First AD

Second AD

Missed opportunities result in under-vaccinated children and adults. Clinicians often mistakenly elect not to give a vaccine thinking that a contraindication exists.

A. DTaP administration to a 4mo-old who spiked a temperature to 105.5 with a previous DTaP

B. DTaP administration to a 5y-old on anticonvulsants for a well-controlled seizure disorder associated w spastic quadriplegia

C. MMR administration to a child whose mother is significantly immune-suppressed

D. HPV administration to a pregnant mother in her third trimester

E.  PPSV23 to a 66y-old with a 101°F fever and a positive influenza B rapid test

F. Flu shot to a 21y-old with egg allergy that causes generalized urticaria that resolves with oral antihistamines

G. LAIV (Flumist) administration to a nurse working in a newborn intensive care unit

 (HPV administration to a pregnant mother in her third trimester) 

is a conraindication to vaccine administration per the CDC. 

HPV should not be given during any of the trimesters. However, the package insert, controlled by the FDA, considers F as a contraindication. Why can't these two government agencies get together and agree on the same recommendations? That's a story for another time.

For one more question, please click here.

Missed Opportunities for Vaccination