|Guide to contraindications* and precautions** to commonly used vaccines —Listed by Vaccine |
|Vaccine ||True contraindications and precautions # ||Untrue (vaccines can be administered) |
|>General for all vaccines, including diphtheria and tetanus toxoids & acellular pertussis vaccine (DTaP); pediatric diphtheria-tetanus toxoid (DT); adult tetanus-diphtheria toxoid (Td); inactivated poliovirus vaccine (IPV); measles-mumps-rubella vaccine (MMR); Haemophilus influenzae type b vaccine (Hib); hepatitis A vaccine, hepatitis B vaccine; varicella vaccine; pneumococcal conjugate vaccine (PCV); influenza vaccine; and pneumococcal polysaccharide vaccine (PPV) ||Contraindications |
|DTaP ||Contraindications || |
|DT, Td ||Contraindications |
|IPV ||Contraindications |
|MMR@ ||Contraindications || |
|Hib ||Contraindications |
|Hepatitis B ||Contraindications |
|Hepatitis A ||Contraindications |
|Varicella@ ||Contraindications |
|PCV ||Contraindications |
|Influenza ||Contraindications || |
|PPV ||Contraindications |
|*Contraindications - A contraindication is a condition in a recipient that increases the risk for a serious adverse reaction. A vaccine will not be administered when a contraindication is present. Consult the MMWR article, "General Recommendations on Immunizations" for a full definition including examples. |
** Precautions - A precaution is a condition in a recipient that might increase the risk for a serious adverse reaction or that might compromise the ability of the vaccine to produce immunity. Injury could result, or a person might experience a more severe reaction to the vaccine than would have otherwise been expected; however, the risk for this happening is less than expected with a contraindication. Under normal circumstances, vaccinations should be deferred when a precaution is present. However, a vaccination might be indicated in the presence of a precaution because the benefit of protection from the vaccine outweighs the risk for an adverse reaction. Consult the MMWR article, "General Recommendations on Immunizations" for a full definition including examples.
# Events or conditions listed as precautions should be reviewed carefully. Benefits and risks of administering a specific vaccine to a person under these circumstances should be considered. If the risk from the vaccine is believed to outweigh the benefit, the vaccine should not be administered. If the benefit of vaccination is believed to outweigh the risk, vaccine should be administered. Whether and when to administer DTaP to children with proven or suspected underlying neurologic disorders should be decided on a case-by-case basis.
+ Hepatitis B vaccination should be deferred for infants weighing <2,000 grams if the mother is documented to be hepatitis B surface antigen (HbsAg)-negative at the time of infant's birth. Vaccination can commence at chronological age 1 month. For infants born to HbsAg-positive women, hepatitis B immunoglobulin and hepatitis B vaccine should be administered at or soon after birth regardless of weight. See MMWR article, "General Recommendations on Immunizations" text for details.
^ Acetaminophen or other appropriate antipyretic can be administered to children with a personal or family history of seizures at the time of DTaP vaccination and every 4-6 hours for 24 hours thereafter to reduce the possibility of post-vaccination fever (Source: American Academy of Pediatrics. Active immunization. In Pickering LK, ed. 2000 Red Book:rep of the Committee on Infectious Diseases. 25th ed. Elk Grove Village, IL; American Academy of Pediatrics, 2000).
@ MMR and varicella vaccines can be administered on the same day. If not administered on the same day, these vaccines should be separated by >28 days.
## Substantially immunosuppressive steroid dose is considered to be >2 weeks of daily receipt of 20 mg or 2 mg/kg body weight of prednisone or equivalent.
++ Measles vaccination can suppress tuberculin reactivity temporarily. Measles-containing vaccine can be administered on the same day as tuberculin skin testing. If testing cannot be performed until after the day of MMR vaccination, the test should be postponed for >4 weeks after the vaccination. If an urgent need exists to skin test, do so with the understanding that reactivity might be reduced by the vaccine.
$$ See text for details.
^^ If a vaccinee experiences a presumed vaccine-related rash 7-25 days after vaccination, avoid direct contact with immunocompromised persons for the duration of the rash.
Contraindications to Vaccines Chart
Guide to contraindications* and precautions** to commonly used vaccines - Listed by Vaccine