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
Vaxchora
  • Vibrio cholerae, recombinant (live) vaccine
  • Effervescent powder and powder for 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. Documents relating to the new coronavirus (COVID-19) vaccination programme, including; protocols and patient group directives (PGDs), can be found here.

COVID-19 mRNA Vaccines
Comirnaty (previously Pfizer-BioNTech COVID-19 vaccine)
  • COVID-19 mRNA Vaccine (nucleoside modified)
  • Concentrate for dispersion for injection
Comirnaty Original/Omicron BA.1 variant (bivalent Pfizer-BioNTech COVID-19 vaccine)
  • COVID-19 mRNA Vaccine (nucleoside modified)
  • Dispersion for injection
Comirnaty Original/Omicron BA.4-5 variant (bivalent Pfizer-BioNTech COVID-19 vaccine)
  • COVID-19 mRNA Vaccine (nucleoside modified)
  • Dispersion for injection
Spikevax (previously Moderna COVID-19 vaccine)
  • COVID-19 mRNA Vaccine (nucleoside modified)
  • Dispersion for injection
Spikevax bivalent Original/Omicron BA.1 variant (bivalent Moderna COVID-19 vaccine)
  • COVID-19 mRNA Vaccine (nucleoside modified)
  • Dispersion for injection
Spikevax bivalent Original/Omicron BA.4-5 variant (bivalent 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
    VidPrevtyn Beta (Sanofi Pasteur COVID-19 vaccine)
    • COVID-19 Vaccine (recombinant, adjuvanted)
    • Solution and emulsion for emulsion 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 and guidance from across SPS on pharmaceutical aspects of COVID-19 vaccines’ use including cautions and contraindications, interactions, and safety in pregnancy and breastfeeding, see here.

    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

    NICE has issued the COVID-19 rapid guideline NG200: vaccine-induced immune thrombocytopenia and thrombosis (VITT). The guideline covers VITT, a syndrome which has been reported in rare cases after COVID-19 vaccination.

    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

    The Joint Committee on Vaccination and Immunisation (JCVI) has been notified of the discontinuation of Menitorix (Hib/MenC). This necessitates a change to the routine schedule as this vaccine is currently given at 12 months. Please refer to the Joint Committee on Vaccination and Immunisation (JCVI) interim statement on the immunisation schedule for children (05 August 2022).

    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 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
    Avaxim Junior
    • Hepatitis A vaccine (inactivated, adsorbed) (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 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 ICBs.

      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
      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 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

      The national annual flu immunisation programme, can be found here (DHSC, PHE, and NHSE)

      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
      Recombinant influenza vaccine
      • Solution for injection in pre-filled syringe
        Live attenuated influenza vaccine
        • Nasal spray suspension

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

        Annual guidance may change; check the GOV.UK website (seasonal influenza) for latest updates.

        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

        Shingrix
        • Shingles (herpes zoster) vaccine (recombinant, adjuvanted)
        • Powder and suspension for suspension for injection

        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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