Screening Patients for Contraindications and Precautions to Vaccination

July 2015

Technically Speaking

Monthly Column by Deborah Wexler, MD

Technically Speaking is a monthly column written by IAC’s Executive Director Deborah Wexler, MD. The column is featured in The Children’s Hospital of Philadelphia Vaccine Education Center’s (VEC’s) monthly e-newsletter for healthcare professionals. Technically Speaking columns cover practical topics in immunization delivery such as needle length, vaccine administration, cold chain, and immunization schedules.

Check out a recent issue of Vaccine Update for Healthcare Providers. The VEC e-newsletter keeps providers up to date on vaccine-related issues and includes reviews of recently published journal articles, media recaps, announcements about new resources, and a regularly updated calendar of events.

TECHNICALLY SPEAKING

Screening Patients for Contraindications and Precautions to Vaccination

Published July 2015

Information presented in this article may have changed since the original publication date. For the most current immunization recommendations from the Advisory Committee on Immunization Practices, visit www.immunize.org/acip/acip_vax.asp.

Use these handy checklists to screen patients for contraindications and precautions to vaccination

Before giving any doses of vaccines, clinicians should make sure patients and parents are carefully questioned about contraindications or precautions to vaccination. This helps ensure that any potential risks of vaccination are minimized.

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A contraindication is a condition that increases the risk for a serious adverse reaction to a vaccine. For example, it is a contraindication for a patient who had a severe allergic reaction (such as anaphylaxis) after a previous dose to receive subsequent doses of the same vaccine.

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A precaution is a condition that might increase the risk for a serious adverse reaction, or that might compromise the ability of the vaccine to produce immunity. An example would be administering measles vaccine to a person with passive immunity to measles from a blood transfusion. In general, when a precaution condition is present, vaccinations are deferred. However, situations may arise when the benefit of protection from the vaccine outweighs the risk of an adverse reaction, and a provider may decide to give the vaccine.

Several lists are available that describe contraindications and precautions for various vaccines. But if you are looking for a simple way to screen patients, the Immunization Action Coalition (IAC) has developed screening checklists (with “yes” or “no” answers) that can be filled out by patients/parents while they are waiting to be seen. This method not only saves clinicians time, but it also helps ensure that all necessary questions are answered prior to vaccination. Also of benefit, a second page accompanying the checklist provides helpful information for healthcare professionals about why each question is included on the checklist and what to do if the patient’s answer suggests a possible reason to withhold a vaccine.

Be sure to check out these handy checklists to determine which ones can be of benefit in your practice setting!

Screenings checklists for:

Specific age groups

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Screening Checklist for Contraindications to HPV, MCV4, and Tdap Vaccines for Teens (NEW!)

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Screening Checklist for Contraindications to Vaccines for Children and Teens

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Screening Checklist for Contraindications to Vaccines for Adults

Specific vaccines

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Screening Checklist for Contraindications to HPV, MCV4, and Tdap Vaccines for Teens (NEW!)