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Sunderland Joint Formulary
NHS Sunderland Clinical Commissioning Group
South Tyneside and Sunderland NHS Foundation Trust
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 Formulary Chapter 14: Immunological products and vaccines - Full Chapter
Notes:

Patient group directions for the administration of vaccines in primary care can be found online here: http://medicines.necsu.nhs.uk/resources/patient-group-directions

Patient group directions for the administration of vaccines in CHS can be found online here: http://chsintranet/2012/06/20/patient-group-directions-pgds/

 Details...
14.01  Expand sub section  Active immunity
14.01  Expand sub section  Immunisation schedule
14.02  Expand sub section  Passive immunity
14.03  Expand sub section  Storage and use
14.04  Expand sub section  Vaccines and antisera to top
14.04  Expand sub section  Anthrax vaccine
14.04  Expand sub section  BCG vaccines
BCG vaccine
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Bacillus Calmette-Guérin Vaccine (BCG Vaccine, Dried/Tub/BCG)  
unlicensed unlicensed Injection: 1 mL multidose ampoules containing freeze dried powder for preparing intradermal injections (InterVax). 


 


Tuberculin Purified Protein Derivative (Tuberculin PPD)
unlicensed unlicensed Vial (1.5 mL): 20 units/mL (2 units/0.1 mL dose) (for routine use); 100 units/mL (10 units/0.1 mL dose) (Statens Serum Institut). 

 
   
14.04  Expand sub section  Botulism antitoxin
14.04  Expand sub section  Cholera vaccine
14.04  Expand sub section  COVID-19 vaccine to top
AstraZeneca COVID-19 vaccine
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Green
 
   
Moderna mRNA-1273 COVID-19 vaccine
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Green
 
   
Pfizer BioNTech COVID-19 mRNA Vaccine BNT162b2
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Green
 
   
14.04  Expand sub section  Diphtheria vaccines
Diphtheria vaccines for Children Under 10 years
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Diphtheria, Tetanus, Pertussis (acellular, 3-component), polio,Haemophilus influenzae type b (Hib) and hepatitis B vaccine (DTaP/IPV/Hib/HepB)
Vial with solvent in a pre-filled syringe 0.5 mL (Infanrix hexa®)
May contain traces of formaldehyde, neomycin and polymyxin B


 


Diphtheria, Tetanus, Pertussis (acellular, 3-component) and Poliomyelitis (inactivated) vaccine (DTaP/IPV)
Prefilled syringe: 0.5 mL (Infanrix-IPV®)
May contain traces of formaldehyde, neomycin and polymyxin B


 


Diphtheria (low dose), Tetanus, Pertussis (acellular, 5-component) and Poliomyelitis (inactivated) vaccine (dTaP/IPV)
Prefilled syringe: 0.5 mL (REPEVAX®, Boostrix-IPV®)
REPEVAX® may contain traces of formaldehyde, glutaraldehyde, streptomycin, neomycin, polymyxin B and bovine serum albumin
Boostrix-IPV® may contain traces of neomycin and polymyxin B


 


Diphtheria, Tetanus, Pertussis (acellular, 5-component), Poliomyelitis (inactivated) and Haemophilus influenzae type b vaccine (DTaP/IPV/Hib)
Prefilled syringe: 0.5mL (Pediacel®)

 
   
Diphtheria vaccines for over 10 years and adults
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Diphtheria (low dose), Tetanus and Poliomyelitis (Inactivated) vaccine (Td/IPV)
Prefilled syringe: 0.5 mL (Revaxis®)
May contain traces of streptomycin, neomycin and polymyxin B

 
   
14.04  Expand sub section  Haemophilus influenzae type B vaccine
Haemophilus influenzae type B
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Use combined vaccines

 
   
14.04  Expand sub section  Hepatitis A vaccine
Hepatitis A vaccine
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Hepatitis A (inactivated, adsorbed) vaccine (HAV)
Prefilled syringe: 1 mL (Havrix Monodose®, VAQTA® Adult)
Prefilled syringe: 0.5 mL (AVAXIM®)
Prefilled syringe: 0.5 mL (Havrix Junior Monodose®, VAQTA® Paediatric)
May contain traces of neomycin
VAQTA® Adult and Paediatric may contain traces of formaldehyde, glutaraldehyde, streptomycin, neomycin, polymyxin B and bovine serum albumin


 


With typhoid vaccine


Hepatitis A (inactivated) and Typhoid Polysaccharide vaccine (adsorbed).
Prefilled syringe: 1 mL (Hepatyrix®)


 


Hepatitis A (inactivated, adsorbed) and Typhoid polysaccharide vaccine
Prefilled syringe: 1 mL (ViATIM®)
May contain traces of neomycin

 
   
Hepatitis A vaccine with Hepatitis B vaccine  (Twinrix)
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Hepatitis A (inactivated) and hepatitis B (rDNA) (HAB) vaccine (adsorbed).
Prefilled syringe: 1 mL (Twinrix® Adult); 0.5 mL (Twinrix® Paediatric)
May contain traces of neomycin
Prefilled syringe: 1 mL (Ambirix®)

