Addendum to the updated recommendations on measles post-exposure prophylaxis
Shortly following the release of the National Advisory Committee on Immunization (NACI) statement on Updated recommendations on measles post-exposure prophylaxis (PEP) on February 13, 2025, Canada experienced a marked surge in measles cases that led to immediate use of the guidance. During deployment of PEP campaigns, focus on access to human Immunoglobulin (Ig) products has created opportunities to further clarify the ideal approach to facilitate timely administration of different Ig products.
Based on consultation with hematologists and blood product suppliers, acknowledging variability in terms of supply and availability of various Ig PEP products, Table 6. Comparison of human immunoglobulin products that may be used for measles PEP has been removed from the NACI Statement. The discontinued Table 6 has been archivedFootnote 1 and is no longer in use as part of the NACI guidance.
The availability and authorisation status of blood products in Canada changes over time, and there was concern that the comparative information provided in Table 6 may not stay up to date or be reflective of clinical practices going forward.
Furthermore, while not all blood products in Canada have been quantified for levels of anti-measles antibody, all available IVIg products in Canada are drawn from similar North American donor populations and are considered interchangeable for most therapeutic applicationsFootnote 2 in Canada.
To support feasibility and interchangeable use of several different blood products, clinical discretion may be used to provide any available IVIg product for measles PEP, including off-label use of IVIg blood products without a measles PEP indication. This will facilitate timely access to IVIg product and prevent delays in PEP.
More details about available blood products in Canada can be found through the Canadian Blood Services websiteFootnote 3 and Héma-QuébecFootnote 4 websites.
References
- Footnote 1
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National Advisory Committee on Immunization. Updated recommendations on measles post-exposure prophylaxis Ottawa, ON. PHAC; [cited 2025 May 26]. Available from: https://publications.gc.ca/site/eng/9.947048/publication.html
- Footnote 2
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National Advisory Committee on Blood and Blood Products. NAC Statement on Clinical Equivalency of Select Fractionated Plasma Protein Products [cited 2025 May 26]. Available from: https://nacblood.ca/en/resource/nac-statement-clinical-equivalency-select-fractionated-plasma-protein-products
- Footnote 3
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Canadian Blood Services. Plasma Protein & Related Products National Formulary [Internet]. [cited 2025 May 26]. Available from: https://formulary.blood.ca/en
- Footnote 4
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HémaQuébec. Stable products [Internet]. [cited 2025 May 26]. Available from: https://www.hemaquebec.ca/en/health-professionals/stable-products
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