Severe illness at the scheduled time of vaccination warrants a delay, but minor illnesses such as colds, coughs or low-grade fevers do not. Children with minor illnesses of this sort respond normally to vaccination and have no added side effects. Parents should discuss with their child's doctor whether to postpone vaccination if their child has had a hypotonic-hyporesponsive episode (HHE) after a previous dose of pertussis vaccine. Although no permanent damage has followed any HHE associated with pertussis vaccination, delaying vaccination may be an alternative if the frequency of pertussis in the family's community is known to be low. If pertussis is occurring, it would be better for the child to be vaccinated. Pertussis vaccination is often deferred in children with progressive or changing neurologic conditions. Such conditions include tuberous sclerosis, recurrent convulsions that are not prevented by medication, and neurodegenerative diseases. The reason for deferral is to avoid introducing a variable (e.g., the vaccine) that may be viewed as causing changes in the child that otherwise would be attributed to the disorder. Deferral should be reassessed at each visit to the doctor; pertussis vaccine should be given when the condition has resolved, been corrected or controlled. If pertussis vaccine is withheld, diphtheria and tetanus toxoids can still be administered without the pertussis vaccine. Anyone who has received immune globulin by injection into muscle or a vein should not receive measles, mumps or rubella vaccine for three months or more, depending on the dose of immune globulin. The antibodies in the immune globulin can interfere with establishment of immunity after vaccination.

This document was published by the Canadian Paediatric society, 1997.

Posted by the Canadian Paediatric Society, July 1997.

---