ADACEL

Indications

• Booster immunization for tetanus
• Booster immunization for diphtheria
• Booster immunization for pertussis

Dosage

Children: Refer to specific guidelines and local health authority recommendations for dosage.

Adults: Refer to specific guidelines and local health authority recommendations for dosage.

Mechanism of action

Adacel works by stimulating the immune system to produce antibodies against the toxins and bacteria responsible for tetanus, diphtheria, and pertussis. The vaccine contains inactivated toxins (toxoids) from the tetanus and diphtheria bacteria, and killed or inactivated components of the Bordetella pertussis bacterium, which together induce an immune response without causing the diseases.

Pharmacodynamics

Upon administration, Adacel induces the production of specific antibodies that confer immunity against tetanus, diphtheria, and pertussis. The immune response can take several weeks to develop, but once established, it provides long-lasting protection. Booster doses are required every 10 years to maintain adequate immunity, especially for tetanus and diphtheria.

Pharmacokinetics

The pharmacokinetics of Adacel involve the absorption of the vaccine components into the immune system, where they trigger an immune response. The half-life of the antibodies produced can vary, but protective levels are generally maintained for several years following vaccination. The vaccine does not undergo metabolism in the traditional sense as it is not a pharmacological drug but rather a biological product.

Contra-indications

• Severe allergic reaction (anaphylaxis) to any component of the vaccine
• Moderate or severe acute illness with or without fever
• History of encephalopathy within 7 days of a previous vaccine containing pertussis

Adverse effects

• Injection site reactions (pain, swelling, redness)
• Fever
• Fatigue
• Headache
• Nausea
• Muscle pain
• Dizziness

Interactions

• Immunosuppressive therapies may reduce vaccine efficacy
• Concurrent administration with other vaccines is generally safe but should be assessed on a case-by-case basis

Precautions

• Use with caution in individuals with a history of Guillain-Barré syndrome
• Monitor individuals with a known allergy to latex due to potential exposure in vaccine components
• Assess for moderate to severe illness before administration

Pregnancy

Adacel is generally not recommended during pregnancy unless the benefits outweigh the risks. Consultation with a healthcare provider is advised.

Breast-feeding

Adacel can be administered during breastfeeding, as it is not expected to pose a risk to the infant.

Storage

Store in a refrigerator at 2°C to 8°C (36°F to 46°F). Do not freeze. Protect from light.

Formulations

• Suspension for injection

Indications

• Prevention of poliomyelitis
• Vaccination in children and high-risk populations

Dosage

Children: Refer to the BNF for Children for appropriate dosing schedules and recommendations for poliovirus vaccination in children.

Adults: Refer to specific guidelines for IPV and OPV administration in adults, as vaccination schedules may vary based on age and immunization history.

Mechanism of action

Poliovirus primarily infects the motor neurons of the spinal cord and brainstem, leading to cell lysis and apoptosis. The viral replication occurs in the cytoplasm of the host cells, resulting in the release of new virions. The immune response triggered by the infection can lead to paralysis due to damage to the motor neurons.

Pharmacodynamics

The pharmacodynamics of polio vaccines involve the induction of an immune response against the poliovirus. The IPV induces serum neutralizing antibodies, while the OPV induces both serum and mucosal immunity. This immune response prevents the establishment of infection and protects against the disease.

Pharmacokinetics

Poliovirus vaccines do not have a pharmacokinetic profile in the traditional sense, as they are biological products. However, the IPV is administered intramuscularly, leading to systemic absorption and subsequent immunogenicity. The OPV is administered orally, leading to replication in the gastrointestinal tract and inducing both humoral and cellular immunity.

Contra-indications

• Severe allergic reaction to polio vaccine components
• Immunocompromised state (inactivated vaccine preferred)

Adverse effects

• Injection site reactions (pain, swelling, redness)
• Fever
• Fatigue
• Gastrointestinal disturbances (nausea, vomiting)
• Rarely, vaccine-derived paralytic poliomyelitis

Interactions

• Live vaccines may be affected by immunosuppressive therapies
• Concurrent administration with other vaccines is generally safe but consult vaccination guidelines

Precautions

• History of allergic reactions
• Patients with a history of Guillain-Barré syndrome
• Caution in patients with neurological disorders

Pregnancy

Polio vaccination is recommended during pregnancy if the woman is at risk of exposure, as the benefits outweigh potential risks.

Breast-feeding

Polio vaccine can be administered to breastfeeding mothers without risk to the infant.

Storage

Store at 2-8°C. Do not freeze. Protect from light.

Formulations

• Inactivated poliovirus vaccine (IPV)
• Oral poliovirus vaccine (OPV)