Chapter 116. Immunization Principles and Vaccine Use (Part 9) pptx

Immunization Principles and Vaccine Use Part 9 Table 116-3 Valid and Invalid Contraindications to Vaccination Contraindicationa Invalid Contraindication Serious allergic reactions

Chapter 116 Immunization Principles

and Vaccine Use

(Part 9)

Table 116-3 Valid and Invalid Contraindications to Vaccination

Contraindicationa

Invalid Contraindication

Serious allergic reactions (e.g., anaphylaxis)

to a previous vaccine dose or

a vaccine component

Mild acute illness with

or without fever

All vaccines in

general

Precaution: Moderate Mild to moderate local

or severe concurrent illness

with or without fever

reactions; low-grade or moderate fever after a previous dose

physical examination in a well-appearing person

therapy (except certain live bacterial vaccines)

illness

(except hepatitis B in some circumstances)

infectious diseases

History of penicillin

allergy, other nonvaccine allergies; relatives with allergies; receiving desensitization treatment

Severe allergic reaction to a previous dose

or a vaccine component

Temperature of

<40.5°C; fussiness; mild drowsiness after a prior dose

of DTP or DTaP

Encephalopathy (e.g., coma, decreased level of consciousness, prolonged seizures) within 7 days of a previous dose of DTP or DTaP

Family history of seizures, sudden infant death syndrome, or adverse event after DTP or DTaP

DTaPb

Progressive neurologic disorder, including infantile spasms,

Stable neurologic conditions (e.g., cerebral palsy, well-controlled

uncontrolled epilepsy,

progressive encephalopathy:

defer DTaP until neurologic

status is clarified and

stabilized

convulsions, developmental delay)

Precaution: Fever of

≥40.5°C at ≤48 h after a

previous dose of DTP or

DTaP

Collapse or shock-like

state (i.e., hypotonic

hyporesponsive episode ≤48

h after a previous dose of

DTP or DTaP)

Seizure ≤3 days after

a previous dose of DTP or

DTaPPersistent, inconsolable

crying lasting ≥3 h/≤48 h

after a previous dose of DTP

or DTaP

Moderate or severe acute illness with or without fever

Severe allergic reaction after a previous dose

or to a vaccine component

Precaution:

Guillain-Barré syndrome ≤6 weeks after a previous dose of tetanus toxoid–containing vaccine

DT, Td

Moderate or severe acute illness with or without fever

Severe allergic reaction to a previous dose

or a vaccine component

IPV

Precautions:

Pregnancy; moderate or severe acute illness with or without fever

Severe allergic reaction to a previous dose

or a vaccine component

Positive tuberculin skin test; simultaneous TB skin testing

MMR

Known severe immunodeficiency (e.g., hematologic and solid tumors, congenital immunodeficiency, long-term immunosuppressive

recipient's mother or other close or household contact; recipient is childbearing-age female or immunodeficient family member or household

therapy, or severely symptomatic HIV infection)

contact; asymptomatic or mildly symptomatic HIV infection; allergy to eggs

Precautions: Recent

(≤11 months) receipt of antibody-containing blood products (specific interval depends on product); history

of thrombocytopenia and thrombocytopenic purpura;

moderate or severe acute illness with or without fever

Severe allergic reaction to a previous dose

or a vaccine component

Age <6 weeks Hib

Precaution: Moderate

or severe acute illness with

or without fever

Severe allergic reaction to a previous dose

or a vaccine component

Pregnancy;

autoimmune disease (e.g., systemic lupus erythematosus

or rheumatoid arthritis) Hepatitis B

Precautions: Infant weighing <2000 g; moderate

or severe acute illness with

or without fever

Severe allergic reaction to a previous dose

or a vaccine component

Hepatitis A

Precaution:

Pregnancy; moderate or severe acute illness with or without fever

Severe allergic reaction to a previous dose

or a vaccine component

recipient's mother or another close or household contact

Substantial suppression of cellular immunity

Immunodeficient family member or household contact; asymptomatic or mildly symptomatic HIV infection

Varicella

Precaution: Recent (≤11 months) receipt of antibody-containing blood products (specific interval depends on product)

Pneumococcal Severe allergic

reaction to a previous dose

or a vaccine component

Precaution: Moderate

or severe acute illness with

or without fever

Severe allergic reaction to a previous dose

or a vaccine component, including egg protein

Nonsevere (e.g., contact) allergy to latex or thimerosal; concurrent administration of warfarin or aminophylline

Influenza

Precaution: Moderate

or severe acute illness with

or without fever

Severe allergic reaction to a previous dose

or a vaccine component

Pneumococcal

polysaccharide

vaccines

Precaution: Moderate

or severe acute illness with

or without fever

a

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, the vaccine should be administered

b

Whether and when to administer DTaP to children with proven or suspected underlying neurologic disorders should be decided on a case-by-case basis

Note: DTP, diphtheria and tetanus toxoids and whole-cell pertussis vaccine;

DTaP, diphtheria and tetanus toxoids and acellular pertussis vaccine; DT, diphtheria and tetanus toxoids; Td, tetanus and reduced-dose diphtheria toxoids, adsorbed; IPV, inactivated polio vaccine; MMR, measles, mumps, and rubella

vaccine; Hib, Haemophilus influenzae type b vaccine

51(RR02):1, 2002