The Bureau of Immunization is pleased to announce the release of an updated Guide to Contraindications and Precautions to Vaccine (April 2009) by the Centers for Disease Control and Prevention (CDC).  In these times of heightened vaccine-safety awareness, it is imperative that all healthcare providers have access to and knowledge of current recommendations regarding licensed vaccines in order to better serve those to whom they administer vaccine.  Invalid contraindications to vaccination lead to missed opportunities and leave patients unnecessarily vulnerable to disease. The attached Guide to Contraindications and Precautions to Vaccine is now posted on CDC's website (http://www.cdc.gov/vaccines/recs/vac-admin/contraindications.htm). This guide summarizes CDCs recommendations regarding common symptoms and conditions that do and do not contraindicate vaccines licensed in the United States.  The guide is available at the direct link at http://www.cdc.gov/vaccines/recs/vac-admin/downloads/contraindications-guide-508.pdf. 

The guide is designed to help immunization providers determine what common symptoms and conditions should contraindicate vaccination and which ones should not. It contains information on all licensed U.S. vaccines as of February 2009, and is arranged alphabetically according to symptoms and conditions which may, correctly or not, be perceived as contraindications to vaccination.

There are very few true contraindication and precaution conditions. Only two of these conditions are generally considered to be permanent: severe (anaphylactic) allergic reaction to a vaccine component or following a prior dose of a vaccine, and encephalopathy not due to another identifiable cause occurring within 7 days of pertussis vaccination.

For detailed information regarding contraindications to vaccination, see Epidemiology and Prevention of Vaccine Preventable Diseases, chapter 2 "General Recommendations" (http://www.cdc.gov/vaccines/pubs/pinkbook/downloads/genrec-508.pdf).  A more thorough discussion of these issues can be found in the General Recommendations on Immunization: Recommendations of the Advisory Committee on Immunization Practices. These recommendations are revised every 3–5 years as needed; the most current edition was published in December 2006 (MMWR 2006;55[RR-15]:1–48  http://www.cdc.gov/mmwr/preview/mmwrhtml/rr5515a1.htm). All providers who administer vaccine should have a copy of this report and be familiar with its content. It can be downloaded from the MMWR website or ordered in print version from the Centers for Disease Control and Prevention. 

Please distribute this information to colleagues, members, coalitions, and partners.  Place this information prominently on your website.  Contact Phyllis Yambor at 850-245-4342 for questions regarding the vaccine recommendations. 

Charles H. Alexander, Chief
Florida Dept. of Health/Bureau of Immunization
4052 Bald Cypress Way, Bin A-11
Tallahassee, FL 32399

Phone:  (850) 245-4331
Fax:       (850) 922-4195
E-mail: Charles_Alexander@doh.state.fl.us