Vaccines-Frequently asked questions about allergies and missed doses

What if my child has allergies?

Children with mild allergies can be vaccinated. A mild allergy comprises symptoms such as itch, redness or small rashes on exposure to a particular substance. Children with eczema or asthma can be vaccinated. Discuss with your doctor if you have a child who has had a severe allergy prior to vaccination. A severe allergy is one that has resulted in swelling of the lips, nose or eyes, closing of the throat, wheezing, rapid breathing, rapid pulse rate or fainting. If the child has had a severe allergic reaction to a previous vaccine or to substances inside a particular vaccine, that vaccine should be avoided in future. Other vaccines that do not contain the substance causing the allergy can still be given. Other children in the same family can still be vaccinated.

If my child is allergic to eggs, can they receive the influenza vaccine?

It depends on how severely allergic they are. In most cases, the egg allergy is a mild allergy and the flu vaccine can still be given. If your child has eaten baked goods containing eggs (such as Marie biscuits) the vaccine can be given. If your child has never eaten eggs previously, the vaccine can be given. If your child has had only mild skin rashes or nausea or diarrhoea from eggs, he/she can still receive the vaccine.

If my child is allergic to antibiotics, can they still receive vaccines?

It depends on how severely allergic they are, and to which antibiotic. Antibiotics are only present in very small amounts in vaccines. The antibiotics have been used in the manufacturing process to prevent bacterial infection of the vaccine during production. Antibiotics used are not those commonly given to children to treat infections, and do not include penicillin, cephalosporins or sulpha drugs. If your child is allergic to penicillins, cephalosporins or sulpha drugs, your child may be safely vaccinated. The antibiotics that may be present in vaccines include neomycin, gentamycin and polymixin B. If your child is allergic to neomycin, gentamycin or polymixin B – depending on how severely allergic they are (see above), you may need to avoid vaccines containing these antibiotics. You can check the package insert of the vaccine to check whether a particular vaccine contains these antibiotics. Other vaccines not containing the antibiotic to which your child is allergic can still be given. If your child has had any severe allergies (see above) a doctor should be consulted prior to vaccination.

My child is allergic to yeast. Can my child still be vaccinated?

Most vaccines do not contain yeast. The hepatitis B vaccine and one type of HPV vaccine (Gardasil®) are produced in yeast cells so may contain traces of yeast. Whether your child can have the vaccines depends on how severely allergic they are. If they have had only gastrointestinal symptoms (nausea, vomiting or constipation) or skin rashes, they may receive the vaccines. If they have had a life-threatening reaction (see above for symptoms) they should not receive vaccines containing yeast.

I missed my appointments and my child has not received all his vaccines, what should I do?

It’s never too late to vaccinate. You should take your child for catch up vaccinations. This can be done at any age. Your health provider will advise you on the appropriate schedule for catch up vaccines. Some changes may be made to the vaccine schedule. Examples of changes to the schedule include: Rotavirus vaccine is not given after 24 weeks of age. The vaccine against Haemophilus influenzae b is not given after 5 years of age because by that age the risk period for severe disease has passed. The dose of the diphtheria, pertussis and tetanus toxoid vaccine changes after age seven years – after which the Tdap (adult dose) will be given. For polio vaccine – in adults the inactivated vaccine is preferred to the live vaccine for a first vaccination. BCG is usually not caught up, as South African children have likely already been exposed to TB and the vaccine is intended for use prior to exposure to TB. It is never too late to vaccinate for measles, pneumococcus and hepatitis B. In fact, adult vaccination is becoming increasingly favoured. Tetanus immunity should be boosted every ten years and some countries recommend Tdap in every pregnancy to protect the infant. Some countries recommend pneumococcal vaccination for the elderly.

Are vaccines safe in pregnancy?

The overriding principle is that for pregnant women, live vaccines should be avoided but non-live (inactivated) vaccines can be given. For specialist advice for particular medical conditions, please consult a doctor. Certain vaccines are particularly recommended for pregnant women, such as influenza vaccines and Tdap-IPV (tetanus, adult dose diphtheria, acelluar pertussis and IPV vaccine).

My child has a weakened immune system (immune-compromised) – can he be vaccinated?

The principle is that for people with weak immune systems such as those born with immune deficiencies, or those recovering from cancer or taking medication which dampens down their immune system, live vaccines should be avoided but non-live (inactivated) vaccines can be given. In fact, the non-live vaccines become even more important to protect the person from possible future infections. It is possible that the immune response to vaccines may not be as strong as in a health person and the child may need re-vaccination once they are fully recovered. It is also important to check that all other children AND adults in the household have been vaccinated, in order to protect the child from catching diseases from them. If household members require vaccination, inactivated vaccines should be given but a doctor should advise regarding whether live vaccines can be given to the household members. Some live vaccines given to household members may prove a risk to a child with a severely weakened immune system.

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