Appendix V
Guide to Contraindications and Precautions to Immunizations,
A contraindication to vaccination is a condition in a patient that increases the risk
of a serious adverse reaction and for whom this increased risk of an adverse reaction
outweighs the benefit of the vaccine. A vaccine should not be administered when a
contraindication is present. The only contraindication applicable to all vaccines is a his-
tory of anaphylaxis to a previous dose or to a vaccine component, unless the patient has
undergone desensitization. A precaution is a condition in a recipient that might increase
the risk or seriousness of an adverse reaction or complicate making another diagnosis
because of a possible vaccine-related reaction. A precaution also may exist for conditions
that might compromise the ability of the vaccine to produce immunity (eg, administering
measles vaccine to a person with passive immunity to measles from a blood transfusion).
This information is based on recommendations of the Advisory Committee on
Immunization Practices (ACIP) of the Centers for Disease Control and Prevention (CDC)
and the Committee on Infectious Diseases of the American Academy of Pediatrics
(AAP). Sometimes, these recommendations vary from those in the manufacturers’ pack-
age inserts. For more detailed information, physicians should consult published recom-
mendations of the ACIP and AAP, manufacturers’ package inserts, and
vaccines/recs/vac-admin/contraindications.htm. These guidelines, originally
issued in 1993, have been updated to give recommendations as of 2015 (on the basis of
information available as of January 2015).
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