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 Formulary Chapter 14: Immunological products and vaccines - Full Chapter
Notes:

Please refer to the Public Health England Green Book on vaccines for the most up to date information on the recommended preparations and use.

The use of travel vaccines in primary care is not recommended in line with NHS England Guidance on items which should not routinely be prescribed in primary care

 Details...
14.01  Active immunity
14.01  Immunisation schedule
14.02  Passive immunity
14.03  Storage and use
14.04  Vaccines and antisera to top
Japanese Encephalitis Vaccine (Ixiaro®)
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Green
 
 
Tuberculin Purified Protein Derivative
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Formulary
Green
 
 
14.04  Anthrax vaccine
14.04  BCG vaccines
BCG vaccine
(Bacillus calmette-guerin vaccine)
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Green

(BCG Vaccine, Dried/Tub/BCG) 1ml multidose vials containing freeze dried powder for preparing intradermal injections

 
 
14.04  Botulism antitoxin
Botulism antitoxin
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Formulary
Red

1 vial of Botulism antitoxin trivalent (equine) A B& E 5000 units injection

 
 
14.04  Cholera vaccine
14.04  COVID-19 vaccine to top
COVID-19 vaccinesBlack Triangle
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Formulary
Green
  • Comirnaty® Original / Omicron BA.4-5
  • Comirnaty® 10 Concentrate for children
  • Comirnaty® 3 (THREE) Concentrate
  • VidPrevtyn Beta®
  • Spikevax® Original/Omicron BA.4-5
 
Link  MHRA Drug Safety Updates: COVID-19 Vaccines
Link  SPS COVID-19 vaccine resources
 
14.04  Diphtheria vaccines
Absorbed Diptheria Low Dose, Tetanus, and Poliomyelitis vaccine
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Formulary
Green
 
 
Absorbed Diptheria Low Dose, Tetanus, Pertussis and Poliomyelitis vaccine
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Formulary
Green
 
 
Absorbed Diptheria, Tetanus, Pertussis and Poliomyelitis vaccine
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Red
 
 
14.04  Haemophilus influenzae type B vaccine
Haemophilus influenzae type B
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Green
 
 
Haemophilus Influenzae type b & Meningococcal Group C Conjugate vaccine
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Formulary
Green
 
 
14.04  Hepatitis A vaccine
Hepatitis A vaccine
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Formulary
Green
 
 
Hepatitis A vaccine with Hepatitis B vaccine  (Twinrix®)
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Formulary
Green
 
 
14.04  Hepatitis B vaccine
Hepatitis B vaccine
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Formulary
Green
 
 
14.04  Human papilloma virus vaccine to top
Human papilloma virus (HPV) vaccine
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Formulary
Green

 

 

 
 
14.04  Influenza vaccine
Influenza vaccine
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Formulary
Green
 
 
14.04  Measles vaccine
14.04  Measles, Mumps and Rubella (MMR) vaccine
Measles, Mumps and Rubella Vaccine, Live (MMR)
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Formulary
Green
 
 
14.04  Meningococcal vaccines
14.04  Mumps vaccine to top
14.04  Pertussis vaccine
14.04  Pneumococcal vaccines
Pneumococcal polysaccharide conjugate vaccine
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Formulary
Green
 
 
14.04  Poliomyelitis vaccines
Poliomyelitis Vaccine Inactivated (Salk)
(Inactivated poliomyelitis vaccine (IPV))
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Formulary
Green
 
 
Poliomyelitis Vaccine Live (oral)
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Formulary
Green
 
 
14.04  Rabies vaccine
Rabies vaccine
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Formulary
Green
 
 
14.04  Rotavirus vaccine to top
Rotavirus vaccine (Rotarix®)
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Formulary
Green
 
 
14.04  Rubella vaccine
14.04  Smallpox vaccine
14.04  Tetanus vaccines
Tetanus vaccine 
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Formulary
Green
 
 
14.04  Tick-borne encephalitis vaccine
Tick-borne encephalitis vaccine
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Formulary
Green
 
 
14.04  Typhoid vaccines to top
Typhoid vaccine
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Formulary
Green
 
 
14.04  Varicella-zoster vaccine
Varicella Zoster vaccine (Zostavax®)
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Formulary
Green
 
 
Varicella-zoster vaccine
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Green
 
 
14.04  Yellow fever vaccine
Yellow fever vaccine (Live)
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Formulary
Green

Only available from designated Yellow Fever Vaccination Centres.

 
Link  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
Link  MHRA Drug Safety Update (Nov 2019): Yellow fever vaccine: stronger precautions in people with weakened immunity and in those aged 60 years or older
Link  MHRA Drug Safety Update (Nov 2021): Yellow fever vaccine (Stamaril): new pre-vaccination checklist
 
14.05  Immunoglobulins
 note 

Please see https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/216671/dh_131107.pdf for information regarding Immunoglobulin which is commissioned by NHS England in line with Department of Health Clinical Guidelines for Immunoglobulin Use

14.05  Normal immunoglobulin
14.05  Specific immunoglobulins to top
14.05  Anti-D (Rho) immunoglobulin
14.05  Interferons
14.05.01  Normal immunoglobulin
Normal Immunoglobulin (Cuvitru®)
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Red
High Cost Medicine
  • 20% - 1g, 2g, 4g & 8g
 
 
Normal Immunoglobulin (Flebogamma®DIF)
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Red
  • 5% - 2.5g, 5g, 10g & 20g
 
