contraindications

Last edited 04/2019

There are very few individuals who cannot receive pertussis-containing vaccines. When there is doubt, appropriate advice should be sought from a consultant paediatrician, local Screening and Immunisation team or consultant in Health Protection rather than withhold vaccine.

Pertussis-containing vaccines should not be given to those who have had:

• a confirmed anaphylactic reaction to a previous dose of a pertussis containing vaccine, or
• a confirmed anaphylactic reaction to neomycin, streptomycin or polymyxin B (which may be present in trace amounts).

Confirmed anaphylaxis occurs extremely rarely. Data from the UK, Canada and the US point to rates of 0.65 to 3 anaphylaxis events per million doses of vaccine given.

The presence of a neurological condition is not a contraindication to immunisation. Where there is evidence of a neurological condition in a child, then consult "The Green Book" and/or seek specialist advice.

Minor illnesses without fever or systemic upset

• are not valid reasons to postpone immunisation

If an individual is acutely unwell, immunisation should be postponed until they have fully recovered - this avoids the confusion of the differential diagnosis of any acute illness by wrongly attributing any signs or symptoms to the adverse effects of the vaccine.

Systemic and local reactions following a previous immunisation - a history of a severe or mild systemic or local reaction within 72 hours of a preceding vaccine

Immunisation with pertussis-containing vaccine should continue following a history of (1):

• fever, irrespective of its severity
• hypotonic-hyporesponsive episodes (HHE)
• persistent crying or screaming for more than three hours
• severe local reaction, irrespective of extent.

Pregnancy and breast-feeding

• pertussis-containing vaccines should be given to pregnant women to protect their infants from birth

For more detailed guidance consult "The Green Book".

Check the Summary of Product Characteristics (SPC) before prescribing/administering a pertussis-containing vaccine.

Reference:

• The Green Book. Chapter 24- Pertussis (April 2019)