Some National Immunisation Program (NIP) vaccines have important contraindications, precautions and administration considerations that health professionals should be aware of.
This page provides a high-level summary of key safety information. It is not an exhaustive list of all warnings, precautions and contraindications.
Before administering any vaccine, refer to the Australian Immunisation Handbook for detailed clinical recommendations and guidance on the safe and effective use of vaccines.
Chickenpox (varicella) vaccine
The chickenpox (varicella) vaccine contains a live attenuated varicella-zoster virus.
Contraindications:
- pregnant women
- people who have experienced anaphylaxis after a previous dose of varicella-containing vaccine or a vaccine component
- people who are severely immunocompromised.
Key considerations:
- Varicella vaccine is a live vaccine and requires additional consideration for people who are immunocompromised.
- Vaccination is recommended for susceptible individuals who have not had chickenpox or previously had a varicella vaccine.
- Pregnancy should be avoided for 28 days after vaccination.
COVID-19 vaccine
COVID-19 vaccines protect against severe illness, hospitalisation and death from COVID-19.
The contraindication for this vaccine is people who have had anaphylaxis after a previous dose of this vaccine or a component of it.
Key considerations:
- Myocarditis and pericarditis following COVID-19 vaccination are rare – the highest risk is in adolescent and young adult males, particularly after messenger RNA (mRNA) COVID-19 vaccines.
- People who develop symptoms suggestive of myocarditis or pericarditis following vaccination should seek prompt medical assessment.
- The risk of myocarditis and other serious complications is higher following COVID-19 infection than after vaccination.
Diphtheria vaccine
Diphtheria vaccines are only available in combination vaccines that also protect against other diseases such as tetanus, pertussis and polio.
The contraindication for this vaccine is people who have had anaphylaxis after a previous dose of this vaccine or a component of it.
The key consideration for this vaccine is that diphtheria vaccines are administered as part of routine childhood, adolescent and adult vaccination schedules.
Haemophilus influenzae type B (Hib) vaccine
Haemophilus influenzae type B (Hib) vaccines protect against serious infections caused by Haemophilus influenzae type B.
The contraindication for this vaccine is people who have had anaphylaxis after a previous dose of this vaccine or a component of it.
Key considerations:
- Hib vaccines are usually given as combination vaccines in infancy.
- Hib vaccination is also recommended for certain people with medical risk factors, regardless of age.
- Hib vaccine can be given during pregnancy or breastfeeding if clinically indicated.
Hepatitis A vaccine
Hepatitis A vaccines protect against hepatitis A virus infection.
The contraindication for this vaccine is people who have had anaphylaxis after a previous dose of this vaccine or a component of it.
Key considerations:
- Hepatitis A vaccines are available as both single-antigen and combination vaccines.
- Vaccination is recommended for selected populations at increased risk of exposure or severe disease.
- Hepatitis A vaccine can be given during pregnancy or breastfeeding if clinically indicated.
Hepatitis B vaccine
Hepatitis B vaccines protect against hepatitis B virus infection.
Contraindications:
- people who have had anaphylaxis after a previous dose of that vaccine or a vaccine component
- people with an anaphylactic reaction to yeast.
Key considerations:
- Hepatitis B vaccine can be given during pregnancy and breastfeeding if indicated.
- Vaccination is recommended for people at risk of hepatitis B infection who are not immune.
- Infants and children can receive hepatitis B vaccines at the same time as other immunisation products such as:
- oral or intramuscular vitamin K
- hepatitis B immunoglobulin
- respiratory syncytial virus (RSV) monoclonal antibodies.
Human papillomavirus (HPV) vaccine
Human papillomavirus (HPV) vaccines protect against HPV-related cancers and other HPV-associated diseases.
Contraindications:
- people who had anaphylaxis after a previous dose of HPV vaccine or a vaccine component
- people with a history of anaphylaxis to yeast.
Key considerations:
- HPV vaccines are not recommended during pregnancy.
- Breastfeeding women can safely receive HPV vaccine.
- If a woman is found to be pregnant after vaccination, no intervention is required, but any remaining doses should be delayed until after pregnancy.
Influenza (flu) vaccine
Influenza (flu) vaccines help protect against seasonal influenza and its complications.
The contraindication for this vaccine is people who have had anaphylaxis after a previous dose of any flu vaccine, or any flu vaccine component.
Key considerations:
- Flucelvax®, a cell-based vaccine, is funded for people aged 5 to 64 years with medical conditions that increase their risk of complications from influenza.
- People with an egg allergy (including with anaphylaxis) can safely get the flu vaccine (unless they have had an anaphylactic reaction to the vaccine).
- People with a history of anaphylaxis to egg should have a full age-appropriate dose (not split doses).
- Live attenuated influenza vaccine (LAIV) – provided through state and territory immunisation programs – is contraindicated for individuals with moderate or severe immunocompromise.
- The flu vaccine is safe for pregnant and breastfeeding women.
- Pregnant women should receive inactivated influenza vaccines, rather than live attenuated influenza vaccine (LAIV).
Measles vaccine
Measles vaccines are only available as combination vaccines – measles, mumps and rubella (MMR) vaccine or measles, mumps, rubella and varicella (MMRV) vaccine. They contain a live attenuated virus.
Contraindications:
- people who have had anaphylaxis after a previous dose of any MMR-containing vaccine or a vaccine component
- pregnant women
- people who are severely immunocompromised.
