In general, vaccines can be administered safely in all most all individuals. In very few, vaccination is contraindicated or should be deferred (1).
- all vaccines are contraindicated in those who have had:
- a confirmed anaphylactic reaction to a previous dose of a vaccine containing the same antigens, or
- a confirmed anaphylactic reaction to another component contained in the relevant vaccine, e.g. neomycin, streptomycin or polymyxin B (which may be present in trace amounts in some vaccines) (1)
- inactivated or killed vaccines are generally safe and the only absolute contraindication is a severe local or general reaction to a previous dose.
- live vaccines are contraindicated in pregnancy and in those who are on systemic steroid therapy or immunosuppressed for any reason. Vaccination may however be performed if the risks of infection exceed the risks of vaccination.
- live vaccines should either be given simultaneously (if possible at different sites) or after a 3 week gap. (Except when BCG is given to infants when oral polio need not be delayed).
- 12 weeks should elapse after a dose of human immunoglobulin before a live vaccine is administered
- avoid during acute febrile illnesses
- BCG should not be given to eczema patients though otherwise eczema, hayfever, asthma and topical steroids are not contraindications to immunization.
- premature infants, and those suffering from heart and lung diseases should be immunised according to the usual schedules. Premature infants should be immunized at the times recommended for full term babies, without correction for gestational age
The following are not contraindications to vaccination, but folklore has had it in the past that they were:
- previous history of infection
- stable neurological condition
- antibiotic therapy
- allergic history, such as allergy to egg proteins
- breast feeding
- sibling of immune suppressed patient, except for live polio vaccine where a killed vaccine should be used
- neonatal jaundice