Vaccine
Talk
(Egyptian Edition)
"Everything you need to know about
vaccines in Egypt"
Vaccine
People who have recently received normal human immunoglobulin and other blood products
Immunoglobulins may inhibit the immune response to some vaccines. Delay giving some vaccines for a certain time after receiving blood products.
Normal human immunoglobulin and blood products
Normal human immunoglobulin may inhibit the immune response to some live parenteral viral vaccines. This is because low levels of antibodies may be present in the blood product that may impair the immune response to the live vaccine. Exceptions are yellow fever, BCG and zoster vaccines. People who have received any blood product, including plasma or platelets, should wait 3–11 months before they receive an MMR (measles-mumps-rubella), MMRV (measles-mumps-rubella-varicella) or varicella vaccine. The length of time depends on the blood product they received. Live Japanese encephalitis vaccine (Imojev) should not be given within 6 weeks of receiving immunoglobulins or immunoglobulin-containing blood products. It is preferable to wait 3 months. People who have received a blood transfusion do not need to repeat any of their vaccinations.
People with agammaglobulinaemia
Live vaccines are not recommended for people with agammaglobulinaemia who are receiving monthly normal human immunoglobulin. This is because their immune response may be inhibited. Also, these people will have sufficient circulating antibodies (for example, against measles and varicella) from the normal human immunoglobulin to protect them if they are exposed.
Inactivated vaccines are recommended as per the routine schedule. The response may be suboptimal, but these vaccines are safe to receive.
Recommended intervals between immunoglobulins or blood products, and measles-mumps-rubella
Spacing of vaccines and antibody-containing products
Live vaccines
Ty21a typhoid, yellow fever, LAIV, and rotavirus vaccines may be administered at any time before, concurrent with, or after administration of any antibody-containing preparation such as immune globulin, hyperimmune globulin, or intravenous immune globulin (IGIV).
Blood (e.g., whole blood, packed red blood cells, and plasma) and other antibody-containing blood products (e.g., immune globulin, hyperimmune globulin, and IGIV) can inhibit the immune response to measles and rubella vaccines for ≥3 months. The effect of blood and immune globulin preparations on the response to mumps and varicella vaccines is unknown; however, commercial immune globulin preparations contain antibodies to these viruses. Blood products available in the United States are unlikely to contain a substantial amount of antibody to yellow fever virus. The length of time that interference with injectable live-virus vaccine (other than yellow fever) can persist after the antibody-containing product is a function of the amount of antigen-specific antibody contained in the product. Therefore, after an antibody-containing product is received, live vaccines (other than Ty21a typhoid, yellow fever, LAIV, and rotavirus vaccines) should be delayed until the passive antibody has degraded. In circumstances where there is high-risk of vaccine-preventable disease it is acceptable to administer a dose of vaccine prior to completion of this interval. If a dose of injectable live-virus vaccine (other than yellow fever) is administered after an antibody-containing product but at an interval shorter than recommended in this report, the vaccine dose should be repeated. The repeat dose should be administered at the interval indicated for the antibody-containing product, after the invalid dose of vaccine.
Although passively acquired antibodies can interfere with the response to rubella vaccine, the low dose of anti-Rho(D) globulin or any other blood product administered to postpartum women have not been demonstrated to reduce the response to the RA27/3 strain rubella vaccine. Congenital rubella syndrome and congenital varicella are conditions with considerable morbidity and represent a true risk in future pregnancies. Because of the importance of rubella and varicella immunity among women of child-bearing age, the postpartum vaccination of women without evidence of immunity to rubella or varicella with MMR, varicella, or MMRV vaccines should not be delayed because of receipt of anti-Rho(D) globulin or any other blood product during the last trimester of pregnancy or at delivery. Any reduction in immunity caused by anti-Rho(D) globulin or other blood products is outweighed by the opportunity to generate immunity. These women should be vaccinated immediately after giving birth and, if possible, tested ≥3 months later to ensure immunity to rubella and, if appropriate, to measles. Measles and rubella serologies have a low false-positive rate and are therefore acceptable for use in this limited postpartum context.
Interference might occur if administration of an antibody-containing product becomes necessary after administration of MMR or varicella vaccines. Usually, vaccine virus replication and stimulation of immunity occurs 1–2 weeks after vaccination. If the interval between administration of any of these vaccines and subsequent administration of an antibody-containing product is less than 14 days, vaccination should be repeated after the recommended interval unless serologic testing indicates a protective antibody response.
A humanized mouse monoclonal antibody product (palivizumab) is available as prophylaxis for serious lower respiratory tract disease from respiratory syncytial virus among infants and young children. This product contains only antibody to respiratory syncytial virus and does not interfere with the immune response to licensed live or non-live vaccines.
Non-live vaccines
Antibody-containing products interact less with non-live vaccines compared with live vaccines. Therefore, administering non-live vaccines either simultaneously with or at any interval before or after receipt of an antibody-containing product should not substantially impair development of a protective antibody response. The vaccine or toxoid and antibody preparation should be administered at different sites using the standard recommended dose.