背景
Transfusions 的 ormal human immunoglobulin (NHIg) 或者 其他 donated blood product秒 或许 used in 这 treatment 的 certain medical conditions, including:
- ITP 或者 川崎病
- traumatic injuries
- haematological conditions
- post。exposure to some infectious diseases (e.g. 破伤风, rabies 乙型肝炎)
- 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 能 provide recipients with short。term protection against certain 疫苗。preventable diseases (VPDs). However, vaccination is still for long。term 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.
建议
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 long。term 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 (non。live) vaccines can be safely administered at any time during or following the administration of NHIg and/or blood products.
Table 1: Live。attenuated vaccines and the action when blood products previously given
| 疫苗 | 疾病 | Action required |
| BCG | tuberculosis | no interval needed |
| Rotarix*/Rotateq* | rotavirus | no interval needed |
| Priorix | meales, mumps and rubella | interval recommended^ |
| Varilrix | 水痘（水痘） | interval recommended^ |
| Priorix-tetra | measles, mumps, rubella and varicella | interval recommended^ |
| 伊莫耶夫 | 日本脑炎 | interval recommended^# |
| Stamaril | 黄热病 | no interval needed |
| Vivotif* | typhoid | no interval needed |
| Zostavax | zoster (shingles) | no interval needed# |
| ACAM2000 | mpox | use JYNNEOS (MVA-BN) |
* oral vaccine
^ Refer to t他 免疫接种 Handbook guidance on Vaccination for people who have recently received normal human immunoglobulin and other blood products for recommended timeframes.
# An 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. transfusion。dependent thalassaemia, sickle cell disease, inherited chronic haemolytic anaemias inherited bone marrow failure syndromes) are unlikely to achieve a transfusion。free period long enough to allow immunisation according to the standard recommendations.
There is limited direct data on which to base decisions 为了 this group.
For patients requiring chronic red blood cell transfusions, who will not achieve a transfusion free period of more than 3 to 6 months in the foreseeable future, MVEC recommend秒 居住。attenuated vaccines be administered per the National 免疫接种 Program (NIP), despite being within the usually recommended deferral period post。transfusion. Please refer to your haematologist or an immunisation specialist for specific advice.
该建议基于：
- 预期疫苗仍将为许多患者提供保护（尽管可能低于一般人群）
- 在这种情况下接种疫苗不存在任何额外的安全问题
- the alternative being indefinite deferral of immunisation.
应告知患者疫苗有效性降低的可能性。
A protocol for optimal timing of immunisation (in relation to blood transfusion, serological testing post immunisation and re。immunisation when there is no evidence of immunity) may help to improve response rates. MVEC has produced A protocol for MMR and varicella vaccines in patients receiving regular red blood cell transfusions.
文档
People who have received NHIg and/或者 其他 blood products and are scheduled 为了 即将到来 疫苗秒 should have a temporary exemption documented on 这 Australian Immunisation Register (AIR). This will ensure that any “no jab, no pay” and “no jab, no play” entitlements are not affected And minimise the likelihood of vaccine administration errors.
常见问题
Do previous live‑attenuated vaccines need to be repeated following a transfusion?
Receiving a blood product at any stage after having already received live。attenuated vaccines does not jeopardise 这 effectiveness of the immune response to those 疫苗秒. 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.
资源
- 澳大利亚免疫手册：最近接受过正常人免疫球蛋白和其他血液制品的人的疫苗接种
- 澳大利亚红十字会生命之血：红细胞
- 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
- 免疫实践咨询委员会 (ACIP) 的最佳实践指南：免疫接种的一般最佳实践指南
- 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
作者： Nigel Crawford（默多克儿童研究所 SAEFVIC 主任）和 Rachael McGuire（默多克儿童研究所 SAEFVIC 研究护士）
审核人： Rachael McGuire (MVEC Education Nurse Coordinator) and Katie Butler (MVEC Education Nurse)
日期： November 2024
本章节内的材料将随着新信息和新疫苗的出现而进行更新。墨尔本疫苗教育中心（MVEC）职员定期审阅材料的准确性。
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.