The Immunization Encounter: Critical Issues

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• The Immunization Encounter Critical Issues
• Screening for Contraindications and Precautions

National Center for Immunization and Respiratory
Diseases Centers for Disease Control and
Prevention
These graphics are in the public domain December
2008
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Immunization Records

• A verbal history of previous immunizations is not
  sufficient evidence
• Accept as valid only immunizations that are
  documented in writing and dated

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Screening Questions

• Is the child sick today?

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Vaccination During Acute Illness

• No evidence that acute illness reduces vaccine
  efficacy or increases vaccine adverse reactions
• Vaccines should be delayed until the illness has
  improved

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Vaccination During Acute Illness

• Mild illness, such as otitis media or an upper
  respiratory infection, is NOT a contraindication
  to vaccination

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Screening Questions

• Is the child sick today?
• Does the child have an allergy to any medication,
  food or vaccine?

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Screening Questions

• Has the child had a serious reaction to a vaccine
  in the past?
• Has the child had a seizure, brain or nerve
  problem?

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Screening Questions

• Has the child had asthma, lung disease, heart
  disease, kidney disease, metabolic disease, such
  as diabetes, or a blood disorder?

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Screening Questions

• Does the child have cancer, leukemia, AIDS, or
  any other immune system problem?
• Has the child taken cortisone, prednisone, other
  steroids, or anticancer drugs, or had x-ray
  treatments in the past 3 months?

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Steroids and Vaccination

• Persons receiving aerosolized steroids, topical
  preparations, or low or moderate daily or
  alternate-day doses of steroids for fewer than 14
  days can receive live vaccines during treatment

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Screening Questions

• Has the child received a transfusion of blood or
  blood products, or been given a medicine called
  immune or gamma globulin in the past year?

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Screening Questions

• Is the child or teen pregnant, or is there a
  chance she could become pregnant during the next
  month?
• Has the child received any vaccinations in the
  past 4 weeks?

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