Neurological contra-indications for vaccination– do we appreciate and apply them in everyday practice ?

Vaccination is the most important medical success of the 20th century, having resulted in saving more lives than any other medical intervention. The contraindications for vaccination are discussed in children with neurological disorders and diseases which were present before or occurred after vaccination. General contraindications for vaccination in these children do not differ from contraindications in the general pediatric population. Special contraindications refer to particular vaccines. Non-progressive encephalopathies caused by early perinatal brain damage (cerebral palsy), well controlled epilepsies, congenital neuromuscular diseases and the majority of metabolic diseases as well as developmental pervasive disorders, acute encephalomyelitis and transverse myelitis, multiple sclerosis and Guillian Bareov syndrome in later childhood – are not contraindications for vaccination. Vaccination is often hampered by „pseudo-contraindications“ such as mild febrile illness, antibiotic therapy, prematurity, „low“ weight, recent exposure to infection or allergy to penicillin. These informal contraindications should be avoided in the best interests of the child. Mild and moderate local or general reactions after previous vaccination are not contraindications for further vaccination. Our experience showed that side effects after acellular vaccine against Diphtheria- Tetanus – Pertussis (DTaP), which is now used in our country too, are less frequent. Progressive acute and subacute infectious, metabolic or immunological encephalo-pathies or encephalomyelopathies, coma, prolonged unconscious state with EEG and cerebro-spinal fluid changes, infantile spasms and Rey’s syndrome are absolute contraindications for vaccination against Pertussis. The children with encephalopathy temporarily related to vaccination against Pertussis as well as children with anaphylactic reaction after vaccination should not be vaccinated against Pertussis. The children who developed aseptic meningitis after MPR vaccination (against Morbilli, Mumps and Rubeolla) should be revaccinated. In the group of 43 children who had perinatal neurological difficulties and were sent to the neuropediatrician in the first three months of life, 56 % of them were vaccinated during the following month after consultation.
Category: Abstracts
Volume: Vol. 52, No 3, july - september 2008
Authors: M. Jurin, D. Richter, Z. Sabol, S. Bela Klancir, M. Kovač Šižgorić
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