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Birmingham, Sandwell, Solihull and environs APC Formulary
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 Formulary Chapter 14: Immunological products and vaccines - Full Chapter
Notes:

Products will be prescribed and used in accordance with the guidance from the Department of Health handbook “Immunisation against infectious diseases” i.e. the Green Book and specialised services circulars”

Travel vaccines: (in line with Birmingham and Solihull CCG Policy for items which should not be prescribed in primary care  and  NHS Clinical Commissioners Items which should not routinely be prescribed in primary care: Guidance for CCGs) This is a restatement of existing regulations and no changes have been made as a result of this guidance

The following vaccines may be administered on the NHS for the purposes of travel, if clinically appropriate: 

  • Cholera
  • Diphtheria/ Tetanus/ Polio
  • Hepatitis A
  • Typhoid

The following vaccines should not be prescribed on the NHS exclusively for the purposes of travel, but may be prescribed on the NHS for all other indications listed in Immunisation Against Infectious Disease (The Green Book)

  • Hepatitis B
  • Japanese encephalitis
  • Meningitis ACWY
  • Yellow Fever
  • Tick-borne encephalitis
  • Rabies
  • BCG

These vaccines should continue to be recommended for travel, but the individual traveller will need to bear the cost of the vaccination.

Patient Information Leaflet

 Details...
14.01  Active immunity
14.01  Immunisation schedule
14.02  Passive immunity
14.03  Storage and use
14.04  Vaccines and antisera to top
14.04  Anthrax vaccine
14.04  BCG vaccines
BCG vaccine diagnostic agent
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Formulary
Green
 
   
BCG vaccine Intradermal
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Formulary
Green
 
Link  Patient Information Leaflet
   
14.04  Botulism antitoxin
Botulism antitoxin
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Formulary
Red
 
   
14.04  Cholera vaccine
Cholera vaccine (Dukoral®)
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Formulary
Amber Recommended
  • via travel vaccine service
 
   
14.04  Diphtheria vaccines to top
Infanrix-IPV®
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Formulary
Green
 
   
Pediacel®
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Formulary
Green
 
   
Repevax®
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Formulary
Green
 
   
Revaxis®
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Formulary
Green
 
   
14.04  Haemophilus influenzae type B vaccine
Haemophilus influenzae type B Combined Vaccine (Menitorix®)
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Formulary
Green
 
   
14.04  Hepatitis A vaccine
Hepatitis A vaccine Single Component (Avaxim®)
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Formulary
Green
 
   
Hepatitis A vaccine Single Component (Epaxal®)
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Formulary
Green
 
   
Hepatitis A vaccine Single Component (Havrix Monodose®)
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Formulary
Green
 
   
Hepatitis A vaccine Single Component (Vaqta® Paediatric)
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Formulary
Green
 
   
Hepatitis A vaccine with Hepatitis B vaccine  (Twinrix®)
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Formulary
Green
 
   
14.04  Hepatitis B vaccine
Hepatitis B vaccine Single Component (Engerix B®)
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Formulary
Green
 
   
Hepatitis B vaccine Single Component (Fendrix®)
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Formulary
Green
 
   
Hepatitis B vaccine Single Component (HBvaxPRO®)
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Formulary
Green
 
   
14.04  Human papilloma virus vaccine
Human papilloma virus vaccine (Gardasil®)
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First Choice
Green
  • For national immunisation campaign in adolescent girls ONLY 
  • Human papilloma virus vaccine (Cervarix®)
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    Formulary
    Green
     
       
    Human papilloma virus vaccine (Gardasil®)
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    Formulary
    Red
  • For use by ENT Specialists only in recurrent respiratory papillomatosis (RRP) 
  •    
    14.04  Influenza vaccine to top
    Inactivated Influenza Vaccine (Split Virion)
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    Formulary
    Green
     
       
    Influenza vaccine
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    Formulary
    Green
  • As per Green Book, Health Service circular, National Flu campaign 
  • Link  Green book: Immunisation against infectious diseases
       
    14.04  Measles vaccine
    14.04  Measles, Mumps and Rubella (MMR) vaccine
    Measles, Mumps and Rubella Vaccine, Live (MMR)
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    Formulary
    Green
     
       
    14.04  Meningococcal vaccines
    Meningococcal A, C, W135, and Y conjugate vaccine
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    Formulary
    Green
     
       
    Meningococcal group B Vaccine (Bexsero®)
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    Formulary
    Green
     
       
    Meningococcal group C conjugate vaccine
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    Formulary
    Green
     
       
    14.04  Mumps vaccine
    14.04  Pertussis vaccine to top
    14.04  Pneumococcal vaccines
    Pneumococcal polysaccharide conjugate vaccine (adsorbed) (Prevenar 13®)
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    Formulary
    Green
     
       
    Pneumococcal polysaccharide conjugate vaccine (adsorbed) (Synflorix®)
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    Formulary
    Green
     
       
    Pneumococcal polysaccharide vaccine (23-valent) (Pneumovax ®)
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    Formulary
    Green
     
       
    14.04  Poliomyelitis vaccines
    Poliomyelitis Vaccine Inactivated (Salk)
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    Formulary The polio vaccine is only given as part of combined products:
    ● diphtheria/tetanus/acellular pertussis/inactivated polio vaccine/
    Haemophilus influenzae type b (DTaP/IPV/Hib)
    ● diphtheria/tetanus/acellular pertussis/inactivated polio vaccine (DTaP/
    IPV or dTaP/IPV)
    ● tetanus/diphtheria/inactivated polio vaccine (Td/IPV). 
       
