Contraindications

A contraindicationContraindicationA condition that makes a particular treatment or procedure, such as vaccination with a particular vaccine, inadvisable. Contraindications can be permanent, such as known allergies to a vaccine component, or temporary, such as an acute febrile illness. to vaccination is a rare condition in a recipient that increases the risk for a serious adverse reaction. Ignoring contraindications can lead to avoidable vaccine reactions. Most contraindications are temporary, and the vaccination can be administered later.

The only contraindication applicable to all vaccines is a history of a severe allergic reaction after a prior dose of vaccine or to a vaccine constituent. Precautions are not contraindications, but are events or conditions to be considered in determining if the benefits of the vaccine outweigh the risks. Precautions stated in product labelling can sometimes be inappropriately used as absolute contraindications, resulting in missed opportunities to vaccinate.

Signs of allergic reactions

Vaccinating health workers should know the signs of allergic reactions and be prepared to take immediate action.

Contraindications to vaccines

Childhood vaccine Anaphylaxis after previous dose or severe allergy to vaccine component Pregnancy Severely immuno-compro-
mised*
Comment
BCG28   Read the GACVS statement on the safety of the BCG vaccine in HIV-infected children
DTwP30    
DTaP30      
OPV29  
IPV29     CAVEAT: allergy to neomycin.
Measles31 Severe allergy to gelatine is a contraindication to vaccination with MMR vaccineMMR vaccineA preparation of live attenuated measles, mumps, and rubella viruses together in one vaccine, used to immunize against measles, mumps, and rubella..
HepB63      
Rotavirus61      
Hib65      
PCV-766      
Yellow fever62 CAVEAT: severe allergy to egg.
Contraindicated in infants less than 6 months.

Key point

True contraindications are rare. Misconceptions about their frequency can lead to missed opportunities to vaccinate and decrease immunization coverage, or conversely increase the risk of adverse reactions, both of which reduce public confidence in the safety of the vaccine.