Condition or circumstance of person to be vaccinated Action Rationale3-5

Unwell today:

  • acute febrile illness (current temperature ≥38.5°C)
  • acute systemic illness 
  • Defer all vaccines until not febrile.
  • Vaccinate children who have minor illnesses (without acute systemic symptoms/signs). 
To avoid an adverse event in an already unwell person, or to avoid attributing symptoms to vaccination
  • Disease that lowers immunity
  • Receiving treatment that lowers immunity
  • Infant of a mother who received immunosuppressive therapy during pregnancy
  • Vaccine safety and effectiveness may be suboptimal in people who are immunocompromised.
  • Live attenuated vaccines may be contraindicated.
Anaphylaxis following a previous dose of the relevant vaccine
  • Do not vaccinate.
  • Seek further medical advice to confirm causality and assist with other vaccinations.
  • See also Contraindications to vaccination.
Anaphylaxis to a previous dose of a vaccine is a contraindication to receiving the same vaccine.
Severe allergy to a vaccine component Anaphylaxis to a vaccine component is generally a contraindication to receiving the vaccine.
Received a live attenuated viral parenteral vaccine or BCG vaccine in past 4 weeks Delay live attenuated viral parenteral vaccines by 4 weeks. The immune response to a live attenuated viral parenteral vaccine may interfere with the response to a subsequent live viral vaccine given within 4 weeks.
  • Received any blood product in the past 7 months
  • Received intramuscular or intravenous immunoglobulin in the past year
  • Antibodies in blood products may interfere with the immune response to MMR, MMRV and varicella vaccines.
  • The recommended interval to vaccination depends on the immunoglobulin or blood product received.
Planning a pregnancy or anticipating parenthood
  • Vaccinating before pregnancy may prevent maternal illness that could affect the infant. It may confer passive immunity to the newborn.
  • There is insufficient evidence to ensure the safety of live vaccines during pregnancy.
Pregnant
  • There is insufficient evidence to ensure the safety of live vaccines during pregnancy.
  • Inactivated vaccines are generally not contraindicated in pregnancy.
  • Influenza and pertussis vaccines protect the mother and provide passive antibodies to the newborn, to protect them in early infancy.
History of Guillain–Barré syndrome (GBS) In people with a history of GBS, the condition may recur after receiving influenza vaccine.
Born preterm
  • See Vaccination for preterm infants.
  • Preterm infants born at <28 weeks gestation and/or with chronic lung disease need extra pneumococcal vaccinations (see Pneumococcal disease) and annual influenza vaccination (see Influenza).
  • Preterm infants born at <32 weeks gestation and/or <2000 g birth weight may need an extra dose of hepatitis B vaccine (see Hepatitis B).
Preterm infants may be at increased risk of vaccine-preventable diseases (eg invasive pneumococcal disease). They may not mount an optimal immune response to certain vaccines (eg hepatitis B).
Severe or chronic illness
  • See Vaccination for special risk groups.
  • These people should receive recommended vaccines such as pneumococcal vaccine and annual influenza vaccination.
  • If they have significant immunocompromise, they should not receive live vaccines.
  • People with a severe or chronic illness may be at increased risk of vaccine-preventable diseases (eg invasive pneumococcal disease). They may not mount an optimal immune response to certain vaccines.
  • Vaccine safety and effectiveness may be suboptimal in people who are immunocompromised.
Bleeding disorder Intramuscular injection may lead to haematomas in people with haemostasis disorders.
Aboriginal or Torres Strait Islander person Some Aboriginal and Torres Strait Islander people are at increased risk of some vaccine-preventable diseases, such as influenza, pneumococcal disease and hepatitis A.
No functioning spleen People with an absent or dysfunctional spleen are at increased risk of severe bacterial infections, especially invasive pneumococcal disease.
Parent, grandparent or carer of an infant ≤6 months of age Ensure that parents, grandparents and carers of infants up to 6 months of age have been offered all vaccines recommended for their age group, including dTpa (see Diphtheria, Tetanus and Pertussis for more details). People in close contact with newborns are the most likely sources of vaccine-preventable diseases, especially pertussis, in the newborn.
Lives with someone who is immunocompromised Household members are the most likely sources of vaccine-preventable diseases among people who are immunocompromised. People who are immunocompromised are often unable to be vaccinated, especially with live viral vaccines.
Planning travel See Vaccination for international travellers. Travellers may be at increased risk of certain vaccine-preventable diseases.
Occupational or lifestyle factors See Vaccination for people at occupational risk Vaccination for people at occupational risk, Vaccination for other groups, and Table. Catch-up schedule for people ≥10 years of age (for vaccines recommended on a population level in Catch-up vaccination. Workers in certain occupations (eg healthcare workers, and people working in early childhood education and care) and people with certain lifestyle factors (eg people who inject drugs) may be at increased risk of certain vaccine-preventable diseases.

BCG = bacille Calmette–Guérin; dTpa = reduced antigen content diphtheria-tetanus-acellular pertussis; MMR = measles-mumps-rubella; MMRV = measles-mumps-rubella-varicella. 

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Last updated: 
8 June 2018
Last reviewed: 
8 June 2018

Definitions

BCG
bacille Calmette-Guérin
MMR
measles-mumps-rubella
MMRV
measles-mumps-rubella-varicella
GBS
Guillain-Barré syndrome
dTpa
diphtheria-tetanus-acellular pertussis vaccine, reduced antigen content formulation