14.1 Vaccines and antisera

Please see section 14.2 Immunoglobulins for immunoglobulin therapies

Cholera vaccine

Please refer to Cholera (The Green Book; Chapter 14) for further information, including dosing and treatment regimens

Dukoral®
  • Vibrio cholerae, recombinant cholera toxin b subunit (inactivated) vaccine
  • Oral suspension

Please see International travel for advice on immunisation for travel abroad

Coronavirus (COVID-19) vaccine

For the latest updates and advice on COVID-19, please visit the NHS website

For a summary of Formulary updates specific to the COVID-19 pandemic, please click here

For Clinical Referral Guideline (CRG) updates specific to the COVID-19 pandemic, please click here

Please refer to COVID-19 (The Green Book; Chapter 14a) for further information, including dosing and treatment regimens

The use of these vaccines should be in accordance with national recommendations

COVID-19 mRNA Vaccines
Comirnaty® (previously Pfizer-BioNTech COVID-19 vaccine)
  • COVID-19 mRNA Vaccine (nucleoside modified)
  • Concentrate for dispersion for injection
Spikevax® (previously Moderna COVID-19 vaccine)
  • COVID-19 mRNA Vaccine (nucleoside modified)
  • Dispersion for injection
Viral Vector COVID-19 Vaccines
Janssen COVID-19 vaccine
  • COVID-19 Vaccine (Ad26.COV2-S [recombinant])
  • Suspension for injection
Vaxzevria® (previously AstraZeneca COVID-19 vaccine)
  • COVID-19 Vaccine (ChAdOx1-S [recombinant])
  • Suspension for injection
Protein Subunit Vaccines COVID-19 Vaccines
Nuvaxovid® (previously Novavax COVID-19 vaccine)
  • COVID-19 Vaccine (recombinant, adjuvanted)
  • Dispersion for injection
Inactivated Whole Virus Vaccines
Valneva COVID-19 vaccine
  • COVID-19 Vaccine (inactivated, adjuvanted, adsorbed)
  • Suspension for injection
Additional COVID-19 vaccine information

MHRA information and guidance for industry, healthcare professional, and patients on coronavirus (COVID-19) can be found here

Information on the timing of COVID-19 vaccination following administration of other vaccines or COVID-19 treatments and for individuals with COVID-19 or a history of COVID-19 (see under COVID-19 treatments) is available at the following site: Interactions information for COVID-19 vaccines – SPS – Specialist Pharmacy Services

To check for an interaction between a COVID-19 vaccine and individual drugs, see the following site: University of Liverpool COVID-19 Drug Interactions

Reporting side effects

Healthcare professionals are asked to report any suspected side effects to COVID-19 vaccines. Report using the dedicated Coronavirus Yellow Card reporting site or the Yellow Card app

Diphtheria vaccine

Diphtheria and tetanus vaccines are only given as part of combined products

Please refer to Diphtheria (The Green Book; Chapter 15) for further information, including dosing and treatment regimens

Please refer to Tetanus (The Green Book; Chapter 30) for further information, including dosing and treatment regimens

Please refer to Polio (The Green Book; Chapter 26) for further information, including dosing and treatment regimens

Infanrix®-IPV+Hib
  • Diphtheria, tetanus, pertussis (acellular component), poliomyelitis (inactivated), and Haemophilus influenzae type b conjugate vaccine (adsorbed) (DTaP/IPV/Hib)
  • Powder and suspension for suspension for injection
Pediacel®
  • Diphtheria, tetanus, pertussis (acellular, component), poliomyelitis (inactivated) and Haemophilus type b conjugate vaccine (adsorbed) (DTaP/IPV/Hib)
  • Suspension for injection in pre-filled syringe
Repevax®
  • Diphtheria, tetanus, pertussis (acellular, component) and poliomyelitis (inactivated) vaccine (adsorbed, reduced antigen(s) content) (DTaP/IPV)
  • Suspension for injection in pre-filled syringe
Infanrix® IPV
  • Diphtheria, tetanus, pertussis (acellular, component) and poliomyelitis (inactivated) vaccine (adsorbed) (DTaP/IPV)
  • Suspension for injection in pre-filled syringe
Revaxis®
  • Diphtheria, tetanus and poliomyelitis (inactivated) vaccine (adsorbed, reduced antigen(s) content) (Td/IPV)
  • Suspension for injection in pre-filled syringe
Infanrix® Hexa
  • Diphtheria, tetanus, pertussis (acellular component), hepatitis B (rDNA), poliomyelitis (inactivated), and Haemophilus influenzae type b conjugate vaccine (adsorbed) (DTaP/IPV/Hib/HepB)
  • Powder and suspension for suspension for injection
Vaxelis®
  • Diphtheria, tetanus, pertussis (acellular, component), hepatitis B (rDNA), poliomyelitis (inactivated), and Haemophilus type b conjugate vaccine (adsorbed)
  • Suspension for injection in pre-filled syringe
Boostrix-IPV®
  • Diphtheria, tetanus, pertussis (acellular, component) and poliomyelitis (inactivated) vaccine (adsorbed, reduced antigen(s) content) (DTaP/IPV)
  • Suspension for injection in pre-filled syringe

