The possibility of allergic reactions in individuals sensitive to the component of the vaccine should be kept in mind. Epinephrine injection (1:1000) must be immediately available should an acute anaphylactic reaction occur to any component of the vaccine. All known precautions should be taken to prevent adverse reactions. This includes the review of the patient's history with respect to possible sensitivity and any previous adverse reactions to the vaccine or similar vaccines, previous immunization history and current health status.
A separate sterile syringe should be used for each individual to prevent transmission of infectious agents. As with the use of all vaccines the vaccinees should remain under observation for not less than 30 minutes for possibility of occurrence of immediate or early allergic reactions.
As with other intramuscular injections, use with caution in patients on anticoagulant therapy. Immunosuppressive therapies, including irradiation, antimetabolites, alkylating agents, cytotoxic drugs and corticosteroids may reduce the immune response to vaccines.
Immune deficiency: Individuals infected with human immune deficiency virus (HIV) both asymptomatic and symptomatic, should be immunised with Td Vaccine according to standard schedules.