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Vaccine update: issue 318, March 2021

Published 23 March 2021

COVID-19 vaccination programme success continues

On Thursday 18 March, in the UK, 25,735,472 people have received the first dose of a vaccine, and 1,879,054 have received a second dose. This represents a phenomenal effort from the vaccination logistics, supply, and delivery teams across the UK working to give the vaccinations at a great pace.

It is very reassuring that so many eligible people have come forward to have their vaccinations in all the settings where they are offered.

Many people in care homes, looked after settings and residential care have taken up the offer. There are several models of delivery now including the large (or mass) vaccination centres in stadiums, town halls, sports venues including racecourses, concert halls and cathedrals some of whom have organists to accompany the teams as they vaccinate!

The primary care networks in local areas have also now been running since December providing local services which are preferable for many eligible groups such as those who are blind or partially sighted, less mobile, those with a learning disability or who have autism, to people in the clinically extremely vulnerable group who may all benefit from a familiar location with staff that know them and can support their needs.

Now many pharmacies have now come on board so that most people have access to the vaccinations in an area close to where they live. In remote areas we have heard of many volunteers working to get people who have mobility or access issues to the vaccination centres and it is clear how much community support there is to help those in more remote areas but there is still work to do.

So many people have shared pictures of their record card on social media and sticker with the #COVIDvaccination and shown their peers that they have had the vaccine and we hope that this will continue as younger people are offered the vaccine. We continue to add more accessible versions and hope that these are used in all the settings to make sure that people have the information they need in a format that suits them.

JCVI issues interim advice on Phase 2 of COVID-19 vaccination programme rollout

The Joint Committee on Vaccination and Immunisation (JCVI) has considered the evidence for Phase 2 of the UK’s COVID-19 vaccination programme.

Dr Mary Ramsay, Head of Immunisations at Public Health England (PHE), said:

Delivering a vaccination programme on this scale is incredibly complex and the JCVI’s advice will help us continue protecting individuals from the risk of hospitalisation at pace.

The age-based approach will ensure more people are protected more quickly. It is crucial that those at higher risk – including men and mixed ethnic communities – are encouraged to take the vaccine, and that local health systems are fully engaged and reaching out to underserved communities to ensure they can access the vaccine.

JCVI will continue closely monitoring the impact of the programme including vaccine safety, effectiveness and uptake, and will update its advice as required.

Guidance for unpaid carers who are eligible for their COVID-19 vaccination

This Standard Operating Procedure (SOP) is intended to support Local Authorities, the NHS Vaccination Programme and local carers organisations deliver the strong system leadership and partnership working which is essential to ensure local arrangements are in place to deliver the national offer for vaccination.

The SOP describes the framework for vaccination delivery, focusing on the definition, identification and necessary actions needed to enable eligible unpaid carers to receive the vaccine and to monitor uptake. It is not intended to disrupt existing vaccination arrangements for those within a higher priority for vaccination, for example, an unpaid carer who is over 65 years old should receive a vaccine as part of cohort 5.

The experience of parents and guardians

Parents’ and guardians’ views and experiences of accessing routine childhood vaccinations during the first wave of the COVID-19 pandemic in England

The NIHR Health Protection Research Unit (HPRU) in Vaccines and Immunisation – a partnership between Public Health England and the London School of Hygiene & Tropical Medicine, in collaboration with the University of Cambridge – conducts research to support national immunisation programme policy and delivery. As part of our research, we focus on improving vaccination access and uptake, and reducing inequalities in vaccination.

In April and May 2020, we conducted an online survey and interviews to find out parents’ and guardians’ views and experiences of accessing routine childhood vaccinations during the first wave of the COVID-19 pandemic and the first national lockdown. During the early phase of the pandemic in England, MMR vaccination counts were 20% lower than the same period in 2019, before recovering in mid-April (McDonald et al., 2020). Our study aimed to identify barriers to accessing routine childhood vaccination during early phase of the pandemic in England.

