Sayenna Uduman*, M I Sahadulla**, Raja Lakshmi***, Pretty G tharakan****
Potential disadvantages and Complexities of combos
Although there are clear benefits with combination vaccines, the main challenge in their development is the risk that the efficacy or safety of the combination would be less than that seen with the administration of the vaccines separately
• Misunderstanding, mix-up and uncertainty about selection of vaccine combinations and schedules for subsequent doses, especially when vaccinations are given by multiple providers who might be using different products.
• From a practical standpoint, uncommon transport and storage conditions and complicated bedside mixing could hamper the development of a combination vaccine.
• Monovalent rHepB vaccine MUST BE USED for the birth dose. Combination vaccines that include HepB vaccine must not be used to give the birth dose because the DTP and Hib vaccines are not recommended to be given at birth.
• Extra doses of certain antigens in the fixed combo product (an extra dose of hepB component , i.e. instead of a total 3 doses schedules, an additional 4th doses will be administered with the Combos use ). An extra dose of a live-virus vaccine component, or Hib or rHepB vaccine, has not been found to be harmful.
• It can be difficult to determine which component of a combination vaccine is responsible for an allergic reaction or other adverse event following immunization.
• Combos may raise babies’ risk for fever-caused seizures. Study finds overall risk associated with combo still low. Indeed, the study also found no evidence that the vaccine increases the risk that a child will develop epilepsy disorder.
• A shorter shelf-life than the individual component vaccines
• The economic impact of the use of combos is unclear because combination products have the potential for either increased or decreased costs compared with single-antigen component vaccines.
• Combination products may be more expensive than separate vaccines; however, combos' might represent a better overall economic value if the direct and indirect costs of extra injections, delayed or missed vaccinations, and additional handling and storage are taken into consideration.


Contributor Information and Disclosures

Sayenna Uduman*, M I Sahadulla**, Raja Lakshmi***, Pretty G tharakan****
Visiting Professor, Infection Control Committee & ID Division of the KIMS
Thiruvananthapuram, Kerala, India

**CMD, ID Division, KIMS
***ID Consultant, KIMS
****Clinical Pharmacist, KIMS

First Created : 3/11/2016


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