Who should not receive the vaccine?
A serious allergic reaction to a prior dose of hepatitis B vaccine or a vaccine component is a contraindication to further doses of hepatitis b vaccine. The recombinant vaccines that are licensed for use in the United States are synthesized by Saccharomyces cerevisiae (common bakers’ yeast), into which a plasmid containing the gene for HBsAg has been inserted. Purified HBsAg is obtained by lysing the yeast cells and separating HBsAg from the yeast components by biochemical and biophysical techniques. Persons allergic to yeast should not be vaccinated with vaccines containing yeast.
Patients with known hypersensitivity to egg protein or feathers should in most cases not receive influenza vaccine (consider seeking specialist advice in some ‘high risk’ patients). The vaccine, although purified, is produced in hens’ eggs and may contain residual egg protein. Gentamycin is also a vaccine constituent, and patients with known hypersensitivity should seek specialist advice. Information regarding the vaccine components is located in the manufacturers package insert.4,5. Such patients could consider the use of specific influenza treatments, such as Tamiflu®6should they get influenza when influenza is prevalent in the community.Patients with acute febrile illness should not be vaccinated until their symptoms have abated.The incidence of Guillain-Barrée Syndrome (GBS) among the general population is low, but persons with a history of GBS have a substantially greater likelihood of subsequently experiencing GBS than persons without such a history.
