## Timing of Immunisation in Acute Illness **Key Point:** According to the National Immunisation Schedule and IAP guidelines, acute febrile illness is a **temporary contraindication** to vaccination. Vaccines should be deferred until the acute illness has resolved and the child is afebrile for at least 48 hours. This prevents confusion between vaccine side effects and symptoms of the underlying illness, and ensures optimal immune response. **High-Yield:** Fever (≥38.5°C) in the context of an acute respiratory infection with clinical signs of pneumonia is a clear indication to defer vaccination. The immune response to vaccines may be suboptimal during acute illness, and the child's clinical status requires treatment rather than additional immune stimulation. **Clinical Pearl:** Minor illnesses (mild upper respiratory tract infection, mild diarrhoea without fever) are NOT contraindications to vaccination. However, moderate to severe acute illness (pneumonia, meningitis, acute gastroenteritis with dehydration, fever ≥38.5°C) warrants deferral. ### Classification of Contraindications to Immunisation | Contraindication Type | Examples | Action | |---|---|---| | **Permanent** | Anaphylaxis to vaccine component, encephalopathy within 7 days of DPT | Do NOT give this vaccine ever | | **Temporary** | Acute febrile illness, recent immunoglobulin, recent live vaccine | Defer until condition resolves | | **Precaution** | Mild fever, mild diarrhoea, minor URI | Vaccinate if benefit outweighs risk | | **NOT a contraindication** | Cough, runny nose, low-grade fever (<38.5°C), antibiotic use | Vaccinate | **Mnemonic:** **FEVER = DEFER** — Febrile illness (≥38.5°C) warrants deferral of routine vaccination until the acute phase resolves. [cite:National Immunisation Schedule India 2024; IAP Immunisation Guidelines 2024; Park 26e Ch 6]
Sign up free to access AI-powered MCQ practice with detailed explanations and adaptive learning.