North East and North Cumbria Formulary


	North East and North Cumbria ICS Formulary

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Formulary Chapter 14: Immunological products and vaccines - Full Chapter

Notes:

Please refer to the Public Health England Green Book on vaccines for the most up to date information on the recommended preparations and use.

The use of travel vaccines in primary care is not recommended in line with NHS England Guidance on items which should not routinely be prescribed in primary care

Details...

14.04

Vaccines and antisera

Japanese Encephalitis Vaccine (Ixiaro^®)

Formulary

Tuberculin Purified Protein Derivative

Formulary

MHRA Drug Safety Updates: COVID-19 Vaccines

14.04

Anthrax vaccine

14.04

BCG vaccines

BCG vaccine
(Bacillus calmette-guerin vaccine)

Formulary

(BCG Vaccine, Dried/Tub/BCG) 1ml multidose vials containing freeze dried powder for preparing intradermal injections

14.04

Botulism antitoxin

Formulary

1 vial of Botulism antitoxin trivalent (equine) A B& E 5000 units injection

14.04

Cholera vaccine

14.04

COVID-19 vaccine

COVID-19 vaccines

Formulary

Comirnaty^® Original / Omicron BA.4-5
Comirnaty^® 10 Concentrate for children
Comirnaty^® 3 (THREE) Concentrate
VidPrevtyn Beta^®
Spikevax^® Original/Omicron BA.4-5

MHRA Drug Safety Updates: COVID-19 Vaccines

SPS COVID-19 vaccine resources

14.04

Diphtheria vaccines

Absorbed Diptheria Low Dose, Tetanus, and Poliomyelitis vaccine

Formulary

Absorbed Diptheria Low Dose, Tetanus, Pertussis and Poliomyelitis vaccine

Formulary

Absorbed Diptheria, Tetanus, Pertussis and Poliomyelitis vaccine

Formulary

14.04

Haemophilus influenzae type B vaccine

Haemophilus influenzae type B

Formulary

Haemophilus Influenzae type b & Meningococcal Group C Conjugate vaccine

Formulary

14.04

Hepatitis A vaccine

Formulary

Hepatitis A vaccine with Hepatitis B vaccine (Twinrix^®)

Formulary

14.04

Hepatitis B vaccine

Formulary

14.04

Human papilloma virus vaccine

Human papilloma virus (HPV) vaccine

Formulary

14.04

Influenza vaccine

Formulary

14.04

Measles vaccine

14.04

Measles, Mumps and Rubella (MMR) vaccine

Measles, Mumps and Rubella Vaccine, Live (MMR)

Formulary

14.04

Meningococcal vaccines

14.04

Mumps vaccine

14.04

Pertussis vaccine

14.04

Pneumococcal vaccines

Pneumococcal polysaccharide conjugate vaccine

Formulary

14.04

Poliomyelitis vaccines

Poliomyelitis Vaccine Inactivated (Salk)
(Inactivated poliomyelitis vaccine (IPV))

Formulary

Poliomyelitis Vaccine Live (oral)

Formulary

14.04

Rabies vaccine

Formulary

14.04

Rotavirus vaccine

Rotavirus vaccine (Rotarix^®)

Formulary

14.04

Rubella vaccine

14.04

Smallpox vaccine

14.04

Tetanus vaccines

Tetanus vaccine

Formulary

14.04

Tick-borne encephalitis vaccine

Formulary

14.04

Typhoid vaccines

Typhoid vaccine

Formulary

14.04

Varicella-zoster vaccine

Varicella Zoster vaccine (Zostavax^®)

Formulary

Varicella-zoster vaccine

Formulary

14.04

Yellow fever vaccine

Yellow fever vaccine (Live)

Formulary

Only available from designated Yellow Fever Vaccination Centres.

MHRA Drug Safety Update (April 2019): Yellow fever vaccine (Stamaril) and fatal adverse reactions: extreme caution needed in people who may be immunosuppressed and those 60 years and older

MHRA Drug Safety Update (Nov 2019): Yellow fever vaccine: stronger precautions in people with weakened immunity and in those aged 60 years or older

MHRA Drug Safety Update (Nov 2021): Yellow fever vaccine (Stamaril): new pre-vaccination checklist

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Key

	Notes
	Section Title (top level)
	Section Title (sub level)
	First Choice item
	Non Formulary section
	Restricted Drug
	Unlicensed
	Display tracking information
	Link to adult BNF
	Link to children's BNF
	Link to SPCs

	Cytotoxic Drug
	Controlled Drug
	High Cost Medicine
	NHS England
	Homecare
	CCG

Traffic Light Status Information

Status	Description
	Drugs for hospital use only. The responsibility for initiation and monitoring treatment should rest with an appropriate hospital clinician and the drug should be supplied through the hospital throughout the duration of treatment. In some very exceptional circumstances (e.g. due to distance from the hospital, storage, supply or mobility/transport problems) it may be appropriate for the GP to be asked to prescribe a Red drug. This should be negotiated on an individual patient basis and should only be done with the GP’s prior informed agreement where the roles of the GP and hospital services are clearly defined and agreed. The GP should not feel under pressure to prescribe in these circumstances. For all RED drugs automatically added to the formulary in response to a positive NICE TA: Prescribers need to ensure that local Trust new drug governance procedures and pharmacy processes are followed before any prescribing.
	Drugs initiated by hospital specialist, but where continuing treatment by GPs may be appropriate under a shared care arrangement. The specialist should send the GP a copy of the shared care agreement to sign. The GP should sign the shared care agreement, or indicate they do not want to be part of such an agreement, and return a copy back to the specialist. Shared care guidelines are available or are being developed for most of the drugs listed as Amber. If no shared care guideline is available, the hospital specialist should provide the patient’s GP with sufficient information and support to allow treatment to be continued and managed safely in primary care.
	Drugs normally recommended or initiated by a specialist (hospital or GP with an extended role https://www.rcgp.org.uk/gpwer), but can be safely maintained in primary care with very little or no monitoring required. In some cases there may be a further restriction for use outlined - these will be defined in each case. Provision of additional information, or an information leaflet, may be appropriate in some cases to facilitate continuing treatment by GPs.
	Drugs where prescribing by GPs is appropriate. Can be initiated and prescribed in all care settings, and if appropriate, discontinued without recourse to secondary care.
	NOT APPROVED: Drugs that have been considered by NTAG or the NENC ICB Medicines Subcommittee (or other approved body) and are not approved for prescribing within the North East and North Cumbria.
	UNDER REVIEW: drugs whose current formulary status or RAG status is currently under review.
	NOT REVIEWED: Drugs that haven not been reviewed yet. This usually means that an application is in progress. These drugs are not normally considered appropriate for prescribing in the North East and North Cumbria until such time that a decision is taken on their formulary status.