Drug Interaction Report

Consumer information for this interaction is not currently available.

ADJUST DOSING INTERVAL: Administration of immune globulin preparations with, shortly before, or after live vaccines may impair the immune response to the vaccination(s). Injected live, attenuated virus vaccines (e.g., measles/mumps/rubella (MMR), measles/mumps/rubella/varicella (MMRV), varicella) may be affected by circulating antibodies present in immune globulin therapy or other blood products. The passive transfer of these antibodies may prevent replication of the vaccine virus, potentially reducing the vaccine's efficacy. In general, there appears to be minimal to no interaction between immune globulin preparations or blood products and the yellow fever vaccine, some live oral vaccines (e.g., rotavirus vaccine, oral typhoid vaccine), the live attenuated influenza vaccine (LAIV), and the Bacille Calmette-Guerin (BCG) vaccine. As this interaction is dependent upon the antibodies present in the immunoglobulin or blood product, it may be affected by the source used to create the product. Additionally, the vaccinations impacted may vary from country to country. Data on the immunogenicity and safety of all different vaccinations after the administration of all different immune globulin preparations are not available.

MANAGEMENT: In general, administration of a live vaccine should be delayed until the passive antibody received from the immune globulin product has degraded, which is product- and dose-dependent. If rapid protection is required, vaccination should proceed, but additional dose(s) of the vaccine and/or laboratory testing to ensure vaccine efficacy may be advised. According to the Advisory Committee on Immunization Practices (ACIP), the Ty21a typhoid, yellow fever, LAIV, and rotavirus vaccines may be administered at any time before, concurrently with, or after the administration of any immune globulin preparation or blood product. Local guidelines and prescribing information for the products involved should be consulted for further recommendations.