According to the assessment of specialists overseeing immunization, many cases of postponement of vaccination in Poland are unjustified. The article summarises the true and false contraindications to vaccination, emphasising the importance of keeping children vaccinated in accordance with the calendar.
Real contraindications to vaccination
1) Any vaccination should be postponed in the case of acute conditions or exacerbation of a chronic disease. Once the acute infection has resolved (usually 7-14 days after recovery), or the exacerbation of the chronic disease has been controlled, the child should be re-admitted to the vaccination programme.
2) Children with significant immunodeficiency permanently cannot be vaccinated with live vaccines (tuberculosis, measles, mumps, rubella, chickenpox, oral polio). Instead, they can be vaccinated with killed vaccines.
3) Vaccination with live vaccines must be postponed for 3-6 months after the child has received a blood product (e.g. a blood transfusion due to anaemia) or immunoglobulin preparations.
4) A history of severe anaphylactic allergic reactions (urticaria, shock) to certain substances is a contraindication to vaccination with preparations that contain the antigen in question (e.g. chicken protein antigen in measles vaccines, or neomycin in some vaccines - measles, polio, rubella). Alternative vaccines that do not contain substances with documented negative effects on the child in question should be sought.
5) Contraindications to pertussis vaccination are progressive neurological diseases and congenital metabolic diseases with damage to the central nervous system. In addition, vaccination should be postponed in children undergoing neurodevelopmental diagnosis, especially those suspected of having progressive disease or epileptic encephalopathy.
6) A contraindication to subsequent doses of pertussis vaccine is the occurrence, after the previous dose, of serious adverse reactions such as: disturbance of consciousness, convulsions, chronic crying or screaming lasting more than 3 hours, fever to more than 39 degrees or an episode of flaccidity or unconsciousness, not explained by other causes, occurring within 3 days after vaccination. In these cases, a so-called acellular vaccine should be considered.
7) Contraindications to oral polio vaccine are chronic diarrhoea, short bowel syndrome, or intestinal malabsorption syndrome. In these cases, a killed, parenteral vaccine can be administered.
8) Vaccination against tuberculosis performed shortly after birth, should be postponed in newborns in severe clinical condition and in all those born before 32 weeks or with a weight of less than 2000 g
9) Vaccination should not be continued if there has been an episode of severe anaphylactic (shock) allergic reaction following a previous dose of the vaccine in question.
10) Great caution should be exercised in qualifying for vaccination if the child has an autoimmune disease (visceral lupus, juvenile chronic arthritis, autoimmune hepatitis or thyroiditis, rheumatic fever, glomerulonephritis and others).
