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The art of immunization requires the provider to apply sound knowledge of vaccines and their administration with careful analysis of an individual's risk.

As the acceptance and practice of immunization is increasing day by day, we do face several circumstances where the routine schedule of immunization is to be altered as per the individual need, allergies, contraindication and special circumstances. Hence we are in a state where a specific guideline, based on substantial evidences and studies, are required for vaccinating these children under special circumstances.

Here we will be discussing most common encountered special circumstances in practicing immunization.

1.         Vaccination of Preterm Infants

2.         Lapsed Vaccination Schedule

3.         Not immunized in the first year of life

4.         Unknown or Uncertain Vaccination Status

5.         Adolescent vaccination

6.         Adopted child vaccination

7.         Child residing in institutions

8.         Child residing in refugee camps

9.         Vaccination of Contacts of Persons with Altered Immunocompetence

10.       Recipients of Hematopoietic Stem Cell Transplant

11.       Corticosteroids

12.       Other Immunosuppressive Drugs

13.       Concurrently Administering Antimicrobial Agents and Vaccines

14.       Anatomic or Functional Asplenia

15.       Vaccination of child with coagulopathy

16.       Vaccination of child with progressive neurological disorder

17.       Past reaction or allergy.

18.       Severe Allergy to Vaccine Components

19.       Tuberculosis Screening and Skin Test Reactivity

20.       Latex Allergy

21.       Breast Feeding and Vaccination

22.       Vaccination During Pregnancy

23.       Pre / Post exposure immunization

24.       Foreign travel / specific area

25.       Immunization during epidemics

26.       Immunization of Thalassemic child

27.       Immunization of diabetic child

28.       Vaccination of child with heart disease

29.       Post surgical immunization

30.       Vaccination with Inactivated Vaccines

31.       Vaccination with Live-Attenuated Vaccines




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