Immunologic agents are contraindicated in patients with known hypersensitivity to the agent or any component of it. The measles, mumps, rubella, and varicella vaccines are contraindicated in patients who have ever had an allergic reaction to gelatin, neomycin, or a previous dose of one of the vaccines. The measles, mumps, rubella, and varicella vaccines are contraindicated during pregnancy, especially during the first trimester, because of the danger of birth defects. Women are instructed to wait at least 3 months before getting pregnant after receiving these vaccines. Vaccines and toxoids are contraindicated during acute febrile illnesses, leukemia, lymphoma, immunosuppressive illness or drug therapy, and non-localized cancer. See Display 54-6 for additional infor-
• Moderate or severe illness, with or without fever
• Anaphylactoid reactions (eg, hives, swelling of the mouth and throat, difficulty breathing [dyspnea], hypotension, and shock)
• Known allergy to vaccine or vaccine constituents, particularly gelatin, eggs, or neomycin
• Individuals with an immunologic deficiency should not receive a vaccine (virus is transmissible to the immunocompromised individual).
• Immunizations are postponed during the administration of steroids, radiation therapy, and antineoplastic (anticancer) drug therapy.
• Virus vaccines against measles, rubella, and mumps should not be given to pregnant women.
• Patients who experience severe systemic or neurologic reactions after a previous dose of the vaccine should not be given any additional doses.
mation on the contraindications for immunologic agents.
The immunologic agents are used with extreme caution in individuals with a history of allergies. Sensitivity testing may be performed in individuals with a history of allergies. No adequate studies have been conducted in pregnant women, and it is not known whether these agents are excreted in breast milk. Thus, the immunologic agents (Pregnancy Category C) are used with caution in pregnant women and during lactation.
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