Precautions to these vaccines include:
- A history of Guillain-Barré syndrome (GBS) within 6 weeks of receiving a tetanus toxoid-containing vaccine
- A history of Arthus-type hypersensitivity reaction after receiving a previous tetanus or diphtheria toxoid-containing vaccine (defer vaccination until at least 10 years have elapsed since the last tetanus toxoid-containing vaccine)
- A moderate or severe acute illness with or without fever
- For pertussis-containing vaccines (DTaP and Tdap only): an additional precaution is a progressive or unstable neurologic disorder, including infantile spasms, uncontrolled seizures or progressive encephalopathy. DTaP and Tdap should be deferred until the neurologic status of the patient is clarified and stabilized.