Drug information of Adenovirus types 4 and 7 live, oral

Mechanism of effect

Live oral vaccine that replicates in intestinal tract and induces immunity in persons with low or no pre-existing neutralizing antibodies to adenoviruses types 4 and 7

Pharmacodynamic

Not available

Pharmacokinetics

Duration: Viral shedding not detected after 28 days

Onset: Viral shedding in the stool starts at 7 days; seroconversion starts at 26 days following vaccination

Absorption: Not detected in serum (limited data)

Dosage

Adult

Adenovirus Active Immunization

Indicated for active immunization of military populations for prevention of febrile acute respiratory disease caused by adenovirus types 4 and 7

Aged 17-50 years: Single vaccine dose consists of 2 tablets: 1 tablet of adenovirus type 4 and one tablet of adenovirus type 7

Swallow tablets whole, do not chew, crush, or split; chewing a tablet could expose the upper respiratory tract to live adenovirus leading to disease

Pediatric

<17 years: Safety and efficacy not established

Drug contraindications

pregnancy , dysphagia

Side effects

Pain , Diarrhea , Headache , nausea , fever , nasal stuffiness

Interactions

Prednisolone , Cabazitaxel , Alefacept , Abatacept , Azathioprine , Epirubicin , Oxaliplatin , Irinotecan , Ifosfamide , Betamethasone , Carmustine , Temsirolimus , Daclizumab , Risankizumab , Tildrakizumab , vedolizumab , Muromonab-CD3 , Guselkumab , Ustekinumab , Nelarabine , Azacitidine , Alemtuzumab , Dupilumab , Ocrelizumab , Ofatumumab , Pralatrexate , Anakinra , Ibrutinib , Baricitinib , Pentostatin , Floxuridine , thiotepa , Idarubicin , Tocilizumab , Ibritumomab tiuxetan , Tisagenlecleucel , Axicabtagene ciloleucel , cortisone , Certolizumab , Altretamine , Sarilumab , Teniposide , Etoposide , Carboplatin , cladribine , Chlorambucil , Fluorouracil , mercaptopurine , prednisone , Hydroxy urea , Hydrocortisone , Vinblastin , Vincristin , Vinorelbine , Capecitabine , Lomustine , Mycophenolate mofetil , Methotrexate , Methylprednisolone , Melphalan , Mitoxantrone , Cytarabine , Sirolimus , Cisplatin , Cyclophosphamide , Fludarabine phosphate , Fingolimod , Dactinomycin , Deflazacort , Dexamethasone , Docetaxel , Doxorubicin , Rituximab , Temozolomide , Topotecan , Thioguanine , Gemcitabine , Daunorubicin , Dacarbazine , Bleomycin , Busulfan , Procarbazine , Paclitaxel , Tacrolimus , Triamcinolone , secukinumab , Anthrax immune globulin

Alerts

Vomiting or diarrhea could decrease effectiveness of vaccine

Safety has not been evaluated in individuals with altered immunocompetence

Contains live viruses that are shed in the stool and can cause disease if transmitted; those vaccinated should avoid close contact with children younger than 7 years and immunocompromised individuals

Tablets contain human albumin (<0.3 mg/tablet), which could theortetically increase risk transmission of blood borne diseases (e.g., Creuzfeldt-Jakob disease)

Effective immunity may not occur in all vaccinated patients

Points of recommendation

• swallow the vaccine tablets whole with a small amount of water and without chewing or crushing them.
• inform clinician if you accidentally chew a vaccine tablet.
• adenovirus type 4 and type 7 vaccine is a live virus vaccine and that vaccine virus is shed in the stool  for up to 28 days following vaccination and can be transmitted to and cause disease in close contacts during this period. To minimize risk of transmission of vaccine virus, advise patients to take precautions (i.e., frequent hand washing, especially after bowel movements) for 28 days after vaccination if in close contact with children younger than 7 years, immunocompromised individuals, or pregnant women.
• Importance of women informing clinician if they are or plan to become pregnant or are breast-feeding. Advise women to avoid pregnancy for at least 6 weeks following vaccination.