Tag: allergic reactions

Precautions vs Contraindications When Vaccinating Your Kids

Believe it or not, there are some anti-vaccine folks who believe that all vaccines are dangerous and unnecessary. And they believe that pediatricians push vaccines on kids in all situations, using a one-size-fits-all kind of immunization schedule.

Of course, neither is true.

Vaccines are safe and necessary.

There are some true medical contraindications and precautions to getting vaccinated though. Still, it is important to remember that even more things are simply “conditions incorrectly perceived as contraindications to vaccination.”

Contraindications To Vaccinating Your Kids

There are actually some good reasons to delay or skip one or a few of your child’s vaccines, but only in some very specific situations.

These very specific situations are called contraindications and are what count as medical exemptions.

“A vaccine should not be administered when a contraindication is present; for example, MMR vaccine should not be administered to severely immunocompromised persons.”

CDC on Vaccine Contraindications and Precautions

Fortunately, there are not that many of these contraindications, they are usually specific to just one or a few vaccines, and they are usually, but not always, temporary.

That’s why it would be really unusual to get a true permanent medical exemption for all vaccines. Even if you had a severe allergy to a vaccine that contained yeast, latex, or gelatin, since vaccines contain different ingredients, you would very likely be able to safely get the others.

Remember, your doctor can’t, or at least shouldn’t, just make up contraindications and exemptions to help you avoid getting your kids vaccinated and help you keep them in school.

“I do not believe vaccines had anything to do with my child’s autism. I never noticed any change in his speech, behavior or development with vaccines. I believe the protection and benefits of vaccines far outweigh the risks!”

Michele Han, MD, FAAP

Autism, for example, has been shown to not be associated with vaccines, so it is not a contraindication to getting vaccinated. That’s why many parents vaccinate and protect their autistic kids!

Precautions To Vaccinating Your Kids

In addition to contraindications to getting vaccinated, there is an accompanying list of  precautions.

“A precaution is a condition in a recipient that might increase the risk for a serious adverse reaction, might cause diagnostic confusion, or might compromise the ability of the vaccine to produce immunity (e.g., administering measles vaccine to a person with passive immunity to measles from a blood transfusion administered up to 7 months prior). A person might experience a more severe reaction to the vaccine than would have otherwise been expected; however, the risk for this happening is less than the risk expected with a contraindication. In general, vaccinations should be deferred when a precaution is present. However, a vaccination might be indicated in the presence of a precaution if the benefit of protection from the vaccine outweighs the risk for an adverse reaction.”

CDC on Vaccine Contraindications and Precautions

Again, we are fortunate that most of the conditions that are listed as precautions are temporary.

The vaccine information sheet that you get with each vaccine will list contraindications and precautions on who should not get the vaccine.
The vaccine information sheet that you get with each vaccine will list contraindications and precautions on who should not get the vaccine.

In fact, the most common is having a “moderate or severe acute illness with or without fever.”

Don’t want to get your child vaccinated when he or she has a severe illness?

Don’t worry.

Your pediatrician usually doesn’t want to vaccinate your child in that situation either.

It is easy enough to wait a few days or a week to get vaccinated, when the illness has passed, keeping in mind that a “mild acute illness with or without fever” is neither a precaution nor a contraindication to getting vaccinated. So you can still get your child their recommended vaccines if they just have a cold, stomach bug, or ear infection, etc.

What to Know About Precautions and Contraindications to Vaccines

Although there are some true medical exemptions or contraindications and precautions to getting vaccinated, most are vaccine specific and many are temporary, so they shouldn’t keep you from getting your child at least mostly vaccinated and protected.

More on Precautions and Contraindications to Vaccines

Vaccine Reactions – Is This Normal?

Vaccines are very safe.

They are not 100% safe though and they can have some side effects.

“Considering that the vaccines in the infant schedule are administered to millions of children each year, the list of known adverse events, even rare ones, is impressively short.”

O’Leary et al on Adverse Events Following Immunization: Will It Happen Again?

Fortunately, most of these side effects are harmless and don’t have any long term risks. And of course, the great benefits of vaccines outweigh those risks.

Common Vaccine Reactions

Although most kids don’t have any reactions at all, some do have mild reactions.

Among the possible vaccine reactions or side effects that can occur include:

  • fussiness
  • headache
  • fever
  • body aches
  • redness or swelling at the injection site
  • soreness or tenderness at the injection site
  • tiredness
  • poor appetite
  • chills and sore joints
  • rash
  • diarrhea
  • vomiting
  • swelling of glands in the cheeks or neck

How commonly do they occur?

In this 2011 report, the IOM concluded that few health problems are caused by or clearly associated with vaccines.
In this 2011 report, the IOM concluded that “few health problems are caused by or clearly associated with vaccines.”

These side effects depend on the vaccine that was received and can range from 1 in 3 kids for some fussiness all the way down to 1 in 75 kids for kids who have swelling of their glands.

And they usually begin 1 to 3 days after the vaccine was given and last for 1 to 7 days.  Fortunately, fever and fussiness don’t last that long, typically going away after just a day or two.

