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This referral pathway will cover referral for vaccination requests, allergic reactions, large local reactions.
The " Green Book" is the Department of Health (DOH) recommendations about vaccinations and each chapter is regularly updated. Please look at this website for detailed information.
Provision of routine immunisations
The NHS vaccinations schedule changes as per new evidence, and should be checked regularly. The most up to date version can be found at the NHS choices vaccination page.
Vaccines are contraindicated in patients who have had:
Large local reactions can be common post vaccination, and do not require further treatment and is not a contra-indication to further vaccination in the community.
Meningitis B vaccine is strongly associated with fever and this should be actively treated and avoided if possible with paracetamol.
BCG – the BCG vaccine can sometimes lead to local infections, abscesses and erosions such as large discharging ulcers. These sometimes require treatment.
Cellulitis can occur due to the inoculation of skin flora; this can be treated as per normal cellulitis pathways.
Infants may be distressed and fractious post immunisations, and paracetamol should be recommended. The change in bowel habit (consistency and colour) should be mentioned before the rotavirus vaccination.
The common allergens present in vaccines are:
There have previously been concerns about vaccines, and there are still some myths surround vaccination:
Anaphylaxis to vaccines or their component.
Treat any allergic reactions with oral cetirizine syrup.
Large local reaction treat with cold compress and paracetamol.
Refer to secondary care if:
e-Referral Service Selection