Vaccines and medicines: availability, supply, shortages and use of unlicensed medicines

Information for health professionals on availability of vaccines and use of unlicensed products

Vaccines with UK marketing authorisation

For vaccines with a UK marketing authorisation (i.e. UK product license), information and recommendations for use are available in the ‘Green Book’ Immunisation against infectious disease. Health professionals should monitor for updates to the Green Book; it is possible to subscribe to email alerts so you will be notified when chapters are amended.

The UK Health Security Agency (UKHSA) regularly publish Vaccine update, describing the latest developments in vaccines and vaccination programmes in the UK including supply updates; you can subscribe to get these by email.

Summary vaccine information is available in the Topics in Brief and Factsheets & Resources section of our website.

The manufacturer’s marketing authorisation information can be found in the Summary of Product Characteristics (SmPC) on the electronic medicines compendium (emc).

Vaccine and medicines shortages

Vaccine shortages occur from time to time for a variety of reasons. Health professionals who are having difficulties obtaining vaccines or medicines are encouraged to contact their supplier for more information.

When vaccine supplies are restricted, health professionals should prioritise vaccine use; an effective risk assessment will ensure vaccine recommendations are appropriate, help identify higher risk travellers, and give priority to those who are most vulnerable.

In some vaccine shortage situations, the Medicines and Healthcare products Regulatory Agency (MHRA) and the Department of Health & Social Care (DHSC) grant approval for vaccine companies to import alternative vaccine products. These products may not have a UK marketing authorisation and preference is that they should only be used where no suitable UK 'licensed' product is available. Temporary recommendations for administration of vaccines (including information on dose sparing) and travel-related medicines may be provided by UKHSA.

Health professionals who are not independent prescribers must use a Patient Specific Direction (PSD) to supply or administer these products, in addition to following any local guidelines. Prescribing information, produced in English should be available from the supplier. Where, unavailable, this information should be sought directly from the manufacturer. Additional resources for guidance on prescribing products without a UK marketing authorisation can be found in the resources section below.

Table 1 below contains information on vaccines (related to travel health) supply shortages/discontinuations.

Table 1. Vaccines supply status

Please note: This table is updated monthly and only covers vaccines discontinued or in short supply. It does NOT replace information obtained from the respective manufacturers.
Vaccine Brand (if applicable) Status Date updated Estimated recovery date Temporary/alternative recommendation
(if applicable)
Japanese encephalitis IXIARO® Out of stock 12 Jan 2024 To be confirmed N/A

Contact Valneva
Rabies Rabies BP Discontinued 25 Nov 2022 Not applicable See Rabipur®*
Rabies Rabipur®* Out of stock 14 Dec 2023 To be confirmed Contact Valneva

Important advice on rabies vaccine shortage for health professionals
Hepatitis A (inactivated, adsorbed) and Typhoid polysaccharide Viatim® Discontinued 25 Nov 2022 Not applicable Single antigen preparations for typhoid and hepatitis A available

*not suitable for individuals with severe egg allergies or other contraindications, consult The Green Book: Rabies Chapter 27.

Information on vaccine supply is available from UK Health Security Agency: Vaccine Update.

Table 2. Antimalarial(s) supply status

Please note: This table is updated monthly and does NOT replace information obtained from the respective manufacturers.
Medicine Brand (if applicable) Status Date updated Estimated recovery date Temporary/alternative recommendation
(if applicable)
Atovaquone
Proguanil
Paediatric
62.5/25mg
Generic product (Amarox Ltd) Not available 16 Mar 2023 4 to 5 months

Contact Amarox Ltd
Malarone® available

For additional information see Children's antimalarial dosage table and ACMP Guidelines for malaria prevention in travellers
Proguanil hydrochloride Paludrine Discontinued 26 May 2023 Not applicable To be advised
Chloroquine phosphate / proguanil hydrochloride Paludrine / Avloclor Antimalarial Travel Pack Discontinued 26 May 2023 Not applicable To be advised

Updates to marketing authorisations

Changes to vaccine and medicines marketing authorisations are published on the electronic medicines compendium (emc). Recommendations for the use of vaccinations are considered and made by Joint Committee on Vaccination and Immunisation (JCVI), and thereafter published in the relevant chapter of Immunisation against infectious disease the 'Green Book'. While the JCVI meet on a regular basis, there may be a time lag between updates to the manufacturers marketing authorisation and updates being made to the Green Book. In these situations, where the Green Book and marketing authorisation differ, health professionals should make a clinical decision if they wish to follow information provided by the manufacturer. Guidelines for use of antimalarials are updated annually by the UKHSA Advisory Committee on Malaria Prevention (ACMP).

Resources

First published : 17 October 2022 Last updated : 12 January 2024
  1. IXIARO status update: out of stock.

  2. IXIARO added to Table 1 with status update.

  3. Rabipur added to Table 1 with status update.

  4. Menveo now back in stock and removed from Table 1.

  5. Supplies of Ticovac Junior are available, according to Pfizer. Removed from Table 1.

  6. Rabipur removed from Table 1.

  7. Link added in the resources section to RPS Competency framework for prescribers.

  8. Menveo added to Table 1.

  9. TicoVac Junior added to Table 1.

  10. Paludrine and Paludrine/Avloclor Antimalarial Travel Pack added to Table 2.

  11. Rabipur short of stock. Table 1 updated to contact Valneva directly.

  12. Cholera vaccine Dukoral, and combined hepatitis A and B Twinrix paediatric vaccine removed from Table 1.

  13. Table updated with supply status and recovery time for Atovaquone Proguanil Paediatric.

  14. Twinrix Paediatric added to table, Tyhim removed from table. Update on Dukoral cholera vaccine. Link added to UKHSA Vaccine update.

  15. IXIARO removed from Table 1 and dates updated for Typhim and Dukoral.

  16. Table updated with recovery time for IXIARO; Engerix B and Havrix Junior removed from table.

  17. Table updated with recovery time for supply status of Dukoral, IXIARO added and VAQTA removed.

  18. Table updated with VAQTA paediatric, Havrix B, Engerix B and Atovaquone/Proguanil paediatric tablets supply status; VAQTA adult removed.

  19. Table updated with cholera and Rabipur supply status.

  20. Updated title to include medicines, edits throughout and tables added.

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Information for health professionals on availability of vaccines and use of unlicensed products

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