 
   
14.04  Expand sub section  Hepatitis B vaccine
Hepatitis B vaccine
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Prefilled syringe: 10 micrograms, 1 mL; 5 micrograms, 0.5 mL (HBVAXPRO®)
Vial: 40 micrograms, 1 mL, (HBVAXPRO®)
May contain traces of formaldehyde and potassium thiocyanate
Prefilled syringe: 10 micrograms, 0.5 mL; 20 micrograms, 1 mL, (Engerix®)
Prefilled syringe: 20 micrograms, 0.5 mL, (Fendrix®)

 
   
14.04  Expand sub section  Human papilloma virus vaccine to top
Human papilloma virus vaccine
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Human Papillomavirus 9-valent (Recombinant, adsorbed) vaccine (HPV).
Prefilled syringe: 0.5 mL (Gardasil 9®)

 
   
14.04  Expand sub section  Influenza vaccine
Influenza vaccine
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Public Health England (PHE) information for vaccine ordering for 2018-19 influenza season can be found here: https://www.england.nhs.uk/wp-content/uploads/2018/02/vaccine-ordering-18-19-influenza-season-gp-pharm.pdf


Inactivated influenza vaccine (split virion) BP


Adjuvanted trivalent influenza vaccine (aTIV) for 65 years and over (Fluad®)


Quadrivalent influenza vaccine (QIV) for at risk adults under 65 years of age (including pregnant women and health care workers).


For the children’s vaccination programme


Influenza vaccine (live attenuated, nasal)
Nasal applicator: 0.2 mL (Fluenz Tetra®)

 
   
14.04  Expand sub section  Measles vaccine
14.04  Expand sub section  Measles, Mumps and Rubella (MMR) vaccine
Measles, Mumps and Rubella Vaccine, Live (MMR)
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Measles, Mumps & Rubella vaccine (MMR)
Vial with solvent in a pre-filled syringe 0.5 mL (MMRVaxPro®)
Pre-filled syringe: 0.5 mL (Priorix®)
May contain traces of neomycin

 
   
14.04  Expand sub section  Meningococcal vaccines
Meningococcal vaccine
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Meningococcal group A, C, W135 and Y conjugate vaccine (MenACWY)
Vial: 0.5 mL (Menveo®)
Pre-filled syringe: 0.5 mL (Nimenrix®)


Meningococcal group B (rDNA, component, adsorbed) vaccine (4CMenB)
Prefilled syringe: 0.5 mL (Bexsero®) 


Hib meningococcal group C combined vaccine (Hib/MenC)
Vial: 0.5 mL (Menitorix®)

 
   
14.04  Expand sub section  Mumps vaccine to top
14.04  Expand sub section  Pertussis vaccine
14.04  Expand sub section  Pneumococcal vaccines
Pneumococcal vaccine
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Pneumococcal conjugate (13 serotypes) vaccine (PCV13)
Prefilled syringe: 0.5 mL (Prevenar 13®)


Pneumococcal polysaccharide (23 serotypes) vaccine (PPV23)
Vial: 0.5 mL (MSD)

 
   
14.04  Expand sub section  Poliomyelitis vaccines
Poliomyelitis Vaccine Live (oral)
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Formulary

Use combined vaccines

 
   
14.04  Expand sub section  Rotavirus vaccine
Rotavirus vaccine
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Rotavirus vaccine, live
Oral suspension: 1.5 mL (Rotarix®)

 
   
14.04  Expand sub section  Rubella vaccine to top
Rubella vaccine
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Use combined vaccines

 
   
14.04  Expand sub section  Smallpox vaccine
14.04  Expand sub section  Tetanus vaccines
Tetanus vaccine
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Use combined vaccines

 
   
14.04  Expand sub section  Tick-borne encephalitis vaccine
14.04  Expand sub section  Typhoid vaccines
Typhoid vaccine
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Typhoid Polysaccharide vaccine
Prefilled syringe: 0.5 mL (TYPHIM Vi®)
Prefilled syringe: 0.5 mL (Typherix®)
Gastro-resistant capsules: three capsules (Vivotif®)

 
   
14.04  Expand sub section  Varicella-zoster vaccine to top
Varicella-Zoster vaccine (VZ)
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Varicella-zoster virus Oka strain (live, attenuated)
Vial with solvent in a pre-filled syringe 0.5 mL strain) (Varilrix®)
May contain traces of neomycin


Varicella virus Oka/Merck strain (live, attenuated)
Vial with solvent in a pre-filled syringe 0.5 mL (VARIVAX®)
May contain traces of gelatin and neomycin


For adult shingles vaccination programme


Varicella-zoster virus Oka/Merck strain (live, attenuated)
Vial with solvent in a pre-filled syringe 0.65 mL (Zostavax®)
May contain traces of gelatin and neomycin

