An eight-month-old child had history of unusual crying, altered sensorium & convulsions following previous vaccination after BCG, DPT & OPV (first dose) & Hepatitis B. Now parents have brought child for next doses of vaccination. Which vaccine is contraindicated in this situation?
High-Yield Explanation
b. DPT(Ref: IAP Guidebook on immunization 2013-2014, p 141-142)Absolute contraindications to any pertussis vaccination (including DTwP vaccine) are: history of anaphylaxis or development of encephalopathy within 7 days following previous DTwP vaccination.Events such as persistent inconsolable crying of > 3 hours duration/ hyperpyrexia (fever >40.5degC)/ hypotonic hyporesponsive episodes (HHE) within 48 hours of DTwP administration and seizures with or without fever within 72 hours of administration of DTwP are considered as precautions but not contraindications to future doses of DTwP because these events generally do not recur with the next dose and they have not been proven to cause permanent sequelae.Progressive/evolving neurological illnesses is a relative contraindication to first dose of DTwP immunization.