Archive for the ‘Virology’ Category

Avaxim (Sanofi Pasteur)   Leave a comment

AVaxim™ 160 U (Sanofi Pasteur)
(Hepatitis A vaccine)

Vaccine Type: inactivated adsorbed vaccine
Composition: inactivated Hepatitis A virus, GBM strain, 160 units, cultured on MRC-5 human diploid cells, adsorbed on aluminium hydroxide (= 0.3mg of Al).

Dosage:

  • indicated for active immunisation from 16 years of age
  • 0.5ml per dose: im/sc one primary dose
  • booster for long-term protection: preferably 6-12 months, but may be administered up to 36 months after first dose
  • Avaxim may be used as booster dose if primary dose was given with another inactivated Hep A vaccine

Contraindicated in:

  • hypersensitivity to neomycin
  • not to be injected in the buttocks or intradermally
  • delay vaccination if acute severe febrile illness
  • response may be reduced in immunosuppressed
  • no studies done in subjects with liver disease

Pregnancy: avoid except in major contamination risk.
Lactation: consider benefit of breastfeeding for child, versus Avaxim for woman.

Adverse reactions:
usually mild, confined to first few days with spontaneous recovery

  • nausea, vomiting, diarrhoea, abdominal pain
  • headache, myalgia, arthralgia, asthenia
  • mild injection site pain, mild fever

Drug interactions:

  • immunoglobulins may be administered together at a different injection site
  • may be given with other inactivated vaccines at different site, including Typhim Vi and yellow fever vaccine

 

Ref:

  1. promotional material, Sanofi Pasteur
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Posted December 13, 2011 by absinthemisia in viral hepatitis, Virology

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Influenza vaccine: Vaxigrip NH 2011/2012   Leave a comment

Vaxigrip NH 2011/2012 (sanofi-aventis)
(from promotional material)

Vaccine type: split virion, inactivated influenza vaccine
Composition:
<complies with WHO recommendation)

  • A/California/7/2009(H1N1)
  • A/Perth/16/2009(H3N2)
  • B/Brisbane/60/2008

Available in:

  • Vaxigrip Pediatric 0.25ml for 6-35 months of age
  • Vaxigrip 0.5ml for children & adults 36 months and older

Posted September 12, 2011 by absinthemisia in influenza, vaccination

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Influenza vaccine: influvac 2011/2012   Leave a comment

Influvac® 2011/2012 (Abbott)
(from promotional material)

Vaccine type: viral subunit vaccine (haemagglutinin & neuraminidase)
Composition:

  • A/California/7/2009(H1N1)-like virus
  • A/Perth/16/2009(H3N2)-like virus
  • B/Brisbane/60/2008-like virus

Posted August 12, 2011 by absinthemisia in influenza, vaccination

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Influenza vaccine: influvac 2010/2011   1 comment

Influvac® 2010/2011 (Solvay, Netherlands)
(from package insert, April 2010)

Vaccine type: viral surface antigen (inactivated) (haemagglutinin & neuraminidase)
Composition: complies with WHO recommendation for N hemisphere 2010/2011
Dosage:

  • 6-35months: 0.25ml or 0.5ml (clinical data limited)
  • >36months & adults: 0.5ml
  • single dose vaccine; however in children who have not previously been vaccinated, second dose (booster) should be given after an interval of at least 4 weeks
  • intramuscular or deep subcutaneous injection

Seroprotection: achieved in 2-3 weeks, duration 6-12 months

Contains traces of:

  • residues of eggs, chicken protein eg. ovalbumin (propagated in fertilised hens’ eggs)
  • formaldehyde
  • gentamicin
  • polysorbate 80, cetyltrimethylammonium bromide

Use in pregnancy/lactation:

  • limited data do not indicate that adverse foetal and maternal outcomes were attributable to the vaccine
  • may be considered from second trimester
  • if medical condition increases risk of complication from influenza, vaccine may be warranted regardless of stage of pregnancy
  • may be used during lactation

Some common side effects:

  • headache, myalgia, arthralgia, fever, malaise, fatigue
  • local: redness, swelling, pain, ecchymosis, induration
  • rare: neuralgia, encelphalomyelitis, GBS

Posted August 25, 2010 by absinthemisia in Infectious Dis, influenza, vaccination

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Hepatitis vaccine: Twinrix™   Leave a comment

Twinrix™ (GSK)
(from package insert, April 2004)

Vaccine type: combined inactivated Hepatitis A and surface antigen Hepatitis B

Composition (per 1.0ml dose):
720 ELISA units Hep A virus and 20mcg recombinant HBsAg

