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Immunizations - travel vaccinations - Management
When should vaccination be delayed?
- Delay vaccination if a person is suffering from any acute illness: postpone immunization until they have fully recovered. This is to avoid wrongly attributing any new symptom or the progression of symptoms to the vaccine.
- Do not delay vaccination if the person has a minor infection without fever or systemic upset.
- Delay vaccination in individuals with an evolving neurological condition. Immunization should be deferred until the neurological condition has resolved or stabilised.
- Delay vaccination with live vaccines in pregnant women until after delivery.
- Inactivated vaccines may be administered in pregnancy if protection is required without delay.
- Delay vaccination with live virus vaccines after an injection of immunoglobulin.
- Live virus vaccines should be given at least three weeks before or three months after an injection of immunoglobulin.
- Immunoglobulin may interfere with the immune response to live vaccine viruses because it may contain antibodies to measles, varicella and other viruses.
- Where there is doubt, seek appropriate advice from a consultant paediatrician, District Immunization Coordinator, or Consultant in Communicable Disease Control, rather than withholding vaccine.
Basis for recommendation
- These recommendations are based on published information from the medical literature [DH, 2006c].
- Postponing a vaccination if someone is acutely unwell is done to avoid wrongly attributing any new symptom or the progression of symptoms to the vaccine.
Pregnancy
- There is a theoretical concern that vaccinating pregnant women with live vaccines may infect the fetus. There is no evidence that any live vaccine (including rubella and MMR) causes birth defects. However, since the theoretical possibility of fetal infection exists, live vaccines should generally be delayed until after delivery. Termination of pregnancy following inadvertent immunization is not recommended.
- Since inactivated vaccines cannot replicate, they cannot cause infection in either the mother or the fetus. However, inactivated vaccines should be administered to pregnant women only if protection is required without delay.
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