Medical - Vaccine Guide 2022 - 18

Appendix
Recommended Child and Adolescent Immunization Schedule for ages 18 years or younger, United States, 2022
Guide to Contraindications and Precautions to Commonly Used Vaccines
Adapted from Table 4-1 in Advisory Committee on Immunization Practices (ACIP) General Best Practice Guidelines for Immunization: Contraindication and Precautions available at www.cdc.gov/vaccines/hcp/aciprecs/general-recs/contraindications.html
and ACIP's Recommendations for the Prevention and Control of 2021-22 seasonal influenza with Vaccines available at www.cdc.gov/mmwr/volumes/70/rr/rr7005a1.htm.
Interim clinical considerations for use of COVID-19 vaccines including contraindications and precautions can be found at
www.cdc.gov/vaccines/covid-19/clinical-considerations/covid-19-vaccines-us.html
Vaccine
Influenza, egg-based,
inactivated injectable (IIV4)
Contraindications1
* Severe allergic reaction (e.g., anaphylaxis) after previous dose of any influenza vaccine (i.e.,
any egg-based IIV, ccIIV, RIV, or LAIV of any valency)
* Severe allergic reaction (e.g., anaphylaxis) to any vaccine component3
(excluding egg)
Precautions2
* Guillain-Barré syndrome (GBS) within 6 weeks after a previous dose of any type of
influenza vaccine
* Persons with egg allergy with symptoms other than hives (e.g., angioedema, respiratory
distress) or required epinephrine or another emergency medical intervention: Any
influenza vaccine appropriate for age and health status may be administered. If using
egg-based IIV4, administer in medical setting under supervision of health care provider
who can recognize and manage severe allergic reactions. May consult an allergist.
* Moderate or severe acute illness with or without fever
Influenza, cell culture-based
inactivated injectable
[(ccIIV4), Flucelvax®
Quadrivalent]
* Severe allergic reaction (e.g., anaphylaxis) to any ccIIV of any valency, or to any component3
of ccIIV4
* Guillain-Barré syndrome (GBS) within 6 weeks after a previous dose of any type of
influenza vaccine
* Persons with a history of severe allergic reaction (e.g., anaphylaxis) after a previous dose
of any egg-based IIV, RIV, or LAIV of any valency. If using ccIV4, administer in medical
setting under supervision of health care provider who can recognize and manage severe
allergic reactions. May consult an allergist.
* Moderate or severe acute illness with or without fever
Influenza, recombinant
injectable
[(RIV4), Flublok®
Quadrivalent]
* Severe allergic reaction (e.g., anaphylaxis) to any RIV of any valency, or to any component3
RIV4
of
* Guillain-Barré syndrome (GBS) within 6 weeks after a previous dose of any type of
influenza vaccine
* Persons with a history of severe allergic reaction (e.g., anaphylaxis) after a previous dose
of any egg- based IIV, ccIIV, or LAIV of any valency. If using RIV4, administer in medical
setting under supervision of health care provider who can recognize and manage severe
allergic reactions. May consult an allergist.
* Moderate or severe acute illness with or without fever
Influenza, live attenuated
[LAIV4, Flumist®
Quadrivalent]
* Severe allergic reaction (e.g., anaphylaxis) after previous dose of any influenza vaccine (i.e.,
any egg-based IIV, ccIIV, RIV, or LAIV of any valency)
* Severe allergic reaction (e.g., anaphylaxis) to any vaccine component3
(excluding egg)
* Children age 2 - 4 years with a history of asthma or wheezing
* Anatomic or functional asplenia
* Immunocompromised due to any cause including, but not limited to, medications and HIV
infection
* Close contacts or caregivers of severely immunosuppressed persons who require a protected
environment
* Pregnancy
* Cochlear implant
* Active communication between the cerebrospinal fluid (CSF) and the oropharynx,
nasopharynx, nose, ear or any other cranial CSF leak
* Children and adolescents receiving aspirin or salicylate-containing medications
* Received influenza antiviral medications oseltamivir or zanamivir within the previous 48
hours, peramivir within the previous 5 days, or baloxavir within the previous 17 days
* Guillain-Barré syndrome (GBS) within 6 weeks after a previous dose of any type of
influenza vaccine
* Asthma in persons aged 5 years old or older
* Persons with egg allergy with symptoms other than hives (e.g., angioedema, respiratory
distress) or required epinephrine or another emergency medical intervention: Any
influenza vaccine appropriate for age and health status may be administered. If using
LAIV4 (which is egg based), administer in medical setting under supervision of health
care provider who can recognize and manage severe allergic reactions. May consult an
allergist.
* Persons with underlying medical conditions (other than those listed under
contraindications) that might predispose to complications after wild-type influenza virus
infection [e.g., chronic pulmonary, cardiovascular (except isolated hypertension), renal,
hepatic, neurologic, hematologic, or metabolic disorders (including diabetes mellitus)]
* Moderate or severe acute illness with or without fever
1. When a contraindication is present, a vaccine should NOT be administered. Kroger A, Bahta L, Hunter P. ACIP General Best Practice Guidelines for Immunization. www.cdc.gov/vaccines/hcp/acip-recs/general-recs/
contraindications.html
2. When a precaution is present, vaccination should generally be deferred but might be indicated if the benefit of protection from the vaccine outweighs the risk for an adverse reaction. Kroger A, Bahta L, Hunter P. ACIP
General Best Practice Guidelines for Immunization. www.cdc.gov/vaccines/hcp/acip-recs/general-recs/contraindications.html
3. Vaccination providers should check FDA-approved prescribing information for the most complete and updated information, including contraindications, warnings, and precautions. Package inserts for U.S.-licensed
vaccines are available at www.fda.gov/vaccines-blood-biologics/approved-products/vaccines-licensed-use-united-states
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http://www.cdc.gov/vaccines/hcp/aciprecs/general-recs/contraindications.html http://www.cdc.gov/vaccines/hcp/aciprecs/general-recs/contraindications.html http://www.cdc.gov/mmwr/volumes/70/rr/rr7005a1.htm http://www.cdc.gov/vaccines/covid-19/clinical-considerations/covid-19-vaccines-us.html http://www.cdc.gov/vaccines/hcp/acip-recs/general-recs/contraindications.html http://www.cdc.gov/vaccines/hcp/acip-recs/general-recs/contraindications.html http://www.cdc.gov/vaccines/hcp/acip-recs/general-recs/contraindications.html http://www.fda.gov/vaccines-blood-biologics/approved-products/vaccines-licensed-use-united-states http://www.henryschein.com/medical

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