1036 APPENDIX IV­— GUIDE TO CONTRAINDICATIONS AND PRECAUTIONS TO IMMUNIZATIONS Appendix IV 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 history of anaphylaxis to a previous dose or to a vaccine component, unless the patient has undergone desensitization. Refer to the Description section of manu- facturer’s package inserts for components of each vaccine package inserts for vac- cines that are licensed for use in the United States are available at www.fda.gov/ BiologicsBloodVaccines/Vaccines/ApprovedProducts/ucm093833.htm. The Centers for Disease Control and Prevention Pink Book (Epidemiology and Prevention of Vaccine-Preventable Diseases www.cdc.gov/vaccines/pubs/pinkbook/genrec. html#contraindications) also is a helpful resource. A precaution is a condition in a recipient that might increase the risk or seri- ousness of an adverse reaction, might interfere with vaccine effectiveness, or might complicate making another diagnosis because of a possible vaccine-related reaction. People who administer vaccines should screen recipients for contraindications and precautions before administering vaccines, and this screening should be documented (eg, in the electronic health record). This information is based on recommendations of the Committee on Infectious Diseases of the American Academy of Pediatrics (AAP) and of 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. A table that lists contraindications and precautions for commonly used vac- cines can be found at www.cdc.gov/vaccines/hcp/acip-recs/general- recs/contraindications.pdf and www.cdc.gov/vaccines/hcp/admin/ contraindications.html. Red_Book_2020_APPENDIX_1027-1060.indd 1036 19/02/21 10:05 AM
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