Stamaril powder and solvent for suspension for injection in pre-filled syringe

• Keep this leaflet. You may need to read it again.
• If you have any further questions, ask your healthcare professional.
• This vaccine has been prescribed for you or your child only. Do not pass it on to others.
• If you get any side effects talk to your healthcare professional and tell them that you received yellow fever vaccine. This includes any possible side effects not listed in this leaflet. See Section 4.

1. What STAMARIL is and what it is used for
2. What you need to know before you or your child use STAMARIL
3. How to use STAMARIL
4. Possible side effects
5. How to store STAMARIL
6. Contents of the pack and other information

• are allergic to:
  • the active substance, or
  • any of the other ingredients of this vaccine (listed in Section 6), or
  • eggs or chicken proteins.
• have experienced a severe allergic reaction after a previous dose of any yellow fever vaccine,
• is less than 6 months old,
• have a poor or weakened immune system for any reason, such as illness or medical treatments (for example high-dose steroids, or any other medicines that affect the immune system, or chemotherapy). If you are unsure whether the medication may affect your or your child's immune system, discuss with your healthcare professional before the vaccine is administered.
• have a weakened immune system due to HIV infection. Your healthcare professional will advise you if you or your child can still receive STAMARIL based on the results of your blood tests,
• are infected with HIV and have active symptoms due to the infection,
• have a history of problems with your or your child's thymus gland or have had the thymus gland removed for any reason,
• have an illness with a high or moderate fever or an acute illness. The vaccination will be postponed until you or your child have recovered.

Before using Stamaril, it is important that you complete a risk assessment with a trained healthcare professional, to determine whether you should receive the vaccine.

• If you are over 60 years old or if your child is less than 9 months as you have an increased risk of certain types of severe but rare reactions to the vaccine (including serious reactions that affect the brain and nerves, and vital organs, see Section 4). You will only be given the vaccine if the risk of infection with the virus is well established in countries where you are going to stay.
• If your child is aged 6 to 9 months. STAMARIL may be given to children aged between 6 and 9 months only in special situations and on the basis of current official advice.
• If you or your child are infected by the HIV virus but do not have active symptoms due to the infection. Your healthcare professional will advise if STAMARIL can be given based on the results of laboratory tests and specialist advice.
• If you or your child have any bleeding disorder (such as haemophilia or low level of platelets) or are taking any medicines that stop the blood clotting normally. You can still be given STAMARIL provided that it is injected under the skin and not into muscle (see Section 3).
• If you had any allergic reaction to latex. The tip cap of the pre-filled syringe contains a natural rubber latex derivative which may cause an allergic reaction.

As with all vaccines, STAMARIL may not fully protect all persons who are vaccinated.

Fainting can occur following, or even before, any needle injection. Therefore tell your healthcare professional if you or your child fainted with a previous injection.

Tell your healthcare professional if you are taking, have recently taken or might take any other medicines.

If you have recently had any treatment or medicine which may have weakened your immune system, the vaccination must be delayed until your laboratory results show that your immune system has recovered. Your doctor will advise you when it is safe for you to be vaccinated.

STAMARIL can be given at the same time as measles vaccine or vaccines against typhoid fever (those containing the Vi capsular polysaccharide) and/ or hepatitis A.

Vaccination with STAMARIL may lead to false positive results of blood tests for dengue or Japanese encephalitis. If you or your child have in the future such tests prescribed, please inform your doctor about this vaccination.

If you are pregnant, or breastfeeding, think you may be pregnant or are planning to have a baby, ask your healthcare professional for advice before being vaccinated.

You should not receive STAMARIL during pregnancy or breastfeeding unless this cannot be avoided. Also, it is recommended that you do not become pregnant within one month after receiving STAMARIL. Your healthcare professional can advise you on whether it is essential that you are vaccinated. In case vaccination is needed, it is recommended to interrupt breastfeeding for at least 2 weeks after you receive STAMARIL. In case you receive the vaccine while pregnant or breastfeeding, consult your healthcare professional.

This medicine contains less than 1 mmol sodium (23 mg) per dose that is to say essentially “sodium free”, and less than 1 mmol potassium (39 mg) per dose that is to say essentially “potassium free”.

This medicine contains approximately 8 mg of sorbitol per dose.

