Screening Patients for Contraindications to Vaccination

October 2011

Technically Speaking
Monthly Column by Deborah Wexler, MD
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.
Screening Patients for Contraindications to Vaccination
Published October 2011
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
Before giving a dose of any vaccine, healthcare providers should carefully question patients or parents about contraindications and precautions to vaccination.
A contraindication is a condition that increases the risk for a serious adverse reaction to a vaccine.
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.
A table in ACIP’s “General Recommendations on Immunization” lists contraindications and precautions to commonly used vaccines. This information is also available as an online chart on CDC’s website.
The Immunization Action Coalition (IAC) offers this same information in a formatted page and also offers a version covering only vaccines recommended for adults.
Guide to Contraindications and Precautions to Commonly Used Vaccines
Guide to Contraindications and Precautions to Commonly Used Vaccines in Adults
IAC also has ready-to-copy screening questionnaires that can help healthcare providers identify contraindications and precautions prior to administering vaccines. Parents or patients fill out the questionnaire while waiting to be seen by their healthcare provider. Having patients do this ahead of time saves time and ensures that all necessary questions are reviewed.
Screening questionnaires are available for children and adults in several languages including English, Spanish, Arabic, Chinese, French, Korean, Russian, Turkish, and Vietnamese.
IAC also offers English and Spanish screening questionnaires for contraindications and precautions for injectable influenza vaccine and nasal spray influenza vaccine
To access all of IAC’s screening questionnaires and their translations, visit IAC’s web page of screening questionnaires.
Sometimes healthcare providers misperceive certain health conditions (e.g., antibiotic use, mild upper respiratory or ear infections) as contraindications when they are not. This can result in missed opportunities to vaccinate. To make sure healthcare providers know the health conditions that are not contraindications to vaccination, CDC offers an online chart titled “Conditions Commonly Misperceived as Contraindications to Vaccination.”
With appropriate screening for true contraindications and precautions to vaccination, clinicians will ensure they provide all recommended vaccines while minimizing risk to their patients and keeping them on schedule.


This page was updated on .