Write a short note on Contraindications to Vaccination & Missed Opportunities.

True Contraindications

• Anaphylaxis to a previous dose or to a vaccine component.
• Live vaccines — significant immunodeficiency and pregnancy.
• Encephalopathy within 7 days of a pertussis dose (for the pertussis component); deferring in acute severe illness.

False Contraindications (MYTHS — Do Not Withhold Vaccines)

• Minor illness or low-grade fever, mild diarrhoea; malnutrition.
• Breastfeeding, prematurity/low birth weight, current antibiotic use, and a family history of AEFI/allergy.
• Withholding vaccines for these reasons creates 'missed opportunities'.

Missed Opportunities

• A 'missed opportunity' is any contact with a health service where an eligible child does not receive a due vaccine.
• Using every contact to vaccinate (and giving all due vaccines together) improves coverage.

Practical Implications

Adhering to true contraindications (and ignoring the false ones) maximises safe coverage; every eligible contact is an opportunity to vaccinate, and vaccines due together should be given together.

Deferral VS Contraindication

A truly contraindicated vaccine is withheld; a vaccine is merely deferred (not cancelled) in acute moderate/severe illness and given once the child recovers — an important distinction that prevents permanent under-immunisation.

Key Points Recap

• True: anaphylaxis to a prior dose/component; live vaccines in immunodeficiency/pregnancy.
• False (do not withhold): mild illness/low-grade fever, malnutrition, breastfeeding, prematurity, antibiotics.

Programme Note

Reducing missed opportunities by respecting only true contraindications is one of the simplest, most effective ways to raise immunisation coverage and protect more children.