Immunisations
Renal Transplantation Protocol: Immunisations
| A. Killed Vaccines |
Pre-Transplant |
Post-Transplant |
| Tetanus / diphtheria / inactive polio1 |
Yes |
| Hepatitis B |
Yes |
Yes |
| Influenza |
Yes |
Yes |
| Typhoid (inactive polysaccharide vaccine) |
Yes |
Yes |
| Pneumococcal / Meningococcal / Hib |
Yes |
| Combined Hepatitis A / B (TWINRIX) |
Yes |
Yes |
| B. Live Vaccines |
Pre-Transplant |
Post-Transplant |
| MMR2 |
Yes |
Contraindicated |
| Varicella |
Yes |
Not recommended |
| BCG |
Yes |
Contraindicated |
| Yellow Fever Vaccine |
Yes |
Contraindicated |
Notes:
- There is no risk of infection from vaccines and susceptible contacts.
- Measles – patients who are immunosuppressed and come into contact with measles should receive HNIG (human normal immunoglobulin) as soon as possible, but within 6 days.
- Chickenpox – See VZV page for info about prophylaxis if a non-immune patient encounters someone with active VZV infection.
- Yellow Fever – patients post-transplant intending to travel to countries where a Yellow Fever vaccination certificate is mandatory should obtain a letter of exemption from a medical practitioner. Yellow Fever occurs in tropical Africa and in South America. NHS UK on Yellow Fever provides useful further information.
Malaria Prophylaxis – up-to-date information on Malaria prophylaxis for a given destination is available from pharmacy. The following table gives an indication of interactions:
| |
Tacrolimus |
Ciclosporin |
| Choloroquine |
↑tacrolimus (CP450 3A4) levels |
↑CyA (CP450 3A4) |
| Proguanil |
No interactions likely |
No interaction likely |
| Mefloquine |
↑tacrolimus levels (displacement from plasma protein) |
No interaction likely |
| Doxycycline |
↑tacrolimus (CP450 3A4) |
↑CyA (CP450 3A4) |
