5 micrograms after 5 months for 1 dose, booster doses
may be required in immunocompromised patients with
low antibody concentration, anterolateral thigh is
preferred site in neonates; not to be injected into the
buttock (vaccine efficacy reduced), dose not to be used
for neonate born to hepatitis B surface antigen positive
mother.▶Child 1 month–15 years: 5 micrograms for 1 dose,
followed by 5 micrograms after 1 month for 1 dose,
then 5 micrograms after 5 months for 1 dose, booster
doses may be required in immunocompromised
patients with low antibody concentration, deltoid
muscle is preferred site of injection in adults and older
children; anterolateral thigh is preferred site in infants;
not to be injected into the buttock (vaccine efficacy
reduced)
▶Child 16–17 years: 10 micrograms for 1 dose, followed by
10 micrograms after 1 month for 1 dose, followed by
10 micrograms after 5 months for 1 dose, booster doses
may be required in immunocompromised patients with
low antibody concentration, deltoid muscle is preferred
site of injection in adults and older children; not to be
injected into the buttock (vaccine efficacy reduced)
Immunisation against hepatitis B infection (accelerated
schedule)
▶BY INTRAMUSCULAR INJECTION
▶Neonate: 5 micrograms every month for 3 doses,
followed by 5 micrograms after 10 months for 1 dose,
booster doses may be required in immunocompromised
patients with low antibody concentration, anterolateral
thigh is preferred site in neonates; not to be injected
into the buttock (vaccine efficacy reduced), dose not to
be used for neonate born to hepatitis B surface antigen
positive mother.
▶Child 1 month–15 years: 5 micrograms every month for
3 doses, followed by 5 micrograms after 10 months for
1 dose, booster doses may be required in
immunocompromised patients with low antibody
concentration, deltoid muscle is preferred site of
injection in older children; anterolateral thigh is
preferred site in infants; not to be injected into the
buttock (vaccine efficacy reduced)
▶Child 16–17 years: 10 micrograms every month for
3 doses, followed by 10 micrograms after 10 months for
1 dose, booster doses may be required in
immunocompromised patients with low antibody
concentration, deltoid muscle is preferred site of
injection in older children; not to be injected into the
buttock (vaccine efficacy reduced)
Neonate born to hepatitis B surface antigen-positive
mother
▶BY INTRAMUSCULAR INJECTION
▶Neonate: 5 micrograms every month for 3 doses,first
dose given at birth with hepatitis B immunoglobulin
injection (separate site), followed by 5 micrograms after
10 months for 1 dose, anterolateral thigh is preferred
site in neonates; not to be injected into the buttock
(vaccine efficacy reduced).
Chronic haemodialysis patients
▶BY INTRAMUSCULAR INJECTION
▶Child 16–17 years: 40 micrograms every month for
2 doses, followed by 40 micrograms after 5 months for
1 dose, booster doses may be required in those with low
antibody concentration, deltoid muscle is preferred site
of injection in older children; not to be injected into
the buttock (vaccine efficacy reduced)
lSIDE-EFFECTS
▶Common or very commonDrowsiness.gastrointestinal
disorder
▶UncommonInfluenza like illness
▶Rare or very rareSensation abnormal
▶Frequency not knownAnaphylactoid reaction.angioedema
.apnoea.arthritis.encephalitis.encephalopathy.
hypotension.meningitis.multiple sclerosis.muscle
weakness.nerve disorders.paralysis.seizure.skin
reactions.thrombocytopenia.vasculitislMEDICINAL FORMS
There can be variation in the licensing of different medicines
containing the same drug.
Suspension for injection
EXCIPIENTS:May contain Thiomersal
▶Engerix B(GlaxoSmithKline UK Ltd)
Hepatitis B virus surface antigen 20 microgram per 1 mlEngerix
B 10 micrograms/ 0. 5 ml vaccine suspension for injection pre-filled
syringes| 1 pre-filled disposable injectionP£ 9. 67
Engerix B 20 micrograms/ 1 ml vaccine suspension for injection pre-
filled syringes| 1 pre-filled disposable injectionP£ 12. 99 |
10 pre-filled disposable injectionP£ 129. 92
▶Fendrix(GlaxoSmithKline UK Ltd)
Hepatitis B virus surface antigen 40 microgram per 1 mlFendrix
20 micrograms/ 0. 5 ml vaccine suspension for injection pre-filled
syringes| 1 pre-filled disposable injectionP£ 38. 10
▶HBVAXPRO(Merck Sharp & Dohme Ltd)
Hepatitis B virus surface antigen 10 microgram per
1mlHBVAXPRO 10 micrograms/ 1 ml vaccine suspension for injection
pre-filled syringes| 1 pre-filled disposable injectionP£ 12. 20
HBVAXPRO 5 micrograms/ 0. 5 ml vaccine suspension for injection pre-
filled syringes| 1 pre-filled disposable injectionP£ 8. 95
Hepatitis B virus surface antigen 40 microgram per
1mlHBvaxPRO 40 micrograms/ 1 ml vaccine suspension for injection
vials| 1 vialP£ 27. 60
eiiiiF 788Human papillomavirus vaccines
02-Mar-2017lINDICATIONS AND DOSE
CERVARIX®
Prevention of premalignant genital lesions and cervical
cancer
▶BY INTRAMUSCULAR INJECTION
▶Child 9–14 years (female): 0. 5 mL for 1 dose, followed by
0. 5 mL after 5 – 7 months for 1 dose, if second dose
administered earlier than 5 months after thefirst, a
third dose should be administered, dose to be
administered into deltoid region, if the course is
interrupted, it should be resumed (using the same
vaccine) but not repeated, even if more
than 24 months have elapsed since thefirst dose or if
the girl is then aged 15 years or more.
▶Child 15–17 years (female): 0. 5 mL for 1 dose, followed by
0. 5 mL after 1 – 2. 5 months for 1 dose, then 0. 5 mL after
5 – 12 months from thefirst dose for 1 dose, dose to be
administered into deltoid region, if the course is
interrupted, it should be resumed (using the same
vaccine) but not repeated, allowing the appropriate
interval between the remaining doses.
GARDASIL®
Prevention of premalignant genital (cervical, vulvar and
vaginal) and anal lesions, cervical and anal cancers, and
genital warts
▶BY INTRAMUSCULAR INJECTION
▶Child 9–14 years (female): 0. 5 mL for 1 dose, followed by
0. 5 mL after 6 months for 1 dose, if the second dose is
administered earlier than 6 months after thefirst dose,
a third dose should be administered, dose to be
administered preferably into deltoid region or
higher anterolateral thigh, if the course is continued→BNFC 2018 – 2019 Vaccination 797
Vaccines14