This site is intended for UK healthcare professionals
Medscape UK Univadis Logo
Medscape UK Univadis Logo

Covid-19 vaccine (chadox1-s recombinant)

Updated 2 Feb 2023 | Coronavirus vaccine


Vaccine containing COVID-19 (ChAdOx1-S recombinant).

Drugs List

  • COVID-19 VACCINE VAXZEVRIA (CHADOX1 S (RECOMBINANT)) suspension for injection multidose vial
  • generic covid-19 vaxzevria chadox1s recombinant vaccine suspension for injection multidose vial
  • Therapeutic Indications


    Coronavirus disease 2019 (COVID-19): Prophylaxis

    For comprehensive information or advice on this product or the immunisation programme in the UK, the following website should be accessed.
    Available at



    Primary dosing schedule
    2 doses (0.5ml each), administered between 4 and 12 weeks apart.

    Booster dose
    1 dose (0.5ml), administered 6 months after primary course.


    Administered via intramuscular injection, preferably in the deltoid muscle.


    Children under 18 years
    History of capillary leak syndrome

    Precautions and Warnings

    Increased risk of cerebral venous and sinus thrombosis
    Recent anticoagulant therapy
    Severe febrile conditions
    Antiphospholipid syndrome
    History of cerebral venous sinus thrombosis
    History of heparin-induced thrombocytopenia and thrombosis
    History of immune thrombocytopenic purpura
    Immunodeficiency syndromes

    Postpone immunisation if there is active or suspected infection
    Advise ability to drive/operate machinery may be affected by side effects
    Assess risk/monitor platelet count if history of immune thrombocytopenia
    Avoid 2nd dose if symptoms of transverse myelitis occur with 1st dose
    Avoid 2nd dose if thrombosis with thrombocytopenia occurs with 1st dose
    Avoid within 90 days after casirivimab and imdevimab therapy
    Impaired response possible in immunocompromised patients
    Vaccine may not be effective in 100% of patients
    Different brands may not be interchangeable
    Do not mix with other drugs or substances
    Record name and batch number of administered product
    Resuscitation facilities must be immediately available
    Evaluate for thrombocytopenia if thrombosis occurs within 3 weeks of dose
    Exclude thrombosis if thrombocytopenia occurs within 3 weeks of dose
    Monitor for signs and symptoms of Guillain-Barre syndrome
    Monitor for signs and symptoms of thromboembolism and/or thrombocytopenia
    Advise patient to contact a doctor if symptoms of thromboembolism develop
    Advise patient to report sudden severe headache and visual disturbances
    Advise pt. to seek medical attention if sudden abdominal,chest or back pain
    Management of cases of shock should follow current medical standards
    Seek urgent medical attention if symptoms of Capillary Leak Syndrome occur
    Follow national immunisation guidelines

    If anaphylaxis occurs following the first dose of the vaccine, do not administer the second dose.

    Precautions should be in place to avoid injury from fainting should a psychogenic response occur from the needle injection.

    Consult specialist to diagnose and treat thrombosis with thrombocytopenia syndrome (TTS).

    The duration of protection provided by the vaccine is unknown. Protection starts from approximately 3 weeks after the first dose. Individuals may not be fully protected until 15 days after the second dose is administered.

    Pregnancy and Lactation


    Use COVID-19 vaccine (ChAdOx1-S recombinant) with caution during pregnancy.

    The manufacturer does not recommend using COVID-19 vaccine (ChAdOx1-S recombinant) during pregnancy unless the potential benefits outweigh any potential risks to the mother or foetus. Animal studies indicate there are no harmful effects during pregnancy. Human data is limited and as such a potential risk cannot be ruled out.


    Use COVID-19 vaccine (ChAdOx1-S recombinant) with caution during breastfeeding.

    The presence of COVID-19 vaccine (ChAdOx1-S recombinant) in human breast milk and the effects on exposed infants are unknown.

    Side Effects

    Abdominal pain
    Bruising at injection site
    Capillary leak syndrome
    Cerebrovascular venous and sinus thrombosis (CVST)
    Decreased appetite
    Erythema at injection site
    Facial paralysis
    Guillain-Barre syndrome
    Hypersensitivity reactions
    Idiopathic thrombocytopenic purpura (ITP)
    Immunologically mediated thrombocytopenia
    Induration (injection site)
    Influenza-like syndrome
    Local pain (injection site)
    Muscle spasm
    Neuroinflammatory disorder
    Painful extremities
    Rise in body temperature
    Sensation of warm and/or cold at injection site
    Swelling (injection site)
    Tenderness (injection site)
    Thrombosis with thrombocytopenia syndrome
    Transverse myelitis


    It is strongly recommended that the UK National Poisons Information Service be consulted on cases of suspected or actual overdose where there is doubt over the degree of risk or about appropriate management.

    The following number will direct the caller to the relevant local centre (0844) 892 0111

    Information may be obtained if you have access to ToxBase the primary clinical toxicology database of the National Poisons Information Service. This is available via password on the internet ( ) or if this is unavailable at the backup site ( ).

    Further Information

    Last Full Review Date: January 2022

    Reference Sources

    Summary of Product Characteristics: Vaxzevria suspension for injection. AstraZeneca UK Limited. Revised January 2022.

    Immunisation against infectious disease - The Green Book.
    Available at
    Last accessed: 26 January 2022

    NICE Evidence Services Available at: Last accessed: 26 January 2022

    Access the full UK drug database with a FREE Medscape UK Account
    It takes just a few minutes, and you’ll get unlimited access to information on over 11,000 UK drugs.
    Register for Free

    Already a member? Log in

    Medscape UK | Univadis prescription drug monographs & interactions are based on FDB Multilex Content

    FDB Logo

    FDB Disclaimer : FDB Multilex is intended for the use of healthcare professionals and is provided on the basis that the healthcare professionals will retain FULL and SOLE responsibility for deciding what treatment to prescribe or dispense for any particular patient or circumstance.