 
Normal Immunoglobulin (Gammanorm®)
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Red
High Cost Medicine
  • 16.5% - 1g, 1.65g, 2g, 3.3g, 4g & 8g
 
 
Normal Immunoglobulin (Gammunex®)
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Red
High Cost Medicine
  • 10% - 5g, 10g & 20g
 
 
Normal Immunoglobulin (Intratect®)
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Red
High Cost Medicine
  • 5% - 1g, 2.5g, 5g & 10g
  • 10% - 1g, 5g, 10g & 20g
 
 
Normal Immunoglobulin (Iqymune®)
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Red
High Cost Medicine
  • 10% - 2g, 5g, 10g & 20g
 
 
Normal Immunoglobulin (Kiovig®)
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Formulary
Red
High Cost Medicine
  • 10% - 1g, 2.5g, 5g, 10g, 20g & 30g
 
 
Normal Immunoglobulin (Octagam®)
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Red
High Cost Medicine
  • 5% - 5g & 10g
  • 10% - 2g, 5g, 10g & 20g
 
 
Normal Immunoglobulin (Privigen®)
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Red
High Cost Medicine
  • 10% - 2.5g, 5g, 10g & 20g
 
 
Normal Immunoglobulin (Subcuvia®)
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Red
High Cost Medicine
  • 16% - 0.8g & 1.6g
 
 
Normal immunoglobulin for Intramuscular use
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Red
High Cost Medicine
 
 
14.05.02  Disease-specific immunoglobulins
Hepatitis B immunoglobulin (HBIG)
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Red
  • 200 international units - for infant use 
 
 
Hepatitis B immunoglobulin (Hepatect CP®)
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Red
 
 
Tetanus immunoglobulin
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Formulary
Red
 
 
Varicella-Zoster immunoglobulin (VZIG)
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Formulary
Red
 
 
14.05.03  Anti-D (Rho) immunoglobulin to top
Anti-D (Rh0) Immunoglobulin (Rhophylac®)
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Formulary
Red
  • Approved for the prevention of RhoD sensitisation in
    women in line NICE.
  • Approved for use by haematologists in appropriate patients with immune thrombo-cytopenia. The 1,500 and 5,000 unit vials (WinRho) are much more expensive than the other formulations and should only be used on advice from haematologists. It is the only formulation licensed for use in immune thrombocytopaenia.
 
 
Anti-D (Rh0) Immunoglobulin (WinRho SDF®)
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Formulary
Red
  • Approved for the prevention of RhoD sensitisation in
    women in line NICE.
  • Approved for use by haematologists in appropriate patients with immune thrombo-cytopenia. The 1,500 and 5,000 unit vials (WinRho) are much more expensive than the other formulations and should only be used on advice from haematologists. It is the only formulation licensed for use in immune thrombocytopaenia.
 
 
14.06  International travel
 note 

The use of travel vaccines in primary care is not recommended in line with NHS England Guidance on items which should not routinely be prescribed in primary care

 ....
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 children's BNF
click to search medicines.org.uk
Link to SPCs
Cytotoxic Drug
Cytotoxic Drug
CD
Controlled Drug
High Cost Medicine
High Cost Medicine
NHSE
NHS England
Homecare
Homecare
CCG
CCG

Traffic Light Status Information

Status Description

Red

Drugs for hospital use only. The responsibility for initiation and monitoring treatment should rest with an appropriate hospital clinician and the drug should be supplied through the hospital throughout the duration of treatment. In some very exceptional circumstances (e.g. due to distance from the hospital, storage, supply or mobility/transport problems) it may be appropriate for the GP to be asked to prescribe a Red drug. This should be negotiated on an individual patient basis and should only be done with the GP’s prior informed agreement where the roles of the GP and hospital services are clearly defined and agreed. The GP should not feel under pressure to prescribe in these circumstances. For all RED drugs automatically added to the formulary in response to a positive NICE TA: Prescribers need to ensure that local Trust new drug governance procedures and pharmacy processes are followed before any prescribing.  

Amber

Drugs initiated by hospital specialist, but where continuing treatment by GPs may be appropriate under a shared care arrangement. The specialist should send the GP a copy of the shared care agreement to sign. The GP should sign the shared care agreement, or indicate they do not want to be part of such an agreement, and return a copy back to the specialist. Shared care guidelines are available or are being developed for most of the drugs listed as Amber. If no shared care guideline is available, the hospital specialist should provide the patient’s GP with sufficient information and support to allow treatment to be continued and managed safely in primary care.  

Green plus

Drugs normally recommended or initiated by a specialist (hospital or GP with an extended role https://www.rcgp.org.uk/gpwer), 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. Provision of additional information, or an information leaflet, may be appropriate in some cases to facilitate continuing treatment by GPs.  

Green

Drugs where prescribing by GPs is appropriate. Can be initiated and prescribed in all care settings, and if appropriate, discontinued without recourse to secondary care.  

Black

NOT APPROVED: Drugs that have been considered by NTAG or the NENC ICB Medicines Subcommittee (or other approved body) and are not approved for prescribing within the North East and North Cumbria.   

Brown

UNDER REVIEW: drugs whose current formulary status or RAG status is currently under review.  

Not Recomended

NOT REVIEWED: Drugs that haven not been reviewed yet. This usually means that an application is in progress. These drugs are not normally considered appropriate for prescribing in the North East and North Cumbria until such time that a decision is taken on their formulary status.  

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