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​​​​​​​​​​Immunoglobulins and Vaccines
The following immunoglobulins and vaccines are supplied by Medical Virology.  Please contact a Medical Virologist on extension 4410 during working hours or via switchboard for out of hours advice. 
  • Varicella-zoster immunoglobulin
  • Rabies immunoglobulin
  • Rabies vaccine
  • Hepatitis B immunoglobulin


If a clinician identifies a patient suspected of having been exposed to rabies they should contact the Infectious Diseases or Virology team for advice. Both teams are available both in working hours and outside working hours.

Inside working hours the Infectious diseases or virology team will obtain advice from RIgS or Colindale Duty doctor.

Outside of working hours the risk assessment should be carried out using UKHSA guidance and the form submitted to RIgS by the Infectious Diseases or Virology team.

If after risk assessment by the Infectious Diseases or virology teams, treatment is deemed necessary then rabies vaccine and rabies immunoglobulin (HRIG) may be obtained from the night store fridge on the Royal site. This can be accessed via the RLH pharmacy team during working hours or the duty manager at RLH outside of working hours. The individual removing the stock from the night store must complete the patient’s details on the night room pharmacy portal system to ensure that the stock will be replenished.

If a member of the LUHFT Infectious Diseases/virology team have undertaken the risk assessment then they must send a request form to RIgS the next working day. RIgS will then arrange for the supply of replacement stock. Details of how to manage patients post-exposure, complete the risk assessment and the request form can be found in the UKHSA Guidelines on managing rabies post exposure (September 2021).​

Tetanus immunoglobulin (for prophylaxis of tetanus-prone wounds) is supplied from Pharmacy and stocked in A&E Minors and the Emergency Drug Cupboard. 
Tetanus immunoglobulin (for treatment of clinically suspected tetanus) has been discontinued.  Human Normal Immunoglobulin is recommended as alternative therapy and is stocked in the Emergency Drug Cupboard. 

Please refer to Trust guidance on the management of suspected tetanus and the assessment and management of tetanus prone wounds for further guidance:Guidance on the Management of Suspected Tetanus and the Assessment and Management of Tetanus Prone Wounds.pdfGuidance on the Management of Suspected Tetanus and the Assessment and Management of Tetanus Prone Wounds.pdf

Trust policy for administration of intravenous immunoglobulin therapy (e.g. Gammaplex) available via Trust document management​ ​website (search for immunoglobulin).