Vaccination after blood products

General Principles

Antibody-containing products interact differently based on vaccine type.
Interference duration depends on antigen-specific antibody concentration within the administered product.

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.

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.

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.