Community vaccine provider immunization (May 2018)

Due to national vaccine purchasing, B.C. will be transitioning from monovalent rotavirus vaccine (RV1, Rotarix®) to pentavalent rotavirus vaccine (RV5, RotaTeq®). The National Advisory Committee on Immunization recommends routine infant rotavirus vaccination with either rotavirus vaccine product owing to comparable efficacy, safety data and contraindications.

The schedule for RotaTeq® is 3 doses (at 2, 4 and 6 months of age) compared to 2 doses for Rotarix®.The maximum age for dose 1 of RotaTeq® is 20 weeks less one day and the maximum age for series completion is 8 months, zero days. The minimum interval between doses is 4 weeks. Ideally, infants who begin their series with Rotarix® will be able to complete their series with the same product; however, if unable to complete the series with Rotarix®or if any dose of the series was RotaTeq® (or the product is unknown), a total of 3 doses of RotaTeq® should be administered.

For questions about RotaTeq® vaccine refer to the following resources or contact your local public health unit.

An updated immunization record for the patient chart reflecting the change in rotavirus vaccine will be available soon on the BCCDC website.

NOTE: Please do not send vaccine home for administration by parent owing to both cold chain maintenance and medical liability such as anaphylaxis post-administration.

Shingrix® is a new adjuvanted recombinant non-live vaccine for the prevention of shingles (>90% vaccine efficacy). It is approved for use in immune competent individuals > 50 years old, administered IM in a two-dose schedule with doses given 2-6 months apart. Vaccine can be administered to individuals who have previously received Zostavax®; while a five-year interval has been examined in trials, shorter intervals (> 2 months) may be considered for individuals who would have derived lower efficacy from Zostavax® based on the age of administration (e.g., > 70 years of age).

Due to a supply disruption of ENGERIX®-B (adult) in 2017, The BCCDC has purchased internationally labelled product to ensure British Columbia’s supply of hepatitis B vaccine was not disrupted. The only difference between these two products is in the format as the product is a pre-filled syringe. The two products are fully interchangeable.

NACI has recommended a dose of Tdap during every pregnancy, ideally between 27 and 32 weeks gestation. Tdap vaccine is currently not publicly funded in B.C. and patients will be required to pay. Patients should be referred to a pharmacy or a travel clinic to purchase the vaccine.

A new drop–in or pre-booked immunization service is available for children receiving other care at BCCH or BCWH and for their family members, or for children with underlying health conditions who are behind in their immunizations. Referral for these families is not necessary; however, physicians are invited to send a note if they have specific concerns. The clinic also welcomes the following referral situations: children who have experienced an adverse event and whose families are reluctant to continue with immunizations, needle phobic/anxious children, or vaccine-hesitant families.

Influenza season is declared over. You will be receiving notification shortly from the local health unit regarding when/where to return any unused influenza vaccine.

Did you know a quarter of two-year-olds in the region are not up to date with their immunizations? Check out your community’s immunization coverage rate and remind parents to report immunizations to public health at reportimmunizations@fraserhealth.ca.

Please report any leakage of a GSK product to BCCDC Pharmacy using the BCCDC Vaccine supply Problem Report. If you observe any leakage deemed to be an appreciable amount (e.g. greater than 0.1 of the 0.5ml dose) administer another dose at the same visit.

• www.fraserhealth.ca/immunizations