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It is good clinical practice that vaccination should be preceded by a review of the medical history (especially with regard to previous vaccination and possible occurrence of undesirable events) and a clinical examination in compliance with local requirements. The frequency and severity of adverse events in recipients of tetanus and diphtheria toxoids are influenced by the number of prior doses and level of pre-existing antitoxin antibody. As with all injectable vaccines, appropriate medical care should be readily available in case of a rare anaphylactic reaction after vaccination.
The vaccine should not be administered intravascularly.
Fractional doses (< 0.5 mL) should not be given.
As with other vaccines, administration of Boostagen to subjects suffering from acute severe febrile illness should be postponed. Boostagen should be administered with precautionary measures to subjects who had any of the following adverse events within 48 hours after a previous immunization with any whooping cough vaccines: high temperature (≥ 40°C) without any identifiable cause, convulsions and collapse or shock-like state.
Boostagen should be administered with caution to the recipient with any bleeding disorders, thrombocytopenia or anticoagulant therapy because bleeding at injection site may occur after intramuscular injection.
In the case of immunosuppressive treatment or immunodeficiency, the immune response to the vaccine may be diminished. Vaccination should be postponed until the end of treatment or resolution of disease. Nevertheless, in the case of chronic immunodeficiency, including HIV-infected persons, vaccination is recommended even if the response may be limited.
