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Japanese encephalitis virus vaccine (JE-VAX, Ixiaro)

Classification: - JE-MB (JE-VAX) a) licensed in 1992 b) production discontinued in 2006 c) only vaccine available for children d) remaining does reserved for children - J-VC (IXIARO) [2] a) licensed in 2009 b) adults >= 17 years of age Indications: - active immunization against Japanese encephalitis for - travelers spending a month or longer in endemic or epidemic areas during season of transmission - people who are moving to a country where JE is endemic, (most parts of Asia & portions of the western Pacific) - frequent travel to endemic regions - lab workers with high exposure risk [5] - approved for children as young as 2 months of age [4] * risk of acquiring Japanese encephalitis is very low for most travelers - < 1 case per million trips to Asia Contraindications: 1) hypersensitivity to JE-VAX, especially manifesting as generalized urticaria or angioedema 2) hypersensitivity to rodent proteins or proteins of neural origin 3) hypersensitivity to thimerosal 4) pregnancy, unless substantial risk of infection Dosage: 1) J-VC (IXIARO) licensed in 2009 [2] - adults >= 17 years of age - two intramuscular injections one month apart 2) JE-MB (JE-VAX) - adults & children > 3 years of age - three doses of 1 mL on days 0, 7, & 14-30 - last dose 10 days before travel - booster may be given 2 years after primary immunization - children 1-3 years of age: 0.5 mL doses Adverse effects: 1) most common (1-10%) - inflammation at injection site, fever, headache, malaise, rash, chills, dizziness, myalgias, nausea/vomiting, abdominal pain, urticaria, pruritus, hypotension 2) uncommon (< 1%) - anaphylaxis, encephalitis, encephalopathy, seizure, peripheral neuropathy, erythema multiforme, erythema nodosum, angioedema, dyspnea, joint swelling 3) adverse effects may occur shortly after or up to 17 days following vaccination 4) report allergic or unusual adverse effects to: Vaccine Adverse Event Reporting System (VAERS) (800) 822-7967 Mechanism of action: - both vaccines are inactivated & stimulate production of neutralizing antibody

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Japanese encephalitis virus

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References

  1. Kaiser Permanente Northern California Regional Drug Formulary, 1998
  2. Fischer M et al. Japanese encephalitis vaccines: Recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR Recomm Rep. 2010 Mar 12;59(RR-1):1-27. PMID: 20224546 corresponding NGC guideline withdrawn Jan 2016
  3. Intercell Announces Pediatric Approval of its Japanese Encephalitis Vaccine in the U.S. Vienna (Austria), May 21, 2013 http://www.intercell.com/main/company/news/news-full/article/intercell-announces-pediatric-approval-of-its-japanese-encephalitis-vaccine-in-the-us/
  4. Centers for Disease Control and Prevention Use of Japanese Encephalitis Vaccine in Children: Recommendations of the Advisory Committee on Immunization Practices, 2013. MMWR. November 15, 2013 / 62(45);898-900 http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6245a3.htm
  5. Hills SL, Walter EB, Atmar RL, Fischer M. Japanese Encephalitis Vaccine: Recommendations of the Advisory Committee on Immunization Practices. MMWR Recomm Rep 2019;68(No. RR-2):1-33 https://www.cdc.gov/mmwr/volumes/68/rr/rr6802a1.htm