APPENDIX V–GUIDE TO CONTRAINDICATIONS 1071 Appendix V Guide to Contraindications and Precautions to Immunizations, 2018 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 out- weighs the benefit of the vaccine. A vaccine should not be administered when a contrain- dication is present. The only contraindication applicable to all vaccines is a history of anaphylaxis to a previous dose or to a vaccine component, unless the patient has under- gone desensitization. Refer to the Description section of manufacturer’s package inserts for components of each vaccine package inserts are available at www.fda.gov/ BiologicsBloodVaccines/Vaccines/ApprovedProducts/ucm093833.htm. 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 product transfusion). People who adminis- ter vaccines should screen recipients for contraindications and precautions before admin- istering vaccines, and this screening should be documented (eg, in the electronic medical record). This information is based on recommendations of the Committee on Infectious Diseases of the American Academy of Pediatrics (AAP) and the Advisory Committee on Immunization Practices (ACIP) of the Centers for Disease Control and Prevention (CDC). Sometimes, these recommendations differ from information in the manufacturers’ package inserts. For more detailed information, physicians should consult published rec- ommendations of the ACIP and AAP, manufacturers’ package inserts, and www.cdc. gov/vaccines/hcp/admin/contraindications.html. These guidelines, originally issued in 1993, have been updated to give recommendations as of 2017 (on the basis of information available as of December 2016).
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