Contradictions and precautions of the DTaP

doctor giving cotton bandage to a child after administering dtap vaccine

Although literature found online states, “All people need protection against these three diseases—diphtheria, tetanus, and pertussis. Routine booster doses are also needed throughout life.” This is not necessarily true. There are some people that DTaP/Tdap, vaccine is contraindicated, meaning absolutely inadvisable and then there are some that should proceed with caution.

 

According to the Immunization Action Coalition, DTaP is inadvisable if the patient has a history of a serious reaction (e.g., anaphylaxis) after a previous dose of DTaP or to a DTaP component, a history of encephalopathy (e.g., coma, decreased level of consciousness; prolonged seizures) not attributable to another or any identifiable cause within 7 days of a previous dose of pertussis-containing vaccine.

Tdap is not contraindicated during pregnancy. It should be given to a pregnant woman who is in contact with an infant younger than age 12 months, is in a community experiencing a pertussis outbreak or is a healthcare provider who sees children. A discussion of the risks and benefits of pertussis vaccine in pregnancy should occur between provider and patient. If there is no risk to the pregnant woman of acquiring or transmitting pertussis during pregnancy, the CDC’s Advisory Committee on Immunization Practices recommends that Tdap vaccination be deferred until the immediate postpartum period. The new mother should receive Tdap before hospital discharge, even if she is breastfeeding.

As stated, in some circumstances a patient should be administered the vaccine with a precaution. In the event that the patient had a fever of 105° F (40.5° C) or higher not attributable to another cause within 48 hours of a previous dose of DTaP, there was a hypotensive-hyporesponsive episode within 48 hours of a previous dose of DTaP seizure within 3 days of a previous dose of DTaP, a persistent, inconsolable crying lasting more than 3 hours that occurred within 48 hours of a dose of DTaP, a history of Guillain-Barré syndrome within 6 weeks of previous dose of tetanus toxoid-containing vaccine moderate or severe acute illness with or without fever.

In other words, generally, any person who has had a serious allergic reaction to a vaccine component or a prior dose of the vaccine should not receive another dose of the same vaccine. People who had a serious allergic reaction to a previous dose of DTaP or Tdap vaccine should not receive another dose.

Certain rare adverse events following pertussis vaccination usually serve as a precaution against receiving further doses. Such events as the high fever, collapse or shock-like state, persistent crying for more than three hours or convulsions within three days. Even if one of these precautions exists, there may be occasions when the benefit of immunization outweighs the risk (for example, during a community-wide outbreak of pertussis). A person who developed one of these adverse events after pediatric DTaP vaccine may receive Tdap as an adolescent or adult.

A person with a recognized, possible or potential neurologic condition should delay receiving DTaP or Tdap vaccine until the condition is evaluated, treated and/or stabilized. Although DTaP vaccine does not cause neurological disorders, receiving the vaccine can cause an already-present underlying condition to show itself.

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