Diagnosis and Assessment
ÎÎIf the intradermal skin test result is negative, the chance that the patient
has IgE antibody to any vaccine constituent is negligible, and the vaccine
can be administered in the usual manner. It is prudent, nonetheless, in a
patient with a history suggestive of an anaphylactic reaction to administer
the vaccine under observation with epinephrine and other treatment
available. (B)
ÎÎIn patients with histories and skin tests results consistent with an IgEmediated reaction to a vaccine, who require additional doses of the suspect
vaccine or other vaccines with common ingredients, consideration can be
given to administering the vaccine in graded doses under observation. (C)
ÎÎSome more serious, and less common, reactions to vaccines require
evaluation, but only a few are absolute contraindications to future doses. (B)
ÎÎPregnant women should not be vaccinated with live vaccines. However,
pregnant women should be given inactivated influenza vaccine as well as
tetanus and hepatitis B vaccine if otherwise indicated. (B)
ÎÎIn general, live vaccines should not be given to persons who are immunecompromised because of a risk of generalized infection with the immunizing
agent. (B)
ÎÎSpecific vaccines or vaccination in general has been purported to have
long-term consequences, including atopy, autism, and multiple sclerosis.
Epidemiologic studies have not supported such associations. (B)
ÎÎLive Vaccines
>> Bacille Calmette-Guerin (BCG)
>> Influenza (intranasal)
>> Measles-mumps-rubella (MMR)
>> Oral poliovirus (OPV)
>> Rotavirus
>> Typhoid (oral)
>> Vaccinia (smallpox)
>> Varicella
>> Yellow fever
>> Zoster
ÎÎKilled Vaccines
>> Diphtheria, tetanus and acellular
pertussis (DTaP, Tdap)
>> Diphtheria-tetanus (DT, Td)
>> Hepatitis A
>> Hepatitis B
>> Hib conjugates
>> Human papillomavirus (HPV)
>> Inactivated poliovirus (IPV)
>> Influenza (injectable)
>> Japanese encephalitis
>> Meningococcal
>> Meningococcal conjugate
>> Pneumococcal
>> Pneumococcal conjugate
>> Rabies
>> Typhoid (injectable)
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