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Guillain-Barré syndrome- An immune-suppressing condition such as HIV or AIDS,diabetes, or cancer
- Had any sort of a reaction to any vaccine in the past
- Epilepsy or any other nervous system disorder
- An illness or infection (such as the flu)
- Had a recent stroke
- Any allergies, including allergies to foods, dyes, or preservatives.
Also, let your healthcare provider know if you are:
- Pregnant or thinking of becoming pregnant
- Breastfeeding.
Make sure to tell your healthcare provider about any medications you are taking, including prescription and non-prescription medicines, vitamins, and herbal supplements.
Warnings and precautions to be aware of prior to receiving Tdap include the following:
- If you are moderately to severely ill, it is probably a good idea to postpone vaccination with Tdap until you are feeling better.
- There is some evidence that tetanus toxoid (one of the components of Tdap) might be linked to Guillain-Barré syndrome (a serious nervous system problem).
- Make sure your healthcare provider knows if you have ever had any serious reactions to any vaccines in the past. It is probably a good idea to ask your parents or other caregivers if you had any problems with your childhood vaccinations.
- Make sure your healthcare provider knows if you have (or have had) epilepsy, seizures, a stroke, or any other nervous system disorders. In some cases, Tdap may need to be postponed; in other cases, Tdap may not be recommended at all.
- If you have had severe swelling or pain with any previous vaccine that contained tetanus toxoid, you should not receive Tdap unless at least 10 years have passed since your last vaccination with tetanus toxoid.
- Make sure to tell your healthcare provider if you are allergic to latex, as part of the Boostrix and Adacel prefilled syringes may contain latex (they come in both prefilled syringes and in vials). The Adacel vial and the Boostrix vial do not contain latex.
- If you have an immune-suppressing condition, Tdap may not be as effective as usual for producing immunity to diphtheria, tetanus, or pertussis.
- Tdap vaccines do not contain thimerosal (a mercury-containing preservative). Individuals who are concerned about exposure to thimerosal can be confident that this vaccine has no thimerosal (not even trace amounts). Some people are concerned about aluminum content of vaccines; Adacel contains 0.33 mg of aluminum per dose and Boostrix contains no more than 0.39 mg of aluminum per dose.
- These vaccines are not made from human fetal components, as some vaccines are. However, Boostrix is made from bovine (cow) components.
- Tdap can potentially interact with a few other medications or vaccines (see Drug Interactions With Tdap).
- Tdap is considered a pregnancy Category C medication. This means it is probably safe for use during pregnancy (seeAdacel and Pregnancy and Boostrix and Pregnancy).
- In general, breastfeeding women can receive this vaccine(see Adacel and Breastfeeding and Boostrix and Breastfeeding).
Who Should Not Take Tdap? Tdap Drug Interactions Explained
The following sections explain in detail the potentially negative interactions that can occur when Tdap is combined with any of the drugs listed above.
Immunosuppressant medications, including (but not limited to):
- Azathioprine (Imuran®)
- Certain biologic medications, such as:
- Abatacept (Orencia®)
- Adalimumab (Humira®)
- Alefacept (Amevive®)
- Alemtuzumab (Campath®)
- Anakinra (Kineret™)
- Basiliximab (Simulect®)
- Canakinumab (Ilaris®)
- Certolizumab pegol (Cimzia®)
- Daclizumab (Zenapax®)
- Eculizumab (Soliris®)
- Efalizumab (Raptiva®)
- Etanercept (Enbrel®)
- Gemtuzumab ozogamicin (Mylotarg®)
- Glatiramer (Copaxone®)
- Golimumab (Simponi™)
- Infliximab (Remicade®)
- Ibritumomab (Zevalin®)
- Muromonab-CD3 (Orthoclone OKT®)
- Natalizumab (Tysabri®)
- Ofatumumab (Arzerra™)
- Rilonacept (Arcalyst™)
- Rituximab (Rituxan®)
- Tositumomab (Bexxar®)
- Ustekinumab (Stelara™)
- Chemotherapy (as well as radiation treatment)
- Corticosteroids, such as:
- Betamethasone (Celestone®)
- Cortisone
- Fludrocortisone (Florinef®)
- Hydrocortisone (Cortef®)
- Methylprednisolone (Depo-Medrol®, Medrol®)
- Prednisolone (Pediapred®)
- Triamcinolone (Kenalog®)
- Cyclosporine (Gengraf®, Neoral®, Sandimmune®)
- Methotrexate (Rheumatrex®)
- Mycophenolate (CellCept®)
- Sirolimus (Rapamune®)
- Tacrolimus (Prograf®)
- Other vaccines
- Tetanus immune globulin.
Immunosuppressant MedicationsIf you are taking an immunosuppressant, you may not receive the full benefit of Tdap for protection from tetanus, diphtheria, and pertussis (whooping cough). With some vaccines (especially live vaccines), people taking immunosuppressants may be at a higher risk of actually developing the infectio
Other VaccinesStudies indicate that giving Tdap at the same time as theinfluenza vaccine ("flu shot") might slightly reduce the effectiveness of Tdap. Giving Tdap with the hepatitis B vaccinedoes not seem to interfere with either of the vaccines. Tdap has not been studied in combination with any other vaccines.If other vaccines are given at the same time, different syringes and different injection sites must be used. Tdap should not be combined with any other vaccines in the same syringe.Tetanus Immune GlobulinIf Tdap and tetanus immune globulin must be given at the same time, they should be given with different syringes and needles at different parts of the body.It is possible that not all drug interactions were discussed in this article. Therefore, you should talk with your pharmacist or healthcare provider about any specific interactions with Tdap that may apply to you.You should not receive Tdap if you:- Have had a serious reaction to any component of the Tdap vaccine, the inactive ingredients in Tdap, or any other vaccine containing tetanus toxoid, diphtheria toxoid, or pertussis antigen. Your healthcare provider or pharmacist has a list of the inactive ingredients.
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