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Letter to the editor
Editor, Dr McIntyre provides an informative guide to childhood immunisations in his recent article 'Update on childhood immunisations' (Aust Prescr 1994;17:91-5) and helpfully provides a more restricted guide to contraindications. He lists contraindications as a concurrent moderate to severe illness, previous anaphylactic reaction to the vaccine (or severe reaction to a vaccine constituent), attenuated live vaccines in immuno compromised patients, and neurological handicap as regards pertussis.
Previously, a fever over 39.5oC, induration and redness around most of the arm and prolonged inconsolable screaming after pertussis vaccine have been considered a contraindication to repeating it.
Are these still considered contraindications (or were such reactions included as an anaphylactic reaction) and what is the risk of subsequent vaccination in a child who has had such a reaction previously?
Surry Hills, N.S.W.
- National Health and Medical Research Council. The Australian immunisation procedures handbook. 5th ed. Canberra: Australian Government Publishing Service, 1994.
- Peter G, editor. 1994 Red Book. Report of the Committee on Infectious Diseases. 23rd ed. Illinois:American Academy of Pediatrics,1994: 364-5.
- Cody CL, Baraff LJ, Cherry JD, Marcy SM, Manclark CR. Nature and rates of adverse reactions associated with DTP and DT immunizations in infants and children. Pediatrics 1981;68:650-60.
- The Australian College of Paediatrics Policy Statement. Contraindications to immunization against pertussis. J Paediatr Child Health 1994;30:310-1.