When are immunisations contraindicated?

There are very few contraindications to immunisations and serious thought must be given before deciding not to give a scheduled immunisation. Mild illness is not a contraindication. Neither is a skin rash or eczema. Antibiotics or allergic illnesses are also not contraindications. If an ill or malnourished child is well enough to go home, he/she can be immunised before going home.

An infant who is well enough to go home is well enough to be immunised.

Contraindications are:

  1. A seriously ill child who needs hospitalisation can be given measles immunisation on admission. The other immunisations can be postponed and given when the child has recovered, but before discharge from hospital.
  2. Live viruses (polio, measles and BCG) should not be given in infants with clinical signs of HIV infection (or a low CD4 count). However, all scheduled immunisations can be given if the infant is HIV positive without signs of HIV infection (and a normal CD4 count).
  3. Live viruses should not be given to children with immunosuppression such as children with leukaemia or receiving cytotoxic drugs. Kwashiorkor, marasmus and low dose or inhaled steroid treatment are not contraindications.
  4. DPT vaccine should not be given to infants with:
    • A high temperature (38 °C or above).
    • Fits or collapse within 3 days of a previous DPT immunisation
    • A serious progressive neurological abnormality such as repeated fits.

In these situations DT should be used instead of DPT.

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