Vaccine updates

Licensed Vaccines
Vaccine Type Notes

Diphtheria Toxoid Schick test to check immunity

Tetanus Toxoid

Vaccination should be deferred if there

Pertussis Killed Bordetella pertussis
is an acute neurological condition

Oral. Killed parenteral vaccine also

Poliomyelitis Live, attenuated
available.

Haemophilus
Conjugate capsular polysaccharide Can also be used in outbreaks
influenzae b (Hib)

Side effects occur due to individual virus

MMR Live, attenuated
components

BCG Live attenuated M. bovis Less effective in endemic areas

Triple vaccine containing strains

Influenza Disrupted virus or subunit
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

Inactivated or capsular polysaccharide

Typhoid
(Vi) or live attenuated (TY21a)

Yellow fever Live, attenuated

Meningococcus Polysaccharide Only effective against types A and C

Japanese encephalitis
Inactivated For travellers to Far East
B

Tick-borne
Inactivated For travellers to forested areas
encephalitis
 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
Hyper-immune
Normal
(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:
o Irritability
o Loss of appetite
o Diarrhoea
o Vomiting
o Flatulence
o Abdominal pain
o Regurgitation of food
o Fever
o Fatigue
o Constipation
o Crying
o Sleepiness
o Hoarseness
o Runny nose
o Rash
o Muscle cramps
o 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.