Appropriately treat & monitor patient if rare anaphylactic reaction occurs after vaccination. Do not inj intravascularly & intradermally. Immunogenicity may be reduced by immunosuppressives or immunodeficiency state. Carefully evaluate potential benefits & risks of continuing vaccination in subjects who have had Guillain-Barré syndrome or brachial plexus neuropathy during previous administration of tetanus toxoid containing vaccine. Individuals w/ thrombocytopenia or coagulation disorders. Search medical history & physical exam prior to vaccination. Possible syncope; put procedures in place to prevent any injury due to fainting & manage syncopal reactions. Carefully consider giving further doses if the following events occur w/in 48 hr after vaccination: Fever ≥40°C (w/ no other identifiable cause), collapse or shock-like state w/ hypotonia-hyporesponsiveness episode, persistent & inconsolable crying lasting ≥3 hr; seizures w/ or w/o fever w/in 3 days after vaccination. Monitor temp & regularly give antipyretics for 48 hr following vaccination. Assess history of febrile convulsions & non-febrile seizures unrelated to previous vaccination. Administer the 2 vaccines (diphtheria-tetanus-pertussis-poliomyelitis & HIB conjugate) at 2 separate inj sites & on different days in the event of oedematous reactions of lower limbs occurring after inj of HIB-containing vaccine. No protection against invasive diseases caused by serotypes other than HIB or meningitis of other origins. Contains phenylalanine, ethanol & Na. Carefully consider potential risk of apnoea & need for resp monitoring for 48-72 hr when administering primary vaccination doses in very premature infants (born at ≤28 wk of pregnancy) particularly those w/ history of resp immaturity. Intended for paed use only.
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