Please see International travel for advice on immunisation for travel abroad

Haemophilus type B (Hib) vaccine

Hib vaccines are available as part of combined products DTaP/IPV/Hib (above) or Hib/MenC

Please refer to Haemophilus influenzae type b (Hib) (The Green Book; Chapter 16) for further information, including dosing and treatment regimens

Menitorix®
  • Haemophilus influenzae type b and meningococcal group C conjugate vaccine (Hib/MenC)
  • Powder and solvent for solution for injection

Please see International travel for advice on immunisation for travel abroad

Hepatitis A vaccine

Hepatitis A vaccines are available as either monovalent, or combined with either typhoid or hepatitis B

Please refer to Hepatitis A (The Green Book; Chapter 17) for further information, including dosing and treatment regimens

Monovalent vaccines
Avaxim®
  • Hepatitis A vaccine (inactivated, adsorbed) (HepA)
  • Suspension for injection in pre-filled syringe
Epaxal®
  • Hepatitis A vaccine (inactivated, virosome) (HepA)
  • Suspension for injection in pre-filled syringe
Havrix Monodose®
  • Hepatitis A (inactivated) vaccine (adsorbed) (HepA)
  • Suspension for injection in pre-filled syringe
Havrix® Junior Monodose®
  • Hepatitis A (inactivated) vaccine (adsorbed) (HepA)
  • Suspension for injection in a pre-filled syringe
VAQTA® Adult
  • Hepatitis A (inactivated) vaccine (adsorbed) (HepA)
  • Suspension for injection
VAQTA® Paediatric
  • Hepatitis A (inactivated) vaccine (adsorbed) (HepA)
  • Suspension for injection

Please see International travel for advice on immunisation for travel abroad

Combined Hepatitis A and B vaccine

Guidance for hepatitis A and B vaccination in drug users in primary care

  • It has been recommended that all people who inject drugs are vaccinated against hepatitis A and B
  • While a combined A and B vaccine is available to assist this, the standard schedule for delivering it is longer than if providing hepatitis B vaccine alone

For information on combination Hepatitis A and B vaccines in drugs users in primary care, please refer to Drug misuse and dependence: UK guidelines on clinical management (Department of Health and Social Care) (Also called 'The Orange Book')

Hepatitis A vaccine with typhoid vaccine

Hepatitis A and typhoid vaccine has been included for instances where both vaccines are required, and it is not practical to administer both vaccines separately.

ViATIM®
  • Hepatitis A (inactivated, adsorbed) and Typhoid polysaccharide vaccine (HepA/Typhoid)
  • Suspension for injection in pre-filled syringe

Please see International travel for advice on immunisation for travel abroad

Hepatitis B vaccine

Hepatitis B vaccines can be given as a single or combined product (Infanrix Hexa®, above)

Please refer to Hepatitis B (The Green Book; Chapter 18) for further information, including dosing and treatment regimens

Hepatitis B vaccine and Chronic Kidney Disease (CKD)

Immunisation against hepatitis B is recommended for patients already on dialysis or renal transplantation programmes and for other patients with chronic renal failure as soon as it is anticipated that they may require these interventions.

People who will need dialysis or may have a kidney transplant in the future are all offered immunisation.

The commissioning and provision of Hepatitis B Vaccination for patients with Chronic Kidney Disease (CKD) is the responsibility of renal services in secondary care.

Nephrology outpatient activity remains the commissioning responsibility of CCGs.

The vaccines formulated for use in patients with chronic renal insufficiency should be used, see drug entries below.

Please refer to Chronic Kidney Disease CRG for information on detection and classification of CKD

Specific information regarding the safety of adults with chronic kidney disease and what you need to stop or start (NICE COVID-19 rapid guideline NG176) during the Coronavirus (COVID-19) pandemic can be found here.

