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Renal Transplantation Protocol: Immunisations

A. Killed Vaccines Pre-Transplant Post-Transplant
Tetanus / diphtheria / inactive polio1 Yes  
Hepatitis B Yes Yes
Influenza Yes Yes
Typhoid (inactive polysaccharide vaccine) Yes Yes
Pneumococcal / Meningococcal / Hib Yes  
Combined Hepatitis A / B (TWINRIX) Yes Yes


B. Live Vaccines Pre-Transplant Post-Transplant
MMR2 Yes Contraindicated
Varicella Yes Not recommended
BCG Yes Contraindicated
Yellow Fever Vaccine Yes Contraindicated



  • There is no risk of infection from vaccines and susceptible contacts.
  • Measles - patients who are immunosuppressed and come into contact with measles should receive HNIG (human normal immunoglobulin) as soon as possible, but within 6 days.
  • Chickenpox - Varicella zoster immunoglobulin (VZIG) is indicated in patients who have had significant exposure to chickenpox or shingles and who have no antibodies to VZ.  VZIG should be given within 7 days of contact.
  • Yellow Fever – patients post-transplant intending to travel to countries where a Yellow Fever vaccination certificate is mandatory should obtain a letter of exemption from a medical practitioner.  (Yellow Fever occurs in tropical Africa and in South America – see WHO website for details.)

Malaria Prophylaxis – up-to-date information on Malaria prophylaxis for a given destination is available from pharmacy.  The following table gives an indication of interactions:





? Î ­ tacrolimus (CP450 3A4)

­Î CyA (CP450 3A4)


No interactions likely

No interaction likely


? ­ Î tacrolimus (displacement from plasma protein)

No interaction likely


? Î ­ tacrolimus (CP450 3A4)

­Î CyA (CP450 3A4)


Cytomegalovirus (CMV) << | Infection prophylaxis and treatment | (no next)

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This page last modified 05.03.2018 14:33 by Emma Farrell. edren and edrep are produced by the Renal Unit at the Royal Infirmary of Edinburgh and the University of Edinburgh. CAUTIONS and Contact us.