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Department of Health and Human Services
Centers for Disease Control and Prevention

Vaccines & Immunizations

Recommendations and Guidelines:

Guide to Contraindications to Vaccinations

This guide is designed to help immunization providers determine what common symptoms
and conditions should contraindicate vaccination and which ones should not. It supersedes the 2000 Guide to Contraindications to Childhood Vaccination and, unlike that and previous Guides, contains information on all licensed U.S. vaccines, not just pediatric vaccines:

Anthrax | BCG | DTaP | DT | Influenza (Flu) | Hepatitis A (HA) | Hepatitis B (HB)
Japanese Encephalitis | MMR | Pneumococcal Conjugate (PCV) |
Pneumococcal Polysaccharide (PPV) | Polio (IPV) | Rabies | Tb | Typhoid |
Vaccinia (routine non-emergency use)* | Varicella | Yellow Fever (YF)

printer friendly versionPrinter-friendly version of Contraindications and Vaccinations guide Adobe Acrobat print-friendly PDF file

Print version contains:

  • Checklist of Selected Conditions (for quick navigation)
  • Symptom or Condition chart
  • Appendix A: Summary of Contents of Vaccines Licensed in the U.S.
  • Appendix B: Suggested Intervals Between Administration of Antibody-Containing Products for Different Indications and Measles-Containing Vaccine and Varricella Vaccine
  • Feedback

Related resources:

Using this Guide

The Guide is arranged alphabetically according to symptoms and conditions that may, correctly or not, be perceived as contraindications to vaccination. The first column states the symptom or condition. The second column lists individual vaccines, when recommendations differ by vaccine. The third column states whether or not a person with that symptom or condition should be vaccinated. Notes describe exceptions and special situations, or provide additional information.

When assessing a patient with multiple symptoms, if any one of them is a contraindication, do not vaccinate.

When using a combination vaccine, if there is a contraindication to any of the components, do not vaccinate.

*Vaccinia Vaccination During a Smallpox Emergency: No absolute contraindications exist regarding vaccination of a person with a high-risk exposure to smallpox. Persons at greatest risk for experiencing serious vaccination complications are also at greatest risk for death from smallpox. If a relative contraindication to vaccination exists, the risk for experiencing serious vaccination complications must be weighed against the risk for experiencing a potentially fatal smallpox infection. When the level of exposure risk is undetermined, the decision to vaccinate should be made after prudent assessment by the clinician and the patient of the potential risks versus the benefits of smallpox vaccination.

The Guide to Contraindications to Vaccinations was developed by the National Immunization Program, Centers for Disease Control and Prevention, using information derived from the Standards for Pediatric Immunization Practices, recommendations of the Advisory Committee on Immunization Practices (ACIP), and those of the Committee on Infectious Diseases (Red Book Committee) of the American Academy of Pediatrics (AAP) (exit). Some of these recommendations may differ from those stated in manufacturers' package inserts. For more details, consult the published recommendations of the ACIP, the AAP (exit), and the American Academy of Family Physicians (AAFP) (exit), and manufacturers' package inserts.

Note: The National Immunization Program (NIP) has since been renamed National Center for Immunization and Respiratory Diseases (NCIRD).

Help us Improve the Guide to Contraindications

Send us your feedback and tell us how we can make the Guide to Contraindications to Vaccinations more useful.

Are there other conditions you would like to see included? Did you prefer the smaller format of previous editions? Are there changes that would make it easier to use? Are there sections that are not clear?

Send your comments to crw4@cdc.gov. We cannot guarantee that all suggestions will be incorporated, but they will all be read and given serious consideration.

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This page last modified on May 18, 2004
Content last reviewed on May 18, 2004
Content Source: National Center for Immunization and Respiratory Diseases

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