Complications

Pain, swelling or redness at the injection site is common and may occur more frequently following subsequent doses

• a small painless nodule may form at the injection site; this usually disappears and is of no consequence
• incidence of local reactions is lower with vaccines combined with acellular pertussis than with whole-cell pertussis, and is similar to that after DT vaccine

Fever, convulsions, high-pitched screaming and episodes of pallor, cyanosis and limpness (hypotonic - hyporesponsive episodes (HHE)) occur with equal frequency after both DTaP and DT vaccines.

Confirmed anaphylaxis occurs extremely rarely

• data from the UK, Canada and the US point to rates of 0.65 to 3 anaphylaxis events per million doses
• other allergic conditions may occur more commonly and are not contraindications to further immunisation (1)

In the past, there was public and professional anxiety that whole-cell pertussis vaccine contributed to the onset of neurological problems in young children but whole-cell pertussis vaccine has not been used in the UK since 2004

Reference:

• The Green Book - Chapter 15 - Pertussis (April 2019)