Haemophilus influenzae Type b (Hib) | Minimal Consist mainly of pain at the injection site | Any severe allergic reaction (eg, anaphylaxis) after a previous dose or to a vaccine component. |
Hepatitis A | Minimal Consist mainly of pain at the injection site | Any severe allergic reaction (eg, anaphylaxis) after a previous dose or to a vaccine component. |
Hepatitis B | Minimal Consist mainly of pain at the injection site | Any severe allergic reaction (eg, anaphylaxis) after a previous dose or to a vaccine component. |
Human papillomavirus | Minimal Consist mainly of mild to moderate localized pain, erythema, swelling Systemic reactions, mainly fever, seen in 4% of recipients | Any severe allergic reaction (eg, anaphylaxis) after a previous dose or to a vaccine component. |
Influenza (intramuscular inactivated and intranasal live attenuated vaccines) | Intramuscular, inactivated vaccine: Local reactions (erythema and tenderness) at the site of injection are common, but fevers, chills, and malaise (which last in any case only 2–3 days) are rare. Either inactivated or live attenuated vaccine: A potential association between Guillain-Barré syndrome (3000–6000 cases per year in the United States, usually following respiratory infections) and vaccination with intramuscular, inactivated influenza vaccine has been reported (possibly, 1–2 persons per million persons vaccinated), but this rate is lower than the risk of the syndrome developing after influenza itself (given that approximately 750 persons per million adults are hospitalized annually with influenza, and many more cases remain as outpatients). Influenza vaccination may be associated with multiple false-positive serologic tests to HIV, HTLV-1, and hepatitis C, but it is self-limited, lasting 2–5 months. | Contraindication to both inactivated and live attenuated vaccine: History of Guillain-Barré syndrome, especially within 6 weeks of receiving a previous influenza vaccine. Any severe allergic reaction (eg, anaphylaxis) after a previous dose or to a vaccine component, including egg protein.2 Intranasal, live attenuated vaccine [FluMist] should not be used in: People 50 years of age and over Immunosuppressed individuals and those on immunosuppressive therapy Household members of immunosuppressed individuals Health care workers, or others with close contact with immunosuppressed persons Presence of reactive airway disease (eg, asthma) or chronic underlying metabolic (eg, kidney), pulmonary, or heart diseases (use intramuscular inactivated vaccine) Pregnancy3 It is recommended that salicylates should be avoided for 6 weeks following vaccination (to prevent Reye syndrome). |
Measles, mumps, and rubella (MMR)4 | Fever will develop in about 5–15% of unimmunized individuals, and a mild rash will develop in about 5% 5–12 days after vaccination. Fever and rash are self-limited, lasting only 2–3 days. Local swelling and induration are particularly common in individuals previously vaccinated with inactivated vaccine. | Pregnancy5 Known severe immunodeficiency (eg, from hematologic and solid cancers, receipt of chemotherapy, congenital immunodeficiency, long-term immunosuppressive therapy [eg, > 2 weeks of prednisone 20 mg daily or higher]), other disease- or therapy-related immune suppression, or patients with HIV infection who are severely immunocompromised. May be used in asymptomatic HIV-infected individuals whose CD4 count is > 200/mcL. Severe allergic reaction (eg, anaphylaxis) to a previous dose or to a vaccine component (eg, neomycin or to related agents such as streptomycin). |
Meningococcal, oligosaccharide conjugate; (MCV4 or MenACWY [Menactra, Menveo]; meningococcal polysaccharide conjugate MPSV4 [Menomune]); meningococcal group B, recombinant (MenB [Bexsero, Trumenba]) | Minor reactions (fever, redness, swelling, erythema, pain) occur slightly more commonly with MCV4. Major reactions are rare. A potential association between Guillain-Barré syndrome (3000–6000 cases per year in the United States, usually following respiratory infections) and vaccination with MCV4 has been reported, but current recommendations favor continued use of MCV4, since the benefits of preventing the serious consequences of meningococcal infection outweigh the theoretical risk of Guillain-Barré syndrome. | Any severe allergic reaction (eg, anaphylaxis) to a previous dose or to a vaccine component (eg, persons with history of adverse reaction to diphtheria toxoid should not receive meningococcal oligosaccharide conjugate and polysaccharide conjugate vaccines since the protein conjugate used in them is diphtheria toxoid). |
Pneumococcal conjugate (PCV13 [Prevnar]); Pneumococcal polysaccharide (PPSV23) [Pneumovax]) | Mild local reactions (erythema and tenderness) occur in up to 50% of recipients, but systemic reactions are uncommon. Similarly, revaccination at least 5 years after initial vaccination is associated with mild self-limited local but not systemic reactions. | Any severe allergic reaction (eg, anaphylaxis) after a previous dose or to a vaccine component (eg, for PCV13 to any vaccine containing diphtheria toxoid). |
Tetanus, diphtheria, and pertussis (DTP, Tdap); tetanus, diphtheria (Td) | Minimal Consist mainly of pain at the injection site | Any severe allergic reaction (eg, anaphylaxis) after a previous dose or to a vaccine component. For pertussis-containing vaccines: any history of unexplained encephalopathy (eg, coma, decreased level of consciousness, or prolonged seizures) within 7 days of administration of a previous dose of Tdap or diphtheria and tetanus toxoids and pertussis (DTP) or diphtheria and tetanus toxoids and acellular pertussis (Tdap) vaccine. |
Varicella | Can occur as late as 4–6 weeks after vaccination. Tenderness and erythema at the injection site are seen in 25%, fever in 10–15%, and a localized maculopapular or vesicular rash in 5%; a diffuse rash, usually with five or fewer vesicular lesions, develops in a smaller percentage. Spread of virus from vaccinees to susceptible individuals is possible, but the risk of such transmission even to immunocompromised patients is small, and disease, when it develops, is mild and treatable with acyclovir. | Known severe immunodeficiency (eg, from hematologic and solid cancers, receipt of chemotherapy, congenital immunodeficiency, long-term immunosuppressive therapy [eg, > 2 weeks of prednisone 20 mg daily or higher; other immunosuppressive medications], other disease- or therapy-related immune suppression, or patients with HIV infection who are severely immunocompromised). Pregnancy. Severe allergic reaction (eg, anaphylaxis) after a previous dose or to a vaccine component (eg, neomycin). For theoretic reasons, it is recommended that salicylates should be avoided for 6 weeks following vaccination (to prevent potential for Reye syndrome). |
Zoster | Mild and limited to local reactions Although it is theoretically possible to transmit the virus to susceptible contacts, no such cases have been reported. | Known severe immunodeficiency (eg, from hematologic and solid cancers, receipt of chemotherapy, congenital immunodeficiency, long-term immunosuppressive therapy [eg, > 2 weeks of prednisone 20 mg daily or higher; other immunosuppressive medications], other disease- or therapy-related immune suppression, or patients with HIV infection who are severely immunocompromised. May be used in asymptomatic HIV-infected individuals whose CD4 count is > 200/mcL). Pregnancy. Any severe allergic reaction (eg, anaphylaxis) after a previous dose or to a vaccine component (eg, gelatin or neomycin). |