| 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
- DT vaccine has been recommended for remaining doses to ensure protection against diphtheria and tetanus. However, as of early 2023, the sole manufacturer discontinued production and distribution of this vaccine. According to the Centers for Disease Control and Prevention, discussions are in progress regarding vaccine recommendations for this group of children.
| - 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
|
| 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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