Engerix B®
  • Hepatitis B (rDNA) vaccine (adsorbed) (HepB)
  • Suspension for injection in pre-filled syringe
  • In renal insufficiency, including dialysis patients aged over 1 month (hospital only)
HBvaxPRO® 5mcg (Paediatric)
  • Hepatitis B vaccine (rDNA) (HepB)
  • Suspension for injection in pre-filled syringe
HBvaxPRO®
  • Hepatitis B vaccine (rDNA) (HepB)
  • Suspension for injection in pre-filled syringe
HBvaxPRO40®
  • Hepatitis B vaccine (rDNA) (HepB)
  • Suspension for injection in pre-filled syringe
  • Indicated for immunisation in chronic dialysis patients aged 16 years or older (hospital only)
Fendrix®
  • Hepatitis B (rDNA) vaccine (adjuvanted, adsorbed) (HepB)
  • Suspension for injection
  • Indicated for immunisation in renal insufficiency (including patients aged 15 years or older (hospital only)

Please see International travel for advice on immunisation for travel abroad

Human papilloma virus (HPV) vaccine

See Public Health England Cervical screening: professional guidance

Please refer to Human papillomavirus (HPV) (The Green Book; Chapter 18a) for further information, including dosing and treatment regimens

Gardasil®
  • Human Papillomavirus vaccine [Types 6, 11, 16, 18] (Recombinant, adsorbed) (HPV)
  • Suspension for injection in pre-filled syringe
Gardasil® 9
  • Human Papillomavirus 9-valent vaccine [Types 6, 11, 16, 18, 31, 33, 45, 52, 58] (Recombinant, adsorbed) (HPV)
  • Suspension for injection
  • Suspension for injection in pre-filled syringe

Influenza vaccine

See Public Health England seasonal influenza: guidance, data and analysis

National flu immunisation programme plan (DHSC, PHE, and NHSE)

Please refer to Influenza (The Green Book; Chapter 19) for further information, including dosing and treatment regimens

Inactivated influenza vaccine
  • Suspension for injection in pre-filled syringe
Live attenuated influenza vaccine
  • Nasal spray suspension

Please see Upper respiratory tract infections for Influenza (flu) guidance

Measles, Mumps, and Rubella (MMR) vaccine

Please refer to Measles (The Green Book; Chapter 21) for further information, including dosing and treatment regimens

Please refer to Mumps (The Green Book; Chapter 23) for further information, including dosing and treatment regimens

Please refer to Rubella (The Green Book; Chapter 28) for further information, including dosing and treatment regimens

Pregnancy should be avoided for one month following MMR vaccination.

MMRVaxPRO®
  • Measles, mumps, and rubella vaccine (Live) (MMR)
  • Powder and solvent for suspension for injection in pre-filled syringe
Priorix®
  • Measles, mumps, and rubella vaccine (Live) (MMR)
  • Powder and solvent for suspension for injection in pre-filled syringe

Meningococcal vaccines

Please refer to Meningococcal (The Green Book; Chapter 22) for further information, including dosing and treatment regimens

Meningococcal Group B vaccine

A conjugate of Haemophilus type B and Meningococcal group C is available, see section on Haemophilus type B (above).

Bexsero®
  • Meningococcal group B vaccine (rDNA, component, adsorbed) (MenB)
  • Suspension for injection in pre-filled syringe
Trumenba®
  • Meningococcal group B vaccine (recombinant, adsorbed) (MenB)
  • Suspension for injection in pre-filled syringe
Meningococcal Group C conjugate vaccine
NeisVac-C®
  • Meningococcal group C polysaccharide conjugate vaccine (adsorbed) (MenC)
  • Suspension for injection in pre-filled syringe
Meningococcal groups A, C, W-135, and Y conjugate vaccine
Nimenrix®
  • Meningococcal Group A, C, W135 and Y conjugate vaccine (MenACWY)
  • Powder and solvent for solution for injection in pre-filled syringe
Menveo®
  • Meningococcal Group A, C, W135 and Y conjugate vaccine (MenACWY)
  • Powder and solution for solution for injection
MenQuadfi®
  • Meningococcal group A, C, W135 and Y conjugate vaccine (MenACWY)
  • Solution for injection

Pneumococcal vaccines

Please refer to Pneumococcal (The Green Book; Chapter 25) for further information, including dosing and treatment regimens

Prevenar 13®
  • Pneumococcal polysaccharide conjugate vaccine (13-valent, adsorbed) (PPV)
  • Suspension for injection
Pneumovax® 23
  • Pneumococcal polysaccharide vaccine (23-valent) (PPV)
  • Solution for injection in pre-filled syringe

Respiratory syncytial virus (RSV)

Please refer to Respiratory syncytial virus (The Green Book; Chapter 27a) for further information, including dosing and treatment regimens

