FA16 Immunization Module’s Updates
Invalid Contraindications to Vaccination
Routine vaccination is pivotal to effective disease control within the population. Due to the principle of herd immunity, it is critical to vaccinate all eligible individuals in order to protect those who are ineligible for certain vaccinations. "Contraindication", in the case of vaccines, is defined as a condition or state in an individual that drastically increases the risk of adverse reaction upon the administration of the vaccine. In addition to being aware of true contraindications for vaccines, healthcare providers should be familiar with the common illegitimate contraindications as well. Knowledge of invalid contraindications is important for the prevention of needless delays to an individual's vaccinations.
Part of the problem with invalid contraindictions is that, on first impression, many of them appear to be resonable concerns for delaying vaccination. A good number of invalid contraindications stem from legitimate contraindications. While the following is not a comprehensive list, these invalid contraindications to vaccination were selected to illustrate the relationship between valid and invalid contraindications.
- Mild Acute Illness: The presence of a mild illness, such as the common cold, should not dissuade a healthcare provider from providing an appropriately timed vaccine to an otherwise elligible individual. This invalid contraindication likely stems from the valid temporary contraindication of severe acute illness. Adverse events related to the vaccine could complicate the management of a patient with a severe acute illness, but they are not as great of a threat to patients with a mild illness.
- Mild to Moderate Local Reaction: A localized reaction, such as redness, discomfort, and swelling, to a prior dose of a vaccine is not cause to withhold further doses of the vaccine. While these side effects may be unpleasant, they are not life threatening and they do not compare to the potential harm the individual faces if he or she were to contract the disease. This invalid contraindication is related to the legitimate concern for severe allergic reactions.
The following chart provides a more complete summary of the commonplace invalid contraindications recognized by the CDC.
Sources:
[1] Immunization Basics powerpoint file.
[2] "Immunization: You Call the Shots" interactive learning activity.
[3] "Conditions Commonly Misperceived as Contraindications to Vaccination" CDC website <http://www.cdc.gov/vaccines/hcp/admin/contraindications-misconceptions.html>.
I agree with @Madeline Bell - it would be slightly more difficult to appease parents who do not want to vaccinate their children due to invalid contraindications. Even as a medical student knowing that invalid contraindications are not reason to delay a vaccine administration, I can understand where the parents would be coming from. Also, I would even be nervous myself to have a vaccine administered if I had, for example, a mild cold. Certainly a crucial topic that should be discussed with parents and anybody receiving vaccines.
Nice summary. How would you suggest physicians talk to their patients who are concerned about vaccinating their children for these reasons?