Lý lịch
Transfusions của ormal human immunoglobulin (NHIg) hoặc khác donated blood productS Có lẽ used in các treatment của certain medical conditions, including:
- ITP hoặc bệnh Kawasaki
- traumatic injuries
- haematological conditions
- postexposure to some infectious diseases (e.g. uốn ván, rabies Và hepatitis B)
- 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 Có thể provide recipients with shortterm protection against certain vắc xinpreventable diseases (VPDs). however, 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.
khuyến nghị
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
| vắc xin | Bệnh | Action required |
| BCG | tuberculosis | no interval needed |
| Rotarix*/Rotateq* | virus rota | no interval needed |
| Priorix | meales, mumps and rubella | interval recommended^ |
| Varilrix | varicella (thủy đậu) | interval recommended^ |
| Priorix-tetra | measles, mumps, rubella and varicella | interval recommended^ |
| imojev | Bệnh viêm não Nhật Bản | interval recommended^# |
| Stamaril | sốt vàng | no interval needed |
| Vivotif* | typhoid | no interval needed |
| Zostavax | zoster (shingles) | no interval needed# |
| ACAM2000 | mpox | use JYNNEOS (MVA-BN) |
* oral vaccine
^ Refer to tAnh ta Immunisation Handbook guidance on Vaccination for people who have recently received normal human immunoglobulin and other blood products for recommended timeframes.
# MỘTn 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 Và 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 vì this group.
For patients requiring chronic red blood cell transfusions, who will not achieve a transfusion free period of more than 3 ĐẾN 6 months in the foreseeable future, MVEC recommendS sốngattenuated vaccines be administered per the National Immunisation Program (NIP), despite being within the usually recommended deferral period posttransfusion. Please refer to your haematologist or an immunisation specialist for specific advice.
Khuyến nghị này dựa trên:
- kỳ vọng rằng vắc-xin vẫn sẽ bảo vệ ở một số bệnh nhân (mặc dù có khả năng thấp hơn so với dân số nói chung)
- thiếu bất kỳ lo ngại bổ sung nào về an toàn liên quan đến việc tiêm vắc-xin trong môi trường này
- the alternative being indefinite deferral of immunisation.
Bệnh nhân nên được thông báo về khả năng làm giảm hiệu quả của vắc-xin.
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 Một protocol for MMR and varicella vaccines in patients receiving regular red blood cell transfusions.
Documentation
People who have received NHIg and/hoặc khác blood products and are scheduled vì sắp tới vắc xinS should have a temporary exemption documented on các MỘTustralian TÔImmunisation register (AIR). This will ensure that any “no jab, no pay” and “no jab, no play” entitlements are not affected Mộtthứ minimise the likelihood of vaccine administration errors.
Các câu hỏi thường gặp
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 các effectiveness of the immune response to those vắc xinS. 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.
Tài liệu
- Cẩm nang Chủng ngừa Úc: Tiêm chủng cho những người gần đây đã nhận được globulin miễn dịch bình thường của người và các sản phẩm máu khác
- Máu Chữ Thập Đỏ Úc: Tế bào hồng cầu
- 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
- Hướng dẫn thực hành tốt nhất của Ủy ban cố vấn về thực hành tiêm chủng (ACIP): Hướng dẫn thực hành tốt nhất chung về tiêm chủng
- 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
Các tác giả: Nigel Crawford (Giám đốc, SAEFVIC, Viện Nghiên cứu Trẻ em Murdoch) và Rachael McGuire (Y tá Nghiên cứu SAEFVIC, Viện Nghiên cứu Trẻ em Murdoch)
Đượcxem xét bởi: Rachael McGuire (MVEC Education Nurse Coordinator) and Katie Butler (MVEC Education Nurse)
Ngày: November 2024
Tài liệu trong phần này được cập nhật khi có thông tin mới và có vắc-xin. Nhân viên của Trung Tâm Giáo Dục Vắc-xin Melbourne (MVEC) thường xuyên xem xét độ chính xác của các tài liệu.
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.