 
   
14.04  Expand sub section  Yellow fever vaccine
Yellow fever vaccine
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Only available from a designated Yellow Fever Vaccination Centre (YFVC) A listing of approved YFVCs in England, Wales, and Northern Ireland (EWNI) can be found at: https://nathnacyfzone.org.uk/search-centres

 
   
14.05  Expand sub section  Immunoglobulins
14.05  Expand sub section  Normal immunoglobulin
14.05  Expand sub section  Specific immunoglobulins
14.05  Expand sub section  Anti-D (Rho) immunoglobulin to top
14.05  Expand sub section  Interferons
14.05.01  Expand sub section  Normal immunoglobulin
Normal immunoglobulin
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High Cost Medicine

Human normal Immunoglobulin (HNIG)
Infusion: 100 mg/mL; 5 g/50 mL, 10 g/100 mL (Iqymune®) preferred product
Infusion: 100 mg/mL; 5 g/50 mL, 10 g/100 mL (Kiovig®)
For patients who cannot have Iqymune®

 
   
14.05.02  Expand sub section  Disease-specific immunoglobulins
Disease-specific immunoglobulins
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Preparations stocked by pharmacy:


Tetanus immunoglobulin (HTIG): 250 units


 


Other immunoglobulins


The following immunoglobulins are kept at the Pharmacy Distribution Centre, Royal Victoria Infirmary, Newcastle upon Tyne, and can be obtained via the Clinical Virology Team at Newcastle Hospitals:



  • Hepatitis B immunoglobulin (HBIG): contact on-call virologist (24/7)

  • Rabies immunoglobulin (HRIG) and also vaccine: contact first on-call for Health Protection at Public Health England NE (24/7)

  • Varicella-zoster immunoglobulin (VZIG): contact virologist (office hours, or 24/7 if close to end of window period - 10 days in pregnancy, 7 days in immunosuppressed)

  • Human Normal Immunoglobulin (HNIG) for HAV and measles post-exposure prophylaxis: contact on-call virologist 24/7


From blood bank


Anti D (Rh0) immunoglobulin

 
   
14.05.03  Expand sub section  Anti-D (Rho) immunoglobulin
14.06  Expand sub section  International travel to top
 ....
 Non Formulary Items
Anthrax vaccine

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Non Formulary
 
Botulism antitoxin

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Non Formulary
 
Cholera vaccine  (Dukoral)

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Non Formulary
 
Japanese Encephalitis Vaccine  (Ixiaro)

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Non Formulary
 
Malaria vaccine  (Mosquirix)

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Non Formulary
 
  
Key
note Notes
Section Title Section Title (top level)
Section Title Section Title (sub level)
First Choice Item First Choice item
Non Formulary Item Non Formulary section
Restricted Drug
Restricted Drug
Unlicensed Drug
Unlicensed
Track Changes
Display tracking information
click to search medicines.org.uk
Link to adult BNF
click to search medicines.org.uk
Link to SPCs
Cytotoxic Drug
Cytotoxic Drug
CD
Controlled Drug
High Cost Medicine
High Cost Medicine
Cancer Drugs Fund
Cancer Drugs Fund
NHSE
NHS England
Homecare
Homecare
CCG
CCG

Traffic Light Status Information

Status Description

Red

Drugs for hospital use or use by a specialist within specialist centre only. Initiation and monitoring of treatment should remain under the total responsibility of the appropriate hospital clinician or specialist. These drugs should only be prescribed under the direct supervision of that clinician or specialist and are not suitable for shared care arrangements. The drug should be supplied via the hospital or specialist centre for the duration of treatment.   

Amber

These are specialist drugs which must be initiated by secondary care specialist prescribers, but with the potential to transfer prescribing to primary care within written and agreed shared care protocols and according to the agreed process for transfer of care. For these drugs, in order to ensure patient safety, some aspects of care must remain with the specialist due to their complexity e.g. monitoring of disease or drug response. Other more routine aspects can be transferred to the GP e.g. monitoring of adverse effects and supply of the medicine. The specific responsibilities of the specialist and GP are defined in the shared care agreement for each drug. Shared care agreements are still under development for some amber drugs. Until these are available, it would be expected that any shared care request from secondary care to a GP would be accompanied by written information which defines prescribing and monitoring responsibilities. The hospital specialist should also provide the GP with enough information and support to allow the safe transfer and ongoing management of prescribing into primary care.   

Green +

Drugs which should usually be initiated in secondary care, or by a specialist clinician, but can be safely maintained in primary care with very little or no monitoring required. In some cases there may be a further restriction for use outlined - these will be defined in each case.  

Green

These are defined as new and established drugs, which may be prescribed, initiated, changed or maintained on FP10 by the GP and, if appropriate, discontinued without recourse to secondary care. N.B. DRUGS NOT IDENTIFIED IN THE FORMULARY BY A RED, AMBER OR GREEN+ SYMBOL ARE CLASSIFIED AS GREEN.   

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