General Principles
- Antibody-containing products interact differently based on vaccine type.
- Interference duration depends on antigen-specific antibody concentration within the administered product.
Inactivated Vaccines
- Blood products interact minimally with inactivated vaccines, toxoids, recombinant subunit, and polysaccharide vaccines.
- Administer simultaneously or at any interval before or after receipt of antibody-containing products.
- Single exception includes administration of rabies immunoglobulin seven days after rabies vaccine.
Live Attenuated Vaccines
- Blood products and immunoglobulins inhibit immune responses to live vaccines including measles, mumps, rubella, and varicella.
- Postpone specific live vaccines for three to eleven months depending on product dose.
- Exceptions include oral Ty21a typhoid, live-attenuated influenza, rotavirus, zoster, and yellow fever vaccines.
- Administer exempt live vaccines at any time before, concurrent with, or after antibody-containing products.
Timing Rules For Measles And Varicella Vaccines
- Vaccine followed by blood product: Vaccine virus replication occurs one to two weeks post-vaccination.
- Avoid blood products for two weeks following live vaccination.
- Repeat vaccine dose if antibody-containing product becomes necessary within fourteen days of measles or varicella vaccination.
- Repeat dose after recommended interval unless serologic testing indicates protective antibody response.
- Blood product followed by vaccine: Delay injectable live-virus vaccines until passive antibody degrades.
- Repeat vaccine dose if administered before recommended interval elapses.