Keep in mind that some reactions are more delayed though. This is especially true for the MMR vaccine, in which mild reactions, like a fever, rash, or swelling of glands might not occur until 6 to 14 days after a child got his vaccine.

What can you do if your child has a mild vaccine reaction?

Consult your health care provider, but keep in mind that treatment is often symptomatic, typically with a cold pack or cool cloth/compress for local reactions and pain reliever.

Fainting also commonly occurs after vaccines, especially in teens, but it is thought to be due to the vaccination process itself and not the vaccines. Still, it is something to be aware of.

What About More Moderate Reactions?

More moderate reactions after vaccines are fortunately more uncommon.

“There is low public tolerance of vaccine adverse reactions. Vaccines are therefore only licensed when the frequency of severe reactions is very rare and when only minor, self-limiting reactions are reported.”

WHO on Adverse events following immunization

Some of these moderate reactions might include:

  • febrile seizures
  • high fever
  • persistent crying for 3 or more hours
  • swelling of the entire arm or leg where the shot was given (especially after the 4th or 5th dose of DTaP)
  • a temporary low platelet count (idiopathic thrombocytopenic purpura or ITP)

Like the more common, mild reactions, these less common moderate reactions are also temporary and don’t usually have any lasting risks or consequences.

Then there are the more severe reactions, which thankfully are even more rare. These are the 1 in a million dose type reactions, such as life-threatening allergic reactions.

Of course, you should seek medical attention if you think that your child is having a more moderate or severe reaction to a vaccine.

And lastly, there are the so-called vaccine induced diseases, which are simply made up.

All of these reactions, as well as the risks of getting a natural infection, are listed in each vaccine’s VIS. The Vaccine Information Statements also includes information on how to report all possible vaccine side effects to VAERS.

What to Know About Common Vaccine Reactions

While most kids don’t have any reactions at all after their vaccines, those that do typically have mild reactions, including some fever, soreness, or swelling at the injection site. More moderate and severe reactions are rare.

More About Common Vaccine Reactions

 

DTaP Vaccine Reactions – Is This Normal?

Vaccines are very safe.

They are not 100% safe though and they can have some side effects.

Fortunately, most of these side effects are harmless and don’t have any long term risks. And of course, the great benefits of vaccines outweigh those risks.

Common DTaP Vaccine Reactions

Although 75% of kids don’t have any reactions at all, some do have mild reactions.

Among the vaccine reactions or side effects that can occur most commonly include:

Vaccine Information Statements from the CDC highlight the risks of each vaccine.
The DTaP Vaccine Information Statement from the CDC highlight all of the vaccine’s possible risks.
  • fussiness
  • fever
  • redness or swelling at the injection site
  • soreness or tenderness at the injection site
  • tiredness
  • poor appetite
  • vomiting

How commonly do they occur?

They range from 1 in 3 kids for some fussiness all the way down to 1 in 50 kids for vomiting.

And they begin 1 to 3 days after the vaccine was given and last for 1 to 7 days.  Fortunately, fever and fussiness don’t last that long, typically going away after just a day or two.

Treatment is symptomatic, with a cold pack or cool cloth/compress and pain reliever

What About More Extensive Swelling and Redness?

Sometimes the swelling and redness after a DTaP vaccine can be more than you expect though. It might even make you think your child has developed a skin infection.

“Sometimes the 4th or 5th dose of DTaP vaccine is followed by swelling of the entire arm or leg in which the shot was given, lasting 1–7 days (up to about 1 child in 30).”

DTaP Vaccine Vaccine Information Statement

This more extensive local reaction, while scary looking, is not dangerous, and will also go away without long term effects.

It is also not an allergic reaction, so your child can finish the DTaP series if he or she still needs another dose.

Call your pediatrician or seek medical attention if you think your child has developed a skin infection after a vaccination, but keep in mind that bacterial cellulitis after getting a vaccine is an extremely rare, almost unheard of, complication.

Other more moderate and severe DTaP vaccine reactions are uncommon or rare.

“A hypotonic-hyporesponsive episode (HHE) is the sudden onset of hypotonia, hyporesponsiveness, and pallor or cyanosis that occurs within 48 hours after childhood immunizations.”

DuVernoy et al on Hypotonic-hyporesponsive episodes reported to the Vaccine Adverse Event Reporting System (VAERS), 1996-1998

What about hypotonic-hyporesponsive episodes (HHE) and seizures? These were removed as table injuries after DTP back in 1995. It is not that HHE can’t occur after DTP, DTaP, or other vaccines, but rather that HHE doesn’t then cause any permanent neurological damage to the child.

And remember that some so-called vaccine induced diseases are simply made up.

Most of these reactions, as well as the risks of getting natural diphtheria, tetanus, and pertussis infections, are listed in the DTaP VIS.

What to Know About Common DTaP Vaccine Reactions

While most kids don’t have any reactions at all after their DTaP vaccines, those that do typically have mild reactions, including some fever, soreness, or swelling at the injection site.

More About Common DTaP Vaccine Reactions