BNF for Children (BNFC) 2018-2019

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Diphtheria with poliomyelitis and

tetanus vaccine

lINDICATIONS AND DOSE

Primary immunisation

▶BY INTRAMUSCULAR INJECTION

▶Child 10–17 years: 0. 5 mL every month for 3 doses

Booster doses

▶BY INTRAMUSCULAR INJECTION

▶Child 10–17 years: 0. 5 mL for 1 dose,first booster dose—

should be given 3 years after primary course (this

interval can be reduced to a minimum of 1 year if the

primary course was delayed), then 0. 5 mL for 1 dose,

second booster dose—should be given 10 years after

first booster dose (this interval can be reduced to a

minimum of 5 years if previous doses were delayed),

second booster dose may also be used asfirst booster

dose in those over 10 years who have received only

3 previous doses of a diphtheria-containing vaccine

lSIDE-EFFECTS

▶Common or very commonVertigo

▶Frequency not knownAbdominal pain.asthenia.chills.

face oedema.influenza like illness.nerve disorders.pallor

.seizure.shock.syncope.vaccination reactions

lPRESCRIBING AND DISPENSING INFORMATIONAvailable as

part of childhood schedule from health organisations or

ImmForm.

lMEDICINAL FORMS

There can be variation in the licensing of different medicines

containing the same drug.

Suspension for injection

EXCIPIENTS:May contain Neomycin, polymyxin b, streptomycin

▶Revaxis(Sanofi Pasteur)

Revaxis vaccine suspension for injection 0. 5 ml pre-filled syringes|

1 pre-filled disposable injectionP£ 7. 80 DT = £ 7. 80

eiiiiF 788

Diphtheria with tetanus, pertussis,

hepatitis B, poliomyelitis and

haemophilus influenzae type b

vaccine 12-Oct-2017

lINDICATIONS AND DOSE

Primary immunisation (first dose)

▶BY DEEP INTRAMUSCULAR INJECTION

▶Child 2 months: 0. 5 mL for 1 dose

Primary immunisation (second dose)

▶BY DEEP INTRAMUSCULAR INJECTION

▶Child 3 months: 0. 5 mL for 1 dose, preferably administer

at a different injection site to that offirst dose

Primary immunisation (third dose)

▶BY DEEP INTRAMUSCULAR INJECTION

▶Child 4 months: 0. 5 mL for 1 dose, preferably administer

at a different injection site to that of second dose

lSIDE-EFFECTS

▶Common or very commonAnxiety.crying abnormal

▶UncommonCough.drowsiness.extensive swelling of

vaccinated limb.increased risk of infection

▶Rare or very rareAnaphylactoid reaction.angioedema.

apnoea.dermatitis.hypotonic-hyporesponsiveness

episode.seizure.swelling.thrombocytopenia

lPRESCRIBING AND DISPENSING INFORMATIONAvailable as

part of childhood schedule from health organisations or

ImmForm.

lMEDICINAL FORMS

There can be variation in the licensing of different medicines

containing the same drug.

Powder and suspension for suspension for injection

EXCIPIENTS:May contain Neomycin, polymyxin b

▶Infanrix Hexa(GlaxoSmithKline UK Ltd)

Infanrix Hexa vaccine powder and suspension for suspension for

injection 0. 5 ml pre-filled syringes| 1 pre-filled disposable

injectionPs

VACCINES›BACTERIAL VACCINES

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Bacillus Calmette-Guérin vaccine

(BCG Vaccine)

lDRUG ACTIONBCG (Bacillus Calmette-Guérin) is a live

attenuated strain derived fromMycobacterium boviswhich

stimulates the development of immunity toM.

tuberculosis.

lINDICATIONS AND DOSE

Immunisation against tuberculosis

▶BY INTRADERMAL INJECTION

▶Neonate: 0. 05 mL, to be injected at insertion of deltoid

muscle onto humerus (keloid formation more likely with

sites higher on arm); tip of shoulder should beavoided.

▶Child 1–11 months: 0. 05 mL, to be injected at insertion of

deltoid muscle onto humerus (keloid formation more

likely with sites higher on arm); tip of shoulder should

beavoided

▶Child 1–17 years: 0. 1 mL, to be injected at insertion of

deltoid muscle onto humerus (keloid formation more

likely with sites higher on arm); tip of shoulder should

beavoided

lCONTRA-INDICATIONSGeneralised septic skin conditions.

neonate in household contact with known or suspected

case of active tuberculosis

CONTRA-INDICATIONS, FURTHER INFORMATION

A lesion-free site should be used to administer BCG

vaccine to patients with eczema.

lCAUTIONS

CAUTIONS, FURTHER INFORMATIONBCG vaccine can be

given simultaneously with another live vaccine, but if they

are not given at the same time an interval of 4 weeks

should normally be allowed. When BCG is given to infants,

there is no need to delay routine primary immunisations.

No further vaccination should be given in the arm used for

BCG vaccination for at least 3 months because of the risk

of regional lymphadenitis.

lINTERACTIONS→Appendix 1 : live vaccines

lSIDE-EFFECTS

▶Rare or very rareIncreased risk of infection.osteitis

lPRE-TREATMENT SCREENINGApart from children under

6 years, any person being considered for BCG

immunisation mustfirst be given a skin test for

hypersensitivity to tuberculoprotein (see tuberculin

purified protein derivative p. 776 ). A skin test is not

necessary for a child under 6 years provided that the child

has not stayed for longer than 3 months in a country with

an incidence of tuberculosis greater than 40 per100 000,

the child has not had contact with a person with

tuberculosis, and there is no family history of tuberculosis

within the last 5 years.

lDIRECTIONS FOR ADMINISTRATION

Intradermal injection techniqueSkin is stretched between

thumb and forefinger and needle (size 25 Gor 26 G)

inserted (bevel upwards) for about 3 mm into superficial

layers of dermis (almost parallel with surface). Needle

should be short with short bevel (can usually be seen

790 Vaccination BNFC 2018 – 2019

Vaccines

14