Public Health England (PHE) has updated chapter 6 of Immunisation against infectious diseases, or the green book, on Contraindications and special considerations.

While almost all individuals can be safely vaccinated, there are small populations of individuals in whom vaccination should not be carried out or should be delayed. When in doubt, advice should be sought rather than withholding vaccination.

The specific populations that the updated guidance considers include:

  • individuals with a history of a confirmed anaphylactic reaction to a previous dose of a vaccine
  • individuals with a history of a confirmed anaphylactic reaction to a component of a vaccine
  • individuals with primary or acquired immunodeficiency
  • individuals on current or recent immunosuppressive or immunosuppressive biological therapy
  • infants born to a mother who received immunosuppressive biological therapy during pregnancy
  • those in contact with an individual with immunodeficiency, current recent immunosuppressive including biological therapy
  • pregnant women.