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12.

Stornge

"f Veeeil1c•.

0. Mcas~es vaccine should be stored at domestic refrigerator temperature '(2 - 10 C). At this temperature it has a life of one year after issue by the manufacturer. It should not be stored at te\!lperatures below DoC, since the vial containing the diluent fl~id may crack if its contents 3re frozen.

April 1968
/'

/

Not.e
livo

nthe

une and l1torn c -of mear.;les vaccine
for :;,'outi.ne vaccination

u'ttcuuatad

1•

Nature

of the vacci.ne is

The vaccine now beine introduced fo::: routine vl:.ccio.ation against measles a freeze-dried preparation containing living attenuatod measles virus.
~. BeCoDsti tution .The vaccine is of tbevaccine 1soued by the manufacturers in s~le-doBe ampoules or

vials eacb accO!llpanied by an ""poule of diluent flUid (aee footnote *). It is necessary to reconstitute tbe vaccine ill1mcdiately before use witb the diluent fluid. lor "this purpose b sterile disposable syringe and.needle are essential, a 2 mi. ayringe vitb a needle 5/6 inch long of Standard Wire Gange 25 being sui. table.. Such syringes and necdlea are currently supplied bi the Miriistry cf Health through Executive Councile. 3. Injection of tho vaccine reconstituti.cg~nd f.or or intramuscular than .one"hour, after aterileayringe "and

The' Siime syringe and needle should be used both. for injecting the val~c1n.,. The dose 1s given. by subcutaneous injection as soon aa posslblo, and in B.n.y .event not later reconstitution. If m.ulti-doae packs are used .~,separate needle should be uaed foreach injection. (eee footnote*) '4. Dose

One ',inja~.ti1:)n~',~bcu'taheoueo.r" :intramuscUlar .--of .~he .entire. conteuts :'.of the 'single-dose vial'oftbe reoonstituted vaccine mJ.approx.);' '.If multi' dose pacll.s are used, one injection of 0:5 mJ.of the reconstituted vaccine (eeefootnote *).

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5.

Mode of action

Injection of the vaccine, in the absence 'ofpr..:.iixisting 111easles antibodies, is followed by multiplication of the attenuated viru.in the tissuea and the davelopment of antibodies. The virus is not transmitted from tho ,vaccinated individciil~to-other--1''9'f'9oils, by contact.

7.

Routine

vncc"ina.tion on VacCinatiOn -and Inmiuniaation -has recommende,d .that me'ssles be offered routinely iD. the -.second year of
of of ,.immunisatio~. aga,iilstdiphtheria,

,The .Toint Committee has also moaslas should be offered to all children who, 'llre .susceptible '..~o measles because they .the .natural disBase.; -Live measles vaccine

ohoulcl not be given to childrt:n below the age of nine ... monthn since it usually fails to immunise ~uch children owi.ngto the pre~ence of matcrnnll;r transmitt.ej antibodies.

-reacti ons "by means

of human normal

SI,ecial consideration should be given to children suffering .from chronic diseases of the heart or lungs in whomit may.be desirable to modify the possible reaction ,to vaccinatiori by the' simultBJ;leous administration of appropriate dose of humannormal immunoglobulin. These can be reduced by the simul taneous administration into fhe opposite limb of a small dose of human normal immunoglobulin of known measles antibody content. The optimumdose is 0.6 mg per 1b. of body weight. It is important not to exceed this dosage, since excess of immunoglubulin may completely inhibit the multiplication of the measles vaccine virns.

an

The Blood Products Laboratory is making a dilute prepsration of humsn. normal immunoglobulin, ,which will be available from about the beginning of June in ampoules each containing 15 mg.of immunglobulin in 0.5 ml of diluent. The contents of one. ampoule contain a dose appropriate for a child in the second.year of life. The preparation will be labelled !tHumannormal immunoglobulin (for' use with measles vaCCine)" and will be issued in bulk to local health euthori ties to meet individual requests from doctors. Estimated .'requirements .should be ordered by local health authorities direct from the Blood Products Laboratory, Liater Institute of Preventive Medicine, Elstree, Herta. The product should be"atored at 20 _100 C: It should not be frozen. This specialpreparationisintend~dfor . of health is such as. to make it necessary febrile reaction: 't'o':me'asles vaccine. 11. Supply of Vaccine use only in children whose state to. ensure the. absence. of any marked

Special arrangementS are being made for the periOd. up to 31st M8:"ch1969 tOsllpplylocalhe •.l thauthori ties with measles vaccine.. At theoutset~he . . mountof;vaccih..Availa a bl ewillbeinsufficien tto-meet all possible demands and 10cal'heiUth •.ut}1"ritie~ ••. beingaskrid *toplantheirarrangelllelltson re the basisth8ti.du~ing'.t~~months0fMay ,Juneand. July". 1968, vaccinstipnagain'!t measlesl'm .b.et):fferedolll!to.susceptiblechildrenwho ..arebej;ween.their, " fourthan.d'seventl{birthdaysand ,.to',.suscriptiblechildren .. ttend ingday .nurseries 1' or nursery .sclmolso~~"i vinginre sidentialesta blishmen tswhoarebetween their first and. seventh birthdays •. General medical'practitionersshould obtain measles .vaccine from tbe local health authority.in whose area they practice •. M:inistI'ybfli'eal th Circular 9/68 ,2