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

1• Nature of the vacci.ne

The vaccine now beine introduced fo::: routine vl:.ccio.ation against measles is
a freeze-dried preparation containing living attenuatod measles virus.
~. BeCoDsti tution of tbevaccine

.The vaccine is 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

The' Siime syringe and needle should be used both. for reconstituti.cg~nd f.or
injecting the val~c1n.,. The dose 1s given. by subcutaneous or intramuscular
injection as soon aa posslblo, and in B.n.y.event not later than .one"hour, after
reconstitution. If m.ulti-doae packs are used .~,separate aterileayringe "and
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 ,10.5
mJ.'approx.);' '.If multi-
dose pacll.s are used, one injection of 0:5 mJ.of the reconstituted vaccine
(eeefootnote *).

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 an
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.

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 use only in children whose state


. of health is such as. to make it necessary to. ensure the. absence. of any marked
febrile reaction: 't'o':me'asles vaccine.

11. Supply of Vaccine

Special arrangementS are being made for the periOd. up to 31st M8:"ch1969
tOsllpplylocalhe •.l thauthori ties with measles vaccine.. At theoutset~he .
.amountof;vaccih..Availa bl ewillbeinsufficien tto-meet all possible demands
and 10cal'heiUth •.ut}1"ritie~ ••.re beingaskrid *toplantheirarrangelllelltson 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 ..1t' tend ingday .nurseries
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

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