Last edited 04/2019

There are very few individuals who cannot receive diphtheria-containing vaccines.

When there is doubt, appropriate advice should be sought from a consultant paediatrician, immunisation co-ordinator or consultant in communicable disease control, rather than withholding the vaccine.

The vaccine should not be given to those who have had:

  • a confirmed anaphylactic reaction to a previous dose of a diphtheria-containing vaccine, or
  • a confirmed anaphylactic reaction to any of the components of the vaccine.

Systemic and local reactions following a previous immunisation

If a history of a severe or mild systemic or local reaction within 72 hours of a preceding vaccine. Immunisation with diphtheria-containing vaccine should continue following a history of (2):

  • fever, irrespective of its severity
  • hypotonic-hyporesponsive episodes (HHEs)
  • persistent crying or screaming for more than three hours
  • severe local reaction, irrespective of extent

Consult the Summary of Product Characteristics (SPC) for the diptheria-containing vaccine before administering the vaccine.


  1. Department of Health (August 10th 2004). New vaccinations for the childhood immunisation programme. PL/CMO/2004/3,PL/CNO/2004/2,PL/CPHO/2004/3.
  2. The Green Book. Chapter 15 - Diptheria (April 2019)