Any medical incident that takes place after immunisation and may be potentially related to immunisation should be reported.
- Every clinic day is an immunisation day.
- Never miss a chance to immunise - never turn a child away if an immunisation is needed, even if it means opening a multi-dose vial for just one child.
- Check the Road to Health Booklet every time the child visits the clinic, and give missed immunisations. These should be given according to the catch-up schedule which is shown in the Catch-up doses table.
- Mild illnesses are not a contra-indication to immunisation - most children who are well enough to be sent home, are well enough to be immunised. Do not immunise a sick child if the mother seriously objects, but encourage her to bring the child for immunisation on recovery.
- Give an extra dose if in doubt whether a child has had a certain dose or not, as extra doses are not harmful.
- The currently used measles vaccine must not be given with other childhood vaccines. All other vaccine listed in the table below can be given safely at the same time, but should not be given in the same syringe.
- Serious adverse events following immunisation are uncommon. All adverse events other than mild systemic symptoms (irritability, fever < 38°C) and minor local reactions (redness/swelling at infection site) should be reported.
There are very few contra-indications, but many missed opportunities.
Adverse events requiring reporting
Local reactions
- Pain, redness and / or swelling of more than 3 days' duration.
- Swelling more than 5cm from injection site
- BCG lymphadenitis following immunisation
- Injection site abscesses following immunisation.
Systemic reactions
- All cases of hospitalisation (thought to be related to immunisation).
- Encephalopathy within 7 days.
- Collapse or shock-like state within 48 hours.
- Fever of more than 38°C within 48 hours.
- Seizures within 3 days.
- All deaths (thought to be related to immunisation).
Conditions that are not contraindications to any of the standard EPI vaccines
- Family history of any adverse reactions following vaccination.
- Family history of convulsions.
- Previous convulsions.
- Previous measles, mumps, rubella or pertussis-like illness.
- Preterm birth.
- History of jaundice after birth.
- Stable neurological conditions such as cerebral palsy or trisomy 21.
- Contact with an infectious disease.
- Minor illness (without systemic illness and with a temperature below 38.5°C).
- Treatment with antibiotics.
- Asthma, eczema, hay fever or ‘snuffles’.
- Treatment with locally acting (inhaled or low-dose topical) steroids.
- Child’s mother is pregnant.
- Child being breastfed.
- Underweight, but otherwise healthy child.
- Over the age recommended in vaccination schedule but not above the allowable upper age limit per manufacturer's recommendations.
- Recent or imminent surgery.