Should a child with a viral infection receive a vaccine?

From the Guidelines

It is generally not recommended to give a vaccine to a child who is currently sick with a viral infection, especially if they have a moderate to severe febrile illness. When a child has an active viral illness with symptoms like fever, significant cough, or other moderate to severe symptoms, it's best to postpone vaccination until they have recovered. This recommendation is primarily for the child's comfort and to avoid confusing vaccine side effects with symptoms of the current illness. However, mild illnesses such as a low-grade fever, cold symptoms, or mild diarrhea are typically not reasons to delay vaccination, as stated in the 2017 study 1. The immune system can still respond effectively to vaccines during minor illnesses.

Some key points to consider when deciding whether to vaccinate a child with a viral infection include:

• The type and severity of the illness
• The specific vaccine scheduled
• The child's overall health status
• The risk of complications from the illness
• The potential benefits of vaccination, as outlined in the 2013 study 1

If you're unsure whether your child's current condition warrants postponing vaccination, consult with their healthcare provider who can assess their specific situation. The provider will consider these factors before making a recommendation. According to the 2016 study 1, minor illnesses, with or without fever, are not contraindications to the use of influenza vaccines, particularly among children with mild upper respiratory infection symptoms or allergic rhinitis. However, children with moderate to severe febrile illness should not be vaccinated with IIV until resolution of the illness.

It's also important to note that the risk of Guillain-Barré syndrome (GBS) is low, especially in children, as stated in the 2017 study 1. However, as a precaution, people who are not at high risk of severe influenza illness and who are known to have experienced GBS within 6 weeks of influenza vaccination generally should not be vaccinated. The benefits of influenza vaccination might outweigh the risks for certain people who have a history of GBS and who also are at high risk of severe complications from influenza.

From the Research

Vaccine Administration and Viral Infections

• The decision to administer a vaccine to a child with a virus depends on various factors, including the type of vaccine and the child's health status 2.
• The US Advisory Committee on Immunization Practices recommends that infants receive several vaccines directed against various infectious diseases, starting from birth 2.
• However, there is no direct evidence in the provided studies that addresses the specific question of whether to give a vaccine to a child with a virus.

Concurrent Administration of Vaccines

• A study published in Pediatrics in 2008 found that concurrent administration of live attenuated influenza vaccine with measles-mumps-rubella and varicella vaccines to infants 12 to 15 months of age was safe and immunogenic 3.
• The study found that the seroresponse rates and geometric mean titers for measles-mumps-rubella vaccine and varicella vaccine were similar with concurrent administration of live attenuated influenza vaccine or placebo 3.

Vaccine Delay and Refusal

• A study published in Public Health Reports in 2011 found that parents who delayed or refused vaccines for their children were less likely to believe that vaccines are necessary to protect the health of children, and that vaccines are safe 4.
• The study also found that children of parents who delayed and refused vaccines had significantly lower vaccination coverage for several recommended childhood vaccines 4.
• Another study published in Expert Review of Vaccines in 2022 found that vaccination delays were negatively associated with parents who reported convenient access to clinics and satisfaction with immunization services 5.

Timeliness of Childhood Immunizations

• A study published in Pediatrics in 2002 found that only 9% of children received all recommended vaccines at the recommended ages, and that 55% of children did not receive all recommended doses by 24 months of age 6.
• The study also found that factors associated with not receiving all vaccines as recommended included having more children in the household, mothers younger than 30 years, use of public providers, and multiple vaccination providers 6.