A 6-week-old infant is scheduled for the first dose of DTwP-HepB-Hib pentavalent vaccine. The mother reports that her previous child developed a hypotonic-hyporesponsive episode (HHE) 8 hours after the first pentavalent dose. What is the appropriate action regarding vaccination of this infant?

• A Permanently contraindicate all pertussis-containing vaccines for this child
• B HHE in a sibling is NOT a contraindication; administer the vaccine as scheduled ✓
• C Switch to DTaP (acellular) for subsequent doses only if the sibling had encephalopathy within 7 days
• D Defer vaccination until 3 months of age to allow immune maturation

Explanation

A hypotonic-hyporesponsive episode (HHE) occurring in a sibling after pertussis vaccine is NOT a contraindication to vaccinating the index child. HHE in the recipient child itself following a prior pertussis vaccine dose is only a precaution (not an absolute contraindication) for subsequent doses. Contraindications to pertussis vaccines include encephalopathy within 7 days of a prior dose (not attributable to another cause) and severe allergic reaction to a prior dose. Family history of adverse reactions does not contraindicate vaccination. The IAP schedule recommends DTwP-based pentavalent vaccine at 6, 10, 14 weeks and 15–18 months.

Reference: Ghai Essential Pediatrics, 10th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.