What illnesses contraindicate immunization

■ Evidence summary Public misperceptions and provider uncertainty about contraindications create missed opportunities for immunization. The Centers for Disease Control and Prevention (CDC) defines contraindications as conditions that increase the risk of a serious reaction to vaccination. Precautions are conditions that might increase the risk of a serious reaction, or that diminish vaccine Know true contraindications; provide clear, factual information to concerned parents Immunizations are among the safest and most cost-effective interventions available in modern medicine. Offices should be organized to assist in assuring delivery of immunizations during preventive, sick, and follow-up visits, and to follow recommended and catch-up schedules to reduce the time patients are susceptible to preventable infectious diseases. Failure to vaccinate due to inappropriate contraindications, particularly mild illness, is a missed opportunity and significant contributor to under-immunization. Know and observe true contraindications and provide clear, factual information to parents concerned about vaccine risks. When temporarily delaying vaccination is prudent—eg, with evolving neurologic conditions and moderate to severe illness— scheduling a return visit for immunizations and documenting the intention to vaccinate at the next visit are strategies to reduce the risk that catch-up immunization will be forgotten.