IAC Express 2011
Issue number 922: April 6, 2011
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- Read "Ask
the Experts" Q&As about common vaccination misconceptions
AAFP, American Academy of Family Physicians; AAP,
American Academy of Pediatrics; ACIP, Advisory Committee on Immunization
Practices; AMA, American Medical Association; CDC, Centers for Disease
Control and Prevention; FDA, Food and Drug Administration; IAC, Immunization
Action Coalition; MMWR, Morbidity and Mortality Weekly Report; NCIRD,
National Center for Immunization and Respiratory Diseases; NIVS, National
Influenza Vaccine Summit; VIS, Vaccine Information Statement; VPD,
vaccine-preventable disease; WHO, World Health Organization.
Issue 922: April 6, 2011
Read "Ask the Experts" Q&As about common vaccination misconceptions
Many readers of Needle Tips and Vaccinate Adults
consistently rank "Ask the Experts" as their favorite feature in these
publications. As a thank-you to our loyal IAC Express readers, we
periodically publish Extra Editions with "Ask the Experts" Q&As answered by
IAC thanks William L. Atkinson, MD, MPH, and Andrew T. Kroger, MD, MPH,
medical epidemiologists at the National Center for Immunization and
Respiratory Diseases, CDC, for agreeing to answer the following questions.
All the Q&As in this edition of IAC Express deal with misconceptions about
vaccination that too frequently get in the way of timely immunization.
Clinicians might misperceive certain conditions and circumstances as valid
contraindications or precautions when they actually do not preclude
vaccination. These misperceptions result in missed opportunities to
administer recommended vaccines.
We encourage you to reprint any of these Q&As in your own newsletters. Please
credit the Immunization Action Coalition and the Centers for Disease Control
and Prevention. Information about IAC's preferred citation style can be found
You can access more "Ask the Experts" Q&As in our online archive at
Editor's note: Information about submitting a question to "Ask the Experts"
is provided at the end of this Extra Edition.
Q: How many vaccines can be given during an office visit?
A: No upper limit exists for the number of vaccines that can
be administered during one visit. ACIP and AAP consistently
recommend that all needed vaccines be administered during an
Q: Which vaccines cannot be administered at an office visit
along with other vaccines?
A: All routine vaccines can be given during an office visit,
as long as a different syringe is used for each vaccine.
Q: If all needed vaccines aren't administered during the
same visit, does one need to wait a certain period of time
before administering the other needed vaccines?
A: All inactivated vaccines can be given on the same day, or
on any day before or after giving other inactivated or live
vaccines. However, if two live vaccines are not given on
the same day, they need to be spaced at least 4 weeks apart.
This recommendation does not apply to rotavirus or oral typhoid
vaccine, which can be given at any time before or after another
Q: Do we have to check vital signs before giving vaccines?
A: No. ACIP does not recommend routinely checking a
patient's temperature or other vital signs before
vaccination. Requiring these extra steps can be a barrier to
Q: Is it necessary to routinely test young women for
pregnancy before administering vaccines?
A: No. However, females of childbearing age should be asked
about the possibility of their being pregnant before they
are given any vaccine for which pregnancy is a
contraindication or precaution. The patient's answer should
be documented in the medical record. If the patient thinks
she might be pregnant, a pregnancy test should be performed
before administering live virus vaccines.
Q: Which vaccines can be given to breastfeeding women?
A: All vaccines except smallpox can be given to
breastfeeding women. Breastfeeding is a precaution for
yellow fever vaccine. Women who are breastfeeding should be
advised to postpone travel to yellow fever endemic or
epidemic regions; however, if travel cannot be postponed the
woman should receive yellow fever vaccine.
Q: Can I administer vaccine to a child who is taking
A: Treatment with antibiotics is not a valid reason to defer
vaccination. If a child or adult is otherwise well, or has
only a minor illness, vaccines should be administered. But
if the person has a moderate or severe acute illness
(regardless of antibiotic use), one should defer vaccination
until the person's condition has improved.
Q: We frequently see patients who have a fever or an acute
illness and are due for vaccinations. We're never quite sure
if we should withhold the vaccines or not. What do you
A: A "moderate or severe acute illness" is a precaution for
administering any vaccine. A mild acute illness (e.g., mild
diarrhea or upper-respiratory tract infection) with or
without fever is not.
Q: Should I vaccinate a child who has recently been exposed
to an infectious disease? What about a child who is
convalescing from illness?
A: Neither of these situations is a contraindication or
precaution to vaccination.
The following resources are useful to check for true
contraindications and precautions.
Portions of ACIP's General Recommendations on Immunization:
Chart of Contraindications and Precautions to Commonly Used
Conditions Commonly Misperceived as Contraindications to
Guide to Contraindications and Precautions to Commonly Used
Guide to Contraindications and Precautions to Commonly Used
Vaccines in Adults http://www.immunize.org/catg.d/p3072.pdf
HOW TO SUBMIT A QUESTION TO "ASK THE EXPERTS"
IAC works with CDC to compile new "Ask the Experts" Q&As for
our publications based on commonly asked questions. We also
consider the need to provide information about new vaccines
and recommendations. Most of the questions are thus a
composite of several inquiries.
You can email your question about vaccines or immunization
to IAC at email@example.com As we receive hundreds of
emails each month, we cannot guarantee that we will print
your specific question in the "Ask the Experts" feature.
However, you will get an answer. To see if your question has
already been answered, you can first check the "Ask the
Experts" online archive at http://www.immunize.org/askexperts
You can also email CDC's immunization experts directly at
firstname.lastname@example.org There is no charge for this service.
If you have a question about IAC materials or services,
Please forward these "Ask the Experts" Q&As to your co-workers and suggest they subscribe to IAC Express at
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