1,252 parents and guardians (aged 16 and over) who reported living in England with a child aged 18 months or under completed the survey – 19 survey respondents were interviewed. Parents and guardians were recruited to the study via social media and by email to baby and toddler groups in England. Survey respondents were asked about their beliefs and experiences surrounding routine vaccination during the COVID-19 pandemic, including how important they felt and how safe it was to take their child(ren) for routine vaccinations.

Knowledge about the availability of routine vaccinations was captured in 2 questions asking if respondents were aware of the government recommendation for routine childhood vaccination services to be maintained, and how certain respondents were that their child(ren) could still receive their routine vaccinations during the pandemic. Respondents were asked to rate their level of agreement with the statement ‘During the coronavirus (COVID-19) pandemic, I feel it is important to vaccinate my child/children on time for their routine vaccinations’:

• 86% somewhat or strongly agreed with this statement
• 13% disagreed to some extent with this statement

Several barriers to vaccination were reported by survey respondents and interview participants, including:

• a lack of clarity around whether vaccination services were operating as usual
• difficulties in organising vaccination appointments
• fears around contracting COVID-19 while attending general practice

One in 4 respondents were not aware of the national recommendation that routine vaccinations should go ahead as normal during the COVID-19 pandemic. Respondents from minority ethnic groups were three times more likely to be unaware of the recommendation that routine vaccination should go ahead as normal than White British, White Irish and White other respondents.

New social media cards to promote routine vaccinations

We have revised and improved our social media cards and included 2 new cards. Ready to share on social media, WhatsApp, websites and channels, they promote the routine childhood vaccination programme and the need for parents to make sure children are up to date with their important routine immunisations.

We have also had reports that parents still think that vaccinations are not happening due to the pandemic and want to send these though all our channels. Please share them widely with partners and on all your networks – we are keen to encourage pregnant mothers, parents and carers of infants, children and young people to ensure their child is up to date with routine immunisations, especially as school settings are opening and a return to the classroom.

There are 2 versions of each card:

• landscape – which is better for digital display screens and Twitter
• square – more suited for Instagram, WhatsApp and websites.

Both can be downloaded from the Health Publications and ordered using product code: 2020058.

Delivering vaccines to people experiencing homelessness

Groundswell has launched a short film and accompanying guide for frontline workers in the homelessness sector, sharing experiences on ‘what works’ when rolling out the COVID-19 vaccine in your service. It offers practical advice such as how to talk about the vaccine, how to communicate the rollout in your service and things to consider around use of language, accessibility, and preparation.

We would value your support in helping this reach frontline workers across the country. Please share via your internal communications channels, social media, newsletters and any other helpful networks or platforms. The film is 3 minutes and has subtitles, so it can be watched and listened to easily. The guide is short, with simple and practical advice given by people who have been working on the vaccine rollout to people experiencing homelessness and people affected by homelessness themselves.

The film (Logistics & communications: for frontline workers), Q&A guide for people experiencing homelessness, and more about the COVID-19 vaccine, are available to view and download.

The Queen’s Nursing Institute (QNI) publishes homeless vaccination outreach case studies

The QNI publishes cases studies from locations around the country to support homeless people to have their COVID-19 vaccinations. There are many great examples of regional services aimed at meeting their needs and helping them to access the vaccine.

COVID-19 programme resources

COVID-19 immunisation programme resources revised – now version 3 (V3) are available

As promised, we have revised the main adult leaflet, pregnancy leaflet and what to expect after your vaccination leaflets. There are more resources in production and we will publish a new issue with all the new versions in and they will be in line with the national campaign.

Resource	Who it is for	When it should be given	Where to use	Digital or paper copies	Product codes
guide for adult leaflet	all adults in eligilble groups	in advance of the appointment, so that the adult can read and consider ahead of the vaccination appointment. It should also accompany any call and recall letters to these adults	all settings	digital print ready and web ready files and paper copies available to order. Trusts and PCNs will be directly supplied with pack A to support vaccine supply delivery	COV2020351V3
what to expect after your COVID-19 vaccination leaflet[footnote 1]	for everyone who has a COVID-19 vaccination	at both appointments	at point of vaccination in all settings with record card	digital print ready and web ready files and paper copies available to order	COV2020307V3
guide to COVID-19 vaccination – for women of childbearing age, those currently pregnant or breastfeeding	for all women of child-bearing age, those currently pregnant or breastfeeding	it should be given with the adult, healthcare worker (COV2020316V2) and social care worker leaflets (COV2020341V2) in advance of the vaccination appointment	all settings and it should be included in any invitation letter except to those aged over 65 years	digital and paper copies available. Trusts and PCNs directly supplied with pack A to support vaccine supply delivery	COV2020374V3

