Renal Transplantation Protocol: Immunisations 2009
| Pre-Transplant | Post-Transplant | |
| A. Killed Vaccines | ||
| - 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 | Yes | |
| - MMR2 | Yes | Contraindicated |
| - Varicella | Yes | Not recommended |
|
- BCG |
Yes | Contraindicated |
| - Yellow Fever Vaccine | Yes | Contraindicated |
- Oral/live polio vaccine not been usedin UK since 2004.
- There is no risk of infection from vaccinees 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 - Varicella zoster immunoglobulin (VZIG) is indicated in patients who have had significant exposure to chickenpox or shingles and who have no antibodies to VZ. VZIG should be given within 7 days of contact.
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 – see WHO website for details.)
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) | ↑ CyA (CP450 3A4) |
| Proguanil | No interactions likely | No interaction likely |
| Mefloquine | ? ↑ tacrolimus (displacement from plasma protein) | No interaction likely |
| Doxycycline | ? ↑ tacrolimus (CP450 3A4) |
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| PJP Prophylaxis << | >> Complementary Medicines |
