As WHO says, vaccines save lives, they are a fundamental right (although, unfortunately, it is not always easily accessible to everyone), and they are cost effective because they are safe, effective and inexpensive.
However, as with any medication, vaccines may also have contraindications that raise the risk of serious adverse reactions. In that case, the pediatrician may recommend postponing or avoiding the administration of the vaccine, always weighing the advantages and disadvantages.
We tell you what recommendations the Vaccine Advisory Committee of the Spanish Association of Pediatrics (CAV-AEP) offers in this regard.
In Babies and more, what should we consider after vaccines are given?What are contraindications?
A contraindication is a specific situation that occurs in the patient and for which a drug, a vaccine or a surgical procedure should not be used, since it could raise the risk of serious or even fatal effects.
When we talk about vaccines, contraindications can be of two types:
Temporary: when the individual presents a condition for a certain time, which may raise the risk of adverse reactions. After that time and after that condition, the risk would cease to exist.
Permanent: when the individual has a certain condition that contradicts vaccination.
In Babies and more No vaccine is contraindicated during breastfeeding In which cases it would be recommended to postpone vaccination
The child is not the recommended age
Each vaccine should be administered at a specific age because if done earlier than recommended, it could not produce the expected immune response. Such is the case, for example, of the triple viral vaccine, which is not advised to be administered before 12 months of life.
Therefore, we must keep in mind the official vaccine schedule to know when it is time to vaccinate our children, the number of doses corresponding to each vaccine and the interval between all.
In Babies and more Vaccines are also essential in adolescence: what they are and when they are administeredEven so, remember that in case of epidemiological risk, the pediatrician could recommend advancing the administration of the triple viral vaccine, if the benefits in that particular case outweigh the risks.
In case of prematurity, the baby will receive the vaccines according to his chronological and uncorrected age, regardless of the gestational age he was at birth and his weight, except for exceptional situations that the doctor determines.
The pregnancy
There are two safe and recommended vaccines during pregnancy: the flu, which must be managed when the campaign begins, and the diphtheria, tetanus and pertussis, which is given at the end of pregnancy to prevent pertussis in the newborn.
But live virus vaccines are contraindicated during pregnancy, because of the potential risk of causing injury to the fetus. However, in special situations and always assessing the risk-benefit, the administration of a specific vaccine may be necessary.
In Babies and more Better to prevent… What vaccines should I get in pregnancy?Acute Disease Process
If at the time of receiving the vaccines the patient is going through a moderate or severe infectious process, vaccination should be postponed until recovery. Also in cases of acute illness when there is a high fever, severe diarrhea, asthmatic crisis or decompensated heart disease or nephropathy.
It is not necessary to postpone vaccination against banal infectious diseases with or without fever, such as colds or mild diarrhea, as it is shown that adverse effects are not increased or disease symptoms are prolonged.What if my child has febrile seizures?
Children who at some time have had febrile seizures can be vaccinated without any additional risk, although the Spanish Association of Vaccination recommends the administration of a preterm prior to and after vaccination.
What if my child is taking an antibiotic?
Antibiotics are not contraindication for vaccines, except for the oral typhoid vaccine.
Patients with immunodeficiencies
In children with immunodeficiencies, the live germ vaccines such as the viral triple (measles, rubella and paritoiditis), chickenpox and yellow fever are contraindicated because they could cause the disease in a serious way. Not all other vaccines, although more doses may be necessary because they usually cause a poor immune response.
In the cases of Children with human immunodeficiency virus (HIV) infection You should consult with the doctor.
In which cases vaccination would not be recommended
Certain allergies and anaphylaxis
The yeast allergic They should not receive the hepatitis B vaccine.
The ones that have gelatin anaphylaxis They should not be vaccinated from the viral triple.
The ones that have neomycin anaphylaxis or polymyxin B They should not receive triple viral vaccine, influenza or the inactivated polio vaccine.
Those who have a history of streptomycin anaphylaxis They should not receive the inactivated polio vaccine.
When an anaphylactic reaction is triggered after vaccination, subsequent doses of that same vaccine are contraindicated. Not so any other different vaccine that does not have the same component.
And in cases of egg allergy?
In the Spanish Association of Vacunology we can read the following regarding egg allergy, so common in childhood:
"If the child with an egg allergy can get vaccinated except in cases where you have a severe egg allergy (hypotension, shock and respiratory distress), in which you will not be able to receive the flu or yellow fever vaccine. In these cases, the triple viral vaccine will be administered under strict medical observation".
"Having diarrhea or abdominal pain after taking eggs are not reasons not to administer the triple viral vaccine"
Encephalopathy of unknown etiology
The presence of an encephalopathy of unknown etiology, which appears within seven days after the administration of a vaccine with a component against pertussis, contraindicates the administration of subsequent doses of vaccines containing said component.
Precautions to consider
In the cases that we will detail below, the vaccination must be assessed by the doctor or / and take into account a series of precautionsbut it is not contraindicated a priori:
Seizures, cerebral palsy and psychomotor retardation do not contraindicate any vaccine, provided that the disease is stabilized.
Fever greater than 40.5 ° C within 48 hours of administering a dose of any vaccine with the pertussis component.
Caution in the administration of subsequent doses, if after the pertussis vaccine the patient has seizures in the next three days, crying crying for more than three hours, and hypotonia syndrome and hyporesponse in the first 48 hours after vaccination.
In Babies and more From A to Z: All childhood vaccines from 0 to 14 years oldIf in the six weeks after the administration of a vaccine the patient develops Guillain-Barré syndrome, the appropriateness or not of administering a subsequent dose of said vaccine will be carefully assessed.
The doctor will assess in each specific case the risk-benefit of vaccination in patients with chronic diseases and immunosuppression, and those in treatment with biological products.
Before administering the triple viral vaccine to people with an untreated active tuberculosis, it is appropriate that the corresponding antituberculous therapy has been initiated.
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