Vaccine | Contraindications | Precautions* |
DTaP | - Severe allergic reaction (eg, anaphylaxis) after a previous dose or to a vaccine component, including latex¶
- Defer vaccination with any of the 3 components because of uncertainty about which component was responsible
- Refer to an allergist to evaluate allergy to tetanus toxoid and possibility of desensitization to tetanus toxoid
- Encephalopathy (eg, coma, decreased level of consciousness, or prolonged seizure) within 7 days of previous dose of DTaP or DTwP that is not attributable to another identifiable cause
- Administer DT vaccine for remaining doses to ensure protection against diphtheria and tetanus
| - Progressive or unstable neurologic disorder, including infantile spasms, uncontrolled epilepsy, or progressive encephalopathy
- Defer pertussis component until neurologic status is clarified and stabilized
- Guillain-Barré syndrome <6 weeks after previous dose of tetanus toxoid-containing vaccine
- History of Arthus-type hypersensitivity reaction after a previous dose of tetanus or diphtheria toxoid-containing vaccines
- Defer vaccination until ≥10 years after the last dose of the tetanus toxoid-containing vaccine
- Moderate or severe acute illness with or without fever
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DT | - Severe allergic reaction (eg, anaphylaxis) after a previous dose or to a vaccine component, including latex¶
- Refer to an allergist to evaluate allergy to tetanus toxoid and possibility of desensitization to tetanus toxoid
| - Guillain-Barré syndrome <6 weeks after previous dose of tetanus toxoid-containing vaccine
- History of Arthus-type hypersensitivity reaction after a previous dose of tetanus or diphtheria toxoid-containing vaccines
- Defer vaccination until ≥10 years after the last dose of the tetanus toxoid-containing vaccine
- Moderate or severe acute illness with or without fever
|
DTaP may be given to children with the following conditions that are incorrectly perceived as contraindications or precautions to DTaP |
- Fever of <40.5°C (105°F), fussiness, or mild drowsiness after a previous dose of DTaP or DTwP; fever ≥40.5°C (105°F) occurs in approximately 1 in 16,000 children[1] and is considered to be an adverse reaction
- Family history of seizures
- Family history of sudden infant death syndrome
- Family history of an adverse event after DTaP or DTwP
- Stable neurologic conditions (eg, cerebral palsy, well-controlled epilepsy, developmental delay)
- History of collapse or shock-like state (ie, hypotonic-hyporesponsive episode) within 48 hours after receiving a previous dose of DTaP or DTwP
- History of seizure within three days after receiving a previous dose of DTaP or DTwP
- History of persistent, inconsolable crying lasting >3 hours within 48 hours after a previous dose of DTaP or DTwP
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