New ‘Which COVID-19 vaccine?’ presentation poster for health professionals

This poster has been updated and is for health professionals to identify the correct syringe, doses and presentation of the Pfizer and Oxford AstraZeneca vaccines.

It shows the Oxford AstraZeneca vial which can now be supplied with a green cap and the blue syringes that accompany.

Free RNIB training for vaccination staff and volunteers

It’s essential that everyone who comes for a vaccine feels safe, supported and understood. The Royal National Institute of Blind People (RNIB) have free training available to staff and volunteers working on the vaccine programme to help you feel more confident in supporting people with sight loss.

You can pick from 3 short online training modules covering communication, how to guide, and the experiences of people with sight loss, relevant to your time in the vaccination programme and beyond. Click on the ‘register’ button to access the training. You can also download a quick ‘handy tips’ guide for working with people with sight loss and display it in staff areas of your vaccination centre.

For more details see the February 2021 issue 317 of vaccine update.

Resources for people using British Sign Language (BSL)

Many people who use sign language may also have reading difficulties and it can be more helpful for them to watch the video version so we have now produced an adult consent form BSL video.

A BSL video explaining the COVID-19 vaccination consent form is available to view and download.

The adult, what to expect after vaccination and pregnancy leaflet BSL videos are available to view and download.

Supply of pneumococcal polysaccharide vaccine (Pneumovax® 23)

Due to increased demand, supplies of pneumococcal polysaccharide vaccine (PPV23) marketed by MSD as Pneumovax® 23 in pre-filled syringes remain limited. Clinicians should continue to prioritise vaccination according to the recommendations below.

PPV23 is recommended for:

• individuals aged from 2 years or over in clinical risk groups
• all individuals aged 65 years and over

Advice on how to manage the PPV23 programme

If you are able to procure stock, the priority should be to offer the vaccine to those newly diagnosed with conditions in the high priority group followed by those in moderate priority groups who have never received PPV23 (see the table below). When such individuals are first identified, if no vaccine is available, please ensure that their records are flagged in order to call them for a future appointment.

Also ensure that other aspects of management are optimised and in place (for example antibiotic prophylaxis, or booster doses of PCV13) – as advised in relevant guidance, or by the specialist clinician caring for patient.

Any PPV23 dose that the surgery is able to access should be offered opportunistically to high and moderate priority groups attending an appointment at the surgery who have never received PPV23 and are due this vaccine.

PPV23 vaccination for lower priority groups (including healthy individuals aged 65 years and over) and booster doses for asplenics, those with splenic dysfunction and chronic kidney disease are less urgent and can be planned when sufficient stock is available. Providers should work together to ensure remaining stocks of PPV23 are where possible, made available to those who will benefit the most. Advice is available on the transfer of stock between providers.

National stocks of PCV13 (Prevenar13), or separately procured PCV10 (Synflorix), should not be used in place of PPV23 because herd protection from the childhood PCV13 programme has reduced pneumococcal disease due to these serotypes across all ages, including the elderly. PPV23 helps provide additional protection against serotypes that are not covered by PCV13 or PCV10.

