2.3 Groups with special vaccination requirements

Please note: due to continuous updates being made to the Immunisation Handbook, the page number on the electronic version will not always match the hard copy version.

People who have received a blood transfusion, including mass blood transfusions, do not require revaccination. However, following the receipt of any blood product, including plasma or platelets, an interval of 3 to 7 months should elapse, dependent on the blood product transfused, before vaccination with an MMR, MMRV or varicella vaccine (see Table 2.3.5 Recommended intervals between either immunoglobulins or blood products and MMR, MMRV or varicella vaccination). Zoster vaccine can be given at any time before or after administration of any antibody-containing blood product (see ‘2.3.4 Vaccination of recent recipients of normal human immunoglobulin’ above).

An interval is suggested because there may be low levels of antibodies present in the blood product that may impair the immune response to the live vaccine.

Table: 2.3.5: Recommended intervals between either immunoglobulins or blood products and MMR, MMRV or varicella vaccination⁶⁵

	Route	Dose
		IU or mL	Estimated mg IgG/kg	Interval (months)
Blood transfusion: Washed RBCs	IV	10 mL/kg	Negligible	0
RBCs, adenine-saline added	IV	10 mL/kg	10	3
Packed RBCs	IV	10 mL/kg	20–60	5
Whole blood	IV	10 mL/kg	80–100	6
Cytomegalovirus immunoglobulin	IV	3 mL/kg	150	6
Hepatitis A prophylaxis (as NHIG)	IM	0.5 mL (<25 kg) 1.0 mL (25–50 kg) 2.0 mL (>50 kg)		3
Hepatitis B prophylaxis (as HBIG)	IM	100 IU 400 IU	10	3
ITP (as NHIG [Intravenous])	IV		400	8
ITP (as NHIG [Intravenous])	IV		1000	10
ITP or Kawasaki disease (as NHIG [Intravenous])	IV		1600–2000	11
Measles prophylaxis (as NHIG): Standard Immunocompromised	IM IM	(max. dose 15 mL) 0.2 mL/kg 0.5 mL/kg		5 6
Plasma or platelet products	IV	10 mL/kg	160	7
Rabies prophylaxis (as RIG)	IM	20 IU/kg	22	4
Replacement (or therapy) of immune deficiencies (as NHIG [Intravenous], various doses)	IV		300–400	9
Rh (D) IG (anti-D)	IM			0
Tetanus (as TIG for IM use)	IM	250 IU (given within 24 hrs of injury) 500 IU (>24 hrs after injury)	10 20	3
Varicella prophylaxis (as ZIG)	IM	200 IU (0–10 kg) 400 IU (11–30 kg) 600 IU (>30 kg)		5

* Zoster vaccine can be given at any time before or after administration of immunoglobulin, or any antibody-containing blood product (see Chapter 3.26, Zoster).

References