Part Two of DTaP Contraindications and Precautions. Special Notes listed about DTaP From: Guide To Vaccine Contraindications and Precautions (2013-2014) Symptom or Condition: Vaccine: DTaP…Vaccinate ? Allergy to any vaccine component: No
Anaphylactic Life threatening reaction to previous dose of vaccine: All vaccines: NO! see note 4. This is specific to the vaccine. So if they had Anaphylactic reaction to say: Hep B vaccine, the CDC would not recommend another…but any future vaccines would be okay.
Bleeding Disorders: All Yes, but see note 9. A fine needle should be used for the vaccination and firm pressure applied to the site, without rubbing, for more than 2 minutes. The patient or family should be instructed concerning the risk of hematoma from the injection.
Convulsions, fits, seizures, family history including epilepsy: DTap, yes, see note 10: Consider giving acetaminophen before DTaP and every 4 hours for 24 hours to children who have a personal or family history of convulsions.
Encephalopathy: See Reaction after previous dose of DTaP appendix C: (We’ll go over appendix C in a few moments) NO.
Fever, with moderate to severe illness, All see note 11: Persons with moderate or severe illnesses, with or without fever, can be vaccinated as soon as they are recovering and no longer acutely ill. (meaning don’t get inoculated if you are ill)
Guillain Barre Syndrome and history of: DTaP: See note 12: The decision to give additional doses of DTap to children who developed GBS within 6 weeks of a prior dose should be based on consideration of the benefits of further vaccination vs. the risk of recurrence of GBS. For example: Completion of the primary series in children is justified. (primary series has 5, 6 if you count the teenage years)
Neurologic disorders, underlying (including seizures, cerebral palsy, and developmental delay): DTaP see note 36: Whether and when to administer DTaP to children with proven or suspected underlying neurologic disorders should be decided individually. Generally, infants and children with stable neurologic conditions, including well-controlled seizures, may be vaccinated.
Pregnancy: TDap: See Note 45: ACIP recommends Td when tetanus and diphtheria protection is required during pregnancy. In some situations, health-care providers can choose to administer Tdap instead of Td to add protection against pertussis. When Td of TDap is administered during pregnancy, the second or third trimester is preferred. Data on safety, immunogenicity and the outcomes of pregnancy are not available for pregnant women who receive Tdap. Providers who choose to administer TDap to pregnant women should discuss the lack of data with the pregnant women and are encouraged to report administration, regardless of trimester to the appropriate manufacturer’s. (This is from 2013-2014 time frame) (I have no words to express my sadness over this)
Appendix C: Reaction after a Previous Dos of Diphtheria, Tetanus or Pertussis Containing Vaccine:
Note C1: Providers should carefully review the medical history to verify the diagnosis of an Arthus reaction, and can consult with an allergist or immunologist. If an Arthus reaction was likely, consider deferring DTaP, Tdap, or Td vaccine until at least 10 years have elapsed since the last tetanus toxoid containing and or diphtheria toxoid-contain vaccine was received. If the Arthus reaction was associated with a vaccine that contained diphtheria toxoid without tetanus toxoid, deferring Tdap or Td might leave the patient inadequately protected against tetanus. In this situation, if the last tetanus toxoid containing vaccine was more than 10 years earlier, providers can obtain a serum antitetanus level to evaluate the need for tetanus vaccination or administer TT.
Note C2: Not a contraindication, but a precaution. Consider carefully the benefits and risks of this vaccine under these circumstances. If the risks are believed to outweigh the benefits withhold the vaccine. If the benefits are believed to outweigh the risks (for example, during an out-break or foreign travel), give the vaccine.
Note C3: Consider giving acetaminophen before DTaP and every 4 hours for 24 hours.
Note C4: The decision to give additional doses of DTaP should be based on consideration of the benefits of further vaccination vs. the risk of recurrence of GBS. For example, completion of the primary series in children is justified.
Note C5: Not a contraindication, but providers should evaluate the risks and benefits of administering Tdap or Td. If a decision is made to continue vaccination with tetanus toxoid, Tdap is preferred to Td if otherwise indicated.
Dapatacel 5.3 READS: Guillain-Barre Syndrome and Brachial Neuritis.
A review by the Institute of Medicine found evidence for a causal relation between TETANUS TOXIOD and both brachial neuritis and Guillain-Barre syndrome. If Guillain-Barre Syndrome occurred within 6 weeks of receipt of Prior Vaccine containing tetanus toxoid, the risk for Guillain-Barre Syndrome MAY BE INCREASED following Daptacel vaccine.
CDC reports that 3000 to 6000 people develop GBS (Guillain-Barre Syndrome) Each year. (Other vaccines list GBS as a possible “side-effect”
Arthus: A severe local inflammatory reaction that occurs at the site of injection of an antigen in a previously sensitized individual. Arthus reactions are a form of type III hypersensitivity reactions producing an antigen-antibody immune complex (Syn: supersensitive, SEE: allergy, anaphylaxis, hay fever)
Side Effects Daptacel: The following adverse events were included based on one or more of the following factors: severity, frequency of reporting, or strength of evidence for a causal relationship to DAPTACEL vaccine.
• Blood and lymphatic disorders Lymphadenopathy
• Cardiac disorders Cyanosis
• Gastro-intestinal disorders Nausea, diarrhea
• General disorders and administration site conditions Local reactions: injection site pain, injection site rash, injection site nodule, injection site mass, extensive swelling of injected limb (including swelling that involves adjacent joints).
• Infections and infestations Injection site cellulitis, cellulitis, injection site abscess
• Immune system disorders Hypersensitivity, allergic reaction, anaphylactic reaction (edema, face edema, swelling face, 243 pruritus, rash generalized) and other types of rash (erythematous, macular, maculo-papular)
• Nervous system disorders Convulsions: febrile convulsion, grand mal convulsion, partial seizures 246 HHE, hypotonia, somnolence, syncope
• Psychiatric disorders Screaming (Okay I have to comment on this: Screaming a Psychiatric disorder, seriously?)
Side Effects for Infanrix: In addition to reports in clinical trials, worldwide voluntary reports of adverse events received for INFANRIX since market introduction are listed below. This list includes serious events and events which have a plausible causal connection to INFANRIX. These adverse events were reported voluntarily from a population of uncertain size; therefore, it is not always possible to reliably estimate their frequency or establish a causal relationship to vaccination.
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