Key considerations:
- Measles vaccines are only available as MMR or MMRV vaccines.
- Additional precautions apply to people who have recently received immunoglobulin or blood products.
- Pregnancy should be avoided for 28 days following vaccination.
Meningococcal vaccine
Meningococcal vaccines come on their own or as a combination vaccine. Meningococcal vaccines protect against different strains of meningococcal disease. No single vaccine protects against all strains.
The contraindication for this vaccine is people who have had anaphylaxis after a previous dose of this vaccine, or a component of it.
Key considerations:
- Meningococcal vaccines are not recommended for pregnant or breastfeeding women unless they are at increased risk.
- You should give paracetamol with the meningococcal B vaccine Bexsero®.
Mumps vaccine
Mumps vaccines are only available as combination (MMR and MMRV) vaccines and contain a live attenuated virus.
Contraindications:
- people who have had anaphylaxis after a previous dose of any MMR-containing vaccine or a vaccine component
- pregnant women
- people who are severely immunocompromised.
Key considerations:
- Additional precautions apply to people who have recently received immunoglobulin or blood products.
- MMR and MMRV vaccines also protect against measles and rubella, with MMRV additionally protecting against varicella.
- Pregnancy should be avoided for 28 days following vaccination.
Polio vaccine
Polio (poliomyelitis) vaccines in Australia use inactivated polio vaccine (IPV), which is included in combination vaccines.
The contraindication for this vaccine is people who have had anaphylaxis after a previous dose of any IPV-containing vaccine, or a component of it.
Key considerations:
- IPV is not a live vaccine.
- IPV can be given during pregnancy and breastfeeding if clinically indicated.
Pneumococcal vaccine
Pneumococcal vaccines protect against invasive pneumococcal disease, pneumonia and other infections caused by Streptococcus pneumoniae.
The contraindication for this vaccine is people who have had anaphylaxis after a previous dose of any pneumococcal vaccine, or a component of it.
Key considerations:
- Breastfeeding women can get the pneumococcal vaccine.
- Consider vaccination during pregnancy for women at high risk who were not vaccinated before pregnancy and require protection before delivery.
Rotavirus vaccine
Rotavirus vaccines are oral vaccines that protect infants against rotavirus gastroenteritis.
Contraindications:
- infants who have anaphylaxis after a previous dose of rotavirus vaccine or a vaccine component
- infants who have previously had intussusception
- infants with a congenital abnormality that may predispose them to intussusception
- infants who have severe combined immunodeficiency (SCID).
Key considerations:
- The timing for getting a rotavirus vaccine is very strict – it should not be given to infants and children over 6 months of age, or adults.
- Rotavirus vaccines are given by mouth, not by injection.
- Intussusception (where one side of bowel slides into the next, like pieces of a telescope) is a rare side effect that is possible within one week of vaccination.
Respiratory syncytial virus (RSV) vaccine
Respiratory syncytial virus (RSV) vaccines are injections that help protect people from RSV disease.
The contraindication for this vaccine is people who have had anaphylaxis after a previous dose of RSV vaccine or a vaccine component.
Key considerations:
- Abrysvo® is recommended during pregnancy after 28 weeks’ gestation to help protect infants from severe RSV disease.
- Arexvy® should not be used during pregnancy.
- RSV vaccines are also recommended for eligible older adults and certain people with medical risk factors.
- RSV vaccines can be administered with other vaccines where appropriate.
Rubella vaccine
Rubella vaccines are only available as MMR or MMRV vaccines and contain a live attenuated virus.
Contraindications:
- people who have had anaphylaxis after a previous dose of any MMR-containing vaccine or a vaccine component.
- pregnant women
- people who are severely immunocompromised.
Key considerations:
- Rubella vaccination helps prevent congenital rubella syndrome during future pregnancies.
- Pregnancy should be avoided for 28 days following vaccination.
Shingles (herpes zoster) vaccine
The shingles vaccine (Shingrix®) helps prevent herpes zoster and its complications.
The contraindication for this vaccine is people who have had anaphylaxis after a previous dose of this vaccine, or a component of it.
Key considerations:
- Shingrix® is not a live vaccine.
- Shingrix® is given as a 2-dose course.
- The vaccine can be given to immunocompromised people with specified medical risk conditions under the NIP.
Tetanus vaccine
Tetanus vaccines are only available in combination vaccines.
The contraindication for this vaccine is people who have had anaphylaxis after a previous dose of any tetanus-toxoid vaccine, or a component of it.
Key considerations:
- Tetanus vaccination may be required as part of wound management.
- Tetanus-containing vaccines on the NIP can be safely given during pregnancy and breastfeeding.
Pertussis (whooping cough) vaccine
Pertussis (whooping cough) vaccines are only available as combination vaccines.
The contraindication for this vaccine is people who have had anaphylaxis after a previous dose of this vaccine, or a component of it.
Key considerations:
- Pertussis vaccination is recommended during every pregnancy, preferably between 20 and 32 weeks’ gestation.
- Additional precautions apply for people who experienced encephalopathy within 7 days of a previous pertussis-containing vaccine.
Next steps
For detailed clinical recommendations, contraindications, precautions and guidance for people with specific medical conditions, refer to the Australian Immunisation Handbook.
More information
Read our information about vaccinating people with medical risk conditions.
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