working unless in contact with high risk patients when an individual risk assessment should be made.
  • The vaccine is contraindicated in pregnancy and this should be avoided for at three months after vaccination.

2) Rotavirus Vaccine:

  • Rotarix is a live attenuated vaccine.
  • Used for the prevention of gastroenteritis (severe diarrhoea and vomiting) caused by rotavirus infection in infants from six weeks of age.
  • Children may excrete the virus in the stool, which has implications for carers.
  • Some children may not mount an adequate immunological reponse e.g. premies.
  • Possible side effects:
    • Irritability
    • Loss of appetite
    • Diarrhoea
    • Vomiting
    • Flatulence
    • Abdominal pain
    • Regurgitation of food
    • Fever
    • Fatigue
    • Constipation
    • Crying
    • Sleepiness
    • Hoarseness
    • Runny nose
    • Rash
    • Muscle cramps
    • Infection of the upper airways (respiratory tract).

There was a problem with intersucception not mentioned on this list. The withdrawl last year was felt to be premature, as there is a significant mortality.

AMH.

P.S. Which vaccines are live attenuated?

MMR is for Posh Randy Virgins! = Measles, Mumps, Rubella, Polio, Rotavirus & Varicella.

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