8 Scenarios to Delay Vaccines for Kids

Vaccines are one of the best ways to ensure your child stays healthy. But there are a few scenarios that merit delaying or even skipping a vaccination. Discuss with your doctor whether these are relevant to your child.

Vaccines are one of the best ways to ensure your child stays healthy. They help provide immunity to diseases by teaching the body how to fight different infections. But many people worry about whether it's safe to vaccinate a child who has a cold, allergies, or other medical conditions.

As it turns out, vaccines are almost always safe. Vaccines are only approved after extensive testing and continue to be monitored for safety. Meanwhile, the Centers for Disease Control and Prevention (CDC) regularly updates immunization schedule recommendations based on the recommendations of physicians and public health experts. These schedules are designed so vaccines can provide the best protection while reducing side effects.

Generally, you should vaccinate your child according to the recommended schedules. Skipping or delaying vaccination can leave your child more vulnerable to infections because their immune systems are not prepared to handle these diseases.

But there are a few scenarios that merit delaying or even skipping a vaccination. Discuss with your doctor whether these are relevant to your child.

01 of 08

Severe Reaction to a Prior Vaccine

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One of the main reasons to avoid vaccinating your child is a severe allergic reaction to a prior vaccine or part of a vaccine, says Robert W. Frenck, Jr., MD, professor of pediatrics at Cincinnati Children's Hospital Medical Center in Ohio.

Allergic reactions "almost never happen," says Dr. Frenck—a 2016 paper from the Journal of Allergy and Clinical Immunology found that anaphylaxis (a severe allergic reaction) occured at a rate of 1.31 per million vaccine doses.

All vaccines have a very low risk of causing allergic side effects. However, not all side effects are allergic. According to Dr. Frenck, symptoms of an allergic reaction include hives, difficulty breathing, or a drop in blood pressure. Other allergic symptoms can include itching, flushing, swelling, or gastrointestinal symptoms.

Non-allergic side effects are also rare but are more common than allergic reactions. Some symptoms include fever, headache, fainting, and redness at the shot site. Check with your doctor to find out if your child's symptoms warrant caution with future shots.

02 of 08

Egg Allergy

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Vaccines against the flu and measles virus are made in chicken eggs. However, vaccines can still be safe for your child even if they have an egg allergy. The amount of egg protein in vaccines is very low, and has a very low chance of causing allergic reactions.

According to the CDC, many children with egg allergies can receive the flu vaccine. The CDC also has recommendations allowing for Yellow Fever vaccination, and states that children with egg allergies can receive MMR vaccines.

One way to give flu shots to kids who are allergic to eggs is to have the vaccine administered in slowly increasing doses by a pediatric allergist, says Andrew Hertz, MD, a pediatrician with University Hospitals Rainbow Babies & Children's Hospital in Cleveland. The CDC has also approved some egg-free flu vaccines that can be an option for people with egg allergies.

If your child has an egg allergy, talk to your doctor to figure out the best way to vaccinate your child.

03 of 08

High Fever

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If your child is running a fever of 101°F or higher, talk to your doctor about whether you should delay a vaccine, advises Dr. Hertz. Vaccines will not harm children with mild illnesses, but the fever can make it harder to identify vaccine side effects.

"You won't know if the fever is a side effect of the vaccine," says Dr. Hertz. Identifying vaccine side effects is important to determine whether your child should receive certain vaccines in the future. The knowledge can help you avoid vaccine side effects.

If your child only has a mild illness, the CDC still recommends getting vaccinations on time. Ask your doctor whether you should delay vaccinations because of your child's condition. Remember to reschedule your vaccination if you postpone it.

04 of 08

Asthma or Lung Conditions

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Kids with asthma and other lung conditions should be first in line to get flu shots each year—they are at higher risk for flu complications like pneumonia.

But ask your doctor whether they should avoid nasal versions of the flu vaccine. These vaccines contain live, weakened viruses, unlike the shot, which contains a dead virus. "[Nasal spray vaccines] might cause an asthma flare," says Dr. Hertz.

The CDC recommends against nasal spray vaccines for 2 to 4 year olds with asthma or children with a history of wheezing in the past year. People over 4 with asthma should also check with their doctor before getting a nasal spray vaccine.

However, these vaccines should be safe for children without asthma or lung conditions, according to Dr. Hertz. Research published in 2022 in Pediatrics also shows promising evidence that nasal spray vaccines may be safe for children with asthma.

05 of 08

High-dose Steroids

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If your child takes high-dose steroids, ask your doctor whether it is safe for them to be vaccinated. These drugs can decrease the activity of immune cells that fight off viral infections, says Dr. Frenck.

As such, the CDC recommends people wait several weeks after taking high-dose steroids before receiving live-virus vaccines. Some examples of live-virus vaccines include nasal flu vaccines, rotavirus, MMR (measles, mumps, rubella), varicella (chicken pox), and zoster (shingles).

Make sure to check with your doctor whether your child is taking high-dose steroids and whether they are safe to be vaccinated.

06 of 08

Immunosuppression or Chemo

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The CDC also recommends immunosuppressed kids wait before receiving live-virus vaccines or be vaccinated before starting treatment. Children can be immunosuppressed if they are receiving chemotherapy or treatment for autoimmune diseases like juvenile rheumatoid arthritis.

These children should still have flu shots because these are made using dead viruses. This vaccination is important to prevent infections since immunocompromised people have increased risks of complications during infections. However, the shots may not be as protective as they are in kids with strong immune systems.

Protecting immunocompromised people is a good argument for getting everyone else immunized, "so the few people that aren't immunized are protected by the herd or cocooning effect," Dr. Frenck says. With fewer people who might spread illnesses, immunocompromised people are safer.

07 of 08

HIV-Positive

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In general, kids with HIV should get vaccinations as long as their immune system is not severely compromised, says Ciro Sumaya, MD, a professor of health policy and management at Texas A&M Health Science Center School of Rural Public Health.

The only exception is the live flu vaccine. Otherwise, as long as a child with HIV has T-cell counts in an acceptable range, they can safely receive other live-virus vaccines including MMR, varicella, and rotavirus. Kids with HIV should not receive nasal flu, Smallpox, BCG, Ty21a, MMRV, or DEN4-CYD vaccines.

Additionally, people with HIV should receive pneumococcal, meningococcal, Hib, and Hepatitis-B vaccines. These vaccines are meant to help immunocompromised people like kids with HIV because they are higher risk.

08 of 08

Someone at Home is Immunocompromised

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Smallpox vaccines shouldn't be given to children who are living with people who have weakened immune systems. Examples of immunosuppression include chemotherapy, having HIV/AIDS or taking immunosuppressive drugs, says Dr. Hertz.

Besides smallpox vaccines, the CDC recommends all members of a household who are not allergic or immunocompromised receive vaccines as scheduled, including live vaccines. This protects your immunocompromised loved one against getting infections from you. Ask your doctor what vaccinations you should complete and if you need to take any special precautions after getting vaccinated.

The live virus in the nasal flu vaccine "theoretically will be secreted in nasal and respiratory secretions in very small amounts," according to Dr. Hertz. However, the CDC does not recommend using a flu shot over a nasal vaccine unless an immunocompromised patient is in a protective environment. Check with your doctor about what kind of flu vaccine you and your family should receive.

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