Priority groups for Pneumococcal polysaccharide 23-valent vaccine (PPV23, Pneumovax 23)

Clinical risk group	Examples (decision based on clinical judgement)
High risk
Asplenia or dysfunction of the spleen	This also includes conditions such as homozygous sickle cell disease and coeliac syndrome that may lead to splenic dysfunction.
Immunosuppression	Due to disease or treatment, including patients undergoing chemotherapy leading to immunosuppression, bone marrow transplant, asplenia or splenic dysfunction, HIV infection at all stages, multiple myeloma or genetic disorders affecting the immune system (e.g. IRAK-4, NEMO, complement deficiency). Individuals on or likely to be on systemic steroids for more than a month at a dose equivalent to prednisolone at 20mg or more per day (any age), or for children under 20kg, a dose of 1mg or more per kg per day.
Individuals with cerebrospinal fluid leaks	This includes leakage of cerebrospinal fluid such as following trauma or major skull surgery (does not include CSF shunts).
Individuals with cochlear implants	It is important that immunisation does not delay the cochlear implantation.
Moderate priority
Chronic respiratory disease	This includes chronic obstructive pulmonary disease (COPD), including chronic bronchitis and emphysema; and such conditions as bronchiectasis, cystic fibrosis, interstitial lung fibrosis, pneumoconiosis and bronchopulmonary dysplasia (BPD). Children with respiratory conditions caused by aspiration, or a neurological disease (e.g. cerebral palsy) with a risk of aspiration. Asthma is not an indication, unless so severe as to require continuous or frequently repeated use of systemic steroids (as defined in Immunosuppression below).
Chronic heart disease	This includes those requiring regular medication and/or follow-up for ischaemic heart disease, congenital heart disease, hypertension with cardiac complications, and chronic heart failure.
Chronic kidney disease	Nephrotic syndrome, chronic kidney disease at stages 4 and 5 and those on kidney dialysis or with kidney transplantation.
Chronic liver disease	This includes cirrhosis, biliary atresia and chronic hepatitis.
Diabetes	Diabetes mellitus requiring insulin or oral hypoglycaemic drugs. This does not include diabetes that is diet controlled.
Low priority
Healthy individuals aged 65 years and over. Booster doses for asplenics, those with splenic dysfunction and chronic kidney disease.

Vaccine supply for the routine vaccination programme

Vaccines for the 2020 to 2021 children’s flu programme, supplied by PHE

Vaccine availability

• ordering for Fluenz® Tetra is now closed
• Fluarix® Tetra remains available to order at this time

PHE does not supply any flu vaccines for patients aged 18 years and over.

Please refer to guidance from your respective health departments for arrangements in Scotland, Wales and Northern Ireland.

Expiry dates for Fluenz Tetra issued for the 2020 to 2021 children’s flu programme

The final batch of Fluenz Tetra expires on 22 March.

Batch numbers and associated expiry dates of all batches of Fluenz Tetra that have been issued this season are set out in the table below. Please ensure that the expiry date is always checked before use and that expired stock is disposed of in line with local policies. Any disposed stock should be recorded through the ImmForm stock incident page.

Batch number	Expiry date			Batch number	Expiry date
MH2021	17/12/2020			MK2249	4/2/2021
MH2022	18/12/2020			MH3202	8/2/2021
MH2023	21/12/2020			MK3389	8/2/2021
MH2218	22/12/2020			MK2250	15/2/2021
MH3188	23/12/2020			MK3390	17/2/2021
MH3199	24/12/2020			MK3467	22/2/2021
MJ3211	06/01/2021			ML2229	1/3/2021
MJ3329	13/01/2021			ML2229C	15/3/2021
MJ3332	18/01/2021			ML2436	15/3/2021
MK3328	25/01/2021			ML2436B	22/3/2021

Providing a second dose of flu vaccine after all Fluenz® Tetra has expired

If you still need to give a second dose of flu vaccine 4 weeks after the first dose (for example, for children in clinical risk groups aged 2 to under 9 years who have not received influenza vaccine before), then it is safe and effective to give inactivated vaccine as a second dose where Fluenz® Tetra is no longer available.

All influenza vaccines for the 2020 to 2021 season

Information on all influenza vaccines that were available in the UK for the 2020 to 2021 season is available.

