BNF for Children 2011-2012

614 14.4 Vaccines and antisera BNFC 2011–201214 Immunological products and vaccinesSide-effects see section 14.1 and notes above; alsoless commonly sleep disturbance, unusual crying ininfants, also reported peripheral and optic neuritis.Licensed use not licensed for use in children under 9monthsIndication and doseImmunisation against measles, mumps, andrubella. By intramuscular or deep subcutaneous injectionCHILD 6 months–18 years primary immunisation,2 doses each of 0.5 mL, see Immunisationschedule, section 14.1, p. 601; see also notes abovefor use in outbreaks, for contacts of cases, and fortravelCombined vaccinesMMRvaxPro c (Sanofi Pasteur) TAInjection, powder for reconstitution, live attenuated,measles virus (Enders’ Edmonston strain) and mumpsvirus (Jeryl Lynn [Level B] strain) prepared in chickembryo cells, and rubella virus (Wistar RA 27/3strain); single-dose vial (with syringe containing solvent)Excipients include gelatin and neomycinOnly available as part of childhood immunisation schedule fromhealth organisations or ImmFormPriorix c (GSK) AInjection, powder for reconstitution, live attenuated,measles virus (Schwarz strain) and mumps virus (RIT4385 strain) prepared in chick embryo cells, and rubellavirus (Wistar RA 27/3 strain), net price singledosevial (with syringe containing solvent) = £6.37Excipients include neomycinAlso available as part of childhood immunisation schedule fromhealth organisations or ImmFormMeningococcal vaccinesAlmost all childhood meningococcal disease in the UKis caused by Neisseria meningitidis serogroups B and C.Meningococcal Group C conjugate vaccine protectsonly against infection by serogroup C. The risk ofmeningococcal disease declines with age—immunisationis not generally recommended after the age of25 years.Tetravalent meningococcal vaccines that cover serotypesA, C, W135, and Y are available. Although theduration of protection has not been established, themeningococcal A, C, W135, and Y conjugate vaccineis likely to provide longer-lasting protection than theunconjugated meningococal polysaccharide vaccine.The antibody response to serotype C in unconjugatedmeningococcal polysaccharide vaccines in young childrenmay be suboptimal.Childhood immunisation Meningococcal Group Cconjugate vaccine provides long-term protectionagainst infection by serogroup C of Neisseria meningitidis.Immunisation consists of 2 doses given at 3months and 4 months of age; a booster dose shouldbe given at 12–13 months of age, usually combined withhaemophilus influenzae type b vaccine (see ImmunisationSchedule, section 14.1, p. 601).It is recommended that meningococcal group C conjugatevaccine be given to anyone aged under 25 yearswho has not been vaccinated previously with thisvaccine; those over 1 year receive a single dose. Childrenwith confirmed serogroup C disease, who havepreviously been immunised with meningococcal groupC vaccine, should be offered meningococcal group Cconjugate vaccine before discharge from hospital.Asplenia, splenic dysfunction, or complementdeficiency See p. 606.Travel Individuals travelling to countries of risk (seebelow) should be immunised with meningococcal A, C,W135, and Y conjugate vaccine, even if they havepreviously received meningitis C conjugate vaccine. Ifan individual has recently received meningococcalgroup C conjugate vaccine, an interval of at least 4weeks should be allowed before administration of thetetravalent (A, C, W135, and Y) vaccine.Vaccination is particularly important for those livingwith local people or visiting an area of risk duringoutbreaks.Immunisation recommendations and requirements forvisa entry for individual countries should be checkedbefore travelling, particularly to countries in Sub-SaharanAfrica, Asia, and the Indian sub-continent whereoutbreaks and epidemics of meningococcal infectionare reported. Country-by-country information is availablefrom the National Travel Health Network andCentre (www.nathnac.org).Proof of vaccination with the tetravalent (A, C, W135and Y) meningococcal vaccine is required for thosetravelling to Saudi Arabia during the Hajj and Umrahpilgrimages (where outbreaks of the W135 strain haveoccurred).Contacts For advice on the immunisation of laboratoryworkers and close contacts of cases of meningococcaldisease in the UK and on the role of the vaccinein the control of local outbreaks, consult Guidelines forPublic Health Management of Meningococcal Diseasein the UK at www.hpa.org.uk. See Table 2, section 5.1for antibacterial prophylaxis for prevention of secondarycases of meningococcal meningitis.MENINGOCOCCAL VACCINESCautions see section 14.1Contra-indications see section 14.1Pregnancy see p. 600Breast-feeding see p. 600Side-effects see section 14.1; also rarely symptoms ofmeningitis reported (but no evidence that vaccinecauses meningococcal C meningitis)Licensed use Menveo c not licensed for use inchildren under 11 yearsIndication and doseImmunisation against Neisseria meningitidisfor dose, see under preparationsMeningococcal Group C conjugate vaccineMeningitec c (Wyeth) AInjection, suspension of capsular polysaccharideantigen of Neisseria meningitidis group C (conjugatedto Corynebacterium diphtheriae protein), adsorbed