Porcine Gelatine in Vaccines
The issue of acceptability of vaccines containing porcine gelatine was revisited during the 2013/14 flu season when the childhood flu immunisation programme and the use of Fluenz, which contains porcine gelatine as a stabiliser, was first rolled out. PHE made contact with a range of faith communities to understand concerns. A communication was issued at the time confirming the PHE and Department of Health position on the use of Fluenz in healthy children together with information materials for health professionals and the public.
Informed consent is essential to maintaining confidence and trust in national immunisation programmes. There are currently three vaccines with porcine gelatine content in use in the national immunisation. Health professionals need to be aware of this and the current national position with regard to possible alternatives available to patients as follows:
The current national position with regards to the three vaccines that contain porcine gelatine is as follows:
- MMR programme: two MMR vaccines of equivalent safety and efficacy are procured for the national programme
- MMRVAXPRO (Sanofi Pasteur MSD) – contains porcine gelatine.
- Priorix (GSK) – does NOT contain porcine gelatine. Priorix® contains no gelatine and can be offered as an alternative to MMRVaxPRO®.
There are 2 shingles vaccines currently available for use within the national programme:
- Zostavax: a live vaccine given as a single dose – offered to everyone from 70 to 79 years of age (unless contraindicated due to underlying medical condition or immunosuppressive treatment)- this contains gelatine.
- Shingrix: a non-live recombinant sub-unit vaccine given as a 2-dose schedule- does not contain gelatine as it is a non-live vaccine and therefore does not require the use of this stabiliser.
From 1 September 2023, Zostavax will be replaced with the 2-dose Shingrix vaccine as Zostavax goes out of production, further information can be found here- Wessex LMCs: Vaccines and Immunisations – Guidance for Practices and in the Updated section of the Green Book.
Childhood influenza programme: the live attenuated vaccine Fluenz (Astra-Zeneca) contains porcine gelatine. It is recommended because it has high efficacy in children, particularly after a single dose, and potential to have broader coverage against drifted strains and to induce immune memory to influenza. For those who may not accept the use of porcine gelatine in medical products, an injected flu vaccine is available as an alternative. If the parent of an eligible child declines LAIV because of its porcine gelatine content (and they understand that it is more effective in the programme than the injected vaccines), they can request an alternative injectable vaccine. QIVc is available to order from ImmForm for these children, more info can be found here- Flu vaccines for the 2023 to 2024 season – GOV.UK (www.gov.uk)
As part of the existing seasonal programme, children in clinical risk groups may be offered inactivated influenza vaccine when Fluenz is not acceptable. This includes all children in clinical risk groups who are aged six months to two years and older children in whom Fluenz® is contra-indicated.
The national immunisation team has developed a Vaccines and porcine gelatine leaflet for health professionals and the public. It is available on the UKSHA website and can be provided to any patients who request further information on this topic. In addition the patient information leaflets and Information for Healthcare Professionals for the flu and shingles programmes have been updated to explicitly mention the porcine gelatine content of the vaccines and the availability or otherwise of alternatives:
1. Shingles Programme:
2.Childhood Flu programme:
Flu vaccination: who should have it this winter and why
Protecting your child against flu: information for parents – This comes in a range of languages.
The MMR vaccine is referred to in several of the core immunisation leaflets available on the gov.uk website and in a number of formats. More information regarding the MMR vaccine can be found here – MMR for all: general guide – GOV.UK (www.gov.uk) In January 2021, UKSHA also published Guidance – Use of human and animal products in vaccines which also references porcine gelatine.
UKSHA recommends that eligible individuals are given the relevant vaccine in a timely manner to receive the best protection as soon as possible. Practices in areas of high Muslim populations may wish to ensure that they always hold stock of a suitable MMR product for their population. Practices in other areas should order stock for specific individuals on request.