Viper antivenom has changed

The viper antivenom product supplied via ImmForm has recently changed from ViperaTAb® to Viperfav®. The products have different active ingredients, formulations and presentations:

Product	ViperaTAb®	Viperfav®
Source of immune sera	Ovine	Equine
Licensed status	Unlicensed in the UK	Unlicensed in the UK
Storage	Store in a refrigerator between 2°C and 8°C	Store in a refrigerator between 2°C and 8°C
Presentation	Each pack includes 2 x 4ml vials, containing 100mg Fab fragments each	Each pack includes 1 x 4ml vial containing F(ab’) 2 fragments
Initial treatment recommendation	The initial dose of ViperaTAb® is the contents of 2 x 4ml vials (i.e. 1 pack per patient)	The initial dose of Viperfav® is the contents of 1 x 4ml vial (i.e. 1 pack per patient)

Recommendations for the treatment of common adder bites and the administration of Viperfav® can be found on TOXBASE.

To minimise wastage, please use all locally held stocks of in date ViperaTAb® to treat eligible patients, before switching to Viperfav®.

ImmForm vaccine ordering account registration and account updates

When you register for or update an existing ImmForm account, Public Health England as a wholesaler of vaccines need to verify the requesting customer. Please ensure you have your professional regulatory body registration number or Wholesaler Dealer Licence and an organisation code which can be verified when requesting updates or requesting a new vaccine ordering account.

For more information please see the ImmForm helpsheet – how to register.

Change to dTaP/IPV vaccine for both the pre-school booster and maternal pertussis dTaP/IPV programmes

Boostrix-IPV® is currently supplied for both the pre-school booster and maternal pertussis dTaP/IPV programmes. This has recently changed from Repevax®. The two vaccines are equivalent. To minimise wastage, please use all your locally held stocks of Repevax® to vaccinate eligible individuals, before switching to Boostrix-IPV®. There is no other change to the pre-school booster or maternal pertussis immunisation programme. Further details about this programme can be found in chapter 24 of the Green Book.

Update to Bexsero patient information leaflet

Every pack of Bexsero (Meningitis B vaccine; 10 doses) is supplied with a pad of 10 patient information leaflets (PILs), as well as there being a single PIL inside each Bexsero pack. Since September 2020, an updated version of the PIL pad has been distributed with Bexsero orders. Please dispose of the single PIL from inside the pack, as it will be out-of-date. We will advise further when the PIL supplied in the pack is in line with the PIL pad.

Ordering the MMR vaccine

To rebalance central supplies of both MMR vaccines please consider ordering M-M-RvaxPRO® as your first choice, which is available without restriction. Customers in England and Wales who require Priorix®, for example because you serve communities that do not accept vaccines containing porcine gelatine, may order up to 6 packs of Priorix® per ImmForm account per week.

For assistance please contact the ImmForm Helpdesk at helpdesk@immform.org.uk or 0207 183 8580. Customers in Scotland should refer to their local ordering restrictions.

The EU Falsified Medicines Directive (FMD) and Delegated Regulation

From 11pm on 31 December 2020, when the UK’s EU exit transition period ended, the ‘safety features’ Delegated Regulation (2016/161) under the EU Falsified Medicines Directive (FMD; 2011/62/EU) no longer applied in Great Britain.

This means that in Great Britain, end users of the majority of prescription-only medicines, including the FMD-compliant products supplied by PHE via ImmForm, are no longer required to verify or decommission the unique identifiers on serialised packs. Serialised packs can none the less continue to be dispensed for as long as they are still in date.

Easter delivery schedule for COVID-19 vaccines

For those customers on a next day delivery schedule, there will be no deliveries or order processing by Movianto UK on Sunday 4 April (Easter Sunday). The order cut-off for delivery on Monday 5 April will be Saturday 3 April at 11:55am. Please see the table below for revised order cut-off and delivery dates.

Please ensure you select the delivery you require to avoid failed deliveries due to site closures.

COVID-19 vaccine schedule delivery day – Easter holidays 2021

Next day delivery schedule

Scheduled delivery day	Delivery date	Place order before 11.55am on	Notes/holiday
Wednesday	31 March	Tuesday 30 March
Thursday	1 April	Wednesday 31 March
Friday	2 April	Thursday 1 April	Bank holiday
Saturday	3 April	Friday 2 April
Sunday	4 April	No deliveries or order processing	Easter Sunday
Monday	5 April	Saturday 3 April	Bank holiday
Tuesday	6 April	Monday 5 April
Wednesday	7 April	Tuesday 6 April

The existing schedule for the rest of the week remains unchanged in that orders placed before 11:55am each day, will be delivered the next day.

