Bexsero

/ GSK

Infants, 2 months to 5 months:
Primary Immunisation: Three doses each of 0.5 ml, with first dose given at 2 months of age.
Intervals between Primary Doses: Not less than 1 month.
Booster: Yes, one dose between 12 and 15 months.
Unvaccinated infants, 6 months to 11 months:
Primary Immunisation: Two doses each of 0.5 ml.
Intervals between Primary Doses: Not less than 2 month.
Booster: Yes, one dose in the second year of life with an interval of at least 2 months between the primary series and booster dose.
Unvaccinated children, 12 months to 23 months:
Primary Immunisation: Two doses each of 0.5 ml.
Intervals between Primary Doses: Not less than 2 month.
Booster: Yes, one dose with an interval of 12 months to 23 months between the
primary series and booster dose.
Children, 2 years to 10 years:
Primary Immunisation: Two doses each of 0.5 ml.
Intervals between Primary Doses: Not less than 2 month.
Booster: Need not established.
Adolescents (from 11 years of age) and adults*:
Primary Immunisation: Two doses each of 0.5 ml.
Intervals between Primary Doses: Not less than 1 month.
Booster: Need not established.
See prescribing information for full details.

Method of administration: The vaccine is given by deep intramuscular injection, preferably in the anterolateral aspect of the thigh in infants or in the deltoid muscle region of the upper arm in older subjects.
Separate injection sites must be used if more than one vaccine is administered at the same time.
The vaccine must not be injected intravenously, subcutaneously or intradermally and must not be mixed with other vaccines in the same syringe.

Bexsero is indicated for active immunization of individuals from 2 months of age and older against invasive meningococcal disease caused by Neisseria meningitidis group B.
The impact of invasive disease in different age groups as well as the variability of antigen epidemiology for group B strains in different geographical areas should be considered when vaccinating. The use of this vaccine should be in accordance with official recommendations.

Hypersensitivity to the active substances or to any of the excipients.

As with other vaccines, administration of Bexsero should be postponed in subjects suffering from an acute severe febrile illness. However, the presence of a minor infection, such as cold, should not result in the deferral of vaccination.
Do not inject intravascularly.
As with all injectable vaccines, appropriate medical treatment and supervision should always be readily available in case of an anaphylactic event following the administration of the vaccine.
Anxiety-related reactions, including vasovagal reactions (syncope), hyperventilation or stress-related reactions may occur in association with vaccination as a psychogenic response to the needle injection. It is important that procedures are in place to avoid injury from fainting.
This vaccine should not be given to individuals with thrombocytopenia or any
coagulation disorder that would contraindicate intramuscular injection, unless the potential benefit clearly outweighs the risk of administration.
As with any vaccine, vaccination with Bexsero may not protect all vaccine recipients.
Bexsero is not expected to provide protection against all circulating meningococcal group B strains.
As with many vaccines, healthcare professionals should be aware that a temperature elevation may occur following vaccination of infants and children (less than 2 years of age). Prophylactic administration of antipyretics at the time and closely after vaccination can reduce the incidence and intensity of post-vaccination febrile reactions. Antipyretic medication should be initiated according to local guidelines in infants and children (less than 2 years of age).
Individuals with impaired immune responsiveness, whether due to the use of immune-suppressive therapy, a genetic disorder, or other causes, may have reduced antibody response to active immunization.
Immunogenicity data are available in individuals with complement deficiencies, asplenia, or splenic dysfunctions.
Individuals with familial complement deficiencies (for example, C3 or C5 deficiencies) and individuals receiving treatments that inhibit terminal complement activation (for example, eculizumab) are at increased risk for invasive disease caused by Neisseria meningitidis group B, even if they develop antibodies following vaccination with Bexsero.
There are no data on the use of Bexsero in subjects above 50 years of age and limited data in patients with chronic medical conditions.
The potential risk of apnoea and the need for respiratory monitoring for 48-72 hours should be considered when administering the primary immunisation series to very premature infants (born ≤ 28 weeks of gestation) and particularly for those with a previous history of respiratory immaturity. As the benefit of vaccination is high in this group of infants, vaccination should not be withheld or delayed.
The tip cap of the syringe may contain natural rubber latex. Although the risk for developing allergic reactions is very small, healthcare professionals should consider the benefit-risk prior to administering this vaccine to subjects with known history of hypersensitivity to latex.
Kanamycin is used in early manufacturing process and is removed during the later stages of manufacture. If present, kanamycin levels in the final vaccine are less than 0.01 micrograms per dose.
The safe use of Bexsero in Kanamycin-sensitive individuals has not been established.

In infants and children (less than 2 years of age) the most common local and systemic adverse reactions observed in clinical trials were tenderness and erythema at the injection site, fever and irritability.
In adolescents and adults the most common local and systemic adverse reactions observed were pain at the injection site, malaise and headache.
No increase in the incidence or severity of the adverse reactions was seen with
subsequent doses of the vaccination series.
See prescribing information for full details.

Use with other vaccines: Bexsero can be given concomitantly with any of the following vaccine antigens, either as monovalent or as combination vaccines: diphtheria, tetanus, acellular pertussis, Haemophilus influenzae type b, inactivated poliomyelitis, hepatitis B, heptavalent pneumococcal conjugate, measles, mumps, rubella, varicella , and meningococcal group CCRM conjugate.
Clinical studies demonstrated that the immune responses of the co-administered routine vaccines were unaffected by concomitant administration of Bexsero, based on non-inferior antibody response rates to the routine vaccines given alone. Inconsistent results were seen across studies for responses to inactivated poliovirus type 2 and pneumococcal conjugate serotype 6B and lower antibody titers to the pertussis pertactin antigen were also noted, but these data do not suggest clinically significant interference.
Due to an increased risk of fever, tenderness at the injection site, change in eating habits and irritability when Bexsero was co-administered with the above vaccines, separate vaccinations can be considered when possible. Prophylactic use of paracetamol reduces the incidence and severity of fever without affecting the immunogenicity of either Bexsero or routine vaccines. The effect of antipyretics other than paracetamol on the immune response has not been studied.
Concomitant administration of Bexsero with vaccines other than those mentioned above has not been studied.
When given concomitantly with other vaccines Bexsero must be administered at separate injection sites.

Pregnancy: Insufficient clinical data on exposed pregnancies are available.
The potential risk for pregnant women is unknown. Nevertheless, vaccination should not be withheld when there is a clear risk of exposure to meningococcal infection.
There was no evidence of maternal or foetal toxicity, and no effects on pregnancy, maternal behaviour, female fertility, or postnatal development in a study in which female rabbits received Bexsero at approximately 10 times the human dose equivalent based on body weights.
Lactation: Information on the safety of the vaccine to women and their children during breastfeeding is not available. The benefit-risk ratio must be examined before making the decision to immunise during breast-feeding.
See prescribing information for full details.

Experience of overdose is limited. In the event of overdose, monitoring of vital functions and possible symptomatic treatment is recommended.

Incompatibilities: In the absence of compatibility studies, this medicinal product must not be mixed with other medicinal products.
Storage: Store in a refrigerator (2°C – 8°C). Do not freeze. Store in the original package in order to protect from light.