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Results for “Immunization--contraindications”

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7 recordsLinked to original sources
PubMed1992

Compulsory and non-compulsory immunizations: contraindications perceived by medical practitioners.

A total of 284 general practitioners (GPs), paediatricians and doctors of public vaccination centres (DPVC) were interviewed to investigate their willingness to immunize children with compulsory (diphtheria-tetanus, oral polio) and non-compulsory (measles, pertussis) vaccines in the presence of 19 different medical histories. We observed a reluctance to immunize in the case of false contraindications, a lack of information mainly about non-compulsory immunizations, and doubts about the real contraindications to polio, measles and pertussis vaccines. The frequency of correct answers to the question posed was significantly higher in the group with less than 20 years of experience, and the DPVCs proved better informed about immunization. However, the crucial role played by the GPs and paediatricians' advice can prejudice the correct use of active immunization.

Attitude of Health Personnel↗
PubMed1992

The use of vaccines in renal failure.

Renal insufficiency is characterised by impaired host defences, which are compromised further by each of the 3 modes of renal replacement--haemodialysis, continuous ambulatory peritoneal dialysis (CAPD) and renal transplantation. Reduced renal clearance of unknown toxins, possible development of nutritional deficiencies and administration of immunosuppressive medications lead to aberrant immune regulation early in the course of renal failure. This results subsequently in increased frequency and severity of infection. Vaccination plays an important role in attenuating this infection risk, but impaired cell-mediated and humoral immunity contraindicates the use of live vaccines and engenders suboptimal and short-lived antibody responses to inactivated vaccines. Reinforced vaccination schedules, increased vaccine dosage and concomitantly administered adjuvant immunomodulators have variably improved the defective antibody responses to certain vaccines. Immunisation against hepatitis B virus has resulted in a significant decrease in prevalence and incidence of this infection in haemodialysis units. Similarly, the inoculation of influenza vaccine in patients with uraemia and of polyvalent pneumococcal vaccine in special risk circumstances has been recommended because of perceived reductions in morbidity and mortality from infection with these agents. Cytomegalovirus (CMV) vaccine may attenuate CMV disease severity in recipients of renal allografts. Staphylococcus aureus vaccine, on the other hand, is ineffective in preventing peritonitis or exit site infections in patients receiving CAPD. Other killed vaccines have not been comprehensively studied, but generally have the same indications for use as in normal individuals. However, the protection that these vaccines afford may be either inadequate or transient, so that other infection control strategies should be simultaneously implemented.

Bacterial Infections↗
PubMed1983

Infantile spasms and pertussis immunisation.

The possible roles of pertussis immunisation and of other factors in the aetiology of infantile spasms were investigated by analysis of 269 cases reported to the National Childhood Encephalopathy Study. In 34% of the cases an antecedent factor which may have caused infantile spasms was identified; the commonest of these were perinatal hypoxia (38 cases) and tuberous sclerosis (16 cases). Case-control analyses showed no significant association between infantile spasms and pertussis immunisation in the 28 days before onset. There was, however, some clustering of cases immunised with either diphtheria-tetanuspertussis or diphtheria-tetanus vaccines in the 7 days before onset. The excess compared with controls was compensated for by a corresponding deficit over the remaining period up to 28 days. It is suggested that these vaccines do not cause infantile spasms but may trigger their onset in those children in whom the disorder is destined to develop.

Acute Disease↗
PubMed1984

Indications and contraindications for vaccines used in the Expanded Programme on Immunization.

The aim of the Expanded Programme on Immunization is to reduce morbidity and mortality from six diseases that can be prevented by immunization. In many countries the immunization coverage is still less than optimal; one of the reasons for this is the fact that frequently health workers are faced with long lists of contraindications to immunization.The present review discusses the risks of adverse reactions after immunization and compares these risks with the complication rates following natural disease. It is concluded that the decision to withhold the benefits of immunization from an eligible child should not be taken lightly, particularly in areas where access to immunization services is limited and the incidence of the vaccine-preventable diseases is still high.Malnutrition should be a prime indication for immunization. Low-grade fever, mild respiratory infection, or diarrhoea should not be considered a contraindication to immunization. Measles immunization of children who have to be admitted to hospital has been shown to reduce the overall mortality rates in paediatric wards. It is recommended that all countries should formulate their own national policy, carefully considering the risks of disease as well as the benefits and potential risks of immunization.

BCG Vaccine↗