Monday to Friday scheduled delivery day

Scheduled delivery day	Delivery date	Place order before 11.55am on	Notes/holiday
Wednesday	31 March	Monday 29 March
Thursday	1 April	Tuesday 30 March
Friday	2 April	Wednesday 31 March	Bank holiday – deliveries will be made

Weekend

Scheduled delivery day	Delivery date	Place order before 11.55am on	Notes/holiday
Monday	5 April	Friday 2 April	Bank holiday – deliveries will made (except Orkney)
Tuesday	6 April	Saturday 3 April	No scheduled delivery to Orkney
Wednesday	7 April	Monday 5 April	No scheduled delivery to Orkney
Thursday	8 April	Tuesday 6 April

If you have any queries about deliveries, please call 01234 587199 or email NHS.VaccineSupport@movianto.com

If you have any queries about ImmForm ordering, please call 0207 183 8580 or email Helpdesk@immform.org.uk

If you have any queries about the vaccine or associated products, please email COVID19PHEsupplies@phe.gov.uk

Easter and May bank holidays delivery schedules for routine vaccinations

Easter orders and deliveries

Due to the Easter bank holiday, there will be no deliveries or order processing by Movianto UK on Friday 2 April and Monday 5 April 2021. Please see the table below for revised order and delivery dates.

For customers with standard delivery days of Friday or Monday, please be aware that:

• after Friday 26 March, your next available delivery day will be Friday 9 April
• after Monday 29 March, your next available delivery day will be Monday 12 April

You are reminded to be prepared for the break in deliveries and to order accordingly. Please make sure you have sufficient room in your fridge for any additional vaccine you wish to stock over this holiday period, bearing in mind the recommendation that only 2 to 4 weeks of vaccine stock be held at any one time.

Easter bank holiday (Friday 2 April to Monday 4 April 2021)

Delivery date	Order cut-off date	Order cut-off time
Friday 26 March	Wednesday 24 March	11:55 AM
Monday 29 March	Thursday 25 March	11:55 AM
Tuesday 30 March	Friday 26 March	11:55 AM
Wednesday 31 March	Monday 29 March	11:55 AM
Thursday 01 April	Tuesday 30 March	11:55 AM
Friday 2 April	Closed – No deliveries or order processing
Monday 5 April	Closed – No deliveries or order processing
Tuesday 6 April	Wednesday 31 March	11:55 AM
Wednesday 7 April	Thursday 1 April	11:55 AM
Thursday 8 April	Tuesday 6 April	11:55 AM
Friday 9 April	Wednesday 7 April	11:55 AM
Monday 12 April	Thursday 8 April	11:55 AM

May bank holiday orders and deliveries

Due to the May bank holidays, there will be no deliveries or order processing by Movianto UK on Monday 3 May and Monday 31 May 2021. Please see the table below for revised order and delivery dates.

For customers with standard delivery dates of Monday, please be aware that:

• after the 26 of April, your next available delivery day will be the 10 May 2021
• after the 24 of May, your next available delivery day will be the 7 June 2021

You are reminded to be prepared for the break in deliveries and to order accordingly. Please make sure you have sufficient room in your fridge for any additional vaccine you wish to stock over this holiday period.

