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 for 1 dose, second dose to be given at least
1 month after thefirst dose, then 0. 5 mL for 1 dose,
third dose to be given at least 3 months after the
second dose, schedule should be completed within
12 months of thefirst dose, dose to be administered
preferably into deltoid region or higher anterolateral
thigh, if the course is interrupted, it should be resumed
(using the same vaccine) but not repeated, allowing the
appropriate interval between the remaining doses.
Prevention of premalignant genital (cervical, vulvar, and
vaginal) and anal lesions, cervical and anal cancers, and
genital warts (alternative schedule)
▶BY INTRAMUSCULAR INJECTION
▶Child 9–14 years (female): 0. 5 mL for 1 dose, followed by
0. 5 mL for 1 dose, second dose to be given at least
1 month after thefirst dose, then 0. 5 mL for 1 dose,
third dose to be given at least 3 months after the
second dose, schedule should be completed within
12 months of thefirst dose, dose to be administered
preferably into deltoid region or higher anterolateral
thigh, if the course is interrupted, it should be resumed
(using the same vaccine) but not repeated, allowing the
appropriate interval between the remaining doses.lUNLICENSED USE
GARDASIL®Two dose schedule not licensed for use in
girls aged 14 years.
lSIDE-EFFECTS
▶Common or very commonPain in extremity
▶Rare or very rareBronchospasm
▶Frequency not knownAcute disseminated
encephalomyelitis.anaphylactoid reaction.asthenia.
chills.Guillain-Barre syndrome.immune
thrombocytopenic purpura.syncope
lPREGNANCYNot known to be harmful, but vaccination
should be postponed until completion of pregnancy.
lPRESCRIBING AND DISPENSING INFORMATIONTo avoid
confusion, prescribers should specify the brand to be
dispensed.lMEDICINAL FORMS
There can be variation in the licensing of different medicines
containing the same drug.
Suspension for injection
▶Cervarix(GlaxoSmithKline UK Ltd)
Cervarix vaccine suspension for injection 0. 5 ml pre-filled syringes|
1 pre-filled disposable injectionP£ 80. 50
▶Gardasil(Merck Sharp & Dohme Ltd)
Gardasil vaccine suspension for injection 0. 5 ml pre-filled syringes|
1 pre-filled disposable injectionP£ 86. 50eiiiiF 788Influenza vaccine
lINDICATIONS AND DOSE
Annual immunisation against seasonal influenza
▶BY INTRAMUSCULAR INJECTION
▶Child 6 months–17 years: 0. 5 mL for 1 dose
▶BY INTRANASAL ADMINISTRATION
▶Child 2–17 years: 0. 1 mL for 1 dose, dose to be
administered into each nostril
Annual immunisation against seasonal influenza (for
children who have not received seasonal influenza
vaccine previously)
▶BY INTRAMUSCULAR INJECTION
▶Child 6 months–9 years: 0. 5 mL for 1 dose, followed by
0. 5 mL for 1 dose, after at least 4 weeks▶BY INTRANASAL ADMINISTRATION
▶Child 2–9 years: 0. 1 mL for 1 dose, followed by 0. 1 mL
for 1 dose, after at least 4 weeks. 0. 1 mL dose to be
administered to each nostrillUNLICENSED USESome products containing inactivated
influenza vaccine (surface antigen) are not licensed for use
in children under 4 years—check product literature.
OPTAFLU®Not licensed for use in children and
adolescents under 18 years.
FLUVIRIN®Not licensed for use in children under 4 years.
lCONTRA-INDICATIONSPreparations marketed by Pfizer, or
CSL Biotherapies in child under 5 years—increased risk of
febrile convulsions
FLUENZ TETRA®Active wheezing.concomitant use with
antiviral therapy for influenza.concomitant use with
salicylates.severe asthma
CONTRA-INDICATIONS, FURTHER INFORMATION
▶Concomitant use with antiviral therapy for influenzaAvoid
influenza antiviral agents for at least 2 weeks after
immunisation; avoid immunisation for at least 48 hours
after stopping the influenza antiviral agent.
ENZIRA®Child under 5 years—increased risk of febrile
convulsions
lCAUTIONSIncreased risk of fever in child 5 – 9 years with
preparations marketed by Pfizer or CSL Biotherapies—use
alternative influenza vaccine if available
ENZIRA®Child 5 – 9 years (increased risk of fever)—use
alternative influenza vaccine if available
lINTERACTIONS→Appendix 1 : live vaccines
lSIDE-EFFECTS
▶Common or very common
▶With intramuscular useChills.hyperhidrosis.local reactions
.pain
▶With intranasal useNasal complaints
▶Uncommon
▶With intranasal useEpistaxis.face oedema
▶Frequency not known
▶With intramuscular useAngioedema.encephalomyelitis.
extensive swelling of vaccinated limb.febrile seizure.
nerve disorders.nervous system disorder.paraesthesia.
presyncope.shock.skin eruption generalised.syncope.
thrombocytopenia.vasculitis
▶With intranasal useGuillain-Barre syndrome
lALLERGY AND CROSS-SENSITIVITYIndividuals with a
history of egg allergy can be immunised with either an egg
free influenza vaccine, if available, or an influenza vaccine
with an ovalbumin content less than 120 nanograms/mL
(facilities should be available to treat anaphylaxis).
Vaccines with an ovalbumin content more than
120 nanograms/mL or where content is not stated should
not be used in individuals with egg allergy. If an influenza
vaccine containing ovalbumin is being considered in those
with a history of anaphylaxis to egg or egg allergy with
uncontrolled asthma, these individuals should be referred
to a specialist in hospital.
lPREGNANCYInactivated vaccines not known to be
harmful.
FLUENZ TETRA®Avoid in pregnancy.
lBREAST FEEDINGInactivated vaccines not known to be
harmful.
FLUENZ TETRA®Avoid in breast-feeding.
lPRESCRIBING AND DISPENSING INFORMATION
FLUARIX TETRA®Ovalbumin content less than
100 nanograms/mL.
lPATIENT AND CARER ADVICE
FLUENZ TETRA®Avoid close contact with severely
immunocompromised patients for 1 – 2 weeks after
vaccination.798 Vaccination BNFC 2018 – 2019
Vaccines14