{"id":2553,"date":"2019-01-10T11:24:44","date_gmt":"2019-01-10T11:24:44","guid":{"rendered":"http:\/\/edren.org\/ren\/?page_id=2553"},"modified":"2020-04-08T10:06:21","modified_gmt":"2020-04-08T10:06:21","slug":"immunisations","status":"publish","type":"page","link":"https:\/\/edren.org\/ren\/handbook\/transplant-handbook\/infection-prophylaxis-and-treatment\/immunisations\/","title":{"rendered":"Immunisations"},"content":{"rendered":"\r\n<h3 class=\"wp-block-heading\"><strong><span style=\"color: #993300;\">Renal Transplantation Protocol: Immunisations<\/span><\/strong><\/h3>\r\n\r\n\r\n\r\n<table class=\"wp-block-table\">\r\n<tbody>\r\n<tr>\r\n<td style=\"width: 377.6px; background-color: #e6f7ed;\"><strong><span style=\"color: #993300;\">A. Killed Vaccines<\/span><\/strong><\/td>\r\n<td style=\"width: 248.083px; background-color: #e6f7ed;\"><strong><span style=\"color: #993300;\">Pre-Transplant<\/span><\/strong><\/td>\r\n<td style=\"width: 158.317px; background-color: #e6f7ed;\"><strong><span style=\"color: #993300;\">Post-Transplant<\/span><\/strong><\/td>\r\n<\/tr>\r\n<tr>\r\n<td style=\"width: 377.6px;\">Tetanus \/ diphtheria \/ inactive polio<sup>1<\/sup><\/td>\r\n<td style=\"width: 248.083px;\">Yes<\/td>\r\n<\/tr>\r\n<tr>\r\n<td style=\"width: 377.6px;\">Hepatitis B<\/td>\r\n<td style=\"width: 248.083px;\">Yes<\/td>\r\n<td style=\"width: 158.317px;\">Yes<\/td>\r\n<\/tr>\r\n<tr>\r\n<td style=\"width: 377.6px;\">Influenza<\/td>\r\n<td style=\"width: 248.083px;\">Yes<\/td>\r\n<td style=\"width: 158.317px;\">Yes<\/td>\r\n<\/tr>\r\n<tr>\r\n<td style=\"width: 377.6px;\">Typhoid (inactive polysaccharide vaccine)<\/td>\r\n<td style=\"width: 248.083px;\">Yes<\/td>\r\n<td style=\"width: 158.317px;\">Yes<\/td>\r\n<\/tr>\r\n<tr>\r\n<td style=\"width: 377.6px;\">Pneumococcal \/ Meningococcal \/ Hib<\/td>\r\n<td style=\"width: 248.083px;\">Yes<\/td>\r\n<\/tr>\r\n<tr>\r\n<td style=\"width: 377.6px;\">Combined Hepatitis A \/ B (TWINRIX)<\/td>\r\n<td style=\"width: 248.083px;\">Yes<\/td>\r\n<td style=\"width: 158.317px;\">Yes<\/td>\r\n<\/tr>\r\n<\/tbody>\r\n<\/table>\r\n\r\n\r\n\r\n<table class=\"wp-block-table\">\r\n<tbody>\r\n<tr>\r\n<td style=\"width: 392.95px; background-color: #e6f7ed;\"><strong><span style=\"color: #993300;\">B. Live Vaccines<\/span><\/strong><\/td>\r\n<td style=\"width: 251.65px; background-color: #e6f7ed;\"><strong><span style=\"color: #993300;\">Pre-Transplant<\/span><\/strong><\/td>\r\n<td style=\"width: 139.4px; background-color: #e6f7ed;\"><strong><span style=\"color: #993300;\">Post-Transplant<\/span><\/strong><\/td>\r\n<\/tr>\r\n<tr>\r\n<td style=\"width: 392.95px;\">MMR<sup>2<\/sup><\/td>\r\n<td style=\"width: 251.65px;\">Yes<\/td>\r\n<td style=\"width: 139.4px;\">Contraindicated<\/td>\r\n<\/tr>\r\n<tr>\r\n<td style=\"width: 392.95px;\">Varicella<\/td>\r\n<td style=\"width: 251.65px;\">Yes<\/td>\r\n<td style=\"width: 139.4px;\">Not recommended<\/td>\r\n<\/tr>\r\n<tr>\r\n<td style=\"width: 392.95px;\">BCG<\/td>\r\n<td style=\"width: 251.65px;\">Yes<\/td>\r\n<td style=\"width: 139.4px;\">Contraindicated<\/td>\r\n<\/tr>\r\n<tr>\r\n<td style=\"width: 392.95px;\">Yellow Fever Vaccine<\/td>\r\n<td style=\"width: 251.65px;\">Yes<\/td>\r\n<td style=\"width: 139.4px;\">Contraindicated<\/td>\r\n<\/tr>\r\n<\/tbody>\r\n<\/table>\r\n\r\n\r\n\r\n<p><span style=\"color: #993300;\"><strong><span style=\"color: #993300;\">Notes:<\/span><\/strong><\/span><\/p>\r\n\r\n\r\n\r\n<ul class=\"wp-block-list\" style=\"list-style-type: disc;\">\r\n<li>There is no risk of infection from vaccines and susceptible contacts.<\/li>\r\n<li><strong><span style=\"color: #993300;\">Measles <\/span><\/strong>&#8211; patients who are immunosuppressed and come into contact with measles should receive HNIG (human normal immunoglobulin) as soon as possible, but within 6 days.<\/li>\r\n<li><strong><span style=\"color: #993300;\">Chickenpox<\/span> <\/strong>&#8211; See <a href=\"http:\/\/edren.org\/ren\/handbook\/transplant-handbook\/infection-prophylaxis-and-treatment\/vzv\/\">VZV page<\/a> for info about prophylaxis if a non-immune patient encounters someone with active VZV infection.