Precautions, Exceptions, and Contraindications
any vaccine, consider the following information based on recommendations
of ACIP and AAP:
- Refer to package
inserts and statements from ACIP and AAP for additional details.
- Follow the manufacturers'
recommendations regarding dosage, route of
administration, and storage of vaccines.
- Decide to administer
or delay DTaP vaccine because of a current or recent
febrile illness based largely on the severity of the symptoms and their etiology.
- Be aware that mild
acute illnesses with or without low-grade fever and current
use of antibiotics or other medicine (except immunosuppressive
medicine or radiation therapy) are not contraindications for
- Delay immunization
if the patient has a moderate or severe illness with or without
a fever and appears to be very sick.
- Recognize that anaphylactic
reaction to a vaccine contraindicates further doses of that
- Also recognize that
anaphylactic reaction to a vaccine constituent contraindicates
the use of vaccines containing that substance.
- Refrain from giving
all live virus vaccines to females known to be pregnant or
considering becoming pregnant within a three-month time period.
- Be aware
- MMR vaccine
is contraindicated for those who have experienced an
anaphylactic reaction to egg ingestion or to neomycin.
is contraindicated for children who have experienced an
to neomycin or streptomycin.
reaction to common bakers yeast contraindicates the
use of hepatitis B vaccine.
Childhood Vaccine Injury Act
the National Childhood Vaccine Injury Act of 1986, PCPs must:
a copy of the most current Vaccine Information Statement
(VIS) to the child’s parent/legal guardian and
to adolescents aged 18 years of age or younger who are
covered under the VFC program
- Maintain documentation
of when and what vaccines were administered
- Document in
medical record the date that the VIS was given (along with
the statement’s publication date)
VISs are required
and available for:
- All vaccines
routinely recommended for infants and children covered by the
National Childhood Vaccine Injury
VISs are also
recommended and available, but not required for the following
- Hepatitis A
from the required immunizations are granted for the following reasons:
exemptions may be granted to students who in good faith believe
that immunizations would violate their religious beliefs.
exemptions may be
granted by PCPs who determine that immunizations would be
medically inadvisable because of health reasons or a time-limited
Submit all exemption
requests in writing to:
Bureau of Epidemiology and Disease Control
899 North Capitol St., NE, Washington, DC 20002
(202) 442-9366; fax (202) 442-4834.
concludes the Immunizations module.
Move on to the next module, Health Education/Anticipatory