Updates to the Handbook

Addition of mpox clade Ib outbreak details and updated mpox vaccination guidance for travellers.

Removed of NeisVac-C as it is no longer available.

Removal of age restriction for MenACWY vaccine as it will be used for catch-up instead of MenC vaccine.

Addition of humanitarian workers to guidance for healthcare workers at risk of exposure to patients with mpox.

Updated to specify that NSAIDs should be avoided for post-vaccination pain relief.

Updated pneumococcal catch-up table headings to improve clarity of who is included.

Updated to include ibuprofen for pain relief.

Addition of a variation to product information regarding the recommended needle gauge for reconstitution of Shingrix.

Update to guidance for vaccination of individuals with a history of GBS following vaccination to discuss the risks and benefits with their healthcare provider.

The table of international vaccines considered valid was updated to remove Abhayrab rabies vaccine doses administered in India, since counterfeit Abhayrab vaccine doses have been identified.

Updates throughout the chapter to remove outdated formulations (Comirnaty XBB.1.5 (Pfizer) 6 months to <5 years, 5 years to <12 years and ≥12 years formulations) and added information about updated strain vaccine formulation that is Comirnaty LP.8.1. 

Factual and editorial updates made to classify adverse events based on age groups rather than individual vaccine products. Updates made to reflect the most recent data on immunogenicity, efficacy and effectiveness of Comirnaty JN.1 and JN.1-derived sublineage formulations where available. 

Added guidance that diphtheria-toxoid vaccines can be co-administered with immunisation products such as RSV monoclonal antibodies.

Updates to advice to provide more detail for live vs non-live vaccines, and specific advice for anti-CD20 therapies.

Updated to specify that infant travellers who receive an early dose of MMR at ≥ 11 months of age but before 12 months may not need a repeat dose, aligning with existing guidance on minimum acceptable age for first dose of MMR.

Added guidance that diphtheria-toxoid vaccines can be co-administered with immunisation products such as RSV monoclonal antibodies. 

Added guidance that diphtheria-toxoid vaccines can be co-administered with immunisation products such as RSV monoclonal antibodies.

Updated to screen for those carrying adrenaline devices for underlying immunological disorders.

Removed Menveo from the list of vaccines which contain latex in their packaging, to align with current product information.

Added detail on which packaging components contain latex.

Updated to remove reference to the Q Fever Register which has ceased operating.

Added guidance that diphtheria-toxoid vaccines can be co-administered with immunisation products such as RSV monoclonal antibodies.

Correction to reference.

Update to table on levels of immunocompromise related to mTOR inhibitors and updates to small molecule therapies resource table related to ALK inhibitors and CLK inhibitors. 

Specified Varilrix must be given subcutaneously while Varivax, Proquad and Priorix Tetra can be given subcutaneously or intramuscularly.