STAMARIL is given as a single, 0.5 millilitre dose to adults and children from 6 months of age.

The first dose should be given at least 10 days before protection from yellow fever is needed. This is because it takes 10 days for the first dose of vaccine to work and provide good protection against the yellow fever virus. The protection provided by this dose is expected to last at least 10 years and may be life-long.

In some circumstances, a booster with one dose (0.5 millilitre) may be needed:

• If you or your child had an insufficient response to the first dose and you or your child continue to be at risk for yellow fever virus infection,
• or depending on official recommendations

STAMARIL is given as an injection by a qualified and trained healthcare professional. It is usually injected just underneath the skin but it can be given into a muscle.

It must not be injected into a blood vessel.

In some cases, more than the recommended dose was used.

In these cases, when side effects were reported, they were in line with those described in Section 4.

The following serious side effects have sometimes been reported:

Allergic reactions:

• Rash, itching or hives on the skin
• Swelling of the face, lips, tongue or other parts of the body
• Difficulty swallowing or breathing
• Loss of consciousness

Reactions affecting the brain and nerves:

These may occur within one month of the vaccination and have sometimes been fatal.

Symptoms may include:

• High fever with headache and confusion
• Extreme tiredness
• Stiff neck
• Inflammation of brain and nerve tissues
• Fits
• Loss of movement or feeling in part or all of the body (for example Guillain-Barré Syndrome)
• Personality change

Serious reaction affecting vital organs:

This may occur within 10 days of the vaccination and may have a fatal outcome. The reaction can resemble an infection with the yellow fever virus. It generally begins with feeling tired, fever, headache, muscle pain and sometimes low blood pressure. It may then go on to a severe muscle and liver disorder, drops in number of some types of blood cells resulting in unusual bruising or bleeding and increased risk of infections, and loss of normal functioning of the kidneys and lungs.

If you experience ANY of the above symptoms after vaccination, seek medical attention IMMEDIATELY mentioning that you have recently received STAMARIL.

Very common (may affect more than 1 in 10 people)

• Headache
• Mild or moderate tiredness or weakness (asthenia)
• Pain or discomfort at the injection site
• Muscle pains
• Fever (in children)
• Vomiting (in children)

Common (may affect up to 1 in 10 people)

• Fever (in adults)
• Vomiting (in adults)
• Painful joints
• Feeling sick (nausea)
• Reactions at the injection site: rednesss, bruising, swelling or appearance of a hard lump

Uncommon (may affect up to 1 in 100 people)

• Dizziness
• Stomach pains
• A pimple (papule) at the injection site

Rare (may affect up to 1 in 1,000 people)

• Diarrhoea
• Runny, blocked or itchy nose (rhinitis)

Not known (frequency cannot be estimated from the available data)

• Swollen glands (lymphadenopathy)
• Numbness or pins and needles sensation (paresthesia)
• Flu-like illness

Very common (may affect more than 1 in 10 people)

• Irritability, crying
• Appetite loss
• Drowsiness

These side effects usually occurred within the 3 days following vaccination and lasted usually not more than 3 days. Most of these side effects were of mild intensity.

If you get any side effects, talk to your healthcare professional. This includes any possible side effects not listed in this leaflet.

You can also report side effects directly via the Yellow Card Scheme at http://www.mhra.gov.uk/yellowcard or search for MHRA Yellow Card in the Google Play or Apple App store.

By reporting side effects you can help provide more information on the safety of this medicine.

After reconstitution, for one dose (0.5 mL):

• The active substance is:
  Yellow fever virus¹ 17D-204 strain (live, attenuated)............................................................ not less than 1000 IU
  ¹produced in specified pathogen-free chick embryos
• The other ingredients are:
  Lactose, sorbitol, L-Histidine hydrochloride, L-Alanine, sodium chloride, potassium chloride, disodium phosphate dihydrate, potassium dihydrogen phosphate, calcium chloride, magnesium sulphate and water for injections.

STAMARIL is presented as a powder and solvent for suspension for injection (powder in a vial (0.5 mL dose) + solvent in a pre-filled syringe (0.5 mL dose) with or without needle). Pack size 1, 10, 20.

After reconstitution the suspension is beige to pink beige, more or less opalescent.

Not all pack sizes may be marketed.