Guidance

Immunoglobulin: when to use

PHE's immunoglobulin handbook, providing guidance on administering immunoglobulin to prevent serious disease.

Documents

Updated restrictions on use of VZIG during supply shortage: advice for health professionals

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Chickenpox (varicella-zoster) immunoglobulin: August 2017

Rabies and immunoglobulin service (RIgS)

Hepatitis A immunoglobulin: June 2017

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General product information and how to administer immunoglobulin: July 2014

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Diphtheria anti-toxin: June 2017

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Hepatitis B immunoglobulin: October 2008

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Babies of hepatitis B infected mothers: August 2008

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Mumps and immunoglobulin: October 2008

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Polio immunoglobulin: October 2008

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Rabies: Human Rabies Immunoglobulin (HRIG)

Details

Tetanus immunoglobulin

For guidance on tetanus, please see tetanus immunoglobulin: recommendations on treatment and prophylaxis

Varicella zoster immunoglobulin

Varicella zoster Immunoglobulin (VZIG) is a scarce blood product that is offered to individuals at high risk of severe chickenpox following an exposure. This includes immunosuppressed individuals, young babies in their first week of life and pregnant women.

In response to a significant shortage of VZIG due to manufacturing issues, on the advice of a PHE convened expert working group, from 8th August 2018, use of VZIG is restricted to susceptible women exposed in the first 20 weeks of pregnancy and neonates. Antiviral agents are recommended for post exposure prophylaxis for pregnant women exposed after 20 weeks and immunosuppressed individuals.

See the detailed guide above “Updated restrictions on use of VZIG during supply shortage: advice for health professionals”

Immunoglobulins are concentrated antibody preparations which provide immediate short-term protection against disease for individuals at high risk of severe disease or serious complications from the disease.

This handbook contains information, indications and guidance for the use of immunoglobulin preparations for each individual disease.

See guidance for measles post-exposure prophylaxis and recommendations on treatment and prophylaxis for tetanus.

Published 1 October 2008
Last updated 8 August 2018 + show all updates
  1. Added document: Updated restrictions on use of VZIG during supply shortage: advice to health professions and RIgs page updated.
  2. Updated to reflect Greenbook changes in Human Rabies Immunoglobulin (HRIG) guidance.
  3. Uploaded interim VZIG guidance for pregnant women exposed to varicella, in relation to current immunoglobulin shortages.
  4. Added details of VZIG restrictions due to shortage.
  5. Updated Chickenpox (varicella-zoster) immunoglobulin guidance to clarify dose of methotrexate on page 10.
  6. Updated hepatitis A immunoglobulin guidance to clarify dosage and timing details.
  7. Updated 'Chickenpox (varicella-zoster) immunoglobulin May 2017' guidance by adding 'methotrexate' to table on page 12.
  8. Updated Chickenpox (varicella-zoster) immunoglobulin guidance.
  9. Updated rabies and immunoglobulin service guidance.
  10. Updated Chickenpox human varicella-zoster immunoglobulin guidance
  11. Details on an update to the Rabies and Immunoglobulin Service (RIgS).
  12. Updated the diphtheria anti-toxin chapter: the dosage section on page 1 has changed, based on WHO guidance and may differ from the Summary of Product Characteristics (SmPC).
  13. First published.