<\/li>\r\n<li><strong><span style=\"color: #993300;\">Yellow Fever<\/span><\/strong> &#8211; 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.\u00a0 Yellow Fever occurs in tropical Africa and in South America. <a href=\"https:\/\/www.nhs.uk\/conditions\/yellow-fever\/vaccination\/\">NHS UK on Yellow Fever<\/a> provides useful further information. <\/li>\r\n<\/ul>\r\n\r\n\r\n\r\n<p><strong><span style=\"color: #993300;\">Malaria Prophylaxis <\/span><\/strong>&#8211; up-to-date information on Malaria prophylaxis for a given destination is available from pharmacy.\u00a0 The following table gives an indication of interactions:<\/p>\r\n\r\n\r\n\r\n<table class=\"wp-block-table\" style=\"height: 140px;\">\r\n<tbody>\r\n<tr style=\"height: 24px;\">\r\n<td style=\"height: 24px; width: 123.183px;\">\u00a0<\/td>\r\n<td style=\"height: 24px; width: 392.467px; background-color: #e6f7ed;\"><strong><span style=\"color: #993300;\">Tacrolimus<\/span><\/strong><\/td>\r\n<td style=\"height: 24px; width: 268.35px; background-color: #e6f7ed;\"><strong><span style=\"color: #993300;\">Ciclosporin<\/span><\/strong><\/td>\r\n<\/tr>\r\n<tr style=\"height: 24px;\">\r\n<td style=\"height: 24px; width: 123.183px; background-color: #e6f7ed;\"><strong><span style=\"color: #993300;\">Choloroquine<\/span><\/strong><\/td>\r\n<td style=\"height: 24px; width: 392.467px;\">\u2191tacrolimus (CP450 3A4) levels<\/td>\r\n<td style=\"height: 24px; width: 268.35px;\">\u2191CyA (CP450 3A4)<\/td>\r\n<\/tr>\r\n<tr style=\"height: 48px;\">\r\n<td style=\"height: 36px; width: 123.183px; background-color: #e6f7ed;\"><strong><span style=\"color: #993300;\">Proguanil<\/span><\/strong><\/td>\r\n<td style=\"height: 36px; width: 392.467px;\">No interactions likely<\/td>\r\n<td style=\"height: 36px; width: 268.35px;\">No interaction likely<\/td>\r\n<\/tr>\r\n<tr style=\"height: 48px;\">\r\n<td style=\"height: 32px; width: 123.183px; background-color: #e6f7ed;\"><strong><span style=\"color: #993300;\">Mefloquine<\/span><\/strong><\/td>\r\n<td style=\"height: 32px; width: 392.467px;\">\u2191tacrolimus levels (displacement from plasma protein)<\/td>\r\n<td style=\"height: 32px; width: 268.35px;\">No interaction likely<\/td>\r\n<\/tr>\r\n<tr style=\"height: 24px;\">\r\n<td style=\"height: 24px; width: 123.183px; background-color: #e6f7ed;\"><strong><span style=\"color: #993300;\">Doxycycline<\/span><\/strong><\/td>\r\n<td style=\"height: 24px; width: 392.467px;\">\u2191tacrolimus (CP450 3A4)<\/td>\r\n<td style=\"height: 24px; width: 268.35px;\">\u2191CyA (CP450 3A4)<\/td>\r\n<\/tr>\r\n<\/tbody>\r\n<\/table>\r\n","protected":false},"excerpt":{"rendered":"<p>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\u2026<\/p>\n<p> <a class=\"continue-reading-link\" href=\"https:\/\/edren.org\/ren\/handbook\/transplant-handbook\/infection-prophylaxis-and-treatment\/immunisations\/\"><span>Continue reading<\/span><i class=\"crycon-right-dir\"><\/i><\/a> <\/p>\n","protected":false},"author":2,"featured_media":0,"parent":1628,"menu_order":148,"comment_status":"closed","ping_status":"closed","template":"","meta":{"_lmt_disableupdate":"","_lmt_disable":"","footnotes":""},"class_list":["post-2553","page","type-page","status-publish","hentry"],"_links":{"self":[{"href":"https:\/\/edren.org\/ren\/wp-json\/wp\/v2\/pages\/2553","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/edren.org\/ren\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/edren.org\/ren\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/edren.org\/ren\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/edren.org\/ren\/wp-json\/wp\/v2\/comments?post=2553"}],"version-history":[{"count":9,"href":"https:\/\/edren.org\/ren\/wp-json\/wp\/v2\/pages\/2553\/revisions"}],"predecessor-version":[{"id":4030,"href":"https:\/\/edren.org\/ren\/wp-json\/wp\/v2\/pages\/2553\/revisions\/4030"}],"up":[{"embeddable":true,"href":"https:\/\/edren.org\/ren\/wp-json\/wp\/v2\/pages\/1628"}],"wp:attachment":[{"href":"https:\/\/edren.org\/ren\/wp-json\/wp\/v2\/media?parent=2553"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}