Vaccine contraindications, precautions and adverse events — formative SAQs

SAQ 1 — Screen and decide (10 marks)

A 2-month-old is due for primary immunisations. Mother reports a mild cold, temperature 37.7°C, and says an older cousin “reacted badly” to vaccines and later received an autism diagnosis. The infant is feeding well and looks well. ^{[1] [4]}

Questions

1. Define contraindication, precaution and false contraindication, and classify each of the mother’s concerns. (4 marks) ^[1]
2. List the essential pre-vaccination safety screen items you still complete. (3 marks) ^{[1] [3]}
3. State your decision for today and the counselling points you document. (3 marks) ^{[1] [4]}

Model answer

Definitions and classification (4). Contraindication: condition that markedly increases serious adverse-reaction risk — withhold that vaccine. Precaution: condition that may increase risk, impair response or confuse later assessment — usually defer. False contraindication: believed barrier without safety justification — vaccinate. Mild cold/low-grade fever in a well infant is a false contraindication (or at most not a reason to cancel). Family autism history is a false contraindication. No true contraindication is described. ^{[1] [4]}

Safety screen (3). Identity and vaccines due; prior anaphylaxis to dose/component; severe immunocompromise or suspected IEI before live products; pregnancy only if relevant; recent antibody products before live vaccines; current illness severity; observation/adrenaline readiness. ^{[1] [3]}

Decision and counselling (3). Vaccinate today if the screen is clear. Explain expected common reactions, when to seek urgent care, and that autism family history is not a vaccine safety stop. Document consent discussion and rebooking if any temporary issue appears. ^{[1] [4]}