पृष्ठभूमि
Transfusions का ormal human immunoglobulin (NHIg) या अन्य donated blood productएस शायद used in the treatment का certain medical conditions, including:
- आईटीपी या कावासाकी रोग
- traumatic injuries
- haematological conditions
- postexposure to some infectious diseases (e.g. धनुस्तंभ, rabies और हेपेटाइटिस बी)
- as an adjunct to cancer treatments or surgery.
These products low levels of antibodies, passed on from the donor to the recipient. The donated antibodies कर सकना provide recipients with shortterm protection against certain टीकाpreventable diseases (VPDs). एचowever, vaccination is still for longterm protection.
Circulating donated antibodies can inhibit the recipient’s own immune response to certain injected live-attenuated vaccines, if the vaccines are administered too soon after the transfusion.
Recommendations
There are prescribed intervals between the transfusion of NHIg and/or a blood product and the administration of certain vaccines. This is to allow enough time for any donated antibodies to clear, optimising longterm effectiveness of the vaccine. The interval length depends on the type of product and the volume/dose transfused.
The following recommendations are aimed at ensuring the adequate immune response is achieved. They do not reflect concerns related to safety or adverse events following vaccine administration.
It is important to note that inactivated (nonlive) vaccines can be safely administered at any time during or following the administration of NHIg and/or blood products.
Table 1: Liveattenuated vaccines and the action when blood products previously given
| टीका | बीमारी | Action required |
| बीसीजी | tuberculosis | no interval needed |
| Rotarix*/Rotateq* | रोटावायरस | no interval needed |
| Priorix | meales, mumps and rubella | interval recommended^ |
| Varilrix | वैरिकाला (चिकनपॉक्स) | interval recommended^ |
| Priorix-tetra | measles, mumps, rubella and varicella | interval recommended^ |
| इमोजेव | जापानी मस्तिष्ककोप | interval recommended^# |
| Stamaril | पीला बुखार | no interval needed |
| Vivotif* | typhoid | no interval needed |
| Zostavax | zoster (shingles) | no interval needed# |
| ACAM2000 | mpox | use JYNNEOS (MVA-BN) |
* oral vaccine
^ Refer to tवह Immunisation Handbook guidance on Vaccination for people who have recently received normal human immunoglobulin and other blood products for recommended timeframes.
# एn alternative, inactivated vaccine is available and may be considered.
Patients receiving regular red blood cell transfusions
Patients requiring regular red blood cell transfusions for a chronic haematologic condition (e.g. transfusiondependent thalassaemia, sickle cell disease, inherited chronic haemolytic anaemias और inherited bone marrow failure syndromes) are unlikely to achieve a transfusionfree period long enough to allow immunisation according to the standard recommendations.
There is limited direct data on which to base decisions के लिए this group.
For patients requiring chronic red blood cell transfusions, who will not achieve a transfusion free period of more than 3 को 6 months in the foreseeable future, एमवीईसी recommendएस रहनाattenuated vaccines be administered per the National Immunisation Program (NIP), despite being within the usually recommended deferral period posटीtransfusion. Please refer to your haematologist or an immunisation specialist for specific advice.
यह सिफारिश इस पर आधारित है:
- उम्मीद है कि टीके अभी भी कई रोगियों में सुरक्षा प्रदान करेंगे (यद्यपि सामान्य जनसंख्या की तुलना में संभावित रूप से कम)
- इस सेटिंग में टीके के प्रशासन से जुड़ी किसी भी अतिरिक्त सुरक्षा चिंताओं की कमी
- the alternative being indefinite deferral of immunisation.
मरीजों को टीके की कम प्रभावशीलता की संभावना के बारे में सूचित किया जाना चाहिए।
A protocol for optimal timing of immunisation (in relation to blood transfusion, serological testing post immunisation and reimmunisation when there is no evidence of immunity) may help to improve response rates. MVEC has produced ए protocol for MMR and varicella vaccines in patients receiving regular red blood cell transfusions.
Documentation
People who have received NHIg and/या अन्य blood products and are scheduled के लिए upcoming टीकाएस should have a temporary exemption documented on the एustralian मैंmmunisation आरegister (AIR). This will ensure that any “no jab, no pay” and “no jab, no play” entitlements are not affected एरा minimise the likelihood of vaccine administration errors.
आमतौर पर पूछे जाने वाले प्रश्न
Do previous live‑attenuated vaccines need to be repeated following a transfusion?
Receiving a blood product at any stage after having already received liveattenuated vaccines does not jeopardise the effectiveness of the immune response to those टीकाएस. There are no safety concerns and no need to repeat any previously given vaccines.
What is the process if a vaccine is inadvertently administered too soon after receiving transfusion?
The patient/family should be informed of the error using the open disclosure framework and reassured that this is not a safety concern. The inadvertently administered dose is an invalid dose and will need to be repeated (after the appropriate interval has passed) to ensure the patient is protected.
It should also be noted in the patient records that this is considered an invalid dose and must be repeated once the appropriate interval has passed/4 weeks after the inadvertent dose was administered (whichever is later).
All vaccines should be reported on AIR, whether they were intended for administration or not.
संसाधन
- ऑस्ट्रेलियाई टीकाकरण पुस्तिका: उन लोगों के लिए टीकाकरण जिन्होंने हाल ही में सामान्य मानव इम्युनोग्लोबुलिन और अन्य रक्त उत्पाद प्राप्त किए हैं
- ऑस्ट्रेलियन रेड क्रॉस लाइफ ब्लड: रेड सेल्स
- Zabeida A, Lebel MH, Renaud C, Cloutier M, Robitaille N. Reevaluating immunization delays after red blood cell transfusion. Transfusion. 2019;59(9):2806-2811. doi:10.1111/trf.15433
- प्रतिरक्षण प्रथाओं पर सलाहकार समिति के सर्वोत्तम अभ्यास मार्गदर्शन (ACIP): प्रतिरक्षण के लिए सामान्य सर्वोत्तम अभ्यास दिशानिर्देश
- Siber GR, Werner BG, Halsey NA, et al. Interference of immune globulin with measles and rubella immunization. J Pediatr. 1993;122(2):204-211. doi:10.1016/s0022-3476(06)80114-9
लेखक: निगेल क्रॉफर्ड (निदेशक, SAEFVIC, मर्डोक चिल्ड्रन रिसर्च इंस्टीट्यूट) और राचेल मैकगायर (SAEFVIC रिसर्च नर्स, मर्डोक चिल्ड्रन रिसर्च इंस्टीट्यूट)
द्वारा समीक्षित: Rachael McGuire (MVEC Education Nurse Coordinator) and Katie Butler (MVEC Education Nurse)
तारीख: November 2024
नई जानकारी और टीके उपलब्ध होते ही इस अनुभाग की सामग्रियों को अद्यतन किया जाता है। मेलबर्न वैक्सीन एजुकेशन सेंटर (MVEC) कर्मचारी सटीकता के लिए नियमित रूप से सामग्रियों की समीक्षा करते हैं।
You should not consider the information on this site to be specific, professional medical advice for your personal health or for your family’s personal health. For medical concerns, including decisions about vaccinations, medications and other treatments, you should always consult a healthcare professional.