Contraindications
A contraindication
ContraindicationA 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 |
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| BCG28 |  |
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Further information available at https://www.who.int/groups/global-advisory-committee-on-vaccine-safety/topics/bcg-vaccines in section “Safety of BCG vaccination in immunocompromised individuals” | |
| DTwP30 | |
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| DTaP30 | |
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| OPV29 | |
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| IPV29 | |
CAVEAT: allergy to neomycin. | ||
| Measles31 | |
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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..
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| HepB63 | |
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| Rotavirus61 | |
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| Hib65 | |
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| PCV-766 | |
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| Yellow fever62 | |
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CAVEAT: severe allergy to egg. Contraindicated in infants less than 6 months. |
| HPV102 | |
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* Includes symptomatic HIV/AIDSHIV/AIDSAcquired immune deficiency syndrome (AIDS) is a collection of symptoms and infections resulting from the specific damage to the immune system caused by the human immunodeficiency virus (HIV). (but for most LAV vaccines, asymptomatic or properly treated HIV infection is not a contraindication).
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.