Early May bank holiday (Monday 3 May 2021)

Delivery date	Order cut-off date	Order cut-off time
Monday 26 April	Thursday 22 April	11:55 AM
Tuesday 27 April	Friday 23 April	11:55 AM
Wednesday 28 April	Monday 26 April	11:55 AM
Thursday 29 April	Tuesday 27 April	11:55 AM
Friday 30 April	Wednesday 28 April	11:55 AM
Monday 3 May	Closed – no deliveries or order processing
Tuesday 4 May	Thursday 29 April	11:55 AM
Wednesday 5 May	Friday 30 April	11:55 AM
Thursday 6 May	Tuesday 4 May	11:55 AM
Friday 7 May	Wednesday 5 May	11:55 AM
Monday 10 May	Thursday 6 May	11:55 AM

Late May bank holiday (Monday 31 May 2021)

Delivery date	Order cut-off date	Order cut-off time
Monday 24 May	Thursday 20 May	11:55 AM
Tuesday 25 May	Friday 21 May	11:55 AM
Wednesday 26 May	Monday 24 May	11:55 AM
Thursday 27 May	Tuesday 25 May	11:55 AM
Friday 28 May	Wednesday 26 May	11:55 AM
Monday 31 May	Closed – no deliveries or order processing
Tuesday 1 June	Thursday 27 May	11:55 AM
Wednesday 2 June	Friday 28 May	11:55 AM
Thursday 3 June	Tuesday 1 June	11:55 AM
Friday 4 June	Wednesday 2 June	11:55 AM
Monday 7 June	Thursday 3 June	11:55 AM

Please be advised that Emergency or ‘Out of Schedule’ deliveries cannot be arranged for failure to place orders in good time.

Vaccine supply for non-routine vaccination programme

Hepatitis A

Adult

• GSK: Havrix Adult pre-filled syringe (PFS) (singles and packs of 10) are available
• Sanofi Pasteur: Avaxim PFS (singles and packs of 10) are available
• MSD: VAQTA (adult) is available

Paediatric

• GSK: Havrix Paediatric PFS (singles and packs of 10) are available
• MSD: VAQTA (paediatric) is available

Hepatitis B

Adult

• GSK: Engerix B PFS (singles and packs of 10) are available
• GSK: Engerix B vials (singles and packs of 10) are discontinued
• GSK: Fendrix is available
• MSD: HBVAXPRO 10 µg is unavailable until late March 2021
• MSD: HBVAXPRO (40 µg) is available

Paediatric:

• GSK: limited supplies of Engerix B Paediatric (singles) are available
• MSD: HBVAXPRO (5µg) is available

Combined hepatitis A and B

• GSK: Twinrix Adult (singles and packs of 10) are available
• GSK: Twinrix (paediatric) is available
• GSK: Ambirix (available) is available

Combined Hepatitis A and typhoid

• Sanofi Pasteur: Viatim is available

Typhoid

• Sanofi Pasteur: Typhim (singles and packs of 10) are available
• Emergent: Vivotif is available

Rabies

• GSK: Rabipur is currently available – orders should be placed directly with Valneva, or via your preferred wholesaler

• Sanofi Pasteur: Rabies BP is currently out of stock – an alternative vaccine is available, please contact Sanofi Pasteur directly for more information

Pneumococcal polysaccharide vaccine (PPV)

• MSD: supply of Pneumovax 23 (PPV23) PFS is currently limited

Pneumococcal polysaccharide conjugate vaccine (PCV)

• Pfizer: Prevenar 13 is currently available

Varicella Zoster

• GSK: VARILRIX is available is available
• MSD: VARIVAX is available is available
• MSD: ZOSTAVAX is currently available without restrictions

Diphtheria, tetanus and poliomyelitis (inactivated)

• Sanofi Pasteur: Revaxis is available

Diphtheria, tetanus, pertussis (acellular) and poliomyelitis (inactivated)

• GSK: Supply of Boostrix-IPV is currently limited
• Sanofi Pasteur: Repevax is available to order without restrictions

MMR

• MSD: MMR Vaxpro is currently available to order without restriction
• GSK: Priorix is currently available

Meningitis ACWY

• GSK: Menveo is available
• Pfizer: Nimenrix is currently available

Yellow fever

• Sanofi Pasteur: Stamaril is available

Human papillomavirus vaccine (HPV)

• MSD: limited supplies of GARDASIL are available
• MSD: Gardasil 9 is currently available
• GSK: Cervarix has been discontinued

Cholera

• Valneva: Dukoral is available

Japanese encephalytis

• Valneva: Ixiaro is available

1. This is currently under revision and version 4 will be published very soon. ↩