BNF for Children 2011-2012

BNFC 2011–2012 14.4 Vaccines and antisera 607Menitorix c (GSK) AInjection, powder for reconstitution, capsular polysaccharideof Haemophilus influenzae type b andcapsular polysaccharide of Neisseria meningitidisgroup C (both conjugated to tetanus protein), netprice single dose vial (with syringe containing 0.5 mLdiluent) = £39.87Dose. By intramuscular injectionCHILD 1–10 year 0.5 mLCHILD over 1 year with asplenia or splenic dysfunction(see notes above), 0.5 mLAvailable as part of the childhood immunisation schedule fromImmFormCombined vaccinesSee also Diphtheria-containing vaccinesHepatitis A vaccineHepatitis A vaccine is prepared from formaldehydeinactivatedhepatitis A virus grown in human diploidcells.Immunisation is recommended for:. residents of homes for those with severe learningdifficulties;. children with haemophilia or other conditions treatedwith plasma-derived clotting factors;. children with severe liver disease;. children travelling to high-risk areas (see p. 626);. adolescents who are at risk due to their sexualbehaviour;. parenteral drug abusers.Immunisation should be considered for:. children with chronic liver disease including chronichepatitis B or chronic hepatitis C;. prevention of secondary cases in close contacts ofconfirmed cases of hepatitis A, within 14 days ofexposure to the primary case (within 8 weeks ofexposure to the primary case where there is morethan 1 contact in the household).A booster dose of hepatitis A vaccine is usually given 6–12 months after the initial dose. A second booster dosecan be given 20 years after the previous booster dose tothose who continue to be at risk. Specialist adviceshould be sought on re-immunisation of immunocompromisedindividuals.Post-exposure prophylaxis is not required for healthychildren under 1 year of age, so long as all thoseinvolved in nappy changing are vaccinated againsthepatitis A. However, children 2–12 months of agecan be given a dose of hepatitis A vaccine if it is notpossible to vaccinate their carers, or if the childbecomes a source of infection to others [unlicenseduse]; in these cases, if the child goes on to requirelong-term protection against hepatitis A after the firstbirthday, the full course of 2 doses should be given.In children under 16 years, a single dose of the combinedvaccine Ambirix c can be used to provide rapidprotection against hepatitis A.Intramuscular normal immunoglobulin (section14.5.1) is recommended for use in addition to HepatitisA vaccine for close contacts (of confirmed cases ofhepatitis A) who have chronic liver disease or HIVinfection, or who are immunosuppressed.HEPATITIS A VACCINECautions section 14.1Contra-indications section 14.1Pregnancy see p. 600Breast-feeding see p. 600Side-effects section 14.1; for combination vaccines,see also Typhoid vaccines, p. 620Indication and doseImmunisation against hepatitis A infectionFor dose, see under preparationsSingle componentAvaxim c (Sanofi Pasteur) AInjection, suspension of formaldehyde-inactivatedhepatitis A virus (GBM grown in human diploid cells)320 antigen units/mL adsorbed onto aluminiumhydroxide, net price 0.5-mL prefilled syringe = £18.10Excipients include neomycinDose. By intramuscular injection(see note below)Child 16–18 years 0.5 mL as a single dose; booster dose0.5 mL 6–12 months after initial doseNote Booster dose may be delayed by up to 3 years if notgiven after recommended interval following primarydose with Avaxim c . The deltoid region is the preferredsite of injection; not to be injected into the buttock(vaccine efficacy reduced). The subcutaneous route maybe used for children with bleeding disordersEpaxal c (Crucell) AInjection, suspension of formaldehyde-inactivatedhepatitis A virus (RG-SB grown in human diploid cells)at least 48 units/mL, net price 0.5-mL prefilledsyringe = £23.81Dose. By intramuscular injection(see note below)Child 1–18 years 0.5 mL as a single dose; booster dose0.5 mL 6–12 months after initial dose (1–6 months ifsplenectomised)Note Booster dose may be delayed by up to 4 years if notgiven after recommended interval following primarydose. The deltoid region is the preferred site of injection.The subcutaneous route may be used for children withbleeding disordersImportant Epaxal c contains influenza virus haemagglutiningrown in the allantoic cavity of chick embryos, and is thereforecontra-indicated in those hypersensitive to eggs or chickenprotein.Havrix Monodose c (GSK) AInjection, suspension of formaldehyde-inactivatedhepatitis A virus (HM 175 grown in human diploidcells) 1440 ELISA units/mL adsorbed onto aluminiumhydroxide, net price 1-mL prefilled syringe = £22.14,0.5-mL (720 ELISA units) prefilled syringe (HavrixJunior Monodose c ) = £16.77Excipients include neomycinDose. By intramuscular injection(see note below)Child 1–15 years 0.5 mL as a single dose; booster dose0.5 mL 6–12 months after initial dose14 Immunological products and vaccines