A 5-year-old child arrives at the outpatient clinic for routine school vaccinations, which includes the live attenuated measles, mumps, and rubella (MMR) vaccine. While gathering the health history, the parent states the child has been taking a high-dose oral corticosteroid for the past two weeks to manage a severe asthma flare-up. What is the most appropriate action for the nurse to take?
- Defer the immunization and discuss the child's current medication therapy with the primary healthcare provider.Answer
- BGive the injection as planned because respiratory conditions do not require pausing vaccination schedules.
- CAsk the parent why the steroid dose is so high and assure them the vaccine is completely safe.
- DCalculate a proportionately smaller dose of the vaccine based on the child's most recent weight.
Answer
Defer the immunization and discuss the child's current medication therapy with the primary healthcare provider.
The MMR vaccine contains live attenuated viruses. High-dose oral corticosteroids suppress the immune system, making the administration of live vaccines highly dangerous due to the risk of active, uncontrolled infection. The nurse must recognize this critical pharmacological contraindication, withhold the administration, and promptly consult the prescribing healthcare provider.
Step-by-Step Solution
Key Concept
Live Vaccine Contraindications and Immunosuppressive Therapy