netFormulary NHS
NHS Bath and North East Somerset, Swindon and Wiltshire CCG
Royal United Hospitals Bath NHS Foundation Trust
Great Western Hospitals NHS Foundation Trust
Salisbury NHS Foundation Trust
 Formulary Chapter 14: Immunological products and vaccines - Full Chapter

Prescribing Guidance

Please see our Prescribing Guidelines page for all prescribing guidance relating to this chapter.

Shared Care Agreements

There are no Shared Care Agreements relating to this chapter.


Chapter Links...
14.05.02  Expand sub section  Disease-specific immunoglobulins
Hepatitis B immunoglobulin (HBIG)
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  •  Advice on the usage and availability can be obtained from the Microbiologist. 
Link  Green Book - Chapter 18
Tetanus immunoglobulin
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  • 100 IU/ml sterile solution
  • Intramuscular injection

NOTE Subgam to be added as the HNIG to use when Tetanus IG is unavailable but indicated as per national guidance. See link below.

Link  Green Book - Chapter 30
Link  PHE Tetanus July 2019 Guidance on the management of suspected tetanus cases and on the assessment and management of tetanus-prone wounds
Varicella-Zoster immunoglobulin
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  • In the first instance where VZIG may be required the midwife or doctor should contact the acute trust Microbiologist on call for immunology screening prior to prescribing and supplying.
  • RUH Pharmacy keep a supply of VZIG which is dispensed only following advice of Consultant Microbiologist. See protocol above for process for obtaining and administering VZIG. NB It is NOT available via community pharmacies.
Link  Green Book - Chapter 34
Link  PHE June 2019: Updated guidelines on post exposure prophylaxis (PEP) for varicella/shingles
Link  PHE Varicella zoster immunoglobulin Guidance on the use and ordering of varicella zoster immunoglobulin (VZIG).
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Traffic Light Status Information

Status Description

Traffic LightRed

RED - Hospital only to be prescribed by a specialist and supplied from secondary care ONLY throughout treatment.  

Traffic LightAmber

Amber medicines are considered suitable for GP prescribing following specialist initiation or recommendation.  

Traffic LightAmber with Shared Care

Shared Care - these medicines require specialist initiation and stabilisation. Ongoing division of responsibility for drug and disease monitoring between specialist and GP by a Shared Care Guideline (SCG). If no SCG in place status reverts to red.  

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These medicines are appropriate for initiation in both primary and secondary care. Prescribing is appropriate within licensed or local recommendations.  

Traffic LightSelf

Suitable for patient to be directed to buy themselves  

Traffic LightGrey

Not currently used. We intend to include this TLS in future to highlight where a decision to use this medicine is under review.   

Traffic LightBlack

(In use from Oct 2020) Used where a decision has been made by the BSW APC not to routinely commission this preparation for its licensed indications. Do not prescribe.   

Traffic LightRed Specialist Centre

Not currently used. We intend to include this TLS in future to highlight where this medicine and indication is ONLY available through a Specialist Centre according to a NICE Highly Specialised Technology or NHSE Specialised Commission Circular / Policy.