Dosage:

  • 16yo and above (3 doses): 1.0ml at 0, 1 month, 6 months (after 1st dose)
  • alternatively, if travel is anticipated urgently: 0, 7 days, 21 days; booster at 12 months
  • 1-15yo (2 doses): 1.0ml at 0 then 6-12 months
  • booster: Twinrix™ can be used if booster of both Hep A & B required. Alternatively, either monovalent vaccine may be used separately

  • intramuscular injection into deltoid or anterolateral thigh (infants); avoid gluteal

  • subcutaneous route may be used in bleeding disorders but suboptimal immune response may result

Contraindicated in:

  • anaphylaxis to neomycin
  • postpone in subjects with acute severe febrile illness

Use in pregnancy/lactation:

  • adequate data not available, but not expected to harm the foetus
  • used during pregnancy only when there is a clear risk of Hep A and B
  • use with caution in breastfeeding women

Some side effects:

  • common: fatigue, headache, malaise, nausea
  • uncommon: fever, vomiting
  • SE involving other organ systems are very rare

Influenza treatment: recommended dosages   1 comment

Treatment course: 5 days

M2 Inhibitors (effective against influenza A only)
Amantadine (Symmetrel)

  • <10y/o: 5mg/kg/d up to 150mg in 2 div doses (include those older than 10 but <40kg)
  • 10y/o and above: 100mg bd
  • 65y/o and above: 100mg/d or less
  • *consult package insert if CrCl <50ml/min

Rimantadine (Flumadine)

  • use in children <13y/o: off-label
  • 13y/o and above: 100mg bd
  • 65y/o and above: 100mg/d
  • *hepatic dysfunction, CrCl <10ml/min: reduce to 100mg/d

 

Neuraminidase Inhibitors (effective against influenza A & B)
Oseltamivir (Tamiflu)

  • 0 to <12 months: 3mg/kg bd
    12 months & above:

  • 15kg or less: 30mg bd
  • 15-23kg: 45mg bd
  • 23-40kg: 60mg bd
  • >40kg and adults: 75mg bd
  • *reduce dose if CrCl <30ml/min

Zanamivir (Relenza)

  • 7y/o and above: 10mg (2 inhalations) bd

 
Ref:

  1. CDC: Table: Recommended Daily Dosage of Seasonal Influenza Antiviral Medications for Treatment and Chemoprophylaxis for the 2008-09 Season—United States. Available at:
    http://www.cdc.gov/flu/professionals/antivirals/dosagetable.htm#table

  2. CDC: Table: Antiviral medication dosing recommendations for treatment or chemoprophylaxis of 2009 H1N1 infection. Available at:
    http://www.cdc.gov/h1n1flu/recommendations.htm#table1

Influenza vaccine: fluvax 2009/2010   2 comments

fluvax® 2009/2010 (CSL, Australia)
(from package insert, March 2009)

Vaccine type: purified, inactivated, split virion vaccine
Composition: conforms to requirements of the Vaccines and Related Biological Products Advisory Committee (VRBPAC) for northern hemisphere winter of 2009/2010

  • A/Brisbane/59/2007(IVR-148) or A/Brisbane/59/2007(H1N1)-like
  • A/Uruguay/716/2007(NYMC X-175C) or A/Brisbane/10/2007(H3N2)-like
  • B/Brisbane/60/2008 or B/Brisbane/60/2008-like

Dosage:

  • 6-35months: 0.25ml
  • >36months & adults: 0.5ml
  • single dose sufficient; however in children <9 years lacking prior antigenic exposure, and in those with impaired immunity, two doses are recommended separated by at least 4 weeks.
  • intramuscular or deep subcutaneous injection

Contraindicated in:

  • anaphylaxis to egg/chicken, neomycin, polymyxin B
  • acute febrile illness (fever >38.5c)

Use in pregnancy/lactation:

  • category B2 (no convincing evidence of risk to foetus)
  • may be offered to pregnant women who will be in 2nd or 3rd trimester during influenza season, including those in the 1st trimester at the time of vaccination

Some common side effects:

  • common: injection site inflammation, influenza-like illness
  • rare: neuralgia, paresthesia, convulsions, transient thrombocytopenia
  • very rare: encelphalomyelitis, GBS, vasculitis with renal involvement

drug interactions:

  • may impair P450 metabolism of warfarin, theophylline, phenytoin, phenobarbitone, cabamazepine

Posted December 1, 2009 by absinthemisia in influenza, vaccination

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