Page 448 - TBE_Book_V2_2019

Chapter 14: Prevention

Institute of Poliomyelitis and Viral other aluminum-adjuvanted, inactivated
Encephalitides (IPVE). It is provided as a vaccines: the first vaccination is followed by a
3
suspension for injection. Klesch-E-Vac has an second shot 4-12 weeks later, and a third shot
adult (0.5mL) and also a pediatric formulation is administered 5-12 months later. However,
licensed for use as of 12 months to 16 years of considerable differences still exist between
age (half of the adult dose, i.e. 0.25 mL). vaccine brands. For Encepur and FSME-
IMMUN, a rapid or accelerated immunization
In addition, there is a dry-lyophilized TBE- schedule is licensed for children and adults
Moscow vaccine (no specific tradename), (Table 2). In the context of the conventional
3
based on the Sofjin strain. The producer is immunization schedule for any of the 4
also the Federal State Enterprise of Chumakov vaccine brands, the first TBE booster immun-
Institute of Poliomyelitis and Viral Encephal- ization is recommended 3 years following the
itides (IPVE). The vaccine is approved for use third vaccination of the primary series.
in patients from 3 years of age as a unified Subsequent boosters for the European vac-
formulation. cines are recommended at intervals of 5 years
in persons below 50 and 60 years of age for
Sen Tai Bao Encepur and FSME-IMMUN, respectively, and
every 3 years for persons older than 50 or 60
Sen Tai Bao (Changchun Institute of Biological years of age, respectively. Booster doses for
Products Co. Ltd: CIBP; in Changchun, Jilin the Russian vaccines are recommended every
Province, China) is another TBE vaccine,
3 years in all age groups.
manufactured by the Changchun Institute of
Biological Products (CIBP) and marketed in Contraindications and precautions
5
China. The first vaccine against TBE was
developed in China in 1953 – an inactivated In general, for all TBE vaccines, hyper-
TBEV grown on infected mouse brain tissues.
sensitivity to the active substances, any of the
Between 1953 and now several vaccine
excipients, or production residues constitutes
formulations have been developed and in use. a contraindication to immunization (Table 1).
Some of them grown on chicken embryo cells Severe hypersensitivity to egg, chicken
and later on using primary hamster kidney
91 proteins, or latex may cause severe allergic
cells. The current formalin-inactivated
reactions in sensitized individuals. A moderate
vaccine formulation is based on the TBEV-Fe allergy to egg proteins (defined as hives after
strain Senzhang and has been approved since consumption/injection) does not constitute a
6
2004. The vaccine is grown on primary contraindication for TBE vaccination with
hamster kidney cells, uses HSA as the stabilizer
either vaccine. However, patients with
and aluminum hydroxide as adjuvant. This
moderate egg allergy should be monitored for
vaccine is approved for use in adults and one hour after application. Therefore, persons
children 8 years of age or older.
with proven “non-severe egg allergy” can
receive a TBE vaccination. In case of a moder-
Vaccination schedules
ate or severe acute illness with or without
fever, TBE vaccination should be postponed.
Details on the schedules for the different
licensed vaccines are summarized in Table 2. Previous exposure to other flaviviruses or
In brief, the basic immunization protocol for flavivirus vaccines (for example, against Yellow
all vaccines consists of 3 doses (except the Sen
fever, Japanese encephalitis virus [JEV], or
Tai Bao, which has only 2 doses), similar to
dengue virus) has been suggested to affect the
conventional immunization schedules with
immune response to TBE vaccination.

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