III.

CONTRAINDICATIONS AND PRECAUTIONS TO VACCINATION

A contraindication is a condition in a recipient which greatly increases the chance of a serious adverse reaction. Example: administering in uenza vaccine to a person with a true anaphylactic allergy to egg could cause serious illness or death in the recipient. A precaution is a condition in a recipient which may increase the chance or severity of an adverse event, or may compromise the ability of the vaccine to produce immunity.Example: administering measles vaccine to a person with passive immunity to measles from a blood transfusion.

Permanent Contraindications to Vaccination y y y severe allergy to a prior dose of vaccine or to a vaccine component encephalopathy following pertussis vaccine

Immunosuppression y Live vaccines can be given after chemotherapy has been discontinued for at least 3 months.Persons receiving large doses of corticosteroids should NOT receive live vaccines.  >20 mg of prednisone per day  >2 mg/kg per day of prednisone  NOT contraindicated with steroids given via aerosols, topical, alternate day, short courses

Recent Blood Products y y y y Varicella and MMR vaccines should be given 14 days prior to the blood product, or delayed until the antibody has degraded. If MMR is given sooner than the minimum interval (3-7 months depending blood product) the recipient should be tested for immunity or the dose repeated at er the appropriate interval.

INVALID CONTRAINDICATIONS TO VACCINATION

y y y y y y y y y y y y y

mild illness disease exposure or convalescence antibiotic therapy pregnancy in the household breastfeeding allergies to products in the vaccine premature birth family history unrelated to immunosuppression need for TB skin testing need for multiple vaccines minor illness- low grade fever, upper respiratory tract infection, otitis media mild diarrhea

SCREENING FOR CONTRAINDICATIONS AND PRECAUTIONS TO VACCINATION Screening questions y y y y y allergies to food or medications? any problem at er the last shot? any problem with the immune system? any blood products received in the last year? are you pregnant or trying to be pregnant?

Reference: http://www.psmid.org.ph/contents/Handbook_on_Adult_Immunization_2009_(contents).pdf