    14.04  Rabies vaccine
    14.04  Rotavirus vaccine
    Rotavirus vaccine (Rotarix®)
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    Formulary
    Green
     
       
    14.04  Rubella vaccine to top
    14.04  Smallpox vaccine
    14.04  Tetanus vaccines
    14.04  Tick-borne encephalitis vaccine
    14.04  Typhoid vaccines
    Polysaccharide vaccine for injection (Typhim Vi®, Typherix®)
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    Formulary
    Green
     
       
    Polysaccharide vaccine with hepatitis A vaccine
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    Formulary
    Green
     
       
    Typhoid Live Oral vaccine (Vivotif®)
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    Formulary
    Green
     
       
    14.04  Varicella-zoster vaccine to top
    Varicella Zoster vaccine
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    Formulary
    Green
     
       
    14.04  Yellow fever vaccine
    14.05  Immunoglobulins
    Rabies immunoglobulin
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    Formulary
    Red
    • Use in line with protocol
     
       
    14.05  Normal immunoglobulin
    Normal immunoglobulin
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    Formulary
    Red

    List of brands available for use:

    • Intratect (5%)
    • Gammaplex
    • Subgam
    • Hizentra
    • Privigen
    • Gamunex (10%)
    • Iqymune
    • Gammanorm
    • Octagam 10%
    • Panzyga
    • Cuvitru
    • Subcuvia
     
       
    14.05  Specific immunoglobulins
    14.05  Anti-D (Rho) immunoglobulin to top
    14.05  Interferons
    14.05.01  Normal immunoglobulin
    Normal immunoglobulin for Intramuscular use
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    Formulary
    Red
     
       
    Normal immunoglobulin for Subcutaneous use
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    Formulary
    Red
     
       
    14.05.02  Disease-specific immunoglobulins
    Hepatitis B immunoglobulin
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    Formulary
    Red
     
       
    Tetanus immunoglobulin
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    Formulary
    Red
     
       
    Varicella-Zoster immunoglobulin
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    Formulary
    Red
     
       
    14.05.03  Anti-D (Rho) immunoglobulin
    Anti-D (Rh0) Immunoglobulin
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    Formulary
    Red
     
    Link  NICE TA156: Anti-D in pregnant women
       
    14.06  International travel to top
     ....
     Non Formulary Items
    Anthrax vaccine

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    Non Formulary
     
    Diphtheria antitoxin

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    Non Formulary
     
    INTERFERON GAMMA-1b

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    Non Formulary
    Black
     
    Japanese Encephalitis Vaccine  (Ixiaro®)

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    Non Formulary Not NHS Not NHS

  • Only available as private prescriptions for travel purposes
  •  
    Poliomyelitis Vaccine Live (oral)

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    Non Formulary no longer available for routine use and will only be available for
    outbreak control
     
    Rabies vaccine  (Rabipur®)

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    Non Formulary Not NHS Not NHS

  • Only available as private prescriptions for travel purposes
  •  
    Tick-borne encephalitis vaccine

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    Non Formulary Not NHS Not NHS

  • Only available as private prescriptions for travel purposes
  •  
    Yellow fever vaccine (Live)

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    Non Formulary Not NHS Not NHS

  • Only available as private prescriptions for travel purposes

  • Available in approved yellow fever vaccination centres only
  • Link  MHRA: Yellow fever vaccine (Stamaril) and fatal adverse reactions: extreme caution needed in people who may be immunosuppressed and those 60 years and older
     
      
    Key
    note Notes
    Section Title Section Title (top level)
    Section Title Section Title (sub level)
    First Choice Item First Choice item
    Non Formulary Item Non Formulary section
    Restricted Drug
    Restricted Drug
    Unlicensed Drug
    Unlicensed
    Track Changes
    Display tracking information
    click to search medicines.org.uk
    Link to adult BNF
    click to search medicines.org.uk
    Link to children's BNF
    click to search medicines.org.uk
    Link to SPCs
    Cytotoxic Drug
    Cytotoxic Drug
    CD
    Controlled Drug
    High Cost Medicine
    High Cost Medicine
    Cancer Drugs Fund
    Cancer Drugs Fund
    NHSE
    NHS England
    Homecare
    Homecare
    CCG
    CCG

    Traffic Light Status Information

    Status Description

    Prescribing in children

    The APC notes that the informed use of unlicensed medicines or of licensed medicines for unlicensed applications (‘off-label’ use) is often necessary in paediatric practice.

    The APC advises GPs to consider specialist prescribing recommendations for Green and Amber medicines that are not subject to ESCAs or RICaDs in combination with the information provided in the BNFC which goes beyond that of marketing authorisations. The BNFC has been designed for rapid reference and the information presented has been carefully selected to aid decisions on prescribing.
      

    Green

    Medicines suitable for routine use within primary care. Initiation and maintenance of prescribing by Specialists, GPs and other qualified clinicians.   

    Amber Initiation

    Amber Specialist Initiation: Initiation and maintenance of prescribing by Specialists and transfer to Primary Care prescribing when appropriate. This may be supported by a RICaD, annotated within the formulary entry.  

    Amber Recommended

    Amber Specialist Recommendation: Initiation and maintenance of prescribing in Primary Care following recommendation from a Specialist.  

    Amber SC

    Amber Shared Care: Initiation and maintenance of prescribing by Specialists and transfer to Primary Care prescribing, in accordance with an ESCA, annotated within the formulary entry.  

    Red

    Medicines for initiation and maintenance prescribing by Specialists only.  

    Black

    Non-formulary Medicines which APC/Trust DTC has actively reviewed and do not recommend for use.  

    Grey

    Positive NICE TA and/or awaiting local clarification on place in therapy; Please contact your Medicines Optimisation team for more information.  

    The term 'Specialist' refers to Consultants, General Practitioners and Independant Prescribers with a Specialist Interest.  

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