Passive immunisation for RSV listed elsewhere in the formulary:

Rotavirus vaccine

Please refer to Rotavirus (The Green Book; Chapter 27b) for further information, including dosing and treatment regimens

Rotarix®
  • Rotavirus vaccine (Live)
  • Suspension in pre-filled oral applicator

Tuberculosis vaccines

Please refer to Tuberculosis (The Green Book; Chapter 32) for further information, including dosing and treatment regimens

BCG (Bacillus Calmette-Guérin) Vaccine AJV®
  • Mycobacterium bovis vaccine (Live)
  • Powder and solvent for suspension for injection

Please see International travel for advice on immunisation for travel abroad

Diagnostic agents
Tuberculin Purified Protein Derivative (PPD) AJV (Mantoux)
  • 2TU/0.1ml tuberculin PPD syringe

Typhoid vaccines

Typhoid vaccines are available as either monovalent, or combined with hepatitis A (see above).

Please refer to Typhoid (The Green Book; Chapter 33) for further information, including dosing and treatment regimens.

Typhim Vi®
  • Typhoid Polysaccharide Vaccine
  • Solution of injection
Vivotif®
  • Typhoid Polysaccharide Vaccine
  • Oral capsule

Please see International travel for advice on immunisation for travel abroad

Varicella-zoster vaccine

The Department of Health recommends varicella-zoster vaccine for seronegative healthcare workers who come into direct contact with patients. Those with a history of chickenpox or shingles can be considered immune, but healthcare workers with a negative or uncertain history should be tested.

After vaccination, contact with the following should be avoided if a vaccine-related cutaneous rash develops within 4-6 weeks of the first or second dose:

  • Varicella-susceptible pregnant women
  • Individuals at high risk of severe varicella, including those with immunodeficiency or those receiving immunosuppressive therapy

Healthcare workers who develop a generalised papular or vesicular rash on vaccination should avoid contact with patients until the lesions have crusted.

Please refer to Varicella (The Green Book; Chapter 34) for further information, including dosing and treatment regimens

Prevention of varicella zoster infection (chickenpox)
Varivax®
  • Varicella-zoster virus (Live), propagated in MRC5 human diploid cells
  • Powder and solvent for suspension for injection,
Varilrix®
  • Varicella-zoster virus (Live), propagated in MRC5 human diploid cells
  • Powder and solvent for suspension for injection
Prevention of herpes zoster (shingles)

Adults aged 70 years should be offered shingles vaccination.

Please refer to Shingles (herpes zoster) (The Green Book; Chapter 28a) for further information, including dosing and treatment regimens

Zostavax®
  • Shingles (herpes zoster) vaccine (Live), propagated in MRC5 human diploid cells
  • Powder and solvent for suspension for injection
Shingrix®
  • Shingles (herpes zoster) vaccine (recombinant, adjuvanted)
  • Powder and suspension for suspension for injection

Notes

  1. Shingrix should be offered to all immunocompromised people for whom Zostavax is contraindicated, but who are eligible for vaccination under the current programme

Vaccines for travel that cannot be given as an NHS service

The following vaccines cannot be provided as an NHS service when required for travel immunisation

Japanese B Encephalitis

Please refer to Japanese encephalitis (The Green Book; Chapter 20) for further information, including dosing and treatment regimens

Please see International travel for advice on immunisation for travel abroad

Rabies vaccine

Please refer to Rabies (The Green Book; Chapter 27) for further information, including dosing and treatment regimens

Please see International travel for advice on immunisation for travel abroad

Tick-borne encephalitis vaccine

Please refer to Tick-borne encephalitis (The Green Book; Chapter 31) for further information, including dosing and treatment regimens

Please see International travel for advice on immunisation for travel abroad

Yellow fever vaccine

Please refer to Yellow fever (The Green Book; Chapter 35) for further information, including dosing and treatment regimens

Please see International travel for advice on immunisation for travel abroad

  • Yellow fever vaccines can only be given by designated Yellow Fever Vaccination Centres, details of which can be found on the NaTHNac website: www.nathnac.org
  • MHRA Drug Safety Update (April 2019): Yellow fever vaccine (Stamaril) and fatal adverse reactions: extreme caution needed in people who may be immunosuppressed and those 60 years and older
  • MHRA Drug Safety Update (November 2019): Yellow fever vaccine: stronger precautions in people with weakened immunity and in those aged 60 years or older
  • MHRA Drug Safety Update (November 2021): Yellow fever vaccine (Stamaril): new pre-vaccination checklist